NEET MDS Lessons
Anatomy
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 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.
The Ear
- The ear contains the vestibulocochlear organ and consists of three main parts: external, middle, and internal.
- It has two functions, balance and hearing.
- The tympanic membrane (eardrum) separates the external ear from the middle ear.
- The auditory tube joins the middle ear or tympanic cavity to the nasopharynx.
The Skeleton of the Nose
- The immovable bridge of the nose, the superior bony part of the nose, consists of the nasal bones, the frontal processes of the maxillae, and the nasal part of the frontal bones.
- The movable cartilaginous part consists of five main cartilages and a few smaller ones.
- The U-shaped alar nasal cartilages are free and movable.
- They dilate and constrict the external nares when the muscles acting on the external nose contract.
The Nasal Cavities
- The nasal cavities are entered through the anterior nares or nostrils.
- They open into the nasopharynx through the choanae.
The Roof and Floor of the Nasal Cavity
- The roof is curved and narrow, except at the posterior end.
- The floor is wider than the roof.
- It is formed from the palatine process of the maxilla and the horizontal plate of the palatine bone.
The Walls of the Nasal Cavity
- The medial wall is formed by the nasal septum; it is usually smooth.
- The lateral wall is uneven owing to the three longitudinal, scroll-shaped elevations, called the conchae (L. shells) or turbinates (L. shaped like a top).
- These elevations are called the superior, middle and inferior conchae according to their position.
- The superior and middle conchae are parts of the ethmoid bone, whereas the inferior conchae are separate bones.
- The inferior and middle conchae project medially and inferiorly, producing air passageways called the inferior and middle meatus (L. passage). Note: the plural of "meatus" is the same as the singular.
- The short superior conchae conceal the superior meatus.
- The space posterosuperior to the superior concha is called the sphenoethmoidal recess.
-> This bone forms much of the base and posterior aspect of the skull.
-> It has a large opening called the foramen magnum, through which the cranial cavity communicates with the vertebral canal.
-> It is also where the spinal cord becomes continuous with the medulla (oblongata) of the brain stem.
-> The occipital bone is saucer-shaped and can be divided into four parts: a squamous part (squama), a basilar part (basioccipital part), and two lateral parts (condylar parts).
-> These four parts develop separately around the foramen magnum and unite at about the age of 6 years to form one bone.
-> On the inferior surfaces of the lateral parts of the occipital bone are occipital condyles, where the skull articulates with C1 vertebra (the atlas) at the atlanto-occipital joints.
-> The internal aspect of the squamous part of the occipital bone is divided into four fossae: the superior two for the occipital poles of the cerebral hemispheres, and the inferior two, called cerebellar fossae, for the cerebellar hemispheres.
The Oropharynx
- The oral part of the pharynx has a digestive function.
- It is continuous with the oral cavity through the oropharyngeal isthmus.
- The oropharynx is bounded by the soft palate superiorly, the base of the tongue inferiorly, and the palatoglossal and palatopharyngeal arches laterally.
- It extends from the soft palate to the superior border of the epiglottis.
The Palatine Tonsils
- These are usually referred to as "the tonsils".
- They are collections of lymphoid tissue the lie on each side of the oropharynx in the triangular interval between the palatine arches.
- The palatine tonsils vary in size from person to person.
- In children, the palatine tonsils tend to be large, whereas in older persons they are usual small and inconspicuous.
- The visible part of the tonsil is no guide to its actual size because much of it may be hidden by the tongue and buried in the soft palate.
The Eye and Orbit
- The orbit (eye socket) appears as a bony recess in the skull when it is viewed from anteriorly.
- It almost surrounds the eye and their associated muscles, nerves and vessels, together with the lacrimal apparatus.
- The orbit is shaped somewhat like a four-side pyramid lying on its side, with its apex pointing posteriorly and its base anteriorly.