• Bones begin to form during the eighth week of embryomic life in the fibrous membranes (intramembranous ossification) and hyaline cartilage (endochondral ossification)

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:

1. The auricular branch of the auriculotemporal nerve (derived from the mandibular, CN V³).
2. The facial nerve (CN VII) by the branches from the tympanic plexus.
3. 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.

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 Palate

• The palate forms the arched roof of the mouth and the floor of the nasal cavities.
• The palate consists of two regions: the anterior 2/3 or bony part, called the hard palate, and the mobile posterior 1/3 or fibromuscular part, known as the soft palate.

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

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.