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Anatomy

Digastric Muscle

  • Origin:
    • Anterior Belly: Digastric fossa of the mandible.
    • Posterior Belly: Mastoid notch of the temporal bone.
  • Insertion: Intermediate tendon attached to the body of the hyoid bone.
  • Nerve Supply:
    • Anterior Belly: Nerve to mylohyoid (branch of the trigeminal nerve, CN V3).
    • Posterior Belly: Facial nerve (CN VII).
  • Arterial Supply:
    • Anterior Belly: Branch of the submental artery.
    • Posterior Belly: Muscular branch of the posterior auricular artery and occipital artery.
  • Action: Raises the hyoid bone and base of the tongue, steadies the hyoid bone, and opens the mouth by lowering the mandible.

BONE

 A rigid form of CT, Consists of matrix and cells

 Matrix contains:

 organic component 35% collagen fibres

 inorganic salts 65% calcium phosphate (58,5%),  calcium carbonate (6,5%)

2 types of bone - spongy (concellous)

 compact (dense)

 Microscopic elements are the same

 Spongy bone consists of bars (trabeculae) which branch and unite to form a meshwork

 Spaces are filled with bone marrow

 Compact bone appears solid but has microscopic spaces

 In long bones the shaft is compact bone

 And the ends (epiphysis) consists of spongy bone covered with compact bone

Flat bones consists of 2 plates of compact bone with spongy bone in-between

 Periosteum covers the bone

 Endosteum lines marrow cavity and spaces

 These 2 layers play a role in the nutrition of bone tissue

 They constantly supply the bone with new osteoblasts for the repair and growth of bone

Microscopically

 The basic structural unit of bone is the Haversian system or osteon

 An osteon consists of a central Haversian canal

- In which lies vessels nerves and loose CT

- Around the central canal lies rings of lacunae

- A lacuna is a space in the matrix in which lies the osteocyte

- The lacunae are connected through canaliculi which radiate from the lacunae

- In the canaliculi are the processes of the osteocytes

- The canaliculi link up with one another and also with the Haversian canal

- The processes communicate with one another in the canaliculi through gap junctions

- Between two adjacent rows of lacunae lie the lamellae, 5-7µm thick

- In three dimensions the Haversian systems are cylindrical

- The collagen fibres lie in a spiral in the lamellae

- Perpendicular to the Haversian canals are the Volkman's canals

- They link up with the marrow cavity and the Haversian canals

- Some lamellae do not form part of a Haversian system

- They are the:

- Inner circumferential lamellae - around the marrow cavity

- Outer circumferential lamellae - underneath the outer surface of the bone

- Interstitial lamellae - between the osteons

Endosteum

Lines all cavities like marrow spaces, Haversian- and Volkman's canals

Consists of a single layer of squamous osteoprogenitor cells with a thin reticular CT layer underneath it

Continuous with the inner layer of periosteum

Covers the trabeculae of spongy bone

Cells differentiate into osteoblasts (like the cells of the periosteum)

Periosteum

 Formed by tough CT

 2 layers

Outer fibrous layer:  Thickest, Contains collagen fibres,

Some fibres enter the bone - called Sharpey's fibres

Contains blood vessels.

Also fibrocytes and the other cells found in common CT

Inner cellular layer

Flattened cells (continuous with the endosteum)

Can divide and differentiate into osteoprogenitor cells

spindle shaped

little amount of rough EPR

poorly developed Golgi complex

play a prominent role in bone growth and repair

Osteoblasts

Oval in shape, Have thin processes, Rough EPR in one part of the cell (basophilic)

On the other side is the nucleus, Golgi and the centrioles in the middle, Form matrix

Become trapped in the matrix

 

Osteocytes

Mature cells, Less basophilic than the osteoblasts, Lie trapped in the lacunae, Their processes lie in the canaliculi, Processes communicate with one another through gap junctions, Substances (nutrients, waste products) are passed on from cell to cell

Osteoclasts

 Very large,  Multinucleate (up to 50),  On inner and outer surface of bone,  Lie in depressions on the surface called Howships lacunae,  The cell surface facing the bone has short irregular processes

Acidophylic

 Has many lysosomes, polyribosomes and rough EPR

 Lysosomal enzymes are secreted to digest the bone

 Resorbs the organic part of bone

Histogenesis

Two types of bone development.

- intramembranous ossification

- endochondral ossification

In both these types of bone development temporary primary bone is deposited which is soon replaced by secondary bone. Primary bone has more osteocytes and the mineral content is lower.

 

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.

Levator Palpebrae Superioris Muscles

  • This is a thin, triangular muscle that elevates the upper eyelid.
  • It is continuously active except during sleeping and when the eye is closing.
  • Origin: roof of orbit, anterior to the optic canal.
  • Insertion: this muscle fans out into a wide aponeurosis that inserts into the skin of the upper eyelid. The inferior part of the aponeurosis contains some smooth muscle fibres that insert into the tarsal plate.
  • Innervation: the superior fibres are innervated by the oculomotor nerve (CN III), and the smooth muscle component is innervated by fibres of the cervical sympathetic trunk and the internal carotid plexus.

 

Illnesses involving the Levator Palpebrae Superioris

  • In third nerve palsy, the upper eyelid droops (ptosis) and cannot be raised voluntarily.
  • This results from damage to the oculomotor nerve (CN III), which supplies this muscle.
  • If the cervical sympathetic trunk is interrupted, the smooth muscle component of the levator palpebrae superioris is paralysed and also causes ptosis.
  • This is part of Horner's syndrome.

 

The Rectus Muscles

 

  • There are four rectus muscles (L. rectus, straight), superior, inferior, medial and lateral.
  • These arise from a tough tendinous cuff, called the common tendinous ring, which surrounds the optic canal and the junction of the superior and inferior orbital fissures.
  • From their common origin, these muscles run anteriorly, close to the walls of the orbit, and attach to the eyeball just posterior to the sclerocorneal junction.
  • The medial and lateral rectus muscles attach to the medial and lateral sides of the eyeball respectively, on the horizontal axis.
  • However, the superior rectus attaches to the anterosuperior aspect of the medial side of the eyeball while the inferior rectus attaches to the anteroinferior aspect of the medial side of the eye.

 

The Oblique Muscles

The Superior Oblique Muscle

  • This muscle arises from the body of the sphenoid bone, superomedial to the common tendinous ring.
  • It passes anteriorly, superior and medial to the superior and medial rectus muscles.
  • It ends as a round tendon that runs through a pulley-like loop called the trochlea (L. pulley).
  • After passing though the trochlea, the tendon of the superior oblique turns posterolaterally and inserts into the sclera at the posterosuperior aspect of the lateral side of the eyeball.

 

The Inferior Oblique Muscle

  • This muscle arises from the maxilla in the floor of the orbit.
  • It passes laterally and posteriorly, inferior to the inferior rectus muscle.
  • It inserts into the sclera at the posteroinferior aspect of the lateral side of the eyeball.

Innervation of the Pharynx

  • The motor and most of the sensory supply of the pharynx is derived from the pharyngeal plexus of nerves on the surface of the pharynx.
  • The plexus is formed by pharyngeal branches of the vagus (CN X) and glossopharyngeal (CN IX) nerves, and by sympathetic branches for the superior cervical ganglion.
  • The motor fibres in the pharyngeal plexus are derived from the cranial root of accessory nerve (CN XI), and are carried by the vagus nerve to all muscles of the pharynx and soft palate.
  • The exceptions are stylopharyngeus (supplied by CN IX) and the tensor veli palatini (supplied by CN V3).

  • The tongue is divided into halves by a medial fibrous lingual septum that lies deep to the medial groove.
  • In each half of the tongue there are four extrinsic and four intrinsic muscles.
  • The lingual muscles are all supplied by the hypoglossal nerve (CN XII).
  • The only exception is palatoglossus, which is supplied by the pharyngeal branch of the vagus nerve, via the pharyngeal plexus.

The Walls of the Orbit

  • Each orbit has four walls: superior (roof), medial, inferior (floor) and lateral.
  • The medial walls of the orbit are almost parallel with each other and with the superior part of the nasal cavities separating them.
  • The lateral walls are approximately at right angles to each other

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