NEET MDS Lessons
Anatomy
The Meatus of the Nose
Sphenopalatine Recess
- This space is posterosuperior to the superior concha.
- The sphenoidal sinus opens into this recess.
Superior Meatus
- This is a narrow passageway between the superior and middle nasal conchae.
- The posterior ethmoidal sinuses open into it by one or more orifices.
Middle Meatus
- This is longer and wider than the superior one.
- The anterosuperior part of this meatus lead into a funnel-shaped opening, called the infundibulum, through which the frontonasal duct leads to the frontal sinus.
- There is one duct for each frontal sinus and since there may be several, there may be several frontonasal ducts.
- When the middle concha is removed, rounded elevation called the ethmoidal bulla (L. bubble), is visible
- The middle ethmoidal air cells open on the surface of the ethmoidal bulla.
- Inferior to this bulla is a semicircular groove called the hiatus semilunaris.
- The frontal sinus opens into this hiatus anterosuperiorly.
- Near the hiatus are the openings of the anterior ethmoid air cells.
- The maxillary sinus also opens into the middle meatus.
Inferior Meatus
- This is a horizontal passage, inferolateral to the inferior nasal concha.
- The nasolacrimal duct opens into the anterior part of this meatus.
- Usually, the orifice of this duct is wide and circular.
Histology
Histology is the study of tissues.
A tissue is a group of cells with similar structure and function plus the extracellular substances located between the cells.
There are four basic types of tissues:
- Epitheliums
- Connective tissue
- Muscle tissue
- Nervous tissue
Muscles Around the Eyelids
- The function of the eyelid (L. palpebrae) is to protect the eye from injury and excessive light. It also keeps the cornea moist.
The Orbicularis Oculi Muscle
- This is the sphincter muscle of the eye.
- Its fibres sweep in concentric circles around the orbital margin and eyelids.
- It narrows the eye and helps the flow of tears from the lacrimal sac.
- This muscle has 3 parts: (1) a thick orbital part for closing the eyes to protect then from light and dust; (2) a thin palpebral part for closing the eyelids lightly to keep the cornea from drying; and (3) a lacrimal part for drawing the eyelids and lacrimal punta medially.
- When all three parts of the orbicularis oculi contract, the eyes are firmly closed and the adjacent skin becomes wrinkled.
- The zygomatic branch of the facial nerve (CN VII) supplies it.
The Levator Palpebrae Superioris Muscle
- This muscle raises the upper eyelid to open the palpebral fissure.
- It is supplied by the oculomotor nerve (CN III).
Skull bones
- 26 bones: 22 bones + hyoid (small bone in neck for swallowing) + 3 auditory ossicles (middle ear: incus, malleus, stapes)
- 21 bones: tightly connected; mandible is freely mobile at temperomandibular joint (synovial)
- connective-tissue interface b/w bones = suture
- bones – mandible = cranium
- cranium
- neurocranium: covers brain anteriorly, laterally and posteriorly
- brain supported by bones of basicranium
- also contributes to interorbital region; b/w eyes and superior to nasal passages
- viscerocranium/splanchnocranium: bones of face
- sutures
- coronal: separates frontal from parietals
- sagittal: separates two parietal bones
- lambdoidal: separates parietal form occipital
- squamosal: b/w temporal and parietal; overlapping sutures
- At birth: 2 frontal bones which eventually fuse; metopic suture disappears

Cranial Cavities: 5 major cavities
Endocranial, left and right orbits, nasal cavities, oral cavity, middle ear cavities
Endocranial cavity
- contains brain, meninges, cerebrospinal fluid, brain’s vascular supply and most proximal portion of cranial nerves
- enclosed by neurocranium and basicranium
- basicranium: foramina for neurovascular bundles
- foramen magnum: spinal cord exit
- floor of endocranial cavity divide into fossae
- anterior: frontal lobes of brain
- middle: pair temporal lobes
- posterior: cerebellum and brainstem
- The six muscles rotate the eyeball in the orbit around three axes (sagittal, horizontal and vertical).
- The action of the muscles can be deduced by their site of insertion on the eyeball.
| Muscle | Action(s) on the Eyeball | Nerve Supply |
| Medial Rectus | Adducts | CN III |
| Lateral Rectus | Abducts | CN VI |
| Superior Rectus | Elevates, adducts, and medially rotates | CN III |
| Inferior Rectus | Depresses, adducts, and laterally rotates | CN III |
| Superior Oblique | Depresses, abducts, and medially rotates | CN IV |
| Inferior Oblique | Elevates, abducts, and laterally rotates | CN III |
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.
The Cheeks
- The cheeks (L. buccae) form the lateral wall of the vestibule of the oral cavity.
- They have essentially the same structure as the lips with which they are continuous.
- The principal muscular component of the cheeks is the buccinator muscle.
- Superficial to the fascia covering this muscle is the buccal fatpad that gives cheeks their rounded contour, especially in infants.
- The lips and cheeks act as a functional unit (e.g. during sucking, blowing, eating, etc.).
- They act as an oral sphincter in pushing food from the vestibule to the oral cavity proper.
- The tongue and buccinator muscle keep the food between the molar teeth during chewing.
Sensory Nerves of the Cheeks
- These are branches of the maxillary and mandibular nerves.
- They supply the skin of the cheeks and the mucous membrane lining the cheeks.