Extrinsic Muscles of the Tongue (p. 746)

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 Palatoglossus Muscle 

• Superior attachment: palatine aponeurosis.
• Inferior attachment: side of tongue.
• Innervation: cranial part of accessory nerve (CN XI) through the pharyngeal branch of vagus (CN X) via the pharyngeal plexus.

• This muscle, covered by mucous membrane, forms the palatoglossal arch.

• The palatoglossus elevates the posterior part of the tongue and draws the soft palate inferiorly onto the tongue.

-> This is a wedge-shaped bone (G. sphen, wedge) is located anteriorly to the temporal bones.
-> It is a key bone in the cranium because it articulates with eight bones (frontal, parietal, temporal, occipital, vomer, zygomatic, palatine, and ethmoid).
-> It main parts are the body and the greater and lesser wings, which spread laterally from the body.
-> The superior surface of its body is shaped like a Turkish saddle (L. sella, a saddle); hence its name sella turcica.
-> It forms the hypophyseal fossa which contains the hypophysis cerebri or pituitary gland.
-> The sella turcica is bounded posteriorly by the dorsum sellae, a square plate of bone that projects superiorly and has a posterior clinoid process on each side.
-> Inside the body of the sphenoid bone, there are right and left sphenoid sinuses. The floor of the sella turcica forms the roof of these paranasal sinuses.
-> Studies of the sella turcica and hypophyseal fossa in radiographs or by other imaging techniques are important because they may reflect pathological changes such as a pituitary tumour or an aneurysm of the internal carotid artery. Decalcification of the dorsum sellae is one of the signs of a generalised increase in intracranial pressure.

The Ear

• The ear contains the vestibulocochlear organ and consists of three main parts: external, middle, and internal.
• It has two functions, balance and hearing.

• The tympanic membrane (eardrum) separates the external ear from the middle ear.
• The auditory tube joins the middle ear or tympanic cavity to the nasopharynx.

•  Provides a rigid support system
• Protects delicate structures (e. g., the protection provided by the bones of the vertebral column to the spinal cord)
• Bones supply calcium to the blood; are involved In the formation of blood cells (hemopoiesis)
• Bones serve as the basis of attachment of muscles; form levers in the joint areas, aIlowing movement

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.