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.

Vessels of the Palate

• The palate has a rich blood supply from branches of the maxillary artery.

• Cartilage model is covered with perichondrium that is converted to periosteum

• Diaphysis-central shaft
• Epiphysis-located at either end of the diaphysis
• Growth in length of the bone is provided by the emetaphyseal plate located between the epiphyseal cartilage and the diaphysis

• Blood capillaries and the mesenchymal cells infiltrate the spaces left by the destroyed chondrocytes

• Osteoblasts are derived from the undifferentiated cells; form an osseous matrix in the cartilage
• Bone appears at the site where there was cartilage

      Microscopic structure

• Compact bone is found on the exterior of all bones; canceIlous bone is found in the interior
• Surface of compact bone is covered by periosteum that is attached by Sharpey's fibers
• Blood vessels enter the periosteum via Volkmann's canals and then enter the haversian canals that are formed by the canaliculi and lacunae

•  

• Marrow
  • FiIls spaces of spongy bone
  • Contains blood vessels and blood ceIls in various stages of development
  • Types
• Red bone marrow
  • Formation of red blood ceIls (RBCs) and some white blood cells (WBCs) in this location
  • Predominate type of marrow in newborn
  • Found in spongy bone of adults (sternum, ribs, vertebrae, and proximal epiphyses of long bones)
•  Yellow bone marrow
  • Fatty marrow
  • Generally replaces red bone marrow in the adult, except in areas mentioned above
•  
• Ossification is completed as the proximal epiphysis joins with the diaphysis between the twentieth and twenty-fifth year

Muscles of the Pharynx

• This consists of three constrictor muscles and three muscles that descend from the styloid process, the cartilaginous part of the auditory tube and the soft palate.

External Muscles of the Pharynx 

• The paired superior, middle, and inferior constrictor muscles form the external circular part of the muscular layer of the wall.
• These muscles overlap each other and are arranged so that the superior one is innermost and the inferior one is outermost.

• These muscles contract involuntarily in a way that results in contraction taking place sequentially from the superior to inferior end of the pharynx.
• This action propels food into the oesophagus.

• All three constrictors of the pharynx are supplied by the pharyngeal plexus of nerves, which lies on the lateral wall of the pharynx, mainly on the middle constrictor of the pharynx.
• This plexus is formed by pharyngeal branches of the glossopharyngeal (CN IX) and vagus (CN X) nerves.

The Superior Constrictor Muscle

• Origin: pterygoid hamulus, pterygomandibular raphe, posterior end of the mylohyoid line of the mandible, and side of tongue.
• Insertion: median raphe of pharynx and pharyngeal tubercle.
• Innervation: though the pharyngeal plexus of nerves.

• The pterygomandibular raphe is the fibrous line of junction between the buccinator and superior constrictor muscles.

The Middle Constrictor Muscle

• Origin: stylohyoid ligament and greater and lesser horns of hyoid bone.
• Insertion: median raphe of pharynx.
• Innervation: through the pharyngeal plexus of nerves.

The Inferior Constrictor Muscle

• Origin: oblique line of thyroid cartilage and side of cricoid cartilage.
• Insertion: median raphe of pharynx.
• Innervation: through the pharyngeal plexus of nerves.

• The fibres arising from the cricoid cartilage are believed to act as a sphincter, preventing air from entering the oesophagus. 

Gaps in the Pharyngeal Musculature

• The overlapping arrangement of the three constrictor muscles leaves 4 deficiencies or gaps in the pharyngeal musculature.
• Various structures enter and leave the pharynx through these gaps.

• Superior to the superior constrictor muscle, the levator veli palatini muscle, the auditory tube, and the ascending palatine artery pass through a gap between the superior constrictor muscle and the skull.
• Superior to the superior border of the superior constrictor, the pharyngobasilar fascia blends with the buccopharyngeal fascia to form, with the mucous membrane, the thin wall of the pharyngeal recess.

• Between the superior and middle constrictor muscles, the gateway to the mouth, though which pass the stylopharyngeus muscle, the glossopharyngeal nerve (CN IX), and the stylohyoid ligament.

• Between the middle and inferior constrictor muscles, the internal laryngeal nerve and the superior laryngeal artery and vein pass to the larynx.

• Inferior to the inferior constrictor muscles, the recurrent laryngeal nerve and inferior laryngeal artery pass superiorly into the larynx.

The Paranasal Sinuses

• These sinuses are air-filled extensions of the respiratory part of the nasal cavity.
• They are in the following bones, frontal, ethmoid, sphenoid and the maxilla.

The Frontal Sinuses

• These are located between the outer and inner tables of the frontal bone, posterior to the superciliary arches.

The Ethmoidal Sinuses

• These comprise of several small cavities, called ethmoidal air cells, within the ethmoidal labyrinth (G. labyrinthos, a maze) of the lateral mass of the ethmoid bone.

The Sphenoidal Sinuses

• These occupy a variable amount in the body of the sphenoid bone and may extend into the wings.

The Maxillary Sinuses

• These are the largest pair of paranasal sinuses.
• They are pyramidal-shaped cavities that may occupy the entire bodies of the maxillae.

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.

The Masseter Muscle

• This is a quadrangular muscle that covers the lateral aspect of the ramus and the coronoid process of the mandible.

• Origin: inferior border and medial surface of zygomatic arch.
• Insertion: lateral surface of ramus of mandible and its coronoid process.
• Innervation: mandibular nerve via masseteric nerve that enters its deep surface.

• It elevates and protrudes the mandible, closes the jaws and the deep fibres retrude it.