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Anatomy

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 Frontalis Muscle

  • The frontalis muscle is part of the scalp muscle called the occipitalfrontalis.
  • The frontalis elevates the forehead, giving the face a surprised look, and produces transverse wrinkles in the forehead when one frowns.

The Nasopharynx

  • The nasal part of the pharynx has a respiratory function.
  • It lies superior to the soft palate and is a posterior extension of the nasal cavity.
  • The nose opens into the nasopharynx via to large posterior apertures called choanae.
  • The roof and posterior wall of the nasopharynx form a continuous surface that lies inferior to the body of the sphenoid bone and the basilar part of the occipital bone.
  • In the mucous membrane of the roof of the posterior wall of the nasopharynx is a collection of lymphoid tissue, known as the pharyngeal tonsil (commonly known as the adenoids).
  • The pharyngeal orifice of the auditory tube is on the lateral wall of the nasopharynx, 1 to 1.5 cm posterior to the inferior concha, and level with the superior border of the palate.
  • The orifice is directed inferiorly and has a hood-like tubal elevation over it called the torus of the auditory tube or the torus tubarius (L. torus, swelling).
  • Extending inferiorly from the torus is a vertical fold of mucous membrane, known as the salpingopharyngeal fold.
  • The collection of lymphoid tissue in the submucosa of the pharynx, posterior to the orifice of the auditory tube, is known as the tubal tonsil.
  • Posterior to the torus and the salpingopharyngeal fold, there is a slit-like lateral projection of the pharynx called the pharyngeal recess.
  • It extends laterally and posteriorly.

->The two parietal bones (L. paries, wall) form large parts of the walls of the calvaria.
->On the outside of these smooth convex bones, there are slight elevations near the centre called parietal eminences.
->The middle of the lateral surfaces of the parietal bones is crossed by two curved lines, the superior and inferior temporal lines.
->The superior temporal line indicates an attachment of the temporal fascia; the inferior temporal line marks the superior limit of the temporalis muscle.
->The parietal bones articulate with each other in the median plane at the sagittal suture. The medial plane of the body passes through the sagittal suture.
->The inverted V-shaped suture between the parietal bones and the occipital bones is called the lambdoid suture because of its resemblance to the letter lambda in the Greek alphabet.
->The point where the parietal and occipital bones join is a useful reference point called the lambda. It can be felt as a depression in some people.
->In addition to articulation with each other and the frontal and occipital bones, the parietal bones articulate with the temporal bones and the greater wings of the sphenoid bone.
->In foetal and infant skulls, the bones of the calvaria are separated by dense connective tissue membranes at sutures.
->The large fibrous area where several sutures meet are called fonticuli or fontanelles.
->The softness of these bones and looseness of their connections at these sutures enable the calvaria to undergo changes of shape during birth called molding. Within a day or so after birth, the shape of the infant’s calvaria returns to normal.
->The loose construction of the new-born calvaria also allows the skull to enlarge and undergo remodelling during infancy and childhood.

->Relationships between the various bones are constantly changing during the active growth period.
->The increase in the size of the cranium is greatest during the first 2 years, the period of most rapid postnatal growth of the brain.
->The cranium normally increases in capacity until about 15 or 16 years of age; thereafter the cranium usually increases only slightly in size as its bones thicken for 3 to 4 years.

 

The Lips

  • These are mobile muscular folds that surround the mouth, the entrance of the oral cavity.
  • The lips (L. labia) are covered externally by skin and internally by mucous membrane.
  • In between these are layers of muscles, especially the orbicularis oris muscle.
  • The upper and lower lips are attached to the gingivae in the median plane by raised folds of mucous membrane, called the labial frenula.

Sensory Nerves of the Lips

  • The sensory nerves of the upper and lower lips are from the infraorbital and mental nerves, which are branches of the maxillary (CN V2) and mandibular (CN V3) nerves.

  • Articulations

    Classified according to their structure, composition,and movability
    •    Fibrous joints-surfaces of bones almost in direct contact with limited movement
        o    Syndesmosis-two bones united by interosseous ligaments
        o    Sutures-serrated margins of bones united by a thin layer of fibrous tissue
        o    Gomphosis-insertion of a cone-shaped process into a socket

    •    Cartilaginous joints-no joint cavity and contiguous bones united by cartilage
        o    Synchondrosis-ends of two bones approximated by hyaline cartilage
        o    Symphyses-approximating bone surfaces connected by fibrocartilage

    •    Synovial joints-approximating bone surfaces covered with cartilage; may be separated by a disk; attached by ligaments 
        o    Hinge-permits motion in one plane only
        o    Pivot-permits rotary movement in which a ring rotates around a central axis
        o    Saddle-opposing surfaces are convexconcave. allowing great freedom of motion
        o    Ball and socket - capable of movement in an infinite number of axes; rounded head of one bone moves in a cuplike cavity of the approximating bone

    Bursae
    •    Sacs filled with synovial fluid that are present where tendons rub against bone or where skjn rubs across bone
    •    Some bursae communicate with a joint cavity 
    •    Prominent bursae found at the elbow. hip, and knee'

    Movements
    •    Gliding
        o    Simplest kind of motion in a joint
        o    Movement on a joint that does not involve any angular or rotary motions
    •    Flexion-decreases the angle formed by the union of two bones
    •    Extension-increases the angle formed by the union of two bones
    •    Abduction-occurs by moving part of the appendicular skeleton away from the median plane of the body
    •    Adduction-occurs by moving part of the appendicular skeleton toward the median plane of the body
    •    Circumduction
        o    Occurs in ball-and-socket joints
        o    Circumscribes the conic space of one bone by the other bone
    •    Rotation-turning on an axis without being displaced from that axis
     

  • 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.

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