The skull, the skeleton of the head, is the most complex bony structure in the body because it:

1. Encloses the brain, which is irregular in shape;
2. Houses the organs of special senses for seeing, hearing, tasting, and smelling; and
3. Surrounds the openings in to the digestive and respiratory tracts.

• In the anatomical position, the skull is oriented so that the inferior margin of the orbit (eye socket) and the superior margin of the external acoustic meatus (auditory canal) are horizontal. This is called the orbitomenial plane (Frankfort plane).

• The term cranium (L. skull) is sometimes used when referring to the skull without the mandible (lower jaw), but the cranium is often used when referring to the part of the skull containing the brain.
• The superior part is the box-like structure called the calvaria (cranial vault, brain case); the remainder of the cranium, including the maxilla (upper jaw), orbits (eyeball sockets) and nasal cavities, forms the facial skeleton.
• The term skullcap (calotte) refers to the superior part of the calvaria, which is removed during autopsies and dissections. The inferior aspect of the cranium is called the cranial base.

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

Muscles of the Soft Palate

The Levator Veli Palatini (Levator Palati)

• Superior attachment: cartilage of the auditory tube and petrous part of temporal bone.
• Inferior attachment: palatine aponeurosis.
• Innervation: pharyngeal branch of vagus via pharyngeal plexus.
• This cylindrical muscle runs inferoanteriorly, spreading out in the soft palate, where it attaches to the superior surface of the palatine aponeurosis.
• It elevates the soft palate, drawing it superiorly and posteriorly.
• It also opens the auditory tube to equalise air pressure in the middle ear and pharynx.

The Tensor Veli Palatini (Tensor Palati)

• Superior attachment: scaphoid fossa of medial pterygoid plate, spine of sphenoid bone, and cartilage of auditory tube.
• Inferior attachment: palatine aponeurosis.
• Innervation: medial pterygoid nerve (a branch of the mandibular nerve).
• This thin, triangular muscle passes inferiorly, and hooks around the hamulus of the medial pterygoid plate.
• It then inserts into the palatine aponeurosis.
• This muscle tenses the soft palate by using the hamulus as a pulley.
• It also pulls the membranous portion of the auditory tube open to equalise air pressure of the middle ear and pharynx.

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 Palatopharyngeus Muscle

• Superior attachment: hard palate and palatine aponeurosis.
• Inferior attachment: lateral wall of pharynx.
• Innervation: cranial part of accessory nerve (CN XI) through the pharyngeal branch of vagus (CN X) via the pharyngeal plexus.
• This thin, flat muscle is covered with mucous membrane to form the palatopharyngeal arch.
• It passes posteroinferiorly in this arch.
• This muscle tenses the soft palate and pulls the walls of the pharynx superiorly, anteriorly and medially during swallowing.

The Musculus Uvulae

• Superior attachment: posterior nasal spine and palatine aponeurosis.
• Inferior attachment: mucosa of uvula.
• Innervation: cranial part of accessory through the pharyngeal branch of vagus, via the pharyngeal plexus.
• It passes posteriorly on each side of the median plane and inserts into the mucosa of the uvula.
• When the muscle contracts, it shortens the uvula and pulls it superiorly.

Muscles of the Soft Palate

The Levator Veli Palatini (Levator Palati)

• Superior attachment: cartilage of the auditory tube and petrous part of temporal bone.
• Inferior attachment: palatine aponeurosis.
• Innervation: pharyngeal branch of vagus via pharyngeal plexus.

• This cylindrical muscle runs inferoanteriorly, spreading out in the soft palate, where it attaches to the superior surface of the palatine aponeurosis.

• It elevates the soft palate, drawing it superiorly and posteriorly.
• It also opens the auditory tube to equalise air pressure in the middle ear and pharynx.

The Tensor Veli Palatini (Tensor Palati)

• Superior attachment: scaphoid fossa of medial pterygoid plate, spine of sphenoid bone, and cartilage of auditory tube.
• Inferior attachment: palatine aponeurosis.
• Innervation: medial pterygoid nerve (a branch of the mandibular nerve).

• This thin, triangular muscle passes inferiorly, and hooks around the hamulus of the medial pterygoid plate.
• It then inserts into the palatine aponeurosis.

• This muscle tenses the soft palate by using the hamulus as a pulley.
• It also pulls the membranous portion of the auditory tube open to equalise air pressure of the middle ear and pharynx.

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.

• Superior attachment: hard palatThe Palatopharyngeus Musclee and palatine aponeurosis.
• Inferior attachment: lateral wall of pharynx.
• Innervation: cranial part of accessory nerve (CN XI) through the pharyngeal branch of vagus (CN X) via the pharyngeal plexus.

• This thin, flat muscle is covered with mucous membrane to form the palatopharyngeal arch.
• It passes posteroinferiorly in this arch.

• This muscle tenses the soft palate and pulls the walls of the pharynx superiorly, anteriorly and medially during swallowing.

The Musculus Uvulae

• Superior attachment: posterior nasal spine and palatine aponeurosis.
• Inferior attachment: mucosa of uvula.
• Innervation: cranial part of accessory through the pharyngeal branch of vagus, via the pharyngeal plexus.

• It passes posteriorly on each side of the median plane and inserts into the mucosa of the uvula.
• When the muscle contracts, it shortens the uvula and pulls it superiorly.

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.

The Lips

• These are mobile muscular folds that surround the mouth, the entrance of the oral cavity.

• The lips (L. labia) are covered externally by skin and internally by mucous membrane.
• In between these are layers of muscles, especially the orbicularis oris muscle.

• The upper and lower lips are attached to the gingivae in the median plane by raised folds of mucous membrane, called the labial frenula.

Sensory Nerves of the Lips

• The sensory nerves of the upper and lower lips are from the infraorbital and mental nerves, which are branches of the maxillary (CN V²) and mandibular (CN V³) nerves.