NEET MDS Lessons
Anatomy
The Inferior Wall of the Orbit
- The thin inferior wall of the orbit or the floor is formed mainly by the orbital surface of the maxilla and partly by the zygomatic bone, and orbital process of the palatine bone.
- The floor of the orbit forms the roof of the maxillary sinus.
- The floor is partly separated from the lateral wall of the orbit by the inferior orbital fissure.
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.
The Superior Roof of the Orbit
- The superior wall or roof of the orbit is formed almost completely by the orbital plate of the frontal bone.
- Posteriorly, the superior wall is formed by the lesser wing of the sphenoid bone.
- The roof of the orbit is thin, translucent, and gently arched. This plate of bone separates the orbital cavity and the anterior cranial fossa.
- The optic canal is located in the posterior part of the roof.
CARTILAGE
There are 3 types:
Hyaline cartilage
Elastic cartilage
Fibrocartilage
Matrix is made up by: Hyaluronic acid
Proteoglycans
- In cartilage the protein core of the proteoglycan molecule binds through a linking protein to hyaluronic acid to form a proteoglycan aggregate which binds to the fibres
- In the matrix there are spaces, lacunae in which one to three of the cells of cartilage, chondrocytes, are found
- The matrix around the lacuna is the territorial matrix
- Type II collagen fibrils are embedded in the matrix
- The type of fiber depends on the type of cartilage
- Cartilage is surrounded by perichondrium which is a dense CT
- Apositional growth takes place in the perichondrium
- The fibroblasts of the perichondrium change to elliptic chondroblasts which later change to round chondrocytes
- Interstitial growth takes place around the lacunae
- Nutrients diffuse through the matrix to get to the chondrocytes this limits the thickness of cartilage
Hyaline cartilage
Found: Rib cartilage, articulating surfaces, nose, larynx, trachea, embryonic skeleton, Articulating cartilage has no perichondrium
Bluish-white and translucent
Contains type II collagen that is not visible
Elastic cartilage
Found: external auditory canal, epiglottis
Similar to hyaline except that it contains many elastic fibres ,Yellow in colour, Can be continuous with hyaline
Fibrocartilage
Found: Intervertebral disk, symphysis pubis
Always associated with dense CT, Many collagen fibres in the matrix, No perichondrium
- Chondrocytes tend to lie in rows, Can withstand strong forces
Veins of the Face
The Supratrochlear Vein
- This vessel begins on the forehead from a network of veins connected to the frontal tributaries of the superficial temporal vein.
- It descends near the medial plane with its fellow on the other side.
- These veins diverge near the orbits, each joining a supraorbital vein to form the facial vein near the medial canthus (angle of the eye).
The Supraorbital Vein
- This vessel begins near the zygomatic process of the temporal bone.
- It joins the tributaries of the superficial and middle temporal veins.
- It passes medially and joins the supratrochlear vein to form the facial vein near the medial canthus.
The Facial Vein
- This vein provides the major venous drainage of the face.
- It begins at the medial canthus of the eye by the union of the supraorbital and supratrochlear veins.
- It runs inferoposteriorly through the face, posterior to the facial artery, but takes a more superficial and straighter course than the artery.
- Inferior to the margin of the mandible, the facial vein is joined by the anterior branch of the retromandibular vein.
- The facial veins ends by draining into the internal jugular vein.
The Superficial Temporal Vein
- This vein drains the forehead and scalp and receives tributaries from the veins of the temple and face.
- In the region of the temporomandibular joint, this vein enters the parotid gland.
The Retromandibular Vein
- The union of the superficial temporal and maxillary veins forms this vessel, posterior to the neck of the mandible.
- It descends within the parotid gland, superficial to the external carotid artery but deep to the facial nerve.
- It divides into an anterior branch that unites with the facial vein, and a posterior branch that joins the posterior auricular vein to form the external jugular vein.
Nerves of the Palate
- The sensory nerves of the palate, which are branches of the pterygopalatine ganglion, are the greater and lesser palatine nerves.
- They accompany the arteries through the greater and lesser palatine foramina, respectively.
- The greater palatine nerve supplies the gingivae, mucous membrane, and glands of the hard palate.
- The lesser palatine nerve supplies the soft palate.
- Another branch of the pterygopalatine ganglion, the nasopalatine nerve, emerges from the incisive foramen and supplies the mucous membrane of the anterior part of the hard palate.
The Meatus of the Nose
Sphenopalatine Recess
- This space is posterosuperior to the superior concha.
- The sphenoidal sinus opens into this recess.
Superior Meatus
- This is a narrow passageway between the superior and middle nasal conchae.
- The posterior ethmoidal sinuses open into it by one or more orifices.
Middle Meatus
- This is longer and wider than the superior one.
- The anterosuperior part of this meatus lead into a funnel-shaped opening, called the infundibulum, through which the frontonasal duct leads to the frontal sinus.
- There is one duct for each frontal sinus and since there may be several, there may be several frontonasal ducts.
- When the middle concha is removed, rounded elevation called the ethmoidal bulla (L. bubble), is visible
- The middle ethmoidal air cells open on the surface of the ethmoidal bulla.
- Inferior to this bulla is a semicircular groove called the hiatus semilunaris.
- The frontal sinus opens into this hiatus anterosuperiorly.
- Near the hiatus are the openings of the anterior ethmoid air cells.
- The maxillary sinus also opens into the middle meatus.
Inferior Meatus
- This is a horizontal passage, inferolateral to the inferior nasal concha.
- The nasolacrimal duct opens into the anterior part of this meatus.
- Usually, the orifice of this duct is wide and circular.