NEET MDS Lessons
Anatomy
The Muscles of Facial Expression
- These lie in the subcutaneous tissue and are attached to the skin of the face.
- They enable us to move our skin and change our facial expression. They produce their effects by pulling on the skin but do not move the facial skeleton.
- These muscles surround the facial orifices and act as sphincters and dilators.
- All facial muscles receive their innervation from the branches of the facial nerve (CN VII)-temporal, zygomatic, buccal, marginal mandibular, cervical.
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.
Innervation of the Pharynx
- The motor and most of the sensory supply of the pharynx is derived from the pharyngeal plexus of nerves on the surface of the pharynx.
- The plexus is formed by pharyngeal branches of the vagus (CN X) and glossopharyngeal (CN IX) nerves, and by sympathetic branches for the superior cervical ganglion.
- The motor fibres in the pharyngeal plexus are derived from the cranial root of accessory nerve (CN XI), and are carried by the vagus nerve to all muscles of the pharynx and soft palate.
- The exceptions are stylopharyngeus (supplied by CN IX) and the tensor veli palatini (supplied by CN V3).
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
The Nose
- The nose is the superior part of the respiratory tract and contains the peripheral organ of smell.
- It is divided into right and left nasal cavities by the nasal septum.
- The nasal cavity is divided into the olfactory area and the respiratory area.
Skeletal Muscle: 1-40 cm long fibres, 10- 60 µm thick, according to myoglobin content there are:
Red fibres: lots of myoglobin, many mitochondriam slow twitching - tire slowly
White fibres: less myoglobin, less mitochondria, fast twitching - tire quickly
Intermediate fibres:
mixture of 2 above
Most muscles have all three - in varying ratios
Structure of skeletal muscle:
Light Microscopy: Many nuclei - 35/mm, Nuclei are oval - situated peripheral, Dark and light bands
Electron Microscopy: Two types of myofilaments
Actin
- 5,6 nm
3 components:
-actin monomers,
-tropomyosin - 7 actin molecules long
- troponin
actin monomers form 2 threats that spiral
- tropomyosin - lie in the groove of the spiral
- troponin - attach every 40 nm
- one end attach to the Z line
- other end goes to the middle of the sarcomere
- Z line consists of á actinin
Myosin:
- 15 nm
- 1,6 µm long
- The molecule has a head and a tail
- tails are parallel
- heads project in a spiral
- in the middle is a thickening
- thin threats bind the myosin at thickening (M line)
Contraction:
A - band stays the same, I - band, H - bands become narrower
Myosin heads ratchet on the actin molecule
Sarcolemma: 9 nm thick, invaginate to form T-tubule,
myofibrils - attach to the sarcolemma
Sarcoplasmic Reticulum:
specialized smooth EPR, Consists of T-tubules, terminal sisternae and sarcotubules
It is speculated that there are gap junctions between the T-tubule and terminal sisterna
An impulse is carried into the fiber by the T-tubule from where it goes to the rest of the sarcoplasmic reticulum
Connective tissue coverings of the muscle
Endomycium around fibres, perimycium around bundles and epimycium around the whole muscle
Blood vessels and nerves in CT
CT goes over into tendon or aponeurosis which attaches to the periosteum
Nerves:
The axon of a motor neuron branches and ends in motor end plates on the fiber
Specialized striated fibres called spindles (stretch receptors) form sensory receptors in muscles telling the brain how far the muscle has stretched
The External Nose
- Noses vary considerably in size and shape, mainly as a result of the differences in the nasal cartilages and the depth of the glabella.
- The inferior surface of the nose is pierced by two apertures, called the anterior nares (L. nostrils).
- These are separated from each other by the nasal septum (septum nasi).
- Each naris is bounded laterally by an ala (L. wing), i.e., the side of the nose.
- The posterior nares apertures or choanae open into the nasopharynx.