NEET MDS Lessons
Anatomy
The Tongue
- The tongue (L. lingua; G. glossa) is a highly mobile muscular organ that can vary greatly in shape.
- It consists of three parts, a root, body, and tip.
- The tongue is concerned with mastication, taste, deglutition (swallowing), articulation (speech), and oral cleansing.
- Its main functions are squeezing food into the pharynx when swallowing, and forming words during speech.
Gross Features of the Tongue
- The dorsum of the tongue is divided by a V-shaped sulcus terminalis into anterior oral (presulcal) and posterior pharyngeal (postsulcal) parts.
- The apex of the V is posterior and the two limbs diverge anteriorly.
- The oral part forms about 2/3 of the tongue and the pharyngeal part forms about 1/3.
Oral Part of the Tongue
- This part is freely movable, but it is loosely attached to the floor of the mouth by the lingual frenulum.
- On each side of the frenulum is a deep lingual vein, visible as a blue line.
- It begins at the tip of the tongue and runs posteriorly.
- All the veins on one side of the tongue unite at the posterior border of the hyoglossus muscle to form the lingual vein, which joins the facial vein or the internal jugular vein.
- On the dorsum of the oral part of the tongue is a median groove.
- This groove represents the site of fusion of the distal tongue buds during embryonic development.
The Lingual Papillae and Taste Buds
- The filiform papillae (L. filum, thread) are numerous, rough, and thread-like.
- They are arranged in rows parallel to the sulcus terminalis.
- The fungiform papillae are small and mushroom-shaped.
- They usually appear are pink or red spots.
- The vallate (circumvallate) papillae are surrounded by a deep, circular trench (trough), the walls of which are studded with taste buds.
- The foliate papillae are small lateral folds of lingual mucosa that are poorly formed in humans.
- The vallate, foliate and most of the fungiform papillae contain taste receptors, which are located in the taste buds.
The Pharyngeal Part of the Tongue
- This part lies posterior to the sulcus terminalis and palatoglossal arches.
- Its mucous membrane has no papillae.
- The underlying nodules of lymphoid tissue give this part of the tongue a cobblestone appearance.
- The lymphoid nodules (lingual follicles) are collectively known as the lingual tonsil.
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.
Superior Constrictor Muscle
- Origin: Hamulus, pterygo-mandibular raphe, and mylohyoid line of the mandible.
- Insertion: Median raphe of the pharynx.
- Nerve Supply: Vagus nerve via the pharyngeal plexus.
- Arterial Supply: Ascending pharyngeal artery, ascending palatine artery, tonsillar branch of the facial artery, and dorsal branch of the lingual artery.
- Action: Constricts the wall of the pharynx during swallowing.
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:
- The auricular branch of the auriculotemporal nerve (derived from the mandibular, CN V3).
- The facial nerve (CN VII) by the branches from the tympanic plexus.
- 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.
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.
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| Motor Innervation | All muscles by hypoglossal nerve (CN XII) except palatoglossus muscle (by the pharyngeal plexus) | ||
| General Sensory Innervation |
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| Special Sensory Innervation |
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The Oral Cavity
- The oral cavity (mouth) consists of two parts: the vestibule and the mouth proper.
- The vestibule is the slit-like spaced between the cheeks and the lips and the teeth and gingivae.
- It is the entrance of the digestive tract and is also used for breathing.
- The vestibule communicates with the exterior through the orifice of the mouth.
- The oral cavity is bounded:
- Externally: by the cheeks and lips.
- Roof of oral cavity: formed by the palate.
- Posteriorly: the oral cavity communicates with the oropharynx.