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NEET MDS Lessons
Anatomy

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.

Skull bones

 

  • 26 bones: 22 bones + hyoid (small bone in neck for swallowing) + 3 auditory ossicles (middle ear: incus, malleus, stapes)
  • 21 bones: tightly connected; mandible is freely mobile at temperomandibular joint (synovial)
  • connective-tissue interface b/w bones = suture
  • bones – mandible = cranium
  • cranium
    • neurocranium: covers brain anteriorly, laterally and posteriorly
    • brain supported by bones of basicranium
      • also contributes to interorbital region; b/w eyes and superior to nasal passages
    • viscerocranium/splanchnocranium: bones of face
  • sutures
    • coronal: separates frontal from parietals
    • sagittal: separates two parietal bones
    • lambdoidal: separates parietal form occipital
    • squamosal: b/w temporal and parietal; overlapping sutures
    • At birth: 2 frontal bones which eventually fuse; metopic suture disappears

Cranial Cavities: 5 major cavities

            Endocranial, left and right orbits, nasal cavities, oral cavity, middle ear cavities

Endocranial cavity

  • contains brain, meninges, cerebrospinal fluid, brain’s vascular supply and most proximal portion of cranial nerves
  • enclosed by neurocranium and basicranium
  • basicranium: foramina for neurovascular bundles
  • foramen magnum: spinal cord exit
  • floor of endocranial cavity divide into fossae
    • anterior: frontal lobes of brain
    • middle: pair temporal lobes
    • posterior: cerebellum and brainstem

  • Articulations

    Classified according to their structure, composition,and movability
    •    Fibrous joints-surfaces of bones almost in direct contact with limited movement
        o    Syndesmosis-two bones united by interosseous ligaments
        o    Sutures-serrated margins of bones united by a thin layer of fibrous tissue
        o    Gomphosis-insertion of a cone-shaped process into a socket

    •    Cartilaginous joints-no joint cavity and contiguous bones united by cartilage
        o    Synchondrosis-ends of two bones approximated by hyaline cartilage
        o    Symphyses-approximating bone surfaces connected by fibrocartilage

    •    Synovial joints-approximating bone surfaces covered with cartilage; may be separated by a disk; attached by ligaments 
        o    Hinge-permits motion in one plane only
        o    Pivot-permits rotary movement in which a ring rotates around a central axis
        o    Saddle-opposing surfaces are convexconcave. allowing great freedom of motion
        o    Ball and socket - capable of movement in an infinite number of axes; rounded head of one bone moves in a cuplike cavity of the approximating bone

    Bursae
    •    Sacs filled with synovial fluid that are present where tendons rub against bone or where skjn rubs across bone
    •    Some bursae communicate with a joint cavity 
    •    Prominent bursae found at the elbow. hip, and knee'

    Movements
    •    Gliding
        o    Simplest kind of motion in a joint
        o    Movement on a joint that does not involve any angular or rotary motions
    •    Flexion-decreases the angle formed by the union of two bones
    •    Extension-increases the angle formed by the union of two bones
    •    Abduction-occurs by moving part of the appendicular skeleton away from the median plane of the body
    •    Adduction-occurs by moving part of the appendicular skeleton toward the median plane of the body
    •    Circumduction
        o    Occurs in ball-and-socket joints
        o    Circumscribes the conic space of one bone by the other bone
    •    Rotation-turning on an axis without being displaced from that axis
     

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

Appendicular Skeleton
Upper extremity
•    Shoulder-clavicle and scapula

Clavicle
    Articulates with the manubrium at the sternal end
    Articulates with the scapula at the lateral end
    Slender S-shaped bone that extends horizontally across the upper part of the thorax
    
Scapula

    Triangular bone with the base upward and the apex downward
    Lateral aspect contains the glenoid cavity that articulates with the head of the humerus
    Spine extends across the upper part of the posterior surface; expands laterally and
    forms the acromion (forms point of shoulder) 
    Coracoid process projects anteriorly from the upper part of the neck of the scapula
    
Arm (humerus)

Consists of a shaft (diaphysis) and two ends (epiphyses)
Proximal end has a head that articulates with the glenoid fossa of the scapula
Greater and lesser tubercles lie below the head

Intertubercular groove is located between them; long tendon of the biceps attaches here
Surgical neck is located below the tubercles

    o    Radial groove runs obliquely on the posterior surface; radial nerve is located here

    o    Deltoid muscles attaches in a V-shaped area in the middle of the shaft. called the deltoid tuberosity
    
Distal end has two projections. the medial and lateral epicondyles
Capitulum-articulates with the radius
Trochlea-articulates with the ulqa

Forearm

Radius
Lateral bone of the forearm
Radial tuberosity is located below the head on the medial side
Distal end is broad for articulation with the wrist: has a styloid process on its lateral side

Ulna

    Medial side of the forearm
    Conspicuous part of the elbow joint (olecranon)
    Curved surface that articulates with the trochlea of the humerus is the trochlearnotch
    Lateral ide is concave (radial notch); articulates with the head of the radius Distal end contains the styloid process 
    Distal end contains the styloid process

Hand

Carpal bones (8)
    Aranged in two rows of four
    Scaphoid. lunate. triquetral. and pisiform  proximal row); trapezium. trapezoid.
    capitate. and hamate (distal row)
    
Metacarpal bones (5)
    Framework of the hand
    Numbered 1 to 5 beginning on the lateral side
    
Phalanges (14)
    Fingers
     Three phalanges in each finger; two phalanges in the thumb

 

3 basic functions
o    protection of respiratory tract during swallowing food/air pathways cross.
    epiglottis provides protection
o    control intra-thoracic pressure (in coughing) -    close off airway to build pressure then rapidly open to release stuff
o    production of sound (in speaking, singing, laughing)

Important structures

o    hyoid bone
o    thyroid cartilage
o    arytenoids cartilage: vocal and muscle process
    sits on slope on posterior side of cricoid - spin and slide
o    cricoid cartilage: signet ring
o    thyroepiglottic ligament

Membranes and ligaments

o    membrane: general; ligament: thickening of membrane
o    folds: free edges of membranes or ligaments
o    names: tell you where located

Important membranes:
    quandrangular/vestibular membrane—from epiglottis to arytenoids
•    inferior edge: false vocal fold
    thyrohyoid membrane
    conus elasticus = cricothyroid = cricovocal
•    superior/medial edge = vocal fold
•    vocal ligaments: true folds, top of cricothyroid membrane

Genioglossus Muscle

  • Origin: Mental spine of the mandible.
  • Insertion: Dorsum of the tongue and hyoid bone.
  • Nerve Supply: Hypoglossal nerve (CN XII).
  • Arterial Supply: Sublingual and submental arteries.
  • Action: Depresses and protrudes the tongue.

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