NEET MDS Lessons
Anatomy
Internal Ear
- Osseous labyrinth: a complex system of cavities in the substance of the petrous bone.
- Membranous labyrinth: filled with endolymph, bathed in perilymph.
EPITHELIUMS
Epithelial Tissue Epithelial tissue covers surfaces, usually has a basement membrane, has little extracellular material, and has no blood vessels. A basement membrane attaches the epithelial cells to underlying tissues. Most epithelia have a free surface, which is not in contact with other cells. Epithelia are classified according to the number of cell layers and the shape of the cells.
- Epitheliums contain no blood vessels. There is normally an underlying layer of connective tissue
- Almost all epitheliums lie on a basement membrane.The basement membrane consists of a basal lamina and reticular lamina. The reticular lamina is connected to the basal lamina by anchoring fibrils. The reticular lamina may be absent in which case the basement membrane consist only of a basal lamina. The basal lamina consists of a - lamina densa in the middle (physical barrier) with a lamina lucida on both sides (+charge barrier),The basement membrane is absent in ependymal cells.The basement membrane is not continuous in sinusoidal capillaries.
- Epitheliums always line or cover something
- Epithelial cells lie close together with little intercellular space
- Epithelial cells are strongly connected to one another especially those epitheliums that are subjected to mechanical forces.
Functions of Epithelium:
→ Simple epithelium involved with diffusion, filtration, secretion, or absorption
→ Stratified epithelium protects from abrasion
→ Squamous cells function in diffusion or filtration
The External Ear
- The auricle (L. auris, ear) is the visible, shell-like part of the external ear.
- It consists of a single elastic cartilage that is covered on both surfaces with thin, hairy skin.
- The external ear contains hairs, sweat glands, and sebaceous glands.
- The cartilage is irregularly ridged and hollowed, which gives the auricle its shell-like form.
- It also shapes the orifice of the external acoustic meatus.
The Ear Lobule
- The ear lobule (earlobe) consists of fibrous tissue, fat and blood vessels that are covered with skin.
- The arteries are derived mainly from the posterior auricular artery and the superficial temporal artery.
- The skin of the auricle is supplied by the great auricular and auriculotemporal nerves.
- The great auricular nerve supplies the superior surface and the lateral surface inferior to the external acoustic meatus with nerve fibres from C2.
- The auriculotemporal nerve supplies the skin of the auricle superior to the external acoustic meatus.
The External Acoustic Meatus
- This passage extends from the concha (L. shell) of the auricle to the tympanic membrane (L. tympanum, tambourine). It is about 2.5 cm long in adults.
- The lateral 1/3 of the S-shaped canal is cartilaginous, whereas its medial 2/3 is bony.
- The lateral third of the meatus is lined with the skin of the auricle and contains hair follicles, sebaceous glands, and ceruminous glands.
- The latter glands produce cerumen (L. cera, wax).
- The medial two-thirds of the meatus is lined with very thin skin that is continuous with the external layer of the tympanic membrane.
- The lateral end of the meatus is the widest part. It has the diameter about that of a pencil.
- The meatus becomes narrow at its medial end, about 4 mm from the tympanic membrane.
- The constricted bony part is called the isthmus.
- Innervation of the external acoustic meatus is derived from three cranial nerves:
- The auricular branch of the auriculotemporal nerve (derived from the mandibular, CN V3).
- The facial nerve (CN VII) by the branches from the tympanic plexus.
- The auricular branch of the vagus nerve (CN X).
The Tympanic Membrane
- This is a thin, semi-transparent, oval membrane at the medial end of the external acoustic meatus.
- It forms a partition between the external and middle ears.
- The tympanic membrane is a thin fibrous membrane, that is covered with very thin skin externally and mucous membrane internally.
- The tympanic membrane shows a concavity toward the meatus with a central depression, the umbo, which is formed by the end of the handle of the malleus.
- From the umbo, a bright area referred to as the cone of light, radiates anteroinferiorly.
- The external surface of the tympanic membrane is supplied by the auriculotemporal nerve.
- Some innervation is supplied by a small auricular branch of the vagus nerve (CN X); this nerve may also contain some glossopharyngeal and facial nerve fibres.
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.
- The forehead is formed by the smooth, broad, convex plate of bone called the frontal squama.
- In foetal skulls, the halves of the frontal squama are divided by a metopic suture.
- In most people, the halves of the frontal bone begin to fuse during infancy and the suture between is usually not visible after 6 years of age.
- The frontal bone forms the thin roof of the orbits (eye sockets).
- Just superior to and parallel with each supraorbital margin is a bony ridge, the superciliary arch, which overlies the frontal sinus. This arch is more pronounced in males.
- Between these arches there is a gently, rounded, medial elevation called the gabella; this term derives from the Latin word glabellus meaning smooth and hairless. In most people, the skin over the gabella is hairless.
-The slight prominences of the forehead on each side, superior to the superciliary arches, are called frontal eminences (tubers).
- The supraorbital foramen (occasionally a notch), which transmits the supraorbital vessels and nerve is located in the medial part of the supraorbital margin.
- The frontal bone articulates with the two parietal bones at the coronal suture.
-It also articulates with the nasal bones at the frontonasal suture. At the point where this suture crosses the internasal suture in the medial plane, there is an anthropological landmark called the nasion . The depression is located at the root of the nose, where it joins the cranium.
- The frontal bone also articulates with the zygomatic, lacrimal, ethmoid, and sphenoid bones.
In about 8% of adult skulls, a remnant of the inferior part of the metopic (interfrontal) suture is visible. It may be mistaken in radiographs for a fracture line by inexperienced observers.
- The superciliary arches are relatively sharp ridges of bone and a blow to them may lacerate the skin and cause bleeding.
- Bruising of the skin over a superciliary arch causes tissue fluid and blood to accumulate in the surrounding connective tissue, which gravitates into the upper eyelid and around the eye. This results in swelling and a "black eye".
- Compression of the supraorbital nerve as it emerges from its foramen causes considerable pain, a fact that may be used by anaesthesiologists and anaesthetists to determine the depth of anaesthesia and by physicians attempting to arouse a moribund patient.
Veins of the Face
The Supratrochlear Vein
- This vessel begins on the forehead from a network of veins connected to the frontal tributaries of the superficial temporal vein.
- It descends near the medial plane with its fellow on the other side.
- These veins diverge near the orbits, each joining a supraorbital vein to form the facial vein near the medial canthus (angle of the eye).
The Supraorbital Vein
- This vessel begins near the zygomatic process of the temporal bone.
- It joins the tributaries of the superficial and middle temporal veins.
- It passes medially and joins the supratrochlear vein to form the facial vein near the medial canthus.
The Facial Vein
- This vein provides the major venous drainage of the face.
- It begins at the medial canthus of the eye by the union of the supraorbital and supratrochlear veins.
- It runs inferoposteriorly through the face, posterior to the facial artery, but takes a more superficial and straighter course than the artery.
- Inferior to the margin of the mandible, the facial vein is joined by the anterior branch of the retromandibular vein.
- The facial veins ends by draining into the internal jugular vein.
The Superficial Temporal Vein
- This vein drains the forehead and scalp and receives tributaries from the veins of the temple and face.
- In the region of the temporomandibular joint, this vein enters the parotid gland.
The Retromandibular Vein
- The union of the superficial temporal and maxillary veins forms this vessel, posterior to the neck of the mandible.
- It descends within the parotid gland, superficial to the external carotid artery but deep to the facial nerve.
- It divides into an anterior branch that unites with the facial vein, and a posterior branch that joins the posterior auricular vein to form the external jugular vein.
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.