A. Anatomic position-erect body position with the arms at the sides and the palms  upward

B. Plane or section

1. Definition-imaginary flat surface formed by an extension through an axis

2. Median plane-a vertical plane. that divides a body into right and left halves

3. Sagittal plane

• Any plane parallel to the median plane
• Divides the body into right and left portions

4. Frontal plane

• Vertical plane that forms at right angles to the sagittal plane
• Divides the body into anterior and posterior sections
• Synonymous with the term coronal plane

5. Transverse plane

• Horizontal plane that forms at right angles to the sagittal and frontal planes
• Divides the body into upper and lower portions
• Synonymous with the term horizontal plane

C. Relative positions

1. Anterior

• Nearest the abdominal surface and the front of the body
• Synonymous with the term ventral
• In referring to hands and forearms, the terms palmar and Volar are used

2. Posterior

• Back of the body
• Synonymous with the term dorsal

3. Superior

• Upper or higher
• Synonymous with the term cranial (head)

4. Inferior

• Below or lower
• Synonymous with the term caudal (tail)
• In referring to the top of the foot and the sole of the foot. the terms dorsal and plantar are used respectively

5. Medial-near to the median plane

6. Lateral-farther away from the median plane

7. Proximal-near the source or attachment

8. Distal-away from the source or. attachment

9. Superficial-near the surface

10. Deep-away from the surface

11. Afferent-conducting toward a structure

12. Efferent-conducting away from a structure

Walls of the Tympanic Cavity or Middle Ear

• This cavity is shaped like a narrow six-sided box that has convex medial and lateral walls.
• It has the shape of the biconcave lens in cross-section (like a red blood cell).

The Roof or Tegmental Wall

• This is formed by a thin plate of bone, called the tegmen tympani (L. tegmen, roof).
• It separates the tympanic cavity from the dura on the floor of middle cranial fossa.
• The tegmen tympani also covers the aditus ad antrum.

The Floor or Jugular Wall

• This wall is thicker than the roof.
• It separates the tympanic cavity from the superior bulb of the internal jugular vein. The internal jugular vein and the internal carotid artery diverge at the floor of the tympanic cavity.

• The tympanic nerve, a branch of the glossopharyngeal nerve (CN IX), passes through an aperture in the floor of the tympanic cavity and its branches form the tympanic plexus.

The Lateral or Membranous Wall

• This is formed almost entirely by the tympanic membrane.
• Superiorly it is formed by the lateral bony wall of the epitympanic recess.
• The handle of the malleus is incorporated in the tympanic membrane, and its head extends into the epitympanic recess.

The Medial or Labyrinthine Wall

• This separates the middle ear from the membranous labyrinth (semicircular ducts and cochlear duct) encased in the bony labyrinth.
• The medial wall of the tympanic cavity exhibits several important features.

• Centrally, opposite the tympanic membrane, there is a rounded promontory (L. eminence) formed by the first turn of the cochlea.
• The tympanic plexus of nerves, lying on the promontory, is formed by fibres of the facial and glossopharyngeal nerves.

• The medial wall of the tympanic cavity also has two small apertures or windows.

• The fenestra vestibuli (oval window) is closed by the base of the stapes, which is bound to its margins by an annular ligament.
• Through this window, vibrations of the stapes are transmitted to the perilymph window within the bony labyrinth of the inner ear.

• The fenestra cochleae (round window) is inferior to the fenestra vestibuli.
• This is closed by a second tympanic membrane.

The Posterior or Mastoid Wall

• This wall has several openings in it.
• In its superior part is the aditus ad antrum (mastoid antrum), which leads posteriorly from the epitympanic recess to the mastoid cells.

• Inferiorly is a pinpoint aperture on the apex of a tiny, hollow projection of bone, called the pyramidal eminence (pyramid).
• This eminence contains the stapedius muscle.
• Its aperture transmits the tendon of the stapedius, which enters the tympanic cavity and inserts into the stapes.

• Lateral to the pyramid, there is an aperture through which the chorda tympani nerve, a branch of the facial nerve (CN VII), enters the tympanic cavity.

The Anterior Wall or Carotid Wall

• This wall is a narrow as the medial and lateral walls converge anteriorly.
• There are two openings in the anterior wall.

• The superior opening communicates with a canal occupied by the tensor tympani muscle.
• Its tendon inserts into the handle of the malleus and keeps the tympanic membrane tense.

• Inferiorly, the tympanic cavity communicates with the nasopharynx through the auditory tube.

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.

Nerves of the Face

Innervation of the Muscles of Facial Expression

The Facial Nerve (CN VII)

• The seventh cranial nerve supplies the superficial muscle of the neck (platysma), the muscles of facial expression, the auricular muscles and the scalp muscles.
• CN VII is the sole motor supply to the muscles of facial expression.

• The facial nerve emerges from the skull though the stylomastoid foramen.
• Almost immediately, it enters the parotid gland. It runs superficially in this gland before giving rise to its five terminal branches: temporal, zygomatic, buccal, marginal mandibular, and cervical.
• These nerve emerge from the superior, anterior and inferior margins of the gland and spread out like the abducted digits of the hand to supply the muscles of facial expression.

• The temporal branches of CN VII cross the zygomatic arch to supply all the superficial facial muscles superior to it, including the orbital and forehead muscles.

• The zygomatic branch of CN VII passes transversely over the zygomatic bone to supply the muscles in the zygomatic, orbital and infraorbital regions.

• The buccal branches of CN VII pass horizontally, external to the masseter muscle, to supply the buccinator and the muscles of the upper lip.

• The marginal mandibular branch of CN VII supplies the muscles of the lower lip and chin.

• The cervical branch of CN VII supplies the platysma and the superficial muscles of the neck.

The Submandibular Glands

• Each of these U-shaped salivary glands is about the size of a thumb and lies along the body of the mandible.
• It is partly superior and partly inferior to the posterior 1/2 of the base of the mandible.
• It is partly superficial and partly deep to the mylohyoid muscle.

• The submandibular duct arises from the portion of the gland that lies between the mylohyoid and hyoglossus muscle.

• The duct passes deep and then superficial to the lingual nerve.
• It opens by one to three orifices on a small sublingual papilla beside the lingual frenulum.

• The submandibular gland is supplied by parasympathetic, secretomotor fibres from the submandibular ganglion (preganglionic fibres from the chorda tympani via the lingual nerve).

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.