NEET MDS Lessons
Anatomy
Eye
At week 4, two depressions are evident on each of the forebrain hemispheres. As the anterior neural fold closes, the optic pits elongate to form the optic vesicles. The optic vesicles remain connected to the forebrain by optic stalks.
The invagination of the optic vesicles forms a bilayered optic cup. The bilayered cup becomes the dual layered retina (neural and pigmented layer)
Surface ectoderm forms the lens placode, which invaginates with the optic cup.
The optic stalk is deficient ventrally to contain choroids fissure to allow blood vessels into the eye (hyaloid artery). The artery feeds the growing lens, but will its distal portion will eventually degenerate such that the adult lens receives no hyaloid vasculature.
At the 7th week, the choroids fissure closes and walls fuse as the retinal nerve get bigger.
The anterior rim of the optic vesicles forms the retina and iris. The iris is an outgrowth of the distal edge of the retina.
Optic vesicles induces/maintains the development of the lens vesicle, which forms the definitive lens. Following separation of the lens vesicle from the surface ectoderm, the cornea develops in the anterior 1/5th of the eye.
The lens and retina are surrounded by mesenchyme which forms a tough connective tissue, the sclera, that is continuous with the dura mater around the optic nerve.
Iridopupillary membrane forms to separate the anterior and posterior chambers of the eye. The membrane breaks down to allow for the pupil
Mesenchyme surrounding the forming eye forms musculature (ciliary muscles and pupillary muscles – from somitomeres 1 and 2; innervated by CN III), supportive connective tissue elements and vasculature.
Eyelids
Formed by an outgrowth of ectoderm that is fused at its midline in the 2nd trimester, but later reopen.
|
Muscle
|
Emotion
|
|
Epicranius
|
Surprise
|
|
Orbicularisoculi
|
Squinting
|
|
Orbicularisoris |
Pouting |
|
Nasalis
|
Smelling
|
|
Zygomaticus
|
Smiling
|
|
Buccinator
|
Chewing
|
|
Mentalis
|
Doubt
|
|
Triangularis
|
Sadness
|
|
Platysma
|
Sadness
|
|
Masseter
|
Chewing
|
|
Temporalis
|
Sternness
|
|
Pterygoid
|
Conternation
|
|
Genioglossus and Styloglossus
|
Swallowing, Speaking, Chewing
|
The Tongue
- The tongue (L. lingua; G. glossa) is a highly mobile muscular organ that can vary greatly in shape.
- It consists of three parts, a root, body, and tip.
- The tongue is concerned with mastication, taste, deglutition (swallowing), articulation (speech), and oral cleansing.
- Its main functions are squeezing food into the pharynx when swallowing, and forming words during speech.
The Tongue
- The tongue (L. lingua; G. glossa) is a highly mobile muscular organ that can vary greatly in shape.
- It consists of three parts, a root, body, and tip.
- The tongue is concerned with mastication, taste, deglutition (swallowing), articulation (speech), and oral cleansing.
- Its main functions are squeezing food into the pharynx when swallowing, and forming words during speech.
Gross Features of the Tongue
- The dorsum of the tongue is divided by a V-shaped sulcus terminalis into anterior oral (presulcal) and posterior pharyngeal (postsulcal) parts.
- The apex of the V is posterior and the two limbs diverge anteriorly.
- The oral part forms about 2/3 of the tongue and the pharyngeal part forms about 1/3.
Oral Part of the Tongue
- This part is freely movable, but it is loosely attached to the floor of the mouth by the lingual frenulum.
- On each side of the frenulum is a deep lingual vein, visible as a blue line.
- It begins at the tip of the tongue and runs posteriorly.
- All the veins on one side of the tongue unite at the posterior border of the hyoglossus muscle to form the lingual vein, which joins the facial vein or the internal jugular vein.
- On the dorsum of the oral part of the tongue is a median groove.
- This groove represents the site of fusion of the distal tongue buds during embryonic development.
The Lingual Papillae and Taste Buds
- The filiform papillae (L. filum, thread) are numerous, rough, and thread-like.
- They are arranged in rows parallel to the sulcus terminalis.
- The fungiform papillae are small and mushroom-shaped.
- They usually appear are pink or red spots.
- The vallate (circumvallate) papillae are surrounded by a deep, circular trench (trough), the walls of which are studded with taste buds.
- The foliate papillae are small lateral folds of lingual mucosa that are poorly formed in humans.
- The vallate, foliate and most of the fungiform papillae contain taste receptors, which are located in the taste buds.
The Pharyngeal Part of the Tongue
- This part lies posterior to the sulcus terminalis and palatoglossal arches.
- Its mucous membrane has no papillae.
- The underlying nodules of lymphoid tissue give this part of the tongue a cobblestone appearance.
- The lymphoid nodules (lingual follicles) are collectively known as the lingual tonsil.
The Auditory Ossicles
The Malleus
- Its superior part, the head, lies in the epitympanic recess.
- The head articulates with the incus.
- The neck, lies against the flaccid part of the tympanic membrane.
- The chorda tympani nerve crosses the medial surface of the neck of the malleus.
- The handle of the malleus (L. hammer) is embedded in the tympanic membrane and moves with it.
- The tendon of the tensor tympani muscle inserts into the handle.
The Incus
- Its large body lies in the epitympanic recess where it articulates with the head of the malleus.
- The long process of the incus (L. an anvil) articulates with the stapes.
- The short process is connected by a ligament to the posterior wall of the tympanic cavity.
The Stapes
- The base (footplate) of the stapes (L. a stirrup), the smallest ossicle, fits into the fenestra vestibuli or oval window on the medial wall of the tympanic cavity.
Functions of the Auditory Ossicles
- The auditory ossicles increase the force but decrease the amplitude of the vibrations transmitted from the tympanic membrane.
- The tongue is divided into halves by a medial fibrous lingual septum that lies deep to the medial groove.
- In each half of the tongue there are four extrinsic and four intrinsic muscles.
- The lingual muscles are all supplied by the hypoglossal nerve (CN XII).
- The only exception is palatoglossus, which is supplied by the pharyngeal branch of the vagus nerve, via the pharyngeal plexus.
The Medial Pterygoid Muscle
- This is a thick, quadrilateral muscle that also has two heads or origin.
- It embraces the inferior head of the lateral pterygoid muscle.
- It is located deep to the ramus of the mandible.
- Origin: deep head—medial surface of lateral pterygoid plate and pyramidal process of palatine bone, superficial head—tuberosity of maxilla.
- Insertion: medial surface of ramus of mandible, inferior to mandibular foramen.
- Innervation: mandibular nerve via medial pterygoid nerve.
- It helps to elevate the mandible and closes the jaws.
- Acting together, they help to protrude the mandible.
- Acting alone, it protrudes the side of the jaw.
- Acting alternately, they produce a grinding motion.