NEET MDS Lessons
Anatomy
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Part of the axial skeleton; strong, flexible rod
Supports the head
Gives base to the ribs
Encloses the spinal cord
o Vertebrae
Consists of 34 bones composing the spinal column
• Cervical-7 bones
• Thoracic-12 bones
• Lumbar-5 bones
• Sacral- 5 bones.
• Coccygeal-4 to 5 bonesIn the adult the vertebrae of the sacral and coccygeal regions are united into two bones, the sacrum and me coccyx
o Curvatures-from a lateraI view there are four curves, alternately convex and concave ventrally
Two convex curves are the cervical and lumbar
Two concave curves are the thoracic and sacralo Vertebra morphology
Each vertebra differs in size and shape hut has similar components
Body-central mass of bone
• Weight bearing
• Fonns anterior part of the vertebra
• Encloses the vertebral foramen
Pedicles of the arch-two thick columns that extend backward from the body to meet with the laminae of the neural arch -
Process (7)
• One spinous, two transverse, two superior articular, and two inferior articular
o Spinous process extends backward from the point of the union of thetwo laminae
o Transverse processes project laterally at either side from the junction of the lamina and the pedicle
o Articular processes arise near the junction of the pedicle and the lamina- superior processes project upward:inferior processes project downward
• Surfaces of the processes are smootho Inferior articular processes of the vertebra fit into the superior articular processes below
o Form true joints, but the contacts established serve to restrict movementDistinguishing features
Cervical region- triangular shape
• All have foramina in the transverse process upper six transmit the vertebral artery
• Spinous processes are short
o C3 to C5 are bifurcated
o C7 is long-prominence felt at the back of the neck
• Have small bodies (except for C1 vertebra)
• C1 vertebra (atlas)
o No body
o Anterior and posterior arch and two lateral masses
o Superiorarticular processes articulate with the condyles of the occipital bone
• C2 vertebra (axis)-process on the upper surface of the body (dens) forms a pivot about which the axis rotatesThoracic region
• Presence of facets for articulation with the ribs (distinguishing feature)
• Processes are larger and heavier than those of the cervical region
• Spinous process is directed downward at a sharp angle
• Circular vertebral foramenLumbar region
• Large and heavy bodies
• Four transverse lines separate the bodies of the vertebrae on the pelvic surface
• Triangular shape-fitted between the halves of the pelvis
• Four pairs of dorsal sacral foramina communicate with four pairs of pelvic sacral foraminaSacral vertebrae
• Five (sometimes six) vertebrae are fused in the adult to form the sacrum
• The sacrum articulates above with L5, laterally with the hip bones, and inferiorly with the coccyx.
• It has a roughly triangular appearance with a pelvic and dorsal surface, a lateral mass on each side, and a base and apex.
• An anesthetic for the spinal nerves may be injected extradurally through the sacral hiatus (caudal analgesia)
• The sacral canal (which contains the dura, cauda equina, and filum terminale) extends from the base to the sacral hiatus.
• The apex of the sacrum may be fused with the coccyx.
Coccygeal vertebrae• Four to five modular pieces fused together
• Triangular shape with the base above and the apex belowF Defects
• Lordosis-exaggerated lumbar concavity
• Scoliosis-lateral curvature of any region
• Kyphosis-exaggerated convexity in the thoracic region
The Hard Palate
- The anterior bony part of the palate is formed by the palatine process of the maxillae and the horizontal plates of the palatine bones.
- Anteriorly and laterally, the hard palate is bounded by the alveolar processes and the gingivae.
- Posteriorly, the hard palate is continuous with the soft palate.
- The incisive foramen is the mouth of the incisive canal.
- This foramen is located posterior to the maxillary central incisor teeth.
- This foramen is the common opening for the right and left incisive canals.
- The incisive canal and foramen transmit the nasopalatine nerve and the terminal branches of the sphenopalatine artery.
- Medial to the third molar tooth, the greater palatine foramen pierces the lateral border of the bony palate.
- The greater palatine vessels and nerve emerge from this foramen and run anteriorly into two grooves on the palate.
- The lesser palatine foramen transmits the lesser palatine nerve and vessels.
- This runs to the soft palate and adjacent structures.
The Tongue
- The tongue (L. lingua; G. glossa) is a highly mobile muscular organ that can vary greatly in shape.
- It consists of three parts, a root, body, and tip.
- The tongue is concerned with mastication, taste, deglutition (swallowing), articulation (speech), and oral cleansing.
- Its main functions are squeezing food into the pharynx when swallowing, and forming words during speech.
Gross Features of the Tongue
- The dorsum of the tongue is divided by a V-shaped sulcus terminalis into anterior oral (presulcal) and posterior pharyngeal (postsulcal) parts.
- The apex of the V is posterior and the two limbs diverge anteriorly.
- The oral part forms about 2/3 of the tongue and the pharyngeal part forms about 1/3.
Oral Part of the Tongue
- This part is freely movable, but it is loosely attached to the floor of the mouth by the lingual frenulum.
- On each side of the frenulum is a deep lingual vein, visible as a blue line.
- It begins at the tip of the tongue and runs posteriorly.
- All the veins on one side of the tongue unite at the posterior border of the hyoglossus muscle to form the lingual vein, which joins the facial vein or the internal jugular vein.
- On the dorsum of the oral part of the tongue is a median groove.
- This groove represents the site of fusion of the distal tongue buds during embryonic development.
The Lingual Papillae and Taste Buds
- The filiform papillae (L. filum, thread) are numerous, rough, and thread-like.
- They are arranged in rows parallel to the sulcus terminalis.
- The fungiform papillae are small and mushroom-shaped.
- They usually appear are pink or red spots.
- The vallate (circumvallate) papillae are surrounded by a deep, circular trench (trough), the walls of which are studded with taste buds.
- The foliate papillae are small lateral folds of lingual mucosa that are poorly formed in humans.
- The vallate, foliate and most of the fungiform papillae contain taste receptors, which are located in the taste buds.
The Pharyngeal Part of the Tongue
- This part lies posterior to the sulcus terminalis and palatoglossal arches.
- Its mucous membrane has no papillae.
- The underlying nodules of lymphoid tissue give this part of the tongue a cobblestone appearance.
- The lymphoid nodules (lingual follicles) are collectively known as the lingual tonsil.
Muscles Moving the Auditory Ossicles
The Tensor Tympani Muscle
- This muscle is about 2 cm long.
- Origin: superior surface of the cartilaginous part of the auditory tube, the greater wing of the sphenoid bone, and the petrous part of the temporal bone.
- Insertion: handle of the malleus.
- Innervation: mandibular nerve (CN V3) through the nerve to medial pterygoid.
- The tensor tympani muscle pulls the handle of the malleus medially, tensing the tympanic membrane, and reducing the amplitude of its oscillations.
- This tends to prevent damage to the internal ear when one is exposed to load sounds.
The Stapedius Muscle
- This tiny muscle is in the pyramidal eminence or the pyramid.
- Origin: pyramidal eminence on the posterior wall of the tympanic cavity. Its tendon enters the tympanic cavity by traversing a pinpoint foramen in the apex of the pyramid.
- Insertion: neck of the stapes.
- Innervation: nerve to the stapedius muscle, which arises from the facial nerve (CN VII).
- The stapedius muscle pulls the stapes posteriorly and tilts its base in the fenestra vestibuli or oval window, thereby tightening the anular ligament and reducing the oscillatory range.
- It also prevents excessive movement of the stapes.
Genioglossus Muscle
- Origin: Mental spine of the mandible.
- Insertion: Dorsum of the tongue and hyoid bone.
- Nerve Supply: Hypoglossal nerve (CN XII).
- Arterial Supply: Sublingual and submental arteries.
- Action: Depresses and protrudes the tongue.
Ligaments of the Joint
- The fibrous capsule is thickened laterally to form the lateral (temporomandibular) ligament. It reinforces the lateral part of this capsule.
- The base of this triangular ligament is attached to the zygomatic process of the temporal bone and the articular tubercle.
- Its apex is fixed to the lateral side of the neck of the mandible.
- Two other ligaments connect the mandible to the cranium but neither provides much strength.
- The stylomandibular ligament is a thickened band of deep cervical fascia.
- It runs from the styloid process of the temporal bone to the angle of the mandible and separates the parotid and submandibular salivary glands.
- The sphenomandibular ligament is a long membranous band that lies medial to the joint.
- This ligament runs from the spine of the sphenoid bone to the lingula on the medial aspect of the mandible.
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