NEET MDS Lessons
Anatomy
- The palate has a rich blood supply from branches of the maxillary artery.
-
BONES OF THE CRANIUM
Occipital (1)
Frontal (1)
Sphenoid (1)
Ethmoid (1)
Parietal (2)
Temporal (2)
BONES OF THE FACE
Mandible (1)
Vomer (1)
Maxillae (2)
Zygomae (2)
Lacrimal (2)
Nasal (2)
Inferior nasal conchae (2)
Palatine (2)
The Nose
- The nose is the superior part of the respiratory tract and contains the peripheral organ of smell.
- It is divided into right and left nasal cavities by the nasal septum.
- The nasal cavity is divided into the olfactory area and the respiratory area.
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.
Muscles of the Tongue
- The tongue is divided into halves by a medial fibrous lingual septum that lies deep to the medial groove.
- In each half of the tongue there are four extrinsic and four intrinsic muscles.
- The lingual muscles are all supplied by the hypoglossal nerve (CN XII).
- The only exception is palatoglossus, which is supplied by the pharyngeal branch of the vagus nerve, via the pharyngeal plexus.
Extrinsic Muscles of the Tongue
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 Palatopharyngeus Muscle
- Superior attachment: hard palate and palatine aponeurosis.
- Inferior attachment: lateral wall of pharynx.
- Innervation: cranial part of accessory nerve (CN XI) through the pharyngeal branch of vagus (CN X) via the pharyngeal plexus.
- This thin, flat muscle is covered with mucous membrane to form the palatopharyngeal arch.
- It passes posteroinferiorly in this arch.
- This muscle tenses the soft palate and pulls the walls of the pharynx superiorly, anteriorly and medially during swallowing.
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.
Muscles Moving the Auditory Ossicles
The Tensor Tympani Muscle
- This muscle is about 2 cm long.
- Origin: superior surface of the cartilaginous part of the auditory tube, the greater wing of the sphenoid bone, and the petrous part of the temporal bone.
- Insertion: handle of the malleus.
- Innervation: mandibular nerve (CN V3) through the nerve to medial pterygoid.
- The tensor tympani muscle pulls the handle of the malleus medially, tensing the tympanic membrane, and reducing the amplitude of its oscillations.
- This tends to prevent damage to the internal ear when one is exposed to load sounds.
The Stapedius Muscle
- This tiny muscle is in the pyramidal eminence or the pyramid.
- Origin: pyramidal eminence on the posterior wall of the tympanic cavity. Its tendon enters the tympanic cavity by traversing a pinpoint foramen in the apex of the pyramid.
- Insertion: neck of the stapes.
- Innervation: nerve to the stapedius muscle, which arises from the facial nerve (CN VII).
- The stapedius muscle pulls the stapes posteriorly and tilts its base in the fenestra vestibuli or oval window, thereby tightening the anular ligament and reducing the oscillatory range.
- It also prevents excessive movement of the stapes.
The Auditory Tube
- This is a funnel-shaped tube connecting the nasopharynx to the tympanic cavity.
- Its wide end is towards the nasopharynx, where it opens posterior to the inferior meatus of the nasal cavity.
- The auditory tube is 3.5 to 4 cm long; its posterior 1/3 is bony and the other 2/3 is cartilaginous.
- It bony part lies in a groove on the inferior aspect of the base of the skull, between the petrous part of the temporal bone and the greater wing of the sphenoid bone.
- The function of the auditory tube is to equalise pressure of the middle ear with atmospheric pressure.