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
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
A. Anatomic position-erect body position with the arms at the sides and the palms upward
B. Plane or section
1. Definition-imaginary flat surface formed by an extension through an axis
2. Median plane-a vertical plane. that divides a body into right and left halves
3. Sagittal plane
- Any plane parallel to the median plane
- Divides the body into right and left portions
4. Frontal plane
- Vertical plane that forms at right angles to the sagittal plane
- Divides the body into anterior and posterior sections
- Synonymous with the term coronal plane
5. Transverse plane
- Horizontal plane that forms at right angles to the sagittal and frontal planes
- Divides the body into upper and lower portions
- Synonymous with the term horizontal plane
C. Relative positions
1. Anterior
- Nearest the abdominal surface and the front of the body
- Synonymous with the term ventral
- In referring to hands and forearms, the terms palmar and Volar are used
2. Posterior
- Back of the body
- Synonymous with the term dorsal
3. Superior
- Upper or higher
- Synonymous with the term cranial (head)
4. Inferior
- Below or lower
- Synonymous with the term caudal (tail)
- In referring to the top of the foot and the sole of the foot. the terms dorsal and plantar are used respectively
5. Medial-near to the median plane
6. Lateral-farther away from the median plane
7. Proximal-near the source or attachment
8. Distal-away from the source or. attachment
9. Superficial-near the surface
10. Deep-away from the surface
11. Afferent-conducting toward a structure
12. Efferent-conducting away from a structure
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.
Walls of the Tympanic Cavity or Middle Ear
- This cavity is shaped like a narrow six-sided box that has convex medial and lateral walls.
- It has the shape of the biconcave lens in cross-section (like a red blood cell).
The Roof or Tegmental Wall
- This is formed by a thin plate of bone, called the tegmen tympani (L. tegmen, roof).
- It separates the tympanic cavity from the dura on the floor of middle cranial fossa.
- The tegmen tympani also covers the aditus ad antrum.
The Floor or Jugular Wall
- This wall is thicker than the roof.
- It separates the tympanic cavity from the superior bulb of the internal jugular vein. The internal jugular vein and the internal carotid artery diverge at the floor of the tympanic cavity.
- The tympanic nerve, a branch of the glossopharyngeal nerve (CN IX), passes through an aperture in the floor of the tympanic cavity and its branches form the tympanic plexus.
The Lateral or Membranous Wall
- This is formed almost entirely by the tympanic membrane.
- Superiorly it is formed by the lateral bony wall of the epitympanic recess.
- The handle of the malleus is incorporated in the tympanic membrane, and its head extends into the epitympanic recess.
The Medial or Labyrinthine Wall
- This separates the middle ear from the membranous labyrinth (semicircular ducts and cochlear duct) encased in the bony labyrinth.
- The medial wall of the tympanic cavity exhibits several important features.
- Centrally, opposite the tympanic membrane, there is a rounded promontory (L. eminence) formed by the first turn of the cochlea.
- The tympanic plexus of nerves, lying on the promontory, is formed by fibres of the facial and glossopharyngeal nerves.
- The medial wall of the tympanic cavity also has two small apertures or windows.
- The fenestra vestibuli (oval window) is closed by the base of the stapes, which is bound to its margins by an annular ligament.
- Through this window, vibrations of the stapes are transmitted to the perilymph window within the bony labyrinth of the inner ear.
- The fenestra cochleae (round window) is inferior to the fenestra vestibuli.
- This is closed by a second tympanic membrane.
The Posterior or Mastoid Wall
- This wall has several openings in it.
- In its superior part is the aditus ad antrum (mastoid antrum), which leads posteriorly from the epitympanic recess to the mastoid cells.
- Inferiorly is a pinpoint aperture on the apex of a tiny, hollow projection of bone, called the pyramidal eminence (pyramid).
- This eminence contains the stapedius muscle.
- Its aperture transmits the tendon of the stapedius, which enters the tympanic cavity and inserts into the stapes.
- Lateral to the pyramid, there is an aperture through which the chorda tympani nerve, a branch of the facial nerve (CN VII), enters the tympanic cavity.
The Anterior Wall or Carotid Wall
- This wall is a narrow as the medial and lateral walls converge anteriorly.
- There are two openings in the anterior wall.
- The superior opening communicates with a canal occupied by the tensor tympani muscle.
- Its tendon inserts into the handle of the malleus and keeps the tympanic membrane tense.
- Inferiorly, the tympanic cavity communicates with the nasopharynx through the auditory tube.
The Nasal Mucosa
- Mucosa lines the entire nasal cavities except for the vestibule of the nose.
- The nasal mucosa is firmly bound to the periosteum and perichondrium of the supporting structures of the nose.
- It is continuous with the adjoining cavities to which the nasal cavity communicates (e.g., the nasopharynx and paranasal sinuses).
- The inferior 2/3 of the nasal mucosa is called the respiratory area and air passing over this is warmed and moistened before it passes into the lungs.
- The superior 1/3 is called the olfactory area.
The Olfactory Area of Nasal Mucosa
- This area contains the peripheral organ of smell.
- Sniffing draws air into this area
- Olfactory receptor cells (from the olfactory nerve, CN I, are located in the mucosa of this area in the nose.
Nerves to the Respiratory Area of Nasal Mucosa
- The inferior 2/3 of the nasal mucosa are supplied chiefly by the trigeminal nerve (CN V).
- The mucous membrane of the nasal septum is supplied chiefly by the nasopalatine nerve, a branch of the maxillary nerve (CN V2).
- Its anterior portion is supplied by the anterior ethmoidal nerve (a branch of the nasociliary nerve) which is derived from the ophthalmic nerve (CN V1).
- The lateral walls of the nasal cavity are supplied by branches of the maxillary nerve (CN V2); the greater palatine nerve, and the anterior ethmoidal nerve.
Arteries of the Nasal Mucosa
- The blood supply of the mucosa of the nasal septum is derived mainly from the maxillary artery.
- The sphenopalatine artery, a branch of the maxillary, supplies most of the blood of the nasal mucosa.
- It enters by the sphenopalatine foramen and sends branches to the posterior regions of the lateral wall and to the nasal septum.
- The greater palatine artery, also a branch of the maxillary, passes through the incisive foramen to supply the nasal septum.
- The anterior and posterior ethmoidal arteries, branches of the ophthalmic artery, supply the anterosuperior part of the mucosa of the lateral wall of the nasal cavity and nasal septum.
- Three branches of the facial artery (superior labial, ascending palatine, and lateral nasal) also supply the anterior parts of the nasal mucosa.
Veins of the Nasal Mucosa
- The veins of the nasal mucosa form a venous network of plexus in the connective tissue of the nasal mucosa.
- Some of the veins open into the sphenopalatine vein and drain to the pterygoid plexus.
- Others join the facial and infraorbital veins.
- Some empty into the ophthalmic veins and drain into the cavernous sinus.
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| Motor Innervation | All muscles by hypoglossal nerve (CN XII) except palatoglossus muscle (by the pharyngeal plexus) | ||
| General Sensory Innervation |
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| Special Sensory Innervation |
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