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Anatomy - NEETMDS- courses
NEET MDS Lessons
Anatomy

The Inferior Wall of the Orbit

  • The thin inferior wall of the orbit or the floor is formed mainly by the orbital surface of the maxilla and partly by the zygomatic bone, and orbital process of the palatine bone.
  • The floor of the orbit forms the roof of the maxillary sinus.
  • The floor is partly separated from the lateral wall of the orbit by the inferior orbital fissure.

Eye 

At week 4, two depressions are evident on each of the forebrain hemispheres.  As the anterior neural fold closes, the optic pits elongate to form the optic vesicles.  The optic vesicles remain connected to the forebrain by optic stalks. 
The invagination of the optic vesicles forms a bilayered optic cup.  The bilayered cup becomes the dual layered retina (neural and pigmented layer)
Surface ectoderm forms the lens placode, which invaginates with the optic cup.
The optic stalk is deficient ventrally to contain choroids fissure to allow blood vessels into the eye (hyaloid artery).  The artery feeds the growing lens, but will its distal portion will eventually degenerate such that the adult lens receives no hyaloid vasculature.
At the 7th week, the choroids fissure closes and walls fuse as the retinal nerve get bigger.
The anterior rim of the optic vesicles forms the retina and iris.  The iris is an outgrowth of the distal edge of the retina.
Optic vesicles induces/maintains the development of the lens vesicle, which forms the definitive lens.  Following separation of the lens vesicle from the surface ectoderm, the cornea develops in the anterior 1/5th of the eye.
The lens and retina are surrounded by mesenchyme which forms a tough connective tissue, the sclera, that is continuous with the dura mater around the optic nerve.  
Iridopupillary membrane forms to separate the anterior and posterior chambers of the eye.  The membrane breaks down to allow for the pupil
Mesenchyme surrounding the forming eye forms musculature (ciliary muscles and pupillary muscles – from somitomeres 1 and 2; innervated by CN III), supportive connective tissue elements and vasculature.


Eyelids

Formed by an outgrowth of ectoderm that is fused at its midline in the 2nd trimester, but later reopen.

Mesodermal Origin

Muscles

Innervation

Somitomeres 1, 2

Superior, medial and ventral recti

Oculomotor (III)

Somitomere 3

Superior oblique

Trochlear (IV)

Somitomere 4

Jaw-closing muscles

Trigeminal (V)

Somitomere 5

Lateral rectus

Abducens (VI)

Somitomere 6

Jaw-opening and other 2nd arch muscles

Facial (VII)

Somitomere 7

Stylopharyngeus

Glossopharyngeal (IX)

Somites 1, 2

Intrinsic laryngeals

Vagus (X)

Somites 2-5

Tongue muscles

Hypoglossal (XII)

3 basic functions
o    protection of respiratory tract during swallowing food/air pathways cross.
    epiglottis provides protection
o    control intra-thoracic pressure (in coughing) -    close off airway to build pressure then rapidly open to release stuff
o    production of sound (in speaking, singing, laughing)

Important structures

o    hyoid bone
o    thyroid cartilage
o    arytenoids cartilage: vocal and muscle process
    sits on slope on posterior side of cricoid - spin and slide
o    cricoid cartilage: signet ring
o    thyroepiglottic ligament

Membranes and ligaments

o    membrane: general; ligament: thickening of membrane
o    folds: free edges of membranes or ligaments
o    names: tell you where located

Important membranes:
    quandrangular/vestibular membrane—from epiglottis to arytenoids
•    inferior edge: false vocal fold
    thyrohyoid membrane
    conus elasticus = cricothyroid = cricovocal
•    superior/medial edge = vocal fold
•    vocal ligaments: true folds, top of cricothyroid membrane

Stylohyoid Muscle

  • Origin: Posterior border of the styloid process of the temporal bone.
  • Insertion: Body of the hyoid bone at the junction with the greater horn.
  • Nerve Supply: Facial nerve (CN VII).
  • Arterial Supply: Muscular branches of the facial artery and muscular branches of the occipital artery.
  • Action: Elevates the hyoid bone and base of the tongue.

  • This is the second cranial nerve (CN II) and is the nerve of sight.

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.

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