NEET MDS Lessons
Anatomy
The Frontalis Muscle
- The frontalis muscle is part of the scalp muscle called the occipitalfrontalis.
- The frontalis elevates the forehead, giving the face a surprised look, and produces transverse wrinkles in the forehead when one frowns.
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.
Eye
At week 4, two depressions are evident on each of the forebrain hemispheres. As the anterior neural fold closes, the optic pits elongate to form the optic vesicles. The optic vesicles remain connected to the forebrain by optic stalks.
The invagination of the optic vesicles forms a bilayered optic cup. The bilayered cup becomes the dual layered retina (neural and pigmented layer)
Surface ectoderm forms the lens placode, which invaginates with the optic cup.
The optic stalk is deficient ventrally to contain choroids fissure to allow blood vessels into the eye (hyaloid artery). The artery feeds the growing lens, but will its distal portion will eventually degenerate such that the adult lens receives no hyaloid vasculature.
At the 7th week, the choroids fissure closes and walls fuse as the retinal nerve get bigger.
The anterior rim of the optic vesicles forms the retina and iris. The iris is an outgrowth of the distal edge of the retina.
Optic vesicles induces/maintains the development of the lens vesicle, which forms the definitive lens. Following separation of the lens vesicle from the surface ectoderm, the cornea develops in the anterior 1/5th of the eye.
The lens and retina are surrounded by mesenchyme which forms a tough connective tissue, the sclera, that is continuous with the dura mater around the optic nerve.
Iridopupillary membrane forms to separate the anterior and posterior chambers of the eye. The membrane breaks down to allow for the pupil
Mesenchyme surrounding the forming eye forms musculature (ciliary muscles and pupillary muscles – from somitomeres 1 and 2; innervated by CN III), supportive connective tissue elements and vasculature.
Eyelids
Formed by an outgrowth of ectoderm that is fused at its midline in the 2nd trimester, but later reopen.
Intrinsic muscles
all innervated by recurrent laryngeal nerve except cricothyroid: external laryngeal nerve
adductors of vocal folds: bring folds together at midline
Transverse and oblique arytenoids: pull arytenoids together
Lateral cricoartenoids: spin and slide arytenoids up
only one abductor of vocal folds
Posterior cricoarytenoids—down and up
adjustors of shape and tension of vocal folds
Cricothyroid muscle
o superficial to lateral cricoarytenoid
o tenses vocal folds by tilting thyroid cartilage forward and sliding forward
Thyroartenoid and vocalis muscles
o vocalis: sometimes treated as medial most fibers of thyroartenoid muscle
o different fiber directions
lateral: adduct
medial: change shape of folds
control voice by bring bringing together different parts of folds
o as move from epithelium to vocalis muscle, fold becomes stiffer
o near connections, vocal folds are stiffer
o vocal fold: complex, multilayered vibrator
The Muscles of Facial Expression
- These lie in the subcutaneous tissue and are attached to the skin of the face.
- They enable us to move our skin and change our facial expression. They produce their effects by pulling on the skin but do not move the facial skeleton.
- These muscles surround the facial orifices and act as sphincters and dilators.
- All facial muscles receive their innervation from the branches of the facial nerve (CN VII)-temporal, zygomatic, buccal, marginal mandibular, cervical.
Intrinsic Muscles of the Tongue
The Superior Longitudinal Muscle of the Tongue
- The muscle forms a thin layer deep to the mucous membrane on the dorsum of the tongue, running from its tip to its root.
- It arises from the submucosal fibrous layer and the lingual septum and inserts mainly into the mucous membrane.
- This muscle curls the tip and sides of the tongue superiorly, making the dorsum of the tongue concave.
The Inferior Longitudinal Muscle of the Tongue
- This muscle consists of a narrow band close to the inferior surface of the tongue.
- It extends from the tip to the root of the tongue.
- Some of its fibres attach to the hyoid bone.
- This muscle curls the tip of the tongue inferiorly, making the dorsum of the tongue convex.
The Transverse Muscle of the Tongue
- This muscle lies deep to the superior longitudinal muscle.
- It arises from the fibrous lingual septum and runs lateral to its right and left margins.
- Its fibres are inserted into the submucosal fibrous tissue.
- The transverse muscle narrows and increases the height of the tongue.
The Vertical Muscle of the Tongue
- This muscle runs inferolaterally from the dorsum of the tongue.
- It flattens and broadens the tongue.
- Acting with the transverse muscle, it increases the length of the tongue.
Initially, four clefts exist; however, only one gives rise to a definite structure in adults.
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1st pharyngeal cleft |
Penetrates underlying mesenchyme and forms EAM. The bottom of EAM forms lateral aspect of tympanic cavity. |
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2nd pharyngeal cleft |
Undergoes active proliferation and overlaps remaining clefts. It merges with ectoderm of lower neck such that the remaining clefts lose contact with outside. Temporarily, the clefts form an ectodermally lined cavity, the cervical sinus, but this disappears during development. |