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Anatomy

Muscles of the Soft Palate

The Levator Veli Palatini (Levator Palati)

  • Superior attachment: cartilage of the auditory tube and petrous part of temporal bone.
  • Inferior attachment: palatine aponeurosis.
  • Innervation: pharyngeal branch of vagus via pharyngeal plexus.
  • This cylindrical muscle runs inferoanteriorly, spreading out in the soft palate, where it attaches to the superior surface of the palatine aponeurosis.
  • It elevates the soft palate, drawing it superiorly and posteriorly.
  • It also opens the auditory tube to equalise air pressure in the middle ear and pharynx.

 

The Tensor Veli Palatini (Tensor Palati)

  • Superior attachment: scaphoid fossa of medial pterygoid plate, spine of sphenoid bone, and cartilage of auditory tube.
  • Inferior attachment: palatine aponeurosis.
  • Innervation: medial pterygoid nerve (a branch of the mandibular nerve).
  • This thin, triangular muscle passes inferiorly, and hooks around the hamulus of the medial pterygoid plate.
  • It then inserts into the palatine aponeurosis.
  • This muscle tenses the soft palate by using the hamulus as a pulley.
  • It also pulls the membranous portion of the auditory tube open to equalise air pressure of the middle ear and pharynx.

 

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.

 

The Palatopharyngeus Muscle

  • Superior attachment: hard palate and palatine aponeurosis.
  • Inferior attachment: lateral wall of pharynx.
  • Innervation: cranial part of accessory nerve (CN XI) through the pharyngeal branch of vagus (CN X) via the pharyngeal plexus.
  • This thin, flat muscle is covered with mucous membrane to form the palatopharyngeal arch.
  • It passes posteroinferiorly in this arch.
  • This muscle tenses the soft palate and pulls the walls of the pharynx superiorly, anteriorly and medially during swallowing.

 

The Musculus Uvulae

  • Superior attachment: posterior nasal spine and palatine aponeurosis.
  • Inferior attachment: mucosa of uvula.
  • Innervation: cranial part of accessory through the pharyngeal branch of vagus, via the pharyngeal plexus.
  • It passes posteriorly on each side of the median plane and inserts into the mucosa of the uvula.
  • When the muscle contracts, it shortens the uvula and pulls it superiorly.

The Articular Capsule

  • The capsule of this joint is loose.
  • The thin fibrous capsule is attached to the margins of the articular area on the temporal bone and around the neck of the mandible.

Sternum

o    Forms the medial part of the anterior chest wall
o    Manubrium (upper part)-clavicle and first rib articulate with the manubrium .
o    Body (middle blade)-second and tenth ribs articulate with the body via the costal cartilages
o    Xiphoid (blunt cartilaginous tip)

Ribs (12 pairs)

o    Each rib articulates with both the body and the transverse process of its corresponding
o    thoracic vertebra
o    The second to ninth ribs articulate with the body of the vertebra above'
o    Ribs curve outward, forward, and then downward
o    Anteriorly, each of the first seven ribs joins a costal cartilage that attaches to the sternum
o    Next three ribs (eighth to tenth) join the cartilage of the rib above
o    Eleventh and twelfth ribs do not attach to the sternum; are called "floating ribs"

 

The Orbital Margin

  • The frontal, maxillary and zygomatic bones contribute equally to the formation of the orbital margin.
  • The supraorbital margin is composed entirely of the frontal bone.
  • At the junction of its medial and middle thirds is the supraorbital foramen (sometimes a notch), which transmits the supraorbital nerves and vessels.
  • The lateral orbital margin is formed almost entirely of the frontal process of the zygomatic bone.
  • The infraorbital margin is formed by the zygomatic bone laterally and the maxilla medially.
  • The medial orbital margin is formed superiorly by the frontal bone and inferiorly by the lacrimal crest of the frontal process of the maxilla.
  • This margin is distinct in its inferior half only.

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.

Intrinsic muscles

    all innervated by recurrent laryngeal nerve except cricothyroid: external laryngeal nerve
    adductors of vocal folds: bring folds together at midline

    Transverse and oblique arytenoids: pull arytenoids together
    Lateral cricoartenoids: spin and slide arytenoids up
    only one abductor of vocal folds
    
    Posterior cricoarytenoids—down and up
    adjustors of shape and tension of vocal folds

    Cricothyroid muscle
    
o    superficial to lateral cricoarytenoid
o    tenses vocal folds by tilting thyroid cartilage forward and sliding forward

    Thyroartenoid and vocalis muscles
    
o    vocalis: sometimes treated as medial most fibers of thyroartenoid muscle
o    different fiber directions
    
    lateral: adduct
    medial: change shape of folds
    control voice by bring bringing together different parts of folds


o    as move from epithelium to vocalis muscle, fold becomes stiffer
o    near connections, vocal folds are stiffer
o    vocal fold: complex, multilayered vibrator

  • Bones begin to form during the eighth week of embryomic life in the fibrous membranes (intramembranous ossification) and hyaline cartilage (endochondral ossification)

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