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Anatomy

The Auditory Tube

  • This is a funnel-shaped tube connecting the nasopharynx to the tympanic cavity.
  • Its wide end is towards the nasopharynx, where it opens posterior to the inferior meatus of the nasal cavity.
  • The auditory tube is 3.5 to 4 cm long; its posterior 1/3 is bony and the other 2/3 is cartilaginous.
  • It bony part lies in a groove on the inferior aspect of the base of the skull, between the petrous part of the temporal bone and the greater wing of the sphenoid bone.
  • The function of the auditory tube is to equalise pressure of the middle ear with atmospheric pressure.

The Temporalis Muscle

  • This is an extensive fan-shaped muscle that covers the temporal region.
  • It is a powerful masticatory muscle that can easily be seen and felt during closure of the mandible.
  • Origin: floor of temporal fossa and deep surface of temporal fascia.
  • Insertion: tip and medial surface of coronoid process and anterior border of ramus of mandible.
  • Innervation: deep temporal branches of mandibular nerve (CN V3).
  • The temporalis elevates the mandible, closing the jaws; and its posterior fibres retrude the mandible after protrusion.

The Meatus of the Nose

Sphenopalatine Recess

  • This space is posterosuperior to the superior concha.
  • The sphenoidal sinus opens into this recess.

Superior Meatus

  • This is a narrow passageway between the superior and middle nasal conchae.
  • The posterior ethmoidal sinuses open into it by one or more orifices.

Middle Meatus

  • This is longer and wider than the superior one.
  • The anterosuperior part of this meatus lead into a funnel-shaped opening, called the infundibulum, through which the frontonasal duct leads to the frontal sinus.
  • There is one duct for each frontal sinus and since there may be several, there may be several frontonasal ducts.
  • When the middle concha is removed, rounded elevation called the ethmoidal bulla (L. bubble), is visible
  • The middle ethmoidal air cells open on the surface of the ethmoidal bulla.
  • Inferior to this bulla is a semicircular groove called the hiatus semilunaris.
  • The frontal sinus opens into this hiatus anterosuperiorly.
  • Near the hiatus are the openings of the anterior ethmoid air cells.
  • The maxillary sinus also opens into the middle meatus.

Inferior Meatus

  • This is a horizontal passage, inferolateral to the inferior nasal concha.
  • The nasolacrimal duct opens into the anterior part of this meatus.
  • Usually, the orifice of this duct is wide and circular.

The Paranasal Sinuses

  • These sinuses are air-filled extensions of the respiratory part of the nasal cavity.
  • They are in the following bones, frontal, ethmoid, sphenoid and the maxilla.

The Frontal Sinuses

  • These are located between the outer and inner tables of the frontal bone, posterior to the superciliary arches.

The Ethmoidal Sinuses

  • These comprise of several small cavities, called ethmoidal air cells, within the ethmoidal labyrinth (G. labyrinthos, a maze) of the lateral mass of the ethmoid bone.

The Sphenoidal Sinuses

  • These occupy a variable amount in the body of the sphenoid bone and may extend into the wings.

The Maxillary Sinuses

  • These are the largest pair of paranasal sinuses.
  • They are pyramidal-shaped cavities that may occupy the entire bodies of the maxillae.

Internal Muscles of the Pharynx

  • The internal, chiefly longitudinal muscular layer, consists of 3 muscles: stylopharyngeus, palatopharyngeus, and salpingopharyngeus.
  • They all elevate the larynx and pharynx during swallowing and speaking.

The Stylopharyngeus Muscle

  • This is a long, thin, conical muscles that descends inferiorly between the external and internal carotid arteries.
  • It enters the wall of the pharynx between the superior and middle constrictor muscles.
  • Origin: styloid process of temporal bone.
  • Insertion: posterior and superior borders of thyroid cartilage with palatopharyngeus muscle.
  • Innervation: glossopharyngeal nerve (CN IX).
  • It elevates the pharynx and larynx and expands the sides of the pharynx, thereby aiding in pulling the pharyngeal wall over a bolus of food.

The Palatopharyngeus Muscle

  • This is a thin muscle and the overlying mucosa form the palatopharyngeal arch.

The Salpingopharyngeus Muscle

  • This is a slender muscle that descends in the lateral wall of the pharynx.
  • The over lying mucous membrane forms the salpingopharyngeal fold.
  • Origin: cartilaginous part of the auditory tube.
  • Insertion: blends with palatopharyngeus muscle.
  • Innervation: through the pharyngeal plexus.
  • It elevates the pharynx and larynx and opens the pharyngeal orifice of the auditory tube during swallowing.

Structure of the Nasal Septum

  • This part bony, part cartilaginous septum divides the chamber of the nose into two narrow nasal cavities.
  • The bony part of the septum is usually located in the median plane until age 7; thereafter, it often deviates to one side, usually the right.
  • The nasal septum has three main components: (1) the perpendicular plate of the ethmoid bone; (2) the vomer, and (3) the septal cartilage.
  • The perpendicular plate, which forms the superior part of the septum, is very thin and descends from the cribiform plate of the ethmoid bone.
  • The vomer, which forms the posteroinferior part of the septum, is a thin, flat bone. It articulates with the sphenoid, maxilla and palatine bones.

Intramembranous ossification

  • Flat bones develop in this way (bones of the skull)
  • This type of bone development takes place in mesenchymal tissue
  • Mesenchymal cells condense to form a primary ossification centre (blastema)
  • Some of the condensed mesenchymal cells change to osteoprogenitor cells
  • Osteoprogenitor cells change into osteoblasts which start to deposit bone
  • As the osteoblasts deposit bone some of them become trapped in lacunae in the bone and then change into osteocytes
  • Osteoblasts lie on the surface of the newly formed bone
  • As more and more bone is deposited more and more osteocytes are formed from mesenchymal cells
  • The bone that is formed is called a spicule
  • This process takes place in many places simultaneously
  • The spicules fuse to form trabeculae
  • Blood vessels grow into the spaces between the trabeculae
  • Mesenchymal cells in the spaces give rise to hemopoetic tissue
  • This type of bone development forms the first phase in endochondral development
  • It is also responsible for the growth of short bones and the thickening of long bones

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