NEET MDS Lessons
Anatomy
The Pharynx
- The pharynx is the continuation of the digestive system from the oral cavity.
- It is a funnel-shaped fibromuscular tube that is the common route for both food and air.
- The pharynx is located posterior to the nasal and oral cavities, and the larynx.
- For the convenience of description, the pharynx is divided into three parts: (1) the nasopharynx, posterior to the nose and superior to the soft palate; (2) the oropharynx, posterior to the mouth; and (3) the laryngopharynx, posterior to the larynx.
- The pharynx is about 15 cm long.
- It extends from the base of the skull to the inferior border of the cricoid cartilage anteriorly, and to the inferior border of C6 vertebra posteriorly.
- It is widest (about 5 cm) opposite the hyoid bone and narrowest (about 1.5) at its inferior end, where it is continuous with the oesophagus.
- The posterior wall of the pharynx lies against the prevertebral fascia, with the potential retropharyngeal space between them.
The Orbital Vessels
- The orbital contents are supplied chiefly by the ophthalmic artery.
- The infraorbital artery, the continuation of the maxillary, also contributes blood to this region.
- Venous drainage is through the superior orbital fissure to enter the cavernous sinus.
The Ophthalmic Artery
- This artery arises from the internal carotid artery as it emerges from the cavernous sinus.
- It passes through the optic foramen within the dural sheath of the optic nerve and runs anteriorly, close to the superomedial wall of the orbit.
The Central Artery of the Retina
- This is the one of the smallest but most important branches of the ophthalmic artery.
- It arises inferior to the optic nerve until it approaches the eyeball.
- It then pierces the optic nerve and runs within it to emerge through the optic disc.
- The central artery of the retina spreads over the internal surface of the retina and supplies it.
The Ophthalmic Veins
The Superior Ophthalmic Vein
- The superior ophthalmic vein anastomoses with the facial vein.
- It has no valves and blood can flow in either direction.
- It crosses superior to the optic nerve, passes through the superior orbital fissure and ends in the cavernous sinus.
The Inferior Ophthalmic Vein
- This begins as a plexus on the floor of the orbit.
- It communicates with the inferior orbital fissure with the pterygoid plexus, crosses inferior to the optic nerve, and ends in either the superior ophthalmic vein or the cavernous sinus.
- This is the second cranial nerve (CN II) and is the nerve of sight.
Muscles Around the Nose
The Nasalis Muscle
- This muscle consists of a transverse (compressor naris) and alar (dilator naris) parts.
- It is supplied by the buccal branch of the facial nerve.
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.
The Palatopharyngeus Muscle
- Superior attachment: hard palate 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.
Initially, four clefts exist; however, only one gives rise to a definite structure in adults.
|
1st pharyngeal cleft |
Penetrates underlying mesenchyme and forms EAM. The bottom of EAM forms lateral aspect of tympanic cavity. |
|
2nd pharyngeal cleft |
Undergoes active proliferation and overlaps remaining clefts. It merges with ectoderm of lower neck such that the remaining clefts lose contact with outside. Temporarily, the clefts form an ectodermally lined cavity, the cervical sinus, but this disappears during development. |
A. Anatomic position-erect body position with the arms at the sides and the palms upward
B. Plane or section
1. Definition-imaginary flat surface formed by an extension through an axis
2. Median plane-a vertical plane. that divides a body into right and left halves
3. Sagittal plane
- Any plane parallel to the median plane
- Divides the body into right and left portions
4. Frontal plane
- Vertical plane that forms at right angles to the sagittal plane
- Divides the body into anterior and posterior sections
- Synonymous with the term coronal plane
5. Transverse plane
- Horizontal plane that forms at right angles to the sagittal and frontal planes
- Divides the body into upper and lower portions
- Synonymous with the term horizontal plane
C. Relative positions
1. Anterior
- Nearest the abdominal surface and the front of the body
- Synonymous with the term ventral
- In referring to hands and forearms, the terms palmar and Volar are used
2. Posterior
- Back of the body
- Synonymous with the term dorsal
3. Superior
- Upper or higher
- Synonymous with the term cranial (head)
4. Inferior
- Below or lower
- Synonymous with the term caudal (tail)
- In referring to the top of the foot and the sole of the foot. the terms dorsal and plantar are used respectively
5. Medial-near to the median plane
6. Lateral-farther away from the median plane
7. Proximal-near the source or attachment
8. Distal-away from the source or. attachment
9. Superficial-near the surface
10. Deep-away from the surface
11. Afferent-conducting toward a structure
12. Efferent-conducting away from a structure