NEET MDS Lessons
Anatomy
The Ear
- The ear contains the vestibulocochlear organ and consists of three main parts: external, middle, and internal.
- It has two functions, balance and hearing.
- The tympanic membrane (eardrum) separates the external ear from the middle ear.
- The auditory tube joins the middle ear or tympanic cavity to the nasopharynx.
- 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.
The Pharynx
- The pharynx is the continuation of the digestive system from the oral cavity.
- It is a funnel-shaped fibromuscular tube that is the common route for both food and air.
- The pharynx is located posterior to the nasal and oral cavities, and the larynx.
- For the convenience of description, the pharynx is divided into three parts: (1) the nasopharynx, posterior to the nose and superior to the soft palate; (2) the oropharynx, posterior to the mouth; and (3) the laryngopharynx, posterior to the larynx.
- The pharynx is about 15 cm long.
- It extends from the base of the skull to the inferior border of the cricoid cartilage anteriorly, and to the inferior border of C6 vertebra posteriorly.
- It is widest (about 5 cm) opposite the hyoid bone and narrowest (about 1.5) at its inferior end, where it is continuous with the oesophagus.
- The posterior wall of the pharynx lies against the prevertebral fascia, with the potential retropharyngeal space between them.
Intrinsic Muscles of the Tongue
The Superior Longitudinal Muscle of the Tongue
- The muscle forms a thin layer deep to the mucous membrane on the dorsum of the tongue, running from its tip to its root.
- It arises from the submucosal fibrous layer and the lingual septum and inserts mainly into the mucous membrane.
- This muscle curls the tip and sides of the tongue superiorly, making the dorsum of the tongue concave.
The Inferior Longitudinal Muscle of the Tongue
- This muscle consists of a narrow band close to the inferior surface of the tongue.
- It extends from the tip to the root of the tongue.
- Some of its fibres attach to the hyoid bone.
- This muscle curls the tip of the tongue inferiorly, making the dorsum of the tongue convex.
The Transverse Muscle of the Tongue
- This muscle lies deep to the superior longitudinal muscle.
- It arises from the fibrous lingual septum and runs lateral to its right and left margins.
- Its fibres are inserted into the submucosal fibrous tissue.
- The transverse muscle narrows and increases the height of the tongue.
The Vertical Muscle of the Tongue
- This muscle runs inferolaterally from the dorsum of the tongue.
- It flattens and broadens the tongue.
- Acting with the transverse muscle, it increases the length of the tongue.
Internal Ear
- Osseous labyrinth: a complex system of cavities in the substance of the petrous bone.
- Membranous labyrinth: filled with endolymph, bathed in perilymph.
The Medial Wall of the Orbit
- This wall is paper-thin and is formed by the orbital lamina or lamina papyracea of the ethmoid bone, along with contributions from the frontal, lacrimal, and sphenoid bones (L. papyraceus, "made of papyrus" or parchment paper).
- There is a vertical lacrimal groove in the medial wall, which is formed anteriorly by the maxilla and posteriorly by the lacrimal bone.
- It forms a fossa for the lacrimal sac and the adjacent part of the nasolacrimal duct.
- Along the suture between the ethmoid and frontal bones are two small foramina; the anterior and posterior ethmoidal foramina.
- These transmit nerves and vessels of the same name.
Nerves of the Face
Innervation of the Muscles of Facial Expression
The Facial Nerve (CN VII)
- The seventh cranial nerve supplies the superficial muscle of the neck (platysma), the muscles of facial expression, the auricular muscles and the scalp muscles.
- CN VII is the sole motor supply to the muscles of facial expression.
- The facial nerve emerges from the skull though the stylomastoid foramen.
- Almost immediately, it enters the parotid gland. It runs superficially in this gland before giving rise to its five terminal branches: temporal, zygomatic, buccal, marginal mandibular, and cervical.
- These nerve emerge from the superior, anterior and inferior margins of the gland and spread out like the abducted digits of the hand to supply the muscles of facial expression.
- The temporal branches of CN VII cross the zygomatic arch to supply all the superficial facial muscles superior to it, including the orbital and forehead muscles.
- The zygomatic branch of CN VII passes transversely over the zygomatic bone to supply the muscles in the zygomatic, orbital and infraorbital regions.
- The buccal branches of CN VII pass horizontally, external to the masseter muscle, to supply the buccinator and the muscles of the upper lip.
- The marginal mandibular branch of CN VII supplies the muscles of the lower lip and chin.
- The cervical branch of CN VII supplies the platysma and the superficial muscles of the neck.