NEET MDS Lessons
Anatomy
Nerves of the Palate
- The sensory nerves of the palate, which are branches of the pterygopalatine ganglion, are the greater and lesser palatine nerves.
- They accompany the arteries through the greater and lesser palatine foramina, respectively.
- The greater palatine nerve supplies the gingivae, mucous membrane, and glands of the hard palate.
- The lesser palatine nerve supplies the soft palate.
- Another branch of the pterygopalatine ganglion, the nasopalatine nerve, emerges from the incisive foramen and supplies the mucous membrane of the anterior part of the hard palate.
- 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.
Genioglossus Muscle
- Origin: Mental spine of the mandible.
- Insertion: Dorsum of the tongue and hyoid bone.
- Nerve Supply: Hypoglossal nerve (CN XII).
- Arterial Supply: Sublingual and submental arteries.
- Action: Depresses and protrudes the tongue.
-> This is a wedge-shaped bone (G. sphen, wedge) is located anteriorly to the temporal bones.
-> It is a key bone in the cranium because it articulates with eight bones (frontal, parietal, temporal, occipital, vomer, zygomatic, palatine, and ethmoid).
-> It main parts are the body and the greater and lesser wings, which spread laterally from the body.
-> The superior surface of its body is shaped like a Turkish saddle (L. sella, a saddle); hence its name sella turcica.
-> It forms the hypophyseal fossa which contains the hypophysis cerebri or pituitary gland.
-> The sella turcica is bounded posteriorly by the dorsum sellae, a square plate of bone that projects superiorly and has a posterior clinoid process on each side.
-> Inside the body of the sphenoid bone, there are right and left sphenoid sinuses. The floor of the sella turcica forms the roof of these paranasal sinuses.
-> Studies of the sella turcica and hypophyseal fossa in radiographs or by other imaging techniques are important because they may reflect pathological changes such as a pituitary tumour or an aneurysm of the internal carotid artery. Decalcification of the dorsum sellae is one of the signs of a generalised increase in intracranial pressure.
The Parotid Glands
- The parotid glands are the largest of the three pairs of salivary glands.
- Each gland is wedged between the mandible and the sternocleidomastoid muscle and partly covers them.
- The parotid gland is wrapped with a fibrous capsule (parotid fascia) that is continuous with the deep investing fascia of the neck.
- Viewed superficially, the parotid gland is somewhat triangular in shape.
- Its apex is posterior to the angle of the mandible and its base is along the zygomatic arch.
- The parotid gland overlaps the posterior part of the masseter muscle.
- The parotid duct (Stensen's duct) is about 5 cm long and 5 mm in diameter.
- It passes horizontally from the anterior edge of the gland.
- At the anterior border of the masseter muscle, the parotid duct turns medially and pierces the buccinator muscle.
- It enters the oral cavity opposite the second maxillary molar.
Blood Vessels of the Parotid Gland
- This gland is supplied by branches of the external carotid artery.
- The veins from the parotid gland drains into the retromandibular vein, which enters the internal jugular vein.
Lymphatic Drainage of the Parotid Gland
- The lymph vessels of this gland end in the superficial and deep cervical lymph nodes.
Nerves of the Parotid Gland
- These nerves are derived from the auriculotemporal nerve and from the sympathetic and parasympathetic systems.
- The parasympathetic fibres are derived from the glossopharyngeal nerve (CN IX) through the otic ganglion.
- Stimulation of these fibres produces a thin watery (serous) saliva to flow from the parotid duct.
- The sympathetic fibres are derived from the cervical ganglia through the external carotid plexus.
- Stimulation of these fibres produces a thick mucous saliva.
The Tongue
- The tongue (L. lingua; G. glossa) is a highly mobile muscular organ that can vary greatly in shape.
- It consists of three parts, a root, body, and tip.
- The tongue is concerned with mastication, taste, deglutition (swallowing), articulation (speech), and oral cleansing.
- Its main functions are squeezing food into the pharynx when swallowing, and forming words during speech.
Gross Features of the Tongue
- The dorsum of the tongue is divided by a V-shaped sulcus terminalis into anterior oral (presulcal) and posterior pharyngeal (postsulcal) parts.
- The apex of the V is posterior and the two limbs diverge anteriorly.
- The oral part forms about 2/3 of the tongue and the pharyngeal part forms about 1/3.
Oral Part of the Tongue
- This part is freely movable, but it is loosely attached to the floor of the mouth by the lingual frenulum.
- On each side of the frenulum is a deep lingual vein, visible as a blue line.
- It begins at the tip of the tongue and runs posteriorly.
- All the veins on one side of the tongue unite at the posterior border of the hyoglossus muscle to form the lingual vein, which joins the facial vein or the internal jugular vein.
- On the dorsum of the oral part of the tongue is a median groove.
- This groove represents the site of fusion of the distal tongue buds during embryonic development.
The Lingual Papillae and Taste Buds
- The filiform papillae (L. filum, thread) are numerous, rough, and thread-like.
- They are arranged in rows parallel to the sulcus terminalis.
- The fungiform papillae are small and mushroom-shaped.
- They usually appear are pink or red spots.
- The vallate (circumvallate) papillae are surrounded by a deep, circular trench (trough), the walls of which are studded with taste buds.
- The foliate papillae are small lateral folds of lingual mucosa that are poorly formed in humans.
- The vallate, foliate and most of the fungiform papillae contain taste receptors, which are located in the taste buds.
The Pharyngeal Part of the Tongue
- This part lies posterior to the sulcus terminalis and palatoglossal arches.
- Its mucous membrane has no papillae.
- The underlying nodules of lymphoid tissue give this part of the tongue a cobblestone appearance.
- The lymphoid nodules (lingual follicles) are collectively known as the lingual tonsil.
The Soft Palate
- This is the posterior curtain-like part, and has no bony support. It does, however, contain a membranous aponeurosis.
- The soft palate, or velum palatinum (L. velum, veil), is a movable, fibromuscular fold that is attached to the posterior edge of the hard palate.
- It extends posteroinferiorly to a curved free margin from which hangs a conical process, the uvula (L. uva, grape).
- The soft palate separates the nasopharynx superiorly and the oropharynx inferiorly.
- During swallowing the soft palate moves posteriorly against the wall of the pharynx, preventing the regurgitation of food into the nasal cavity.
- Laterally, the soft palate is continuous with the wall of the pharynx and is joined to the tongue and pharynx by the palatoglossal and palatopharyngeal folds.
- The soft palate is strengthened by the palatine aponeurosis, formed by the expanded tendon of the tensor veli palatini muscle.
- This aponeurosis attaches to the posterior margin of the hard palate.