NEET MDS Lessons
Anatomy
Muscles Around the Eyelids
- The function of the eyelid (L. palpebrae) is to protect the eye from injury and excessive light. It also keeps the cornea moist.
The Orbicularis Oculi Muscle
- This is the sphincter muscle of the eye.
- Its fibres sweep in concentric circles around the orbital margin and eyelids.
- It narrows the eye and helps the flow of tears from the lacrimal sac.
- This muscle has 3 parts: (1) a thick orbital part for closing the eyes to protect then from light and dust; (2) a thin palpebral part for closing the eyelids lightly to keep the cornea from drying; and (3) a lacrimal part for drawing the eyelids and lacrimal punta medially.
- When all three parts of the orbicularis oculi contract, the eyes are firmly closed and the adjacent skin becomes wrinkled.
- The zygomatic branch of the facial nerve (CN VII) supplies it.
The Levator Palpebrae Superioris Muscle
- This muscle raises the upper eyelid to open the palpebral fissure.
- It is supplied by the oculomotor nerve (CN III).
- This is the posterior curtain-like part, and has no bony support. It does, however, contain a membranous aponeurosis.
- The soft palate, or velum palatinum (L. velum, veil), is a movable, fibromuscular fold that is attached to the posterior edge of the hard palate.
- It extends posteroinferiorly to a curved free margin from which hangs a conical process, the uvula (L. uva, grape).
- The soft palate separates the nasopharynx superiorly and the oropharynx inferiorly.
- During swallowing the soft palate moves posteriorly against the wall of the pharynx, preventing the regurgitation of food into the nasal cavity.
- Laterally, the soft palate is continuous with the wall of the pharynx and is joined to the tongue and pharynx by the palatoglossal and palatopharyngeal folds.
- The soft palate is strengthened by the palatine aponeurosis, formed by the expanded tendon of the tensor veli palatini muscle.
- This aponeurosis attaches to the posterior margin of the hard palate.
The Arteries of the Face
- The superficial arteries are derived from the external carotid arteries.
The Facial Artery
- This is the chief artery of the face.
- It arises from the external carotid artery and winds its way to the inferior border of the mandible, just anterior to the masseter muscle.
- It hooks around the inferior border of the mandible and grooves the bone. Here the artery is superficial, just beneath the platysma and its pulsation can be felt.
- In its course over the face to the medial angle of the eye, the facial artery crosses the mandible, buccinator muscle, and maxilla.
- It lies deep to the zygomaticus major.
- The facial artery ends by sending branches to the lip and side of the nose.
- The part of the artery that runs along the side of the nose to supply the eyelids is called the angular artery.
The Superficial Temporal Artery
- This artery is the smaller of the two terminal branches of the external carotid artery (the other is the maxillary artery).
- It begins deep to the parotid gland, posterior to the neck of the mandible, and ascends superficial to the posterior end of the zygomatic process of the temporal bone. It then enters the temporal fossa.
- The superficial temporal artery ends in the scalp by dividing into the frontal and parietal branches.
- Pulsation of this artery can be felt by compressing the root of the zygomatic process of the temporal bone.
The Transverse Facial Artery
- This small artery arises from the superficial temporal artery before it emerges from the parotid gland.
- It crosses the face superficial to the masseter muscle, about a fingerbreadth inferior to the zygomatic arch.
- It divides into numerous branches that supply the parotid gland and duct, the masseter muscle, and the skin of the face.
- It anastomoses with branches of the facial artery.
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.
Intramembranous ossification
- Flat bones develop in this way (bones of the skull)
- This type of bone development takes place in mesenchymal tissue
- Mesenchymal cells condense to form a primary ossification centre (blastema)
- Some of the condensed mesenchymal cells change to osteoprogenitor cells
- Osteoprogenitor cells change into osteoblasts which start to deposit bone
- As the osteoblasts deposit bone some of them become trapped in lacunae in the bone and then change into osteocytes
- Osteoblasts lie on the surface of the newly formed bone
- As more and more bone is deposited more and more osteocytes are formed from mesenchymal cells
- The bone that is formed is called a spicule
- This process takes place in many places simultaneously
- The spicules fuse to form trabeculae
- Blood vessels grow into the spaces between the trabeculae
- Mesenchymal cells in the spaces give rise to hemopoetic tissue
- This type of bone development forms the first phase in endochondral development
- It is also responsible for the growth of short bones and the thickening of long bones
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
The Palate
- The palate forms the arched roof of the mouth and the floor of the nasal cavities.
- The palate consists of two regions: the anterior 2/3 or bony part, called the hard palate, and the mobile posterior 1/3 or fibromuscular part, known as the soft palate.
The Hard Palate
- The anterior bony part of the palate is formed by the palatine process of the maxillae and the horizontal plates of the palatine bones.
- Anteriorly and laterally, the hard palate is bounded by the alveolar processes and the gingivae.
- Posteriorly, the hard palate is continuous with the soft palate.
- The incisive foramen is the mouth of the incisive canal.
- This foramen is located posterior to the maxillary central incisor teeth.
- This foramen is the common opening for the right and left incisive canals.
- The incisive canal and foramen transmit the nasopalatine nerve and the terminal branches of the sphenopalatine artery.
- Medial to the third molar tooth, the greater palatine foramen pierces the lateral border of the bony palate.
- The greater palatine vessels and nerve emerge from this foramen and run anteriorly into two grooves on the palate.
- The lesser palatine foramen transmits the lesser palatine nerve and vessels.
- This runs to the soft palate and adjacent structures.