NEET MDS Lessons
Anatomy
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.
- This is the posterior curtain-like part, and has no bony support. It does, however, contain a membranous aponeurosis.
- The soft palate, or velum palatinum (L. velum, veil), is a movable, fibromuscular fold that is attached to the posterior edge of the hard palate.
- It extends posteroinferiorly to a curved free margin from which hangs a conical process, the uvula (L. uva, grape).
- The soft palate separates the nasopharynx superiorly and the oropharynx inferiorly.
- During swallowing the soft palate moves posteriorly against the wall of the pharynx, preventing the regurgitation of food into the nasal cavity.
- Laterally, the soft palate is continuous with the wall of the pharynx and is joined to the tongue and pharynx by the palatoglossal and palatopharyngeal folds.
- The soft palate is strengthened by the palatine aponeurosis, formed by the expanded tendon of the tensor veli palatini muscle.
- This aponeurosis attaches to the posterior margin of the hard palate.
The Temporomandibular Joint
- This articulation is a modified hinge type of synovial joint.
- The articular surfaces are: (1) the head or condyle of the mandible inferiorly and (2) the articular tubercle and the mandibular fossa of the squamous part of the temporal bone.
- An oval fibrocartilaginous articular disc divides the joint cavity into superior and inferior compartments. The disc is fused to the articular capsule surrounding the joint.
- The articular disc is more firmly bound to the mandible than to the temporal bone.
- Thus, when the head of the mandible slides anterior on the articular tubercle as the mouth is opened, the articular disc slides anteriorly against the posterior surface of the articular tubercle
Endochondral ossification
- A cartilage model exists
- Through intramembraneous ossification in the perichondrium a collar of bone forms around the middle part of the cartilage model
- The perichondrium change to a periostium
- The bone collar cuts off the nutrient and oxygen supply to the chondrocytes in the cartilage model
- The chondrocytes then increase in size and resorb the surrounding cartilage matrix until only thin vertical septae of matrix are left over
- These thin plates then calcify after which the chondrocytes die
- The osteoclasts make holes in the bone collar through which blood vessels can now enter the cavities left behind by the chondrocytes
- With the blood vessels osteoprogenitor cells enter the tissue
- They position themselves on the calcified cartilage septae, change into osteoblasts and start to deposit bone to form trabeculae
- In the mean time the periosteum is depositing bone on the outside of the bone collar making it thicker and thicker
- The trabeculae,consisting of a core of calcified cartilage with bone deposited on top of it, are eventually resorbed by osteoclasts to form the marrow cavity
- The area where this happens is the primary ossification centre and lies in what is called the diaphysis (shaft)
- This process spreads in two directions towards the two ends of the bone the epiphysis
- In the two ends (heads) of the bone a similar process takes place
- A secondary ossification centre develops from where ossification spreads radially
- Here no bone collar forms
- The outer layer of the original cartilage remains behind to form the articulating cartilage
- Between the primary and the secondary ossification centers two epiphyseal cartilage plates remain
- This is where the bone grows in length
- From the epiphyseal cartilage plate towards the diaphysis a number of zones can be identified:
Resting zone of cartilage
Hyaline cartilage
Proliferation zone
Chondrocytes divide to form columns of cells that mature.
Hypertrophic cartilage zone
Chondrocytes become larger, accumulate glycogen, resorb the surrounding matrix so that only thin septae of cartilage remain
Calcification and degeneration zone
The thin septae of cartilage become calcified.
The calsified septae cut off the nutrient supply to the chondrocytes so subsequently they die.
Ossification zone.
Osteoclasts make openings in the bone collar through which blood vessels then invade the spaces left vacant by the chondrocytes that died.
Osteoprogenitor cells come in with the blood and position themselves on the calcified cartilage
septae, change into osteoblasts and start to deposit bone.
When osteoblasts become trapped in bone they change to osteocytes.
Growth and remodeling of bone
Long bones become longer because of growth at the epiphyseal plates
They become wider because of bone formed by the periosteum
The marrow cavity becomes bigger because of resorbtion by the osteoclasts
Fracture repair
When bone is fractured a blood clot forms
Macrophages then remove the clot, remaining osteocytes and damaged bone matrix
The periosteum and endosteum produce osteoprogenitor cells that form a cellular tissue in the fracture area
Intramembranous and endochondral ossification then take place in this area forming trabeculae.
Trabeculae connect the two ends of the broken bone to form a callus
Remodelling then takes place to restore the bone as it was
Joints
The capsule of a joint seals off the articular cavity,
The capsule has two layers
fibrous (outer)
synovial (inner)
The synovial layer is lined by squamous or cuboidal epithelial cells, Under this layer is a layer of loose or dense CT, The lining cells consists of two types:
- A cells
- B cells
They secrete the synovial fluid
They are different stages of the same cell, They are also phagocytic., The articular cartilage has fibres that run perpendicular to the bone and then turn to run parallel to the surface
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.
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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
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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
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- 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
The Ear
- The ear contains the vestibulocochlear organ and consists of three main parts: external, middle, and internal.
- It has two functions, balance and hearing.
- The tympanic membrane (eardrum) separates the external ear from the middle ear.
- The auditory tube joins the middle ear or tympanic cavity to the nasopharynx.