NEET MDS Lessons
Anatomy
The Scalp
- The scalp consists of five layers of soft tissue.
- It extends from the superior nuchal line on the posterior aspect of the skull of the supraorbital margins.
- Laterally, the scalp extends into the temporal fossa to the level of the zygomatic arches.
Layers of the Scalp
- The scalp proper is composed of three fused layers. It is separated from the pericranium by loose connective tissue.
- Because of this potential areolar cleavage plane, the scalp is fairly mobile.
- Each letter of the word "S C A L P" serves as a memory key for one of the layers of the scalp: Skin, Connective Tissue, Aponeurosis Epicranialis, Loose Areolar Tissue and Pericranium.
Layer 1: Skin
- Hair covers the scalp in most people.
- The skin of the scalp is thin, especially in elderly people, except in the occipital region.
- The skin contains many sweat and sebaceous glands and hair follicles.
- The skin of the scalp has an abundant arterial supply and good venous and lymphatic drainage systems.
Layer 2: Connective Tissue
- This is a thick, subcutaneous layer of connective tissue and is richly vascularised and innervated.
- It attaches the skin to the third layer of the scalp.
- Fat is enclosed in lobules between the connective fibres.
Layer 3: Aponeurosis Epicranialis
- This is a strong membranous sheet that covers the superior aspect of the cranium.
- This aponeurosis is the membranous tendon of the fleshy bellies of the epicranius muscle.
- The epicranius muscle consists of four parts: two occipital bellies, occipitalis and two frontal bellies, frontalis that are connected by the epicranial aponeurosis.
Layer 4: Loose Areolar Tissue
- This is a subaponeurotic layer or areolar or loose connective tissue.
- It is somewhat like a sponge because it contains innumerable potential spaces that are capable of being distended by fluid.
- It is this layer that allows free movement of the scalp proper, composed of layers 1-3.
Layer 5: Pericranium
- This is a dense layer of specialised connective tissue.
- The pericranium is firmly attached to the bones by connective tissue fibres called Sharpey’s fibres, however, they can be fairly easily stripped from the cranial bones of living persons, except where they are continuous with the fibrous tissues of the cranial sutures.
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.
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.
The Salivary Glands
- There are three large, paired salivary glands: the parotid, submandibular, and sublingual glands.
- In addition to the main salivary glands, there are numerous small accessory salivary glands scattered over the palate, lips, cheeks, tonsils, and tongue.
MUSCLE
Types:
Skeletal (voluntary)
Cardiac (involuntary)
Smooth (involuntary)
- Bones begin to form during the eighth week of embryomic life in the fibrous membranes (intramembranous ossification) and hyaline cartilage (endochondral ossification)
Muscles acting on the Temporomandibular Joint
- Movements of the temporomandibular joint are chiefly from the action of the muscles of mastication.
- The temporalis, masseter, and medial pterygoid muscles produce biting movements.
- The lateral pterygoid muscles protrude the mandible with the help from the medial pterygoid muscles and retruded largely by the posterior fibres of the temporalis muscle.
- Gravity is sufficient to depress the mandible, but if there is resistance, the lateral pterygoid, suprahyoid and infrahyoid, mylohyoid and anterior digastric muscles are activated.
| Actions | Muscles | |||
| Depression (Open mouth) |
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| Elevation (Close mouth) |
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| Protrusion (Protrude chin) |
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| Retrusion (Retrude chin) |
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| Side-to-side movements (grinding and chewing) |
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