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Anatomy - NEETMDS- courses
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Anatomy

The Eye and Orbit

  • The orbit (eye socket) appears as a bony recess in the skull when it is viewed from anteriorly.
  • It almost surrounds the eye and their associated muscles, nerves and vessels, together with the lacrimal apparatus.
  • The orbit is shaped somewhat like a four-side pyramid lying on its side, with its apex pointing posteriorly and its base anteriorly.

 

ENDOCRINE

Endocrine glands have no ducts

They secrete into the blood from where the secretion (hormone) reaches a target cell

The following is a list of endocrine glands:

  • Hypophysis
  • Thyroid
  • Parathyroid
  • Adrenals
  • Islets of Langerhans
  • Pineal
  • Gonads

Hypophysis: Develops from oral ectoderm and nerve tissue,  The oral part forms an upgrowth with an invagination (Rathke's pouch) The nervous part grows from the floor of the diencephalon - staying intact .The oral part separates from the mouth

Ectoderm – adenohypophysis - pars tuberalis

- pars distalis

- pars intermedia .

 

Diencephalon – neurohypophysis   - pars nervosa .

- infundibulum

- median eminence

Rathke's pouch remains as Rathke's cysts

Pars Distalis: Forms 75% of the gland, The cells form cords,  with fenestrated capillaries in-between

2 Cell types:

Chromophobes :  50% of the cells, do not stain  lie in groups, they are resting chromophils

granules have been used

Chromophils: Stain

They can be subdivided according to their reaction with different stains

Acidophils (40%) :Cells have acidophilic granules in their cytoplasm. The cells are secretory.

They have a well developed EPR and Golgi apparatus.They have secretory granules.

subdivided into:

- Somatotropin cells: secrete somatotropin (growth hormone)

- Mammotropic cells:  secrete prolactin

Basophils (10%) :  These cells have basophilic granules in their cytoplasm and can be subdivided into:

Thyrotropin cells:  secrete thyroid - stimulating hormone (TSH)

Corticotrophin cells:  secrete adrenocorticotropic (ACTH)

Gonadotropic cells:  secrete two hormones:  Follicle stimulating hormone (FSH):

Stimulate follicle development and spermatogenesis

Luteinizing hormone (LH): Stimulate the formation of the corpus luteum and Leydig cells

Pars Tuberalis:  Cells lie around the infundibulum . It is continuous with the pars distalis

Cells are cuboidal with no granules. Their function is unknown

Pars Intermedia:  Poorly developed in the human. Follicles lined by cuboidal cells and filled with colloid are found Known as Rathke's cysts .There are also a few big basophilic cells

Their function is unknown

Pars Nervosa: Contains: - myelinated axons  pituicytes,  blood vessels

Axons:

The cell bodies of the axons lie in the supra-optic and paraventricular nuclei of the hypothalamus .From the cell bodies the axons go through the infundibulum forming the  hypothalamohypophyseal tract to end in the pars nervosa

 The axons have dilated blind endings filled with hormones (Herring bodies) coming from the cell bodies.

Two hormones are secreted:

Oxytoxin: - Cause contraction of the uterus

    - Cause contraction of the myoepithelial cells of the milkgland

    - The hormone is secreted by the paraventricular nuclei

Vasopressin :- Cause reabsorption of H2O in the kidney (also known as antidiuretic hormone ADH)  The hormone is secreted by the supraoptic nuclei.  A hypophyseal portal system exists

A primary capillary plexus of fenestrated capillaries form around the median eminence. Inhibitory hormones are secreted into these capillaries

The capillaries rejoin to form the portal veins that traverse the pituitary stalk

The portal veins break up into a secondary capillary plexus which lies close to the cells of the adenohypophysis

This portal system regulates the functions of the anterior pituitary function.

 

Pineal

Surrounded by pia which sends septae into the gland Cells are mainly pinealocytes and astroglial cells

Pinealocytes:Irregular shaped cells. with processes ending in flattened dilatations

Have a well developed smooth surfaced endoplasmic reticulum, Also a rough EPR not well developed, Lots of microtubules

 

Astroglial Cells: Elongated nucleus, Cells have long processes, They perform a supporting function

Hormones:

Melatonin - secreted during the night .suppress the onset of puberty

Serotonin - secreted during the day

In humans the pineal form concretions of calcified material called brain sand

Brain sand vary in size and number with age and is visible on X-rays

Mast cells are also found in the pineal and cause the high histamine contend of the gland

THYROID

Has a CT capsule that sends septae into the gland to divide it up into incomplete lobes and lobules. In the lobules are follicles, Follicles vary in size,  They are surrounded by surrounded by reticular CT and capillaries

Cells of the Follicle:

Follicular Cells :  Single layer of cuboidal cells,  lie around the colloid, Follicular cells can become columnar when very active, Nucleus  central, EPR has wide cisternae ,Golgi present

  • microvilli on the free surface

 

Parafollicular Cells:  Also known as C-cells, Form part of the epithelium or form clusters between the follicles

- They never come into contact with the colloid

- Larger and stain less intensely than the follicular cells, Form 2% of the cells, Secrete calcitonin

Hormones: Thyroxine and thyriodothyronine - stimulate the metabolic rate, Calcitonin - lower the blood calcium

Parathyroid:

Has a CT capsule which send septae into the gland to divide it up into incomplete lobules, The CT contains fat which increase with age - may eventually be 50% of the gland, Glandular cells are arranged in cords

 

Glandular Cells:

Chief Cells:  Small cells so their nuclei lie close together, Rich in glycogen, Biggest omponent

Secrete parathyroid hormone - essential for life

Oxyphil Cells:Develop at puberty, Bigger than the chief cells, Nuclei are smaller, Acidophilic

Hormones:

Parathyroid hormone - regulate calcium and phosphate ions in the blood

ADRENAL

- Thick CT capsule that do not send septae into the gland

Cortex:

Has 3 layers

Zona glomerulosa: 15% of the cortex, Directly under the capsule, Cells are columnar or pyramidal,  Arranged in small groups or clusters, Wide fenestrated capillaries surround the clusters, Cells have an extensive smooth EPR

Zona Fasciculata: 78% of the cortex, Cells are arranged in cords ,1 to 2 cells wide perpendicular to the surface, Sinusoids lie between the cords, Cells are polyhedral with a central nucleus which is bigger than that of the zona glomerulosa, Lots of lipid in the cytoplasm cause the cells to stain lightly,  Cells have a well developed smooth and rough EPR

The mitochondria in the cells are round with tubular or vesicular cristae

Zona Reticularis:  7% of the cortex, Cells form a network of cords with wide capillaries in-between The mitochondria in the cells are more ofte6n elongated than that in the zona fasciculate  Degenerating cells with pyknotic nuclei are found.  Cells contain numerous large lipofuscin granules. Cells of the cortex do not store their secretions but form and secrete on demand.

Hormones:

3 Groups:

Glucocorticoids (e.g. cortisol) - have an affection on carbohydrate metabolism

Mineralocorticoid (e.g. aldosterone) - control water and electrolyte balans

Androgens (e.g. dehyroepiandrosterone) - not very important

Medulla:

- Cells are big and oval and lie in groups and cords around bloodvessels

- Oxidising agents stain the granules in these cells brown - cells are therefore called chromaffin cells

- Granules contain adrenaline or non-adrernalin

- A few parasympathetic ganglion cells are also present

Hormones:

- Adrenaline - increase oxygen uptake

- increase blood pressure

- Noradrenaline - maintain blood pressure

Blood Supply:

- Blood vessel enter from the capsule to form the wide capillaries

- They flow into venules that form a central vein

- Between the endothelium of the capillaries and the glandular cells there is a subendothelial

- space.

- The glandular cells have microvilli protruding into this space.

ISLES OF LANGERHANS

Endocrine part of pancreas.  The isles are round clusters in the exocrine tissue

- 100 - 200 µm

Islands consists of slightly stained polygonal or rounded cells,  The cells are separated by fenestrated capillaries

- Autonomic nerve fibres innervate the blood vessels and the island cells

- 4 different cell types have been described

A cells : 20% of the cells,  Bigger than B cells, Lie at the periphery, Have secretory granules ,Contain glucagon

B cells :  80%,  Lie in the centre of the island,  The cells are small with granules which are crystals,  Granules are formed by insulin

D cells :  Not numerous, Membrane bound granules, Store somatostatin (inhibit somatotropin)

F cells :  Have membrane bound granules,  Store pancreatic polypeptide, The hormone inhibits pancreatic exocrine secretion

Extrinsic Muscles of the Tongue (p. 746)

The Genioglossus Muscle

  • This is a bulky, fan-shaped muscle that contributes to most of the bulk of the tongue.
  • It arises from a short tendon from the genial tubercle (mental spine) of the mandible.
  • It fans out as it enters the tongue inferiorly and its fibres attach to the entire dorsum of the tongue.
  • Its most inferior fibres insert into the body of the hyoid bone.
  • The genioglossus muscle depresses the tongue and its posterior part protrudes it.

 

The Hyoglossus Muscle

  • This is a thin, quadrilateral muscle.
  • It arises from the body and greater horn of the hyoid bone and passes superoanteriorly to insert into the side and inferior aspect of the tongue.
  • It depresses the tongue, pulling its sides inferiorly; it also aids in retrusion of the tongue.

 

The Styloglossus Muscle

  • This small, short muscle arises from the anterior border of the styloid process near its tip and from the stylohyoid ligament.
  • It passes inferoanteriorly to insert into the side and inferior aspect of the tongue.
  • The styloglossus retrudes the tongue and curls its sides to create a trough during swallowing.

 

The Palatoglossus Muscle 

  • Superior attachment: palatine aponeurosis.
  • Inferior attachment: side of tongue.
  • Innervation: cranial part of accessory nerve (CN XI) through the pharyngeal branch of vagus (CN X) via the pharyngeal plexus.
  • This muscle, covered by mucous membrane, forms the palatoglossal arch.
  • The palatoglossus elevates the posterior part of the tongue and draws the soft palate inferiorly onto the tongue.

The Orbital Vessels

  • The orbital contents are supplied chiefly by the ophthalmic artery.
  • The infraorbital artery, the continuation of the maxillary, also contributes blood to this region.
  • Venous drainage is through the superior orbital fissure to enter the cavernous sinus.

The Ophthalmic Artery

  • This artery arises from the internal carotid artery as it emerges from the cavernous sinus.
  • It passes through the optic foramen within the dural sheath of the optic nerve and runs anteriorly, close to the superomedial wall of the orbit.

 

The Central Artery of the Retina

  • This is the one of the smallest but most important branches of the ophthalmic artery.
  • It arises inferior to the optic nerve until it approaches the eyeball.
  • It then pierces the optic nerve and runs within it to emerge through the optic disc.
  • The central artery of the retina spreads over the internal surface of the retina and supplies it.

 

The Ophthalmic Veins

The Superior Ophthalmic Vein

  • The superior ophthalmic vein anastomoses with the facial vein.
  • It has no valves and blood can flow in either direction.
  • It crosses superior to the optic nerve, passes through the superior orbital fissure and ends in the cavernous sinus.

The Inferior Ophthalmic Vein

  • This begins as a plexus on the floor of the orbit.
  • It communicates with the inferior orbital fissure with the pterygoid plexus, crosses inferior to the optic nerve, and ends in either the superior ophthalmic vein or the cavernous sinus.

The Submandibular Glands

  • Each of these U-shaped salivary glands is about the size of a thumb and lies along the body of the mandible.
  • It is partly superior and partly inferior to the posterior 1/2 of the base of the mandible.
  • It is partly superficial and partly deep to the mylohyoid muscle.
  • The submandibular duct arises from the portion of the gland that lies between the mylohyoid and hyoglossus muscle.
  • The duct passes deep and then superficial to the lingual nerve.
  • It opens by one to three orifices on a small sublingual papilla beside the lingual frenulum.
  • The submandibular gland is supplied by parasympathetic, secretomotor fibres from the submandibular ganglion (preganglionic fibres from the chorda tympani via the lingual nerve).

Skull bones

 

  • 26 bones: 22 bones + hyoid (small bone in neck for swallowing) + 3 auditory ossicles (middle ear: incus, malleus, stapes)
  • 21 bones: tightly connected; mandible is freely mobile at temperomandibular joint (synovial)
  • connective-tissue interface b/w bones = suture
  • bones – mandible = cranium
  • cranium
    • neurocranium: covers brain anteriorly, laterally and posteriorly
    • brain supported by bones of basicranium
      • also contributes to interorbital region; b/w eyes and superior to nasal passages
    • viscerocranium/splanchnocranium: bones of face
  • sutures
    • coronal: separates frontal from parietals
    • sagittal: separates two parietal bones
    • lambdoidal: separates parietal form occipital
    • squamosal: b/w temporal and parietal; overlapping sutures
    • At birth: 2 frontal bones which eventually fuse; metopic suture disappears

Cranial Cavities: 5 major cavities

            Endocranial, left and right orbits, nasal cavities, oral cavity, middle ear cavities

Endocranial cavity

  • contains brain, meninges, cerebrospinal fluid, brain’s vascular supply and most proximal portion of cranial nerves
  • enclosed by neurocranium and basicranium
  • basicranium: foramina for neurovascular bundles
  • foramen magnum: spinal cord exit
  • floor of endocranial cavity divide into fossae
    • anterior: frontal lobes of brain
    • middle: pair temporal lobes
    • posterior: cerebellum and brainstem

  •     Part of the axial skeleton; strong, flexible rod
        Supports the head
        Gives base to the ribs
        Encloses the spinal cord
        
    o    Vertebrae
        Consists of 34 bones composing the spinal column
    •    Cervical-7 bones
    •    Thoracic-12 bones
    •    Lumbar-5 bones
    •    Sacral- 5 bones.
    •    Coccygeal-4 to 5 bones

        In the adult the vertebrae of the sacral and coccygeal regions are united into two bones, the sacrum and me coccyx
        
    o    Curvatures-from a lateraI view there are four curves, alternately convex and concave ventrally
        Two convex curves are the cervical and lumbar
        Two concave curves are the thoracic and sacral

    o    Vertebra morphology

        Each vertebra differs in size and shape hut has similar components
        Body-central mass of bone
    •    Weight bearing
    •    Fonns anterior part of the vertebra
    •    Encloses the vertebral foramen
        Pedicles of the arch-two thick columns that extend backward from the body to meet with the laminae of the neural arch 

  •     Process (7)
    •    One spinous, two transverse, two superior articular, and two inferior articular
    o    Spinous process extends backward from the point of the union of thetwo laminae
    o    Transverse processes project laterally at either side from the junction of the lamina and the pedicle
    o    Articular processes arise near the junction of the pedicle and the lamina- superior processes project upward:inferior processes project downward
    •    Surfaces of the processes are smooth

    o    Inferior articular processes of the vertebra fit into the superior articular processes below
    o    Form true joints, but the contacts established serve to restrict movement

    Distinguishing features

    Cervical region- triangular shape

    •    All have foramina in the transverse process upper six transmit the vertebral artery
    •    Spinous processes are short
        o    C3 to C5 are bifurcated
        o    C7 is long-prominence felt at the back of the neck
    •    Have small bodies (except for C1 vertebra)
    •    C1 vertebra (atlas)
    o    No body
    o    Anterior and posterior arch and two lateral masses
    o    Superiorarticular processes articulate with the condyles of the occipital bone
    •    C2 vertebra (axis)-process on the upper surface of the body (dens) forms a pivot about which the axis rotates

    Thoracic region

    •    Presence of facets for articulation with the ribs (distinguishing feature)
    •    Processes are larger and heavier than those of the cervical region
    •    Spinous process is directed downward at a sharp angle
    •    Circular vertebral foramen

     Lumbar region
     
    •    Large and heavy bodies
    •    Four transverse lines separate the bodies of the vertebrae on the pelvic surface
    •    Triangular shape-fitted between the  halves of the pelvis
    •    Four pairs of dorsal sacral foramina communicate with four pairs of pelvic sacral foramina

    Sacral vertebrae 
    •    Five (sometimes six) vertebrae are fused in the adult to form the sacrum
    •    The sacrum articulates above with L5, laterally with the hip bones, and inferiorly with the coccyx.
    •    It has a roughly triangular appearance with a pelvic and dorsal surface, a lateral mass on each side, and a base and apex.
    •    An anesthetic for the spinal nerves may be injected extradurally through the sacral hiatus (caudal analgesia)
    •    The sacral canal (which contains the dura, cauda equina, and filum terminale) extends from the base to the sacral hiatus. 
    •    The apex of the sacrum may be fused with the coccyx.


    Coccygeal vertebrae

    •    Four to five modular pieces fused together
    •    Triangular shape with the base above and the apex below

    F Defects

    •    Lordosis-exaggerated lumbar concavity
    •    Scoliosis-lateral curvature of any region
    •    Kyphosis-exaggerated convexity in the thoracic region

 

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