Muscles Around the Mouth

• The sphincter of the mouth is orbicularis oris and the dilator muscles radiate outward from the lips like the spokes of a wheel.

Orbicularis Oris Muscle

• This muscle encircles the mouth and is the sphincter of the oral aperture
• This muscle (1) closes the lips, (2) protrudes them and (3) compresses them against the teeth.
• It plays an important role in articulation and mastication. Together with the buccinator muscle, it helps to hold the food between the teeth during mastication.

Zygomaticus Major Muscle

• It extends from the zygomatic bone to the angle of the mouth.
• It draws the corner of the moth superolaterally during smiling and laughing.

Zygomaticus Minor Muscle

• This is a narrow slip of muscle, and passes obliquely from the zygomatic bone to the orbicularis oris.
• It helps raise the upper lip when showing contempt or to deepen the nasolabial sulcus when showing sadness.

The Buccinator Muscle

• This is a thin, flat, rectangular muscle.
• It is attached laterally to the alveolar processes of the maxilla and mandible, opposite the molar teeth and the pterygomandibular raphe.
• Medially, its fibres mingle with those of orbicularis oris.Innervation: the buccal branch of facial.

• It aids mastication and swallowing by pushing the cheeks against the molar teeth during chewing.

Endochondral ossification

• A cartilage model exists
• Through intramembraneous ossification in the perichondrium a collar of bone forms around the middle part of the cartilage model
• The perichondrium change to a periostium
• The bone collar cuts off the nutrient and oxygen supply to the chondrocytes in the cartilage model
• The chondrocytes then increase in size and resorb the surrounding cartilage matrix until only thin vertical septae of matrix are left over
• These thin plates then calcify after which the chondrocytes die
• The osteoclasts make holes in the bone collar through which blood vessels can now enter the cavities left behind by the chondrocytes
• With the blood vessels osteoprogenitor cells enter the tissue
• They position themselves on the calcified cartilage septae, change into osteoblasts and start to deposit bone to form trabeculae
• In the mean time the periosteum is depositing bone on the outside of the bone collar making it thicker and thicker
• The trabeculae,consisting of a core of calcified cartilage with bone deposited on top of it, are eventually resorbed by osteoclasts to form the marrow cavity
• The area where this happens is the primary ossification centre and lies in what is called the diaphysis (shaft)
• This process spreads in two directions towards the two ends of the bone the epiphysis
• In the two ends (heads) of the bone a similar process takes place
• A secondary ossification centre develops from where ossification spreads radially
• Here no bone collar forms
• The outer layer of the original cartilage remains behind to form the articulating cartilage
• Between the primary and the secondary ossification centers two epiphyseal cartilage plates remain
• This is where the bone grows in length

• From the epiphyseal cartilage plate towards the diaphysis a number of zones can be identified:

 Resting zone of cartilage

 Hyaline cartilage

 Proliferation zone

 Chondrocytes divide to form columns of cells that mature.

Hypertrophic cartilage zone

 Chondrocytes become larger, accumulate glycogen, resorb the surrounding matrix so that only thin septae of cartilage remain 

Calcification and degeneration zone

The thin septae of cartilage become calcified.

The calsified septae cut off the nutrient supply to the chondrocytes so subsequently they die.

Ossification zone.

Osteoclasts make openings in the bone collar through which blood vessels then invade the spaces left vacant by the chondrocytes that died.

Osteoprogenitor cells come in with the blood and position themselves on the calcified cartilage

septae, change into osteoblasts and start to deposit bone.

 When osteoblasts become trapped in bone they change to osteocytes.

Growth and remodeling of bone

Long bones become longer because of growth at the epiphyseal plates

They become wider because of bone formed by the periosteum

The marrow cavity becomes bigger because of resorbtion by the osteoclasts

Fracture repair

When bone is fractured a blood clot forms

 Macrophages then remove the clot, remaining osteocytes and damaged bone matrix

The periosteum and endosteum produce osteoprogenitor cells that form a cellular tissue in the fracture area

 Intramembranous and endochondral ossification then take place in this area forming trabeculae.

Trabeculae connect the two ends of the broken bone to form a callus

Remodelling then takes place to restore the bone as it was

Joints

The capsule of a joint seals off the articular cavity,  

The capsule has two layers

 fibrous (outer)

synovial (inner)

The synovial layer is lined by squamous or cuboidal epithelial cells,  Under this layer is a layer of loose or dense CT, The lining cells consists of two types:

- A cells

- B cells

They secrete the synovial fluid

They are different stages of the same cell, They are also phagocytic., The articular cartilage has fibres that run perpendicular to the bone and then turn to run parallel to the surface

•     Part of the axial skeleton; strong, flexible rod
      Supports the head
      Gives base to the ribs
      Encloses the spinal cord
      
  o    Vertebrae
      Consists of 34 bones composing the spinal column
  •    Cervical-7 bones
  •    Thoracic-12 bones
  •    Lumbar-5 bones
  •    Sacral- 5 bones.
  •    Coccygeal-4 to 5 bones

      In the adult the vertebrae of the sacral and coccygeal regions are united into two bones, the sacrum and me coccyx
      
  o    Curvatures-from a lateraI view there are four curves, alternately convex and concave ventrally
      Two convex curves are the cervical and lumbar
      Two concave curves are the thoracic and sacral

  o    Vertebra morphology

      Each vertebra differs in size and shape hut has similar components
      Body-central mass of bone
  •    Weight bearing
  •    Fonns anterior part of the vertebra
  •    Encloses the vertebral foramen
      Pedicles of the arch-two thick columns that extend backward from the body to meet with the laminae of the neural arch 

•     Process (7)
  •    One spinous, two transverse, two superior articular, and two inferior articular
  o    Spinous process extends backward from the point of the union of thetwo laminae
  o    Transverse processes project laterally at either side from the junction of the lamina and the pedicle
  o    Articular processes arise near the junction of the pedicle and the lamina- superior processes project upward:inferior processes project downward
  •    Surfaces of the processes are smooth

  o    Inferior articular processes of the vertebra fit into the superior articular processes below
  o    Form true joints, but the contacts established serve to restrict movement

  Distinguishing features

  Cervical region- triangular shape

  •    All have foramina in the transverse process upper six transmit the vertebral artery
  •    Spinous processes are short
      o    C3 to C5 are bifurcated
      o    C7 is long-prominence felt at the back of the neck
  •    Have small bodies (except for C1 vertebra)
  •    C1 vertebra (atlas)
  o    No body
  o    Anterior and posterior arch and two lateral masses
  o    Superiorarticular processes articulate with the condyles of the occipital bone
  •    C2 vertebra (axis)-process on the upper surface of the body (dens) forms a pivot about which the axis rotates

  Thoracic region

  •    Presence of facets for articulation with the ribs (distinguishing feature)
  •    Processes are larger and heavier than those of the cervical region
  •    Spinous process is directed downward at a sharp angle
  •    Circular vertebral foramen

   Lumbar region
   
  •    Large and heavy bodies
  •    Four transverse lines separate the bodies of the vertebrae on the pelvic surface
  •    Triangular shape-fitted between the  halves of the pelvis
  •    Four pairs of dorsal sacral foramina communicate with four pairs of pelvic sacral foramina

  Sacral vertebrae 
  •    Five (sometimes six) vertebrae are fused in the adult to form the sacrum
  •    The sacrum articulates above with L5, laterally with the hip bones, and inferiorly with the coccyx.
  •    It has a roughly triangular appearance with a pelvic and dorsal surface, a lateral mass on each side, and a base and apex.
  •    An anesthetic for the spinal nerves may be injected extradurally through the sacral hiatus (caudal analgesia)
  •    The sacral canal (which contains the dura, cauda equina, and filum terminale) extends from the base to the sacral hiatus. 
  •    The apex of the sacrum may be fused with the coccyx.

  
  Coccygeal vertebrae

  •    Four to five modular pieces fused together
  •    Triangular shape with the base above and the apex below

  F Defects

  •    Lordosis-exaggerated lumbar concavity
  •    Scoliosis-lateral curvature of any region
  •    Kyphosis-exaggerated convexity in the thoracic region

Extrinsic Muscles of the Tongue (p. 746)

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 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 External Ear

• The auricle (L. auris, ear) is the visible, shell-like part of the external ear.
• It consists of a single elastic cartilage that is covered on both surfaces with thin, hairy skin.
• The external ear contains hairs, sweat glands, and sebaceous glands.
• The cartilage is irregularly ridged and hollowed, which gives the auricle its shell-like form.
• It also shapes the orifice of the external acoustic meatus.

The Ear Lobule

• The ear lobule (earlobe) consists of fibrous tissue, fat and blood vessels that are covered with skin.
• The arteries are derived mainly from the posterior auricular artery and the superficial temporal artery.
• The skin of the auricle is supplied by the great auricular and auriculotemporal nerves.

• The great auricular nerve supplies the superior surface and the lateral surface inferior to the external acoustic meatus with nerve fibres from C2.
• The auriculotemporal nerve supplies the skin of the auricle superior to the external acoustic meatus.

The External Acoustic Meatus

• This passage extends from the concha (L. shell) of the auricle to the tympanic membrane (L. tympanum, tambourine). It is about 2.5 cm long in adults.
• The lateral 1/3 of the S-shaped canal is cartilaginous, whereas its medial 2/3 is bony.

• The lateral third of the meatus is lined with the skin of the auricle and contains hair follicles, sebaceous glands, and ceruminous glands.
• The latter glands produce cerumen (L. cera, wax).

• The medial two-thirds of the meatus is lined with very thin skin that is continuous with the external layer of the tympanic membrane.

• The lateral end of the meatus is the widest part. It has the diameter about that of a pencil.
• The meatus becomes narrow at its medial end, about 4 mm from the tympanic membrane.
• The constricted bony part is called the isthmus.

• Innervation of the external acoustic meatus is derived from three cranial nerves:

1. The auricular branch of the auriculotemporal nerve (derived from the mandibular, CN V³).
2. The facial nerve (CN VII) by the branches from the tympanic plexus.
3. The auricular branch of the vagus nerve (CN X).

The Tympanic Membrane

• This is a thin, semi-transparent, oval membrane at the medial end of the external acoustic meatus.
• It forms a partition between the external and middle ears.
• The tympanic membrane is a thin fibrous membrane, that is covered with very thin skin externally and mucous membrane internally.

• The tympanic membrane shows a concavity toward the meatus with a central depression, the umbo, which is formed by the end of the handle of the malleus.
• From the umbo, a bright area referred to as the cone of light, radiates anteroinferiorly.

• The external surface of the tympanic membrane is supplied by the auriculotemporal nerve.
• Some innervation is supplied by a small auricular branch of the vagus nerve (CN X); this nerve may also contain some glossopharyngeal and facial nerve fibres.

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.