NEET MDS Lessons
Anatomy
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.
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Ossification
- Intramembranous-found in the flat bones of the face
- Mesenchymal cells cluster and form strands
- Strands are cemented in a uniform network. Which is known as osteoid
- Calcium salts are deposited; osteoid is converted to bone
- Trabeculae are formed and make cancellous bone with open spaces known as marrow cavities
- Periosteum forms on the inner and outer surfaces of the ossification centers
- Surface bone becomes compact bone
- Endochondral-primary type of ossification In the human
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Pharyngeal Arch |
Arch Artery |
Cranial Nerve |
Skeletal elements |
Muscles |
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1 |
Terminal Branch of maxillary artery |
Maxillary and mandibular division of trigemenial (V) |
Derived from arch cartilages (originating from neural crest): From maxillary cartilages: Alispenoid, incus From mandibular: Mackel’s cartilage, malleus
Upper portion of external ear (auricle) is derived from dorsal aspect of 1st pharyngeal arch.
Derived by direct ossification from arch dermal mesenchyme: Maxilla, zygomatic, squamous portion of temporal bone, mandible
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Muscles of mastication (temporalis, masseter, and pterygoids), mylohyoid, anterior belly of digastric, tensor tympani, tensor veli palatini (originate from cranial somitomere 4) |
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2 |
Stapedius artery (embryologic) and cortiotympanic artery (adult) |
Facial nerve (VII) |
Stapes, styloid process, stylohyoid ligament, lesser horns and upper rim of hyoid (derived from the second arch cartilage; originate from neural crest).
Lower portion of external ear (auricle) is derived from 2nd pharyngeal arch. |
Muscles of facial expression (orbicularis oculi, orbicularis oris, auricularis, platysma, fronto-ooccipitalis, buccinator), posterior belly of digastric, stylohyoid, stapedius (originate from cranial somitomere 6) |
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3 |
Common carotid artery, most of internal carotid |
Glossopharyngeal (IX) |
Lower rim and greater horn of hyoid (derived from the third arch cartilage; originate from neural crest cells) |
Sytlopharyngeus (originate from cranial somitomere 7) |
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4 |
Left: Arch of aorta; Right: Right subclavian artery; Original sprouts of pulmonary arteries |
Superior laryngeal branch of vagus (X) |
Laryngeal cartilages (Derived from the 4th arch cartilage, originate from lateral plate mesoderm) |
Constrictors of pharynx, cricothyroid, levator veli palatine (originate from occipital somites 2-4) |
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6 |
Ductus arteriosus; roots of definitive pulmonary arteries |
Recurrent laryngeal branch of vagus (X) |
Laryngeal cartilages (derived from the 6th-arch cartilage; originate from lateral plate mesoderm) |
Intrinsic muscles of larynx (originate from occipital somites 1 and 2) |
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.
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.
Internal Ear
- Osseous labyrinth: a complex system of cavities in the substance of the petrous bone.
- Membranous labyrinth: filled with endolymph, bathed in perilymph.
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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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