The Skeleton of the Nose

• The immovable bridge of the nose, the superior bony part of the nose, consists of the nasal bones, the frontal processes of the maxillae, and the nasal part of the frontal bones.

• The movable cartilaginous part consists of five main cartilages and a few smaller ones.
• The U-shaped alar nasal cartilages are free and movable.
• They dilate and constrict the external nares when the muscles acting on the external nose contract.

The Nasal Cavities

• The nasal cavities are entered through the anterior nares or nostrils.
• They open into the nasopharynx through the choanae.

The Roof and Floor of the Nasal Cavity

• The roof is curved and narrow, except at the posterior end.

• The floor is wider than the roof.
• It is formed from the palatine process of the maxilla and the horizontal plate of the palatine bone.

The Walls of the Nasal Cavity

• The medial wall is formed by the nasal septum; it is usually smooth.

• The lateral wall is uneven owing to the three longitudinal, scroll-shaped elevations, called the conchae (L. shells) or turbinates (L. shaped like a top).
• These elevations are called the superior, middle and inferior conchae according to their position.

• The superior and middle conchae are parts of the ethmoid bone, whereas the inferior conchae are separate bones.

• The inferior and middle conchae project medially and inferiorly, producing air passageways called the inferior and middle meatus (L. passage). Note: the plural of "meatus" is the same as the singular.
• The short superior conchae conceal the superior meatus.
• The space posterosuperior to the superior concha is called the sphenoethmoidal recess.

EPITHELIUMS

Epithelial Tissue Epithelial tissue covers surfaces, usually has a basement membrane, has little extracellular material, and has no blood vessels. A basement membrane attaches the epithelial cells to underlying tissues. Most epithelia have a free surface, which is not in contact with other cells. Epithelia are classified according to the number of cell layers and the shape of the cells.

• Epitheliums contain no blood vessels.  There is normally an underlying layer of connective tissue
• Almost all epitheliums lie on a basement membrane.The basement membrane consists of  a basal lamina and  reticular lamina. The reticular lamina is connected to the basal lamina by anchoring fibrils. The reticular lamina may be absent in which case the basement membrane consist only of a basal lamina. The basal lamina consists of a   - lamina densa in the middle (physical barrier) with a lamina lucida on both sides (+charge barrier),The basement membrane is absent in ependymal cells.The basement membrane is not continuous in sinusoidal capillaries.

• Epitheliums always line or cover something
• Epithelial cells lie close together with little intercellular space
• Epithelial cells are strongly connected to one another especially those epitheliums that are subjected to mechanical forces.  

Functions of Epithelium:

→ Simple epithelium involved with diffusion, filtration, secretion, or absorption

→ Stratified epithelium protects from abrasion

→ Squamous cells function in diffusion or filtration

NEUROHISTOLOGY

The nervous system develops embryologically from ectoderm, which forms the neural plate

Successive growth and folding of the plate results in the formation of the primitive neural tube.

The neuroblasts in the wall of the tube differentiates into 3 cell types:

Neurons:  conduction of impulses

Neuroglial cells: connective tissue and support of CNS

Ependymal cells:  Lines the lumen of the tube.

   - Specialized neuro-ectodermal cells which lines the ventricles of the adult brain

                - Essentially also a neuroglial cell

Basic Unit = neuron

Exhibits irritability (excitability) and conductivity

A typical neurons consists of:

Cell body : Has nucleus (karyon) and surrounding cytoplasm (perikaryon) which contains organelles cell's vitality

Dendrites:  Several short processes

Axon:One large process

Terminates in twig like branches (telodendrons)

May also have collateral branches projecting along its course. These exit at nodes of Ranvier

Axon enveloped in a sheath, and together forms the nerve fiber

Classification:

May be done in different ways, i.e.

Functional = afferent, efferent, preganglionic, postganglionic, etc.

Morphological = shape, processes, etc

A typical morphological classification is as follows

a. Unipolar: Has one process only Not found in man

b. Bipolar (so-called ganglion cell):Has two processes Found in sensory systems, e.g. retina olfactory system

c. Multipolar: Has several process Most common in CNS

Cell bodies vary in shape, e.g.  stellate (star) , pyramidal

d. Pseudo-unipolar: Essentially bipolar neurons, but processes have swung around cb and fused with each other. They therefore enter and leave at one pole of the cell.

Typical neuron:

- Has 2 or more dendrites

Close to the cb the cytoplasm of dendrites has Nissl granules as well as mitochondria

Only one axon Arises from axon hillock, Devoid of Nissl granules, Encased in myelin sheath

No additional covering except for occasional foot processes of neuroglial cells

May branch at right angles

Branches at a node of Ranvier is known as a collateral

Ends of axons break up into tree-like branches, known as telodendria

Axons may be short (Golgi Type II) e.g. internuncial long (Golgi Type I) e.g. pyramidal neuron

Nucleus Central position Large and spherical

Chromatin is extended and thus not seen in LM. This allows the nucleolus to be prominent

Cytoplasm (perikaryon)

Surrounds nucleus  May be large or small, shape may be round, oval, flattened, pyramidal, etc

Contains aggregates Nissl granules(Bodies) which is also sometimes referred to as rhomboid flakes

aggregation of membranes and cisternae of rough endoplasmic reticulum (RER)

numerous ribosomes and polyribosomes scattered between cisternae

(Polyribosome = aggregate of free ribosomes clumped together)

responsible for ongoing synthesis of new cytoplasm and cytoplasmic substances

needed for conduction of impulses

highly active in cell protein synthesis

resultant loss of power to divide which is characteristic of neurons

- Golgi network surrounding nucleus (seen in EM only)

- Fibrils made up of:

- neurofilaments

- microtubules

Tubules involved in:

1. plasmic transport

2. maintenance of cell shape

3. essential for growth and elongation of axons and dendrites

Neurofilament:

1. provide skeletal framework

2. maintenance of cell shape

3. possible role in axonal transport

(Axonal [axoplasmic; plasmic] transport may be antero- or retrograde. Anterograde transport via neurotubules is fast and moves neurotransmitters. Retrograde transport is slow and is the reason why viruses and bacteria can attack and destroy cell bodies. E.g. polio in the ventral columns and syphilis in the dorsal columns).

- Numerous mitochondria

- Neurons lack ability to store glycogen and are dependent for energy on circulating glucose

Impulses are conducted in one direction only

Dendrites conduct towards the cb

Axons conduct away from cb

Synapses:

- Neurons interconnect by way of synapses

- Normally the telodendria of an axon synapse with the dendrites of a succeeding axon

axo-dendritic synapse

This is usually excitatory

- Other types of synapses are:

 axo-axonic

May be excitatory and/or inhibitory

axo-somatic

May be excitatory and/or inhibitory

 dendrodendritic

Usually inhibitory

- Synapses are not tight junctions but maintain a narrow space the so-called synaptic cleft

- The end of an telodendron is usually enlarged (bouton) and contains many synaptic vesicles,

mitochondrion, etc. Its edge that takes part in the synapse is known as the postsynaptic membrane and no

vesicles are seen in this area

- Synapses may be chemical (as above) or electrical as in the ANS supplying smooth muscle cells subjacent to adjacent fibres

Gray and White Matter of Spinal Cord:

- Gray matter contains:

- cb's (somas) of neurons

- neuroglial cells

- White matter contains:

- vast number of axons

- no cb's

- colour of white matter due to myelin that ensheathes axons

Myelin:

- Non-viable fatty material contains phospholipids, cholesterol and some proteins

- Soluble and not seen in H&E-sections because it has become dissolved in the process, thus leaving empty spaces around the axons

- Osmium tetroxide (OsO4) fixes myelin and makes it visible by staining it black. Seen as concentric rings in cross section

- Myelin sheath (neurolemma) is formed by two types of cells

- Within the CNS by Oligodendrocytes

- On the peripheral neurons system by Schwann cells

- Sheath is formed by being wrapped around the axon in a circular fashion by both types of cells

Neuroglial Cells:

- Forms roughly 40% of CNS volume

- May function as: 1. support

2. nurture ("feeding")

3. maintain

Types of glial cells:

Oligodendrocytes:

- Small dark stained dense nucleus

- Analogue of Schwann cell in peripheral nervous system

- Has several processes which forms internodal segments of several fibres (one cell ensheathes more than one axon)

- Provides myelin sheaths in CNS

- Role in nurturing (feeding) of cells

Astrocytes:

Protoplasmic astrocytes:

- found in gray matter

- round cell body

- large oval nucleus with prominent nucleolus

- large thick processes

- processes are short but profusely branched

- perivascular and perineurial foot processes

- sometimes referred to as mossy fibres

Fibrous Astrocytes:

- found in white matter

- polymorphic cells body

- large oval nucleus

- long thin processes

Microglia:

- Neural macrophages

- smallest of the glial cells

- intense dark stained nucleus

- conspicuously fine processes which has numerous short branches

Cerebral Cortex:

Consists of six layers which are best observed in the cortex of the hippocampus

From superficial to deep:

- Molecular layer:

- Has few cells and many fibres of underlying cells

- Outer granular layer:

- Many small nerve cells

- Pyramidal layer:

- Pyramidally-shaped cells bodies

- Inner granular layer:

- Smaller cells and nerve fibres

- Internal (inner) pyramidal layer:

- Pyramidal cells bodies

- Very large in the motor cortex and known as Betz-cells

- Polymorphic layer:

- Cells with many shapes

Cerebellar Cortex:

Consists of three layers

Connections are mainly inhibitory

From superficial to deep

- Outer molecular layer:

- Few cells and many fibres

- Purkinje layer:

- Huge flask-shaped cells that are arranged next to one another

- Inner granular layer:

- Many small nerve cells

Motor endplate:

Seen in periphery on striated muscle fibres

- known as boutons

- has no continuous myelin covering from the Schwann cells

- passes through perimysium of muscle fiber to "synapse"

- multiple synaptic gutter (fold) in sarcoplasma of muscle fiber beneath bouton

- contains numerous synaptic vesicles and mitochondria

Ganglia:

- Sensory Ganglia:

(e.g. trigeminal nerve, ganglia and dorsal root ganglia)

- No synapse (trophic unit)

- pseudo-unipolar neurons

- centrally located nucleus

- spherical smooth border

- conspicuous axon hillock

- Surrounded by cuboidal satellite cells (Schwann cells)

- Covered by spindle shaped capsular cells of delicate collagen which forms the endoneurium

- Visceral and Motor Ganglia (Sympathetic and Parasympathetic):

- Synapse present

- Ratio of preganglionic: postganglionic fibres

1. Sympathetic 1:30

Therefore excitatory and catabolic

2. Parasympathetic 1:2

Therefore anabolic

Except in Meissner and Auerbach's plexuses where ratio is 1:1000 '2 because of parasympathetic component's involvement in digestion

- Preganglionic axons are myelinated (e.g. white communicating rami)

- Postganglionic axon are non-myelinated (e.g. gray communicating rami)

- small multipolar cell body

- excentrally located nucleus

- Inconspicuous axon hillock

- satellite cells few or absent

- few capsular cells

The Soft Palate

• 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.

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.

The Temporalis Muscle

• This is an extensive fan-shaped muscle that covers the temporal region.
• It is a powerful masticatory muscle that can easily be seen and felt during closure of the mandible.

• Origin: floor of temporal fossa and deep surface of temporal fascia.
• Insertion: tip and medial surface of coronoid process and anterior border of ramus of mandible.
• Innervation: deep temporal branches of mandibular nerve (CN V³).

• The temporalis elevates the mandible, closing the jaws; and its posterior fibres retrude the mandible after protrusion.