NEET MDS Lessons
Anatomy
The Muscles of Facial Expression
- These lie in the subcutaneous tissue and are attached to the skin of the face.
- They enable us to move our skin and change our facial expression. They produce their effects by pulling on the skin but do not move the facial skeleton.
- These muscles surround the facial orifices and act as sphincters and dilators.
- All facial muscles receive their innervation from the branches of the facial nerve (CN VII)-temporal, zygomatic, buccal, marginal mandibular, cervical.
The Masseter Muscle
- This is a quadrangular muscle that covers the lateral aspect of the ramus and the coronoid process of the mandible.
- Origin: inferior border and medial surface of zygomatic arch.
- Insertion: lateral surface of ramus of mandible and its coronoid process.
- Innervation: mandibular nerve via masseteric nerve that enters its deep surface.
- It elevates and protrudes the mandible, closes the jaws and the deep fibres retrude it.
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.
Hip
Constitutes the pelvic girdle
United with the vertebral column
Union of three parts that is marked by a cup shaped cavity (acetabulum) Ilium
• Prominence of the hip
• Superior border is the crest
• Anterosuperior spine-projection at the anterior tip of the crest
• Corresponding projections on the posterior part are the posterosuperior and posteroinferior iliac spines
• Greater sciatic notch-located beneath the posterior part
• Most is a smooth concavity (iliac fossa)
• Posteriorly it is rough and articulates with the sacrum in the formation of the sacroiliac joint
Pubic bone
Anterior part of the innominate bone
Symphysis pubic-joining of the two pubic bones at the midline
Body and two rami
• Body forms one fifth of the acetabulum
• Superior ramis extends from the body to the median plane: superior border forms the pubic crest
• Inferior ramus extends downward and meets with the ischium
• Pubic arch is formed by the inferior rami of both pubic hones
Ischium
Forms the lower and back part of the innominate bone
Body
• Forms two fifths of the accrabulum
• Ischial tuberosiry-supports the body in a sitting position
• Ramus-passes upward to join the inferior ramus of rhe pubis; known as rhe obturator foramen
Pelvis
Fanned by the right and left hip bones, sacrum, and coccyx
Greater pelvis
o Bounded by the ilia and lower lumbar vertebrae
o Gives support to the abdominal viscera
Lesser pelvis
o Brim of the pelvis corresponds to the sacral promontory
o Inferior outlet is bounded by the tip of the coccyx, ischial tuberosities, and inferior rami of the pubic bones
Female pelvis
o Shows adaptations related to functions as a birth canal Wide outlet
o Angle of the pubic arch is obtuse
Male pelvis
o Shows adaptations that contribute to power and speed
o Heart-shaped outlet
o Angle of the pubic arch is acute
Thigh
Femur-longest and strongest bone of the body
Proximal end has a rounded head that articulates with the acetabulum
Constricted portion-the neck
Greater and lesser trochanters
Slightly arched shaft; is concave posteriorly
o Linea aspera-strengthened by this prominent ridge
o Site of attachment for several muscles
Distal end has two condyles separated on the posterior side by the intercondyloid notch
Knee cap
Patella-sesamoid bone
Embedded in the tendon of the quadriceps muscle
Articulates with the femur
Leg
Tibia-medial bone
o Proximal end has two condyles that articulate with the femur
o Triangular shaft
Anterior-shin
Posterior-soleal line
Distal-medial malleolus that articulates with the latus to form the ankle joint
Fibula-lateral bone
o Articulates with the lateral condyle of the tibia but does not enter the knee joint
o Distal end projects as the lateral malleolus
Ankle, foot, and toes
Adapted for supporting weight but similar in structure to the hand
Talus
o Occupies the uppennost and central position in the tarsus
o Distributes the body weight from the tibia above to the other tarsal bones
Calcaneus (heel)-Iocated beneath the talus
Navicular-located in front of the talus on the medial side; articulates with three cuneifonn bones distally
Cuboid-lies along the lateral border of the navicular bone
Metatarsals
o First, second, and third p1etatarsals lie in front of the three cuneifonn bones
o (2) Fourth and fifth metatarsals lie in front of the cuboid bone
Phalanges
o Distal to the metatarsals
o (2) Two in the great toe; three in each of the other four toes .
Longitudinal arches in the foot (2)
o Lateral-fonned by the calcaneus, talus, cuboid, and fourth and fifth metatarsal bones
o Medial-fonned by the calcaneus, talus, navicular, cuneifonn, and first, second, and third metatarsal bones
Transverse arches-formed by the tarsal and metatarsal bones
The Oropharynx
- The oral part of the pharynx has a digestive function.
- It is continuous with the oral cavity through the oropharyngeal isthmus.
- The oropharynx is bounded by the soft palate superiorly, the base of the tongue inferiorly, and the palatoglossal and palatopharyngeal arches laterally.
- It extends from the soft palate to the superior border of the epiglottis.
The Palatine Tonsils
- These are usually referred to as "the tonsils".
- They are collections of lymphoid tissue the lie on each side of the oropharynx in the triangular interval between the palatine arches.
- The palatine tonsils vary in size from person to person.
- In children, the palatine tonsils tend to be large, whereas in older persons they are usual small and inconspicuous.
- The visible part of the tonsil is no guide to its actual size because much of it may be hidden by the tongue and buried in the soft palate.
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
The External Ear
- The auricle (L. auris, ear) is the visible, shell-like part of the external ear.
- It consists of a single elastic cartilage that is covered on both surfaces with thin, hairy skin.
- The external ear contains hairs, sweat glands, and sebaceous glands.
- The cartilage is irregularly ridged and hollowed, which gives the auricle its shell-like form.
- It also shapes the orifice of the external acoustic meatus.
The Ear Lobule
- The ear lobule (earlobe) consists of fibrous tissue, fat and blood vessels that are covered with skin.
- The arteries are derived mainly from the posterior auricular artery and the superficial temporal artery.
- The skin of the auricle is supplied by the great auricular and auriculotemporal nerves.
- The great auricular nerve supplies the superior surface and the lateral surface inferior to the external acoustic meatus with nerve fibres from C2.
- The auriculotemporal nerve supplies the skin of the auricle superior to the external acoustic meatus.
The External Acoustic Meatus
- This passage extends from the concha (L. shell) of the auricle to the tympanic membrane (L. tympanum, tambourine). It is about 2.5 cm long in adults.
- The lateral 1/3 of the S-shaped canal is cartilaginous, whereas its medial 2/3 is bony.
- The lateral third of the meatus is lined with the skin of the auricle and contains hair follicles, sebaceous glands, and ceruminous glands.
- The latter glands produce cerumen (L. cera, wax).
- The medial two-thirds of the meatus is lined with very thin skin that is continuous with the external layer of the tympanic membrane.
- The lateral end of the meatus is the widest part. It has the diameter about that of a pencil.
- The meatus becomes narrow at its medial end, about 4 mm from the tympanic membrane.
- The constricted bony part is called the isthmus.
- Innervation of the external acoustic meatus is derived from three cranial nerves:
- The auricular branch of the auriculotemporal nerve (derived from the mandibular, CN V3).
- The facial nerve (CN VII) by the branches from the tympanic plexus.
- The auricular branch of the vagus nerve (CN X).
The Tympanic Membrane
- This is a thin, semi-transparent, oval membrane at the medial end of the external acoustic meatus.
- It forms a partition between the external and middle ears.
- The tympanic membrane is a thin fibrous membrane, that is covered with very thin skin externally and mucous membrane internally.
- The tympanic membrane shows a concavity toward the meatus with a central depression, the umbo, which is formed by the end of the handle of the malleus.
- From the umbo, a bright area referred to as the cone of light, radiates anteroinferiorly.
- The external surface of the tympanic membrane is supplied by the auriculotemporal nerve.
- Some innervation is supplied by a small auricular branch of the vagus nerve (CN X); this nerve may also contain some glossopharyngeal and facial nerve fibres.