NEET MDS Lessons
Anatomy
The Nasopharynx
- The nasal part of the pharynx has a respiratory function.
- It lies superior to the soft palate and is a posterior extension of the nasal cavity.
- The nose opens into the nasopharynx via to large posterior apertures called choanae.
- The roof and posterior wall of the nasopharynx form a continuous surface that lies inferior to the body of the sphenoid bone and the basilar part of the occipital bone.
- In the mucous membrane of the roof of the posterior wall of the nasopharynx is a collection of lymphoid tissue, known as the pharyngeal tonsil (commonly known as the adenoids).
- The pharyngeal orifice of the auditory tube is on the lateral wall of the nasopharynx, 1 to 1.5 cm posterior to the inferior concha, and level with the superior border of the palate.
- The orifice is directed inferiorly and has a hood-like tubal elevation over it called the torus of the auditory tube or the torus tubarius (L. torus, swelling).
- Extending inferiorly from the torus is a vertical fold of mucous membrane, known as the salpingopharyngeal fold.
- The collection of lymphoid tissue in the submucosa of the pharynx, posterior to the orifice of the auditory tube, is known as the tubal tonsil.
- Posterior to the torus and the salpingopharyngeal fold, there is a slit-like lateral projection of the pharynx called the pharyngeal recess.
- It extends laterally and posteriorly.
Smooth Muscle
Light microscopic Structure:
cells - long - spindle shaped, nucleus lies in the widest widest part of the fiber, when the fiber contract the nucleus become folded, 30 - 200 µm long,between fibres lie endomycium
Electron microscopic structure:
Mitochondria, ribosomes, golgi, rough EPR, myofilaments are present but no sarcomeres and no Z lines,thin filaments - actin and tropomyosin (7nm), thick filaments - myosin (17nmØ)
- intermediate filaments (10 nm)
- actin and myosin overlap more than in skeletal muscle and can therefore contract more
A rudimentary sacroplasmic reticulum is present in the form of invaginations on the surface called caveolae , So there are no T-tubules, Cells communicate through gap junctions.
Dense bodies
Filaments are attached to dense bodies which take the place of the Z line in skeletal muscle
There are two types of dense bodies - cytoplasmic and membrane
contains a percentage actinin (like the Z line)
dense bodies transmit contractile force to adjacent fibres
Arrangement:
Fibres can be single or in groups, normally arranged in sheaths, In the GIT are 2 or 3 layers
Nerve supply:
2 types:
Where it is arranged in layers a few fibres are innervated together
impulse spread through the gap junctions between fibres (slow contraction)
In the iris and the vas deferens each fiber is individually supplied (quick contraction)
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
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.
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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
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Articulations
Classified according to their structure, composition,and movability
• Fibrous joints-surfaces of bones almost in direct contact with limited movement
o Syndesmosis-two bones united by interosseous ligaments
o Sutures-serrated margins of bones united by a thin layer of fibrous tissue
o Gomphosis-insertion of a cone-shaped process into a socket• Cartilaginous joints-no joint cavity and contiguous bones united by cartilage
o Synchondrosis-ends of two bones approximated by hyaline cartilage
o Symphyses-approximating bone surfaces connected by fibrocartilage• Synovial joints-approximating bone surfaces covered with cartilage; may be separated by a disk; attached by ligaments
o Hinge-permits motion in one plane only
o Pivot-permits rotary movement in which a ring rotates around a central axis
o Saddle-opposing surfaces are convexconcave. allowing great freedom of motion
o Ball and socket - capable of movement in an infinite number of axes; rounded head of one bone moves in a cuplike cavity of the approximating boneBursae
• Sacs filled with synovial fluid that are present where tendons rub against bone or where skjn rubs across bone
• Some bursae communicate with a joint cavity
• Prominent bursae found at the elbow. hip, and knee'Movements
• Gliding
o Simplest kind of motion in a joint
o Movement on a joint that does not involve any angular or rotary motions
• Flexion-decreases the angle formed by the union of two bones
• Extension-increases the angle formed by the union of two bones
• Abduction-occurs by moving part of the appendicular skeleton away from the median plane of the body
• Adduction-occurs by moving part of the appendicular skeleton toward the median plane of the body
• Circumduction
o Occurs in ball-and-socket joints
o Circumscribes the conic space of one bone by the other bone
• Rotation-turning on an axis without being displaced from that axis
The Laryngopharynx
- The laryngeal part of the pharynx lies posterior to the larynx.
- It extends from the superior border of the epiglottis to the inferior border of the cricoid cartilage, where it narrows to become continuous with the oesophagus.
- Posteriorly, the laryngopharynx is related to the bodies of C4 to C6 vertebrae.
- Its posterior and lateral walls are formed by the middle and inferior constrictor muscles, with the palatopharyngeus and stylopharyngeus internally.
- The laryngopharynx communicates with the larynx through the aditus or inlet of the larynx.
- The piriform recess is a small, pear-shaped depression of the laryngopharyngeal cavity on each side of the inlet of the larynx.