NEET MDS Lessons
Anatomy
Nerves of the Palate
- The sensory nerves of the palate, which are branches of the pterygopalatine ganglion, are the greater and lesser palatine nerves.
- They accompany the arteries through the greater and lesser palatine foramina, respectively.
- The greater palatine nerve supplies the gingivae, mucous membrane, and glands of the hard palate.
- The lesser palatine nerve supplies the soft palate.
- Another branch of the pterygopalatine ganglion, the nasopalatine nerve, emerges from the incisive foramen and supplies the mucous membrane of the anterior part of the hard palate.
The Parotid Glands
- The parotid glands are the largest of the three pairs of salivary glands.
- Each gland is wedged between the mandible and the sternocleidomastoid muscle and partly covers them.
- The parotid gland is wrapped with a fibrous capsule (parotid fascia) that is continuous with the deep investing fascia of the neck.
- Viewed superficially, the parotid gland is somewhat triangular in shape.
- Its apex is posterior to the angle of the mandible and its base is along the zygomatic arch.
- The parotid gland overlaps the posterior part of the masseter muscle.
- The parotid duct (Stensen's duct) is about 5 cm long and 5 mm in diameter.
- It passes horizontally from the anterior edge of the gland.
- At the anterior border of the masseter muscle, the parotid duct turns medially and pierces the buccinator muscle.
- It enters the oral cavity opposite the second maxillary molar.
Blood Vessels of the Parotid Gland
- This gland is supplied by branches of the external carotid artery.
- The veins from the parotid gland drains into the retromandibular vein, which enters the internal jugular vein.
Lymphatic Drainage of the Parotid Gland
- The lymph vessels of this gland end in the superficial and deep cervical lymph nodes.
Nerves of the Parotid Gland
- These nerves are derived from the auriculotemporal nerve and from the sympathetic and parasympathetic systems.
- The parasympathetic fibres are derived from the glossopharyngeal nerve (CN IX) through the otic ganglion.
- Stimulation of these fibres produces a thin watery (serous) saliva to flow from the parotid duct.
- The sympathetic fibres are derived from the cervical ganglia through the external carotid plexus.
- Stimulation of these fibres produces a thick mucous saliva.
Smooth Muscle
Light microscopic Structure:
cells - long - spindle shaped, nucleus lies in the widest widest part of the fiber, when the fiber contract the nucleus become folded, 30 - 200 µm long,between fibres lie endomycium
Electron microscopic structure:
Mitochondria, ribosomes, golgi, rough EPR, myofilaments are present but no sarcomeres and no Z lines,thin filaments - actin and tropomyosin (7nm), thick filaments - myosin (17nmØ)
- intermediate filaments (10 nm)
- actin and myosin overlap more than in skeletal muscle and can therefore contract more
A rudimentary sacroplasmic reticulum is present in the form of invaginations on the surface called caveolae , So there are no T-tubules, Cells communicate through gap junctions.
Dense bodies
Filaments are attached to dense bodies which take the place of the Z line in skeletal muscle
There are two types of dense bodies - cytoplasmic and membrane
contains a percentage actinin (like the Z line)
dense bodies transmit contractile force to adjacent fibres
Arrangement:
Fibres can be single or in groups, normally arranged in sheaths, In the GIT are 2 or 3 layers
Nerve supply:
2 types:
Where it is arranged in layers a few fibres are innervated together
impulse spread through the gap junctions between fibres (slow contraction)
In the iris and the vas deferens each fiber is individually supplied (quick contraction)
Cardiac Muscle
Fibres anastomose through cross bridges
Fibres are short, connected end to end at intercalated discs, also striated, contract automatically
Light microscopic Structure:
Short fibres connected at intercalated disks, 85 - 100 µm long, 15 µm
same bands as in skeletal muscle, 1 or 2 nuclei - oval and central, in perinuclear area is a sarcoplasmic reticulum, intercalated discs lie at the Z line
Electron microscopic structure:
Between myofibrils lie the mitochondria, 2,5 µm long mitochondria, dense cristae
and are as long as the sarcomere, fibres have more glycogen than skeletal muscle fibres
myofilaments, actin and myosin are the same as in skeletal muscle, the sarcoplasmic reticulum differs in that there is no terminal sisterna. The sarcotubules end in little feet that
sit on the T-tubule
Intercalated Disc:
on Z lines, fibres interdigitate,
3 types of junctions in the disc
Transverse Part:
zonula adherens
desmosomes
Lateral Part:
Gap junctions (nexus) - for impulse transfer
Mechanism of Contraction:
slide - ratchet like in skeletal muscle, certain fibres are modified for conduction, Impulses spread from cell to cell through gap junctions, Purkinje cells are found in the AV bundle
they have less myofibrils, lots of glycogen and intercalated discs
Connective tissue coverings:
Only endomycium in cardiac muscle, Blood vessels, lymph vessels and nerves lie in the endomycium
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.
Nerve Supply of the Muscles of the Orbit (pp. 715-6)
- Three cranial nerves supply the muscles of the eyeball; the oculomotor (CN III), trochlear (CN IV) and abducent (CN IV) nerves.
- All three enter the orbit via the superior orbital fissure.
- The trochlear nerve supplies the superior oblique muscle.
- The abducent nerve supplies the lateral rectus muscle.
- The oculomotor nerve supplies everything else.
- A mnemonic that is used is this formula for this strange sulfate: SO4(LR6)3
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Cartilage model is covered with perichondrium that is converted to periosteum
- Diaphysis-central shaft
- Epiphysis-located at either end of the diaphysis
- Growth in length of the bone is provided by the emetaphyseal plate located between the epiphyseal cartilage and the diaphysis
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Blood capillaries and the mesenchymal cells infiltrate the spaces left by the destroyed chondrocytes
- Osteoblasts are derived from the undifferentiated cells; form an osseous matrix in the cartilage
- Bone appears at the site where there was cartilage
Microscopic structure
- Compact bone is found on the exterior of all bones; canceIlous bone is found in the interior
- Surface of compact bone is covered by periosteum that is attached by Sharpey's fibers
- Blood vessels enter the periosteum via Volkmann's canals and then enter the haversian canals that are formed by the canaliculi and lacunae
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- Marrow
- FiIls spaces of spongy bone
- Contains blood vessels and blood ceIls in various stages of development
- Types
- Red bone marrow
- Formation of red blood ceIls (RBCs) and some white blood cells (WBCs) in this location
- Predominate type of marrow in newborn
- Found in spongy bone of adults (sternum, ribs, vertebrae, and proximal epiphyses of long bones)
- Yellow bone marrow
- Fatty marrow
- Generally replaces red bone marrow in the adult, except in areas mentioned above
- Ossification is completed as the proximal epiphysis joins with the diaphysis between the twentieth and twenty-fifth year