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Anatomy

  • Cartilage model is covered with perichondrium that is converted to periosteum

  • Diaphysis-central shaft
  • Epiphysis-located at either end of the diaphysis
  • Growth in length of the bone is provided by the emetaphyseal plate located between the epiphyseal cartilage and the diaphysis
  • Blood capillaries and the mesenchymal cells infiltrate the spaces left by the destroyed chondrocytes

  • Osteoblasts are derived from the undifferentiated cells; form an osseous matrix in the cartilage
  • Bone appears at the site where there was cartilage

      Microscopic structure

  • Compact bone is found on the exterior of all bones; canceIlous bone is found in the interior
  • Surface of compact bone is covered by periosteum that is attached by Sharpey's fibers
  • Blood vessels enter the periosteum via Volkmann's canals and then enter the haversian canals that are formed by the canaliculi and lacunae
  •  

  • Marrow
    • FiIls spaces of spongy bone
    • Contains blood vessels and blood ceIls in various stages of development
    • Types
  • Red bone marrow
    • Formation of red blood ceIls (RBCs) and some white blood cells (WBCs) in this location
    • Predominate type of marrow in newborn
    • Found in spongy bone of adults (sternum, ribs, vertebrae, and proximal epiphyses of long bones)
  •  Yellow bone marrow
    • Fatty marrow
    • Generally replaces red bone marrow in the adult, except in areas mentioned above
  •  
  • Ossification is completed as the proximal epiphysis joins with the diaphysis between the twentieth and twenty-fifth year


-> Most of the facial skeleton is formed by nine bones: four paired (nasal, zygomatic, maxilla, and palatine) and one unpaired (mandible).
-> The calvaria of the new-born infant is large compared with the relatively small fascial skeleton.
-> This results from the small size of the jaws and the almost complete absence of the maxillary and other paranasal sinuses in the new-born skull.
-> These sinuses form large spaces in the adult facial skeleton. As the teeth and sinuses develop during infancy and childhood, the facial bones enlarge.
-> The growth of the maxillae between the ages of 6 and 12 years accounts for the vertical elongation of the child’s face.


The Nasal Bones 

-> These bones may be felt easily because they form the bridge of the nose.
-> The right and left nasal bones articulate with each other at the internasal suture.
-> They also articulate with the frontal bones, the maxillae, and the ethmoid bones.
-> The mobility of the anteroinferior portion of the nose, supported only by cartilages, serves as a partial protection against injure (e.g., a punch in the nose). However, a hard blow to the anterosuperior bony portion of the nose may fracture the nasal bones (broken nose).
-> Often the bones are displaced sideways and/or posteriorly.

The Maxillae 

-> The skeleton of the face between the mouth and the eyes is formed by the two maxillae.
-> They surround the anterior nasal apertures and are united in the medial plane at the intermaxillary suture to form the maxilla (upper jaw).
-> This suture is also visible in the hard palate, where the palatine processes of the maxillae unite.
-> Each adult maxilla consists of: a hollow body that contains a large maxillary sinus; a zygomatic process that articulates with its mate on the other side to form most of the hard palate; and alveolar processes that form sockets for the maxillary (upper) teeth.
-> The maxillae also articulate with the vomer, lacrimal, sphenoid, and palatine bones.
-> The body of the maxilla has a nasal surface that contributes to the lateral wall of the nasal cavity; an orbital surface that forms most of the floor of the orbit; an infratemporal surface that forms the anterior wall of the infratemporal fossa; and an anterior surface that faces partly anteriorly and partly anterolaterally and is covered buy facial muscles.
-> The relatively large infraorbital foramen, which faces inferomedially, is located about 1 cm inferior to the infraorbital margin; it transmits the infraorbital nerve and vessels.
-> The incisive fossa is a shallow concavity overlying the roots of the incisor teeth, just a shallow concavity overlying the roots of the incisor teeth, just inferior to the nasal cavity. This fossa is the injection site for anaesthesia of the maxillary incisor teeth.
-> If infected maxillary teeth are removed, the bone of the alveolar processes of the maxillae begins to be reabsorbed. As a result, the maxilla becomes smaller and the shape of the face changes.
-> Owing to absorption of the alveolar processes, there is a marked reduction in the height of the lower face, which produces deep creases in the facial skin that pass posteriorly from the corners of the mouth.


The Mandible 

-> This is a U-shaped bone and forms the skeleton of the lower jaw and the inferior part of the face. It is the largest and strongest facial bone.
-> The mandibular (lower) teeth project superiorly from their sockets in the alveolar processes.
-> The mandible (L. mandere, to masticate) consists of two parts: a horizontal part called the body, and two vertical oblong parts, called rami.
-> Each ramus ascends almost vertically from the posterior aspect of the body.
-> The superior part of the ramus has two processes: a posterior condylar process with a head or condyle and a neck, and a sharp anterior coronoid process.
-> The condylar process is separated from the coronoid process by the mandibular notch, which forms the concave superior border of the mandible.
-> Viewed from the superior aspect, the mandible is horseshoe-shaped, whereas each half is L-shaped when viewed laterally.
-> The rami and body meet posteriorly at the angle of the mandible.
-> Inferior to the second premolar tooth on each side of the mandible is a mental foramen (L. mentum, chin) for transmission of the mental vessels and the mental nerve.
-> In the anatomical position, the rami of the mandible are almost vertical, except in infants and in edentulous (toothless) adults.
-> On the internal aspect of the ramus, there is a large mandibular foramen.
-> It is the oblong entrance to the mandibular canal that transmits the inferior alveolar vessels and nerve to the roots of the mandibular teeth.
-> Branches of these vessels and the mental nerve emerge from the mandibular canal at the mental foramen.
-> Running inferiorly and slightly anteriorly on the internal surface of the mandible from the mandibular foramen is a small mylohyoid groove (sulcus), which indicates the course taken by the mylohyoid nerve and vessels.
-> These structures arise from the inferior alveolar nerve and vessels, just before they enter the mandibular foramen.
-> The internal surface of the mandible is divided into two areas by the mylohyoid line, which commences posterior to the third molar tooth. -> Just superior to the anterior end of the mylohyoid line are two small, sharp mental spines (genial tubercles), which serve as attachments for the genioglssus muscles.

The Zygomatic Bones 

-> The prominences of the cheeks (L. mala), the anterolateral rims and much of the infraorbital margins of the orbits, are formed by the zygomatic bones (malar bones, cheekbones).
-> They articulate with the frontal, maxilla, sphenoid, and temporal bones.
-> The frontal process of the zygomatic bone passes superiorly, where it forms the lateral border of the orbit (eye socket) and articulates with the frontal bone at the lateral edge of the supraorbital margin.
-> The zygomatic bones articulate medially with the greater wings of the sphenoid bone. The site of their articulation may be observed on the lateral wall of the orbit.
-> On the anterolateral aspect of the zygomatic bone near the infraorbital margin is a small zygomaticofacial foramen for the nerve and vessels of the same name.
-> The posterior surface of the zygomatic bone near the base of its frontal process is pierced by a small zygomaticotemporal foramen for the nerve of the same name.
-> The zygomaticofacial and zygomaticotemporal nerves, leaving the orbit through the previously named foramina, enter the zygomatic bone through small zygomaticoorbital foramina that pierces it orbital surface.
-> The temporal process of the zygomatic bone unites with the zygomatic process of the temporal bone to form the zygomatic arch.
-> This arch can be easily palpated on the side of the head, posterior to the zygomatic prominence (malar eminence) at the inferior boundary of the temporal fossa (temple).
-> The zygomatic arches form one of the useful landmarks for determining the location of the pterion. These arches are especially prominent in emaciated persons.
-> A horizontal plane passing medially from the zygomatic arch separates the temporal fossa superiorly from the infratemporal fossa inferiorly.

Other Bones

There are several other, very important bones in the skull, including the palatine bone, ethmoid bone, vomer, inferior concha and the ossicles of the ear (malleus, incus and stapes). These, however, are covered to greater detail where they are relevant in the head (e.g., ethmoid bone with the orbit and nasal cavity).

 

Internal Muscles of the Pharynx

  • The internal, chiefly longitudinal muscular layer, consists of 3 muscles: stylopharyngeus, palatopharyngeus, and salpingopharyngeus.
  • They all elevate the larynx and pharynx during swallowing and speaking.

The Stylopharyngeus Muscle

  • This is a long, thin, conical muscles that descends inferiorly between the external and internal carotid arteries.
  • It enters the wall of the pharynx between the superior and middle constrictor muscles.
  • Origin: styloid process of temporal bone.
  • Insertion: posterior and superior borders of thyroid cartilage with palatopharyngeus muscle.
  • Innervation: glossopharyngeal nerve (CN IX).
  • It elevates the pharynx and larynx and expands the sides of the pharynx, thereby aiding in pulling the pharyngeal wall over a bolus of food.

The Palatopharyngeus Muscle

  • This is a thin muscle and the overlying mucosa form the palatopharyngeal arch.

The Salpingopharyngeus Muscle

  • This is a slender muscle that descends in the lateral wall of the pharynx.
  • The over lying mucous membrane forms the salpingopharyngeal fold.
  • Origin: cartilaginous part of the auditory tube.
  • Insertion: blends with palatopharyngeus muscle.
  • Innervation: through the pharyngeal plexus.
  • It elevates the pharynx and larynx and opens the pharyngeal orifice of the auditory tube during swallowing.

-> 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.

 

 
Anterior 2/3 of tongue Posterior 1/3 of tongue
Motor Innervation All muscles by hypoglossal nerve (CN XII) except palatoglossus muscle (by the pharyngeal plexus)
General Sensory Innervation
Lingual nerve (branch of mandibular nerve CN V3) Glossopharyngeal nerve (CN IX)
Special Sensory Innervation
Chorda tympani nerve (branch of facial nerve) Glossopharyngeal nerve (CN IX)

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.

First pouch

Auditory tube, which comes in contact

    with epithelial line of first pharyngeal

    cleft, where future external acoustic

    meatus will form.

Distal portion will form tympanic   

    cavity (lining will become eardrum)

Proximal portion will become auditory tube

Second pouch

Forms buds that penetrate surrounding

    mesenchyme, which together form the 

    palatine tonsils

Third pouch

Forms thymus and inferior parathyroid

    glands

Fourth pouch

Forms superior parathyroid glands

Fifth pouch

Forms utlimobranchial body

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