NEET MDS Lessons
Anatomy
The Middle Ear
- This part of the ear is in a narrow cavity in the petrous part of the temporal bone.
- It contains air, three auditory ossicles, a nerve and two small muscles.
- The middle ear is separated from the external acoustic meatus by the tympanic membrane.
- This cavity includes the tympanic cavity proper, the space directly internal to the tympanic membrane, and the epitympanic recess, the space superior to it.
- The middle ear is connected anteriorly with the nasopharynx by the auditory tube.
- Posterosuperiorly, the tympanic cavity connects with the mastoid cells through the aditus ad antrum (mastoid antrum).
- The tympanic cavity is lined with mucous membrane that is continuous with the mucous membrane of the auditory tube, mastoid cells, and aditus ad antrum.
Contents of the Tympanic Cavity or Middle Ear
- This cavity contains the auditory ossicles (malleus, incus and stapes); the stapedius and tensor tympani muscles; the chorda tympani nerve (a branch of the facial nerve, CN VII); and the tympanic plexus of nerves.
BONE
A rigid form of CT, Consists of matrix and cells
Matrix contains:
organic component 35% collagen fibres
inorganic salts 65% calcium phosphate (58,5%), calcium carbonate (6,5%)
2 types of bone - spongy (concellous)
compact (dense)
Microscopic elements are the same
Spongy bone consists of bars (trabeculae) which branch and unite to form a meshwork
Spaces are filled with bone marrow
Compact bone appears solid but has microscopic spaces
In long bones the shaft is compact bone
And the ends (epiphysis) consists of spongy bone covered with compact bone
Flat bones consists of 2 plates of compact bone with spongy bone in-between
Periosteum covers the bone
Endosteum lines marrow cavity and spaces
These 2 layers play a role in the nutrition of bone tissue
They constantly supply the bone with new osteoblasts for the repair and growth of bone
Microscopically
The basic structural unit of bone is the Haversian system or osteon
An osteon consists of a central Haversian canal
- In which lies vessels nerves and loose CT
- Around the central canal lies rings of lacunae
- A lacuna is a space in the matrix in which lies the osteocyte
- The lacunae are connected through canaliculi which radiate from the lacunae
- In the canaliculi are the processes of the osteocytes
- The canaliculi link up with one another and also with the Haversian canal
- The processes communicate with one another in the canaliculi through gap junctions
- Between two adjacent rows of lacunae lie the lamellae, 5-7µm thick
- In three dimensions the Haversian systems are cylindrical
- The collagen fibres lie in a spiral in the lamellae
- Perpendicular to the Haversian canals are the Volkman's canals
- They link up with the marrow cavity and the Haversian canals
- Some lamellae do not form part of a Haversian system
- They are the:
- Inner circumferential lamellae - around the marrow cavity
- Outer circumferential lamellae - underneath the outer surface of the bone
- Interstitial lamellae - between the osteons
Endosteum
Lines all cavities like marrow spaces, Haversian- and Volkman's canals
Consists of a single layer of squamous osteoprogenitor cells with a thin reticular CT layer underneath it
Continuous with the inner layer of periosteum
Covers the trabeculae of spongy bone
Cells differentiate into osteoblasts (like the cells of the periosteum)
Periosteum
Formed by tough CT
2 layers
Outer fibrous layer: Thickest, Contains collagen fibres,
Some fibres enter the bone - called Sharpey's fibres
Contains blood vessels.
Also fibrocytes and the other cells found in common CT
Inner cellular layer
Flattened cells (continuous with the endosteum)
Can divide and differentiate into osteoprogenitor cells
spindle shaped
little amount of rough EPR
poorly developed Golgi complex
play a prominent role in bone growth and repair
Osteoblasts
Oval in shape, Have thin processes, Rough EPR in one part of the cell (basophilic)
On the other side is the nucleus, Golgi and the centrioles in the middle, Form matrix
Become trapped in the matrix
Osteocytes
Mature cells, Less basophilic than the osteoblasts, Lie trapped in the lacunae, Their processes lie in the canaliculi, Processes communicate with one another through gap junctions, Substances (nutrients, waste products) are passed on from cell to cell
Osteoclasts
Very large, Multinucleate (up to 50), On inner and outer surface of bone, Lie in depressions on the surface called Howships lacunae, The cell surface facing the bone has short irregular processes
Acidophylic
Has many lysosomes, polyribosomes and rough EPR
Lysosomal enzymes are secreted to digest the bone
Resorbs the organic part of bone
Histogenesis
Two types of bone development.
- intramembranous ossification
- endochondral ossification
In both these types of bone development temporary primary bone is deposited which is soon replaced by secondary bone. Primary bone has more osteocytes and the mineral content is lower.
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 Layers of the Pharyngeal Wall
- The pharyngeal wall is composed of 5 layers. From internal to external, they are as follows.
- Mucous membrane: this lines the pharynx and is continuous with all chambers with which it communicates.
- Submucosa
- Pharyngobasilar fascia: this is a fibrous layer that is attached to the skull.
- Muscular layer: this is composed of inner longitudinal and outer circular parts.
- Buccopharyngeal fascia: this is a loose connective tissue layer.
- This fascia is continuous with the fascia covering the buccinator and pharyngeal muscle.
- It contains the pharyngeal plexus of nerves and veins.
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.
- Bones begin to form during the eighth week of embryomic life in the fibrous membranes (intramembranous ossification) and hyaline cartilage (endochondral ossification)
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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