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Anatomy

Movements of the Temporomandibular Joint

  • The two movements that occur at this joint are anterior gliding and a hinge-like rotation.
  • When the mandible is depressed during opening of the mouth, the head of the mandible and articular disc move anteriorly on the articular surface until the head lies inferior to the articular tubercle.
  • As this anterior gliding occurs, the head of the mandible rotates on the inferior surface of the articular disc.
  • This permits simple chewing or grinding movements over a small range.
  • Movements that are seen in this joint are: depression, elevation, protrusion, retraction and grinding

Muscles of the Tongue

  • 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.

 

Extrinsic Muscles of the Tongue

The Genioglossus Muscle

  • This is a bulky, fan-shaped muscle that contributes to most of the bulk of the tongue.
  • It arises from a short tendon from the genial tubercle (mental spine) of the mandible.
  • It fans out as it enters the tongue inferiorly and its fibres attach to the entire dorsum of the tongue.
  • Its most inferior fibres insert into the body of the hyoid bone.
  • The genioglossus muscle depresses the tongue and its posterior part protrudes it.

 

The Hyoglossus Muscle

  • This is a thin, quadrilateral muscle.
  • It arises from the body and greater horn of the hyoid bone and passes superoanteriorly to insert into the side and inferior aspect of the tongue.
  • It depresses the tongue, pulling its sides inferiorly; it also aids in retrusion of the tongue.

 

The Styloglossus Muscle

  • This small, short muscle arises from the anterior border of the styloid process near its tip and from the stylohyoid ligament.
  • It passes inferoanteriorly to insert into the side and inferior aspect of the tongue.
  • The styloglossus retrudes the tongue and curls its sides to create a trough during swallowing. 

 

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. 

Intrinsic Muscles of the Tongue

The Superior Longitudinal Muscle of the Tongue

  • The muscle forms a thin layer deep to the mucous membrane on the dorsum of the tongue, running from its tip to its root.
  • It arises from the submucosal fibrous layer and the lingual septum and inserts mainly into the mucous membrane.
  • This muscle curls the tip and sides of the tongue superiorly, making the dorsum of the tongue concave.

 

The Inferior Longitudinal Muscle of the Tongue

  • This muscle consists of a narrow band close to the inferior surface of the tongue.
  • It extends from the tip to the root of the tongue.
  • Some of its fibres attach to the hyoid bone.
  • This muscle curls the tip of the tongue inferiorly, making the dorsum of the tongue convex.

The Transverse Muscle of the Tongue

  • This muscle lies deep to the superior longitudinal muscle.
  • It arises from the fibrous lingual septum and runs lateral to its right and left margins.
  • Its fibres are inserted into the submucosal fibrous tissue.
  • The transverse muscle narrows and increases the height of the tongue.

The Vertical Muscle of the Tongue

  • This muscle runs inferolaterally from the dorsum of the tongue.
  • It flattens and broadens the tongue.
  • Acting with the transverse muscle, it increases the length of the tongue.

The Laryngopharynx

  • The laryngeal part of the pharynx lies posterior to the larynx.
  • It extends from the superior border of the epiglottis to the inferior border of the cricoid cartilage, where it narrows to become continuous with the oesophagus.
  • Posteriorly, the laryngopharynx is related to the bodies of C4 to C6 vertebrae.
  • Its posterior and lateral walls are formed by the middle and inferior constrictor muscles, with the palatopharyngeus and stylopharyngeus internally.
  • The laryngopharynx communicates with the larynx through the aditus or inlet of the larynx.
  • The piriform recess is a small, pear-shaped depression of the laryngopharyngeal cavity on each side of the inlet of the larynx.

Gross anatomy-study of structures that can be identified with the naked eye; usually involves the use of cadavers

  • Microscopic anatomy (histology)-study of cells that compose tissues and organs; involves the use of a microscope to study the details of the species
  • Developmental anatomy (embryology)-study of an individual from beginning as a single cell to birth
  • Comparative anatomy -comparative study of the animal structure in regard to similar organs or regions

Nerve Supply of the Muscles of the Orbit (pp. 715-6)

  • Three cranial nerves supply the muscles of the eyeball; the oculomotor (CN III), trochlear (CN IV) and abducent (CN IV) nerves.
  • All three enter the orbit via the superior orbital fissure.
  • The trochlear nerve supplies the superior oblique muscle.
  • The abducent nerve supplies the lateral rectus muscle.
  • The oculomotor nerve supplies everything else.
  • A mnemonic that is used is this formula for this strange sulfate: SO4(LR6)3

The Temporomandibular Joint

  • This articulation is a modified hinge type of synovial joint.
  • The articular surfaces are: (1) the head or condyle of the mandible inferiorly and (2) the articular tubercle and the mandibular fossa of the squamous part of the temporal bone.
  • An oval fibrocartilaginous articular disc divides the joint cavity into superior and inferior compartments. The disc is fused to the articular capsule surrounding the joint.
  • The articular disc is more firmly bound to the mandible than to the temporal bone.
  • Thus, when the head of the mandible slides anterior on the articular tubercle as the mouth is opened, the articular disc slides anteriorly against the posterior surface of the articular tubercle

Appendicular Skeleton
Upper extremity
•    Shoulder-clavicle and scapula

Clavicle
    Articulates with the manubrium at the sternal end
    Articulates with the scapula at the lateral end
    Slender S-shaped bone that extends horizontally across the upper part of the thorax
    
Scapula

    Triangular bone with the base upward and the apex downward
    Lateral aspect contains the glenoid cavity that articulates with the head of the humerus
    Spine extends across the upper part of the posterior surface; expands laterally and
    forms the acromion (forms point of shoulder) 
    Coracoid process projects anteriorly from the upper part of the neck of the scapula
    
Arm (humerus)

Consists of a shaft (diaphysis) and two ends (epiphyses)
Proximal end has a head that articulates with the glenoid fossa of the scapula
Greater and lesser tubercles lie below the head

Intertubercular groove is located between them; long tendon of the biceps attaches here
Surgical neck is located below the tubercles

    o    Radial groove runs obliquely on the posterior surface; radial nerve is located here

    o    Deltoid muscles attaches in a V-shaped area in the middle of the shaft. called the deltoid tuberosity
    
Distal end has two projections. the medial and lateral epicondyles
Capitulum-articulates with the radius
Trochlea-articulates with the ulqa

Forearm

Radius
Lateral bone of the forearm
Radial tuberosity is located below the head on the medial side
Distal end is broad for articulation with the wrist: has a styloid process on its lateral side

Ulna

    Medial side of the forearm
    Conspicuous part of the elbow joint (olecranon)
    Curved surface that articulates with the trochlea of the humerus is the trochlearnotch
    Lateral ide is concave (radial notch); articulates with the head of the radius Distal end contains the styloid process 
    Distal end contains the styloid process

Hand

Carpal bones (8)
    Aranged in two rows of four
    Scaphoid. lunate. triquetral. and pisiform  proximal row); trapezium. trapezoid.
    capitate. and hamate (distal row)
    
Metacarpal bones (5)
    Framework of the hand
    Numbered 1 to 5 beginning on the lateral side
    
Phalanges (14)
    Fingers
     Three phalanges in each finger; two phalanges in the thumb

 

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