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Anatomy

Mylohyoid Muscle

  • Origin: Mylohyoid line of the mandible.
  • Insertion: Median raphe and body of the hyoid bone.
  • Nerve Supply: Nerve to mylohyoid (branch of the trigeminal nerve, CN V3).
  • Arterial Supply: Sublingual branch of the lingual artery and submental branch of the facial artery.
  • Action: Elevates the hyoid bone, base of the tongue, and floor of the mouth; depresses the mandible.

Geniohyoid Muscle

  • Origin: Inferior genial tubercles of the mandible.
  • Insertion: Anterior surface of the body of the hyoid bone.
  • Nerve Supply: Branch of C1 through the hypoglossal nerve (CN XII).
  • Arterial Supply: Sublingual branch of the lingual artery.
  • Action: Elevates the hyoid bone and depresses the mandible.

Levator Palpebrae Superioris Muscles

  • This is a thin, triangular muscle that elevates the upper eyelid.
  • It is continuously active except during sleeping and when the eye is closing.
  • Origin: roof of orbit, anterior to the optic canal.
  • Insertion: this muscle fans out into a wide aponeurosis that inserts into the skin of the upper eyelid. The inferior part of the aponeurosis contains some smooth muscle fibres that insert into the tarsal plate.
  • Innervation: the superior fibres are innervated by the oculomotor nerve (CN III), and the smooth muscle component is innervated by fibres of the cervical sympathetic trunk and the internal carotid plexus.

 

Illnesses involving the Levator Palpebrae Superioris

  • In third nerve palsy, the upper eyelid droops (ptosis) and cannot be raised voluntarily.
  • This results from damage to the oculomotor nerve (CN III), which supplies this muscle.
  • If the cervical sympathetic trunk is interrupted, the smooth muscle component of the levator palpebrae superioris is paralysed and also causes ptosis.
  • This is part of Horner's syndrome.

 

The Rectus Muscles

 

  • There are four rectus muscles (L. rectus, straight), superior, inferior, medial and lateral.
  • These arise from a tough tendinous cuff, called the common tendinous ring, which surrounds the optic canal and the junction of the superior and inferior orbital fissures.
  • From their common origin, these muscles run anteriorly, close to the walls of the orbit, and attach to the eyeball just posterior to the sclerocorneal junction.
  • The medial and lateral rectus muscles attach to the medial and lateral sides of the eyeball respectively, on the horizontal axis.
  • However, the superior rectus attaches to the anterosuperior aspect of the medial side of the eyeball while the inferior rectus attaches to the anteroinferior aspect of the medial side of the eye.

 

The Oblique Muscles

The Superior Oblique Muscle

  • This muscle arises from the body of the sphenoid bone, superomedial to the common tendinous ring.
  • It passes anteriorly, superior and medial to the superior and medial rectus muscles.
  • It ends as a round tendon that runs through a pulley-like loop called the trochlea (L. pulley).
  • After passing though the trochlea, the tendon of the superior oblique turns posterolaterally and inserts into the sclera at the posterosuperior aspect of the lateral side of the eyeball.

 

The Inferior Oblique Muscle

  • This muscle arises from the maxilla in the floor of the orbit.
  • It passes laterally and posteriorly, inferior to the inferior rectus muscle.
  • It inserts into the sclera at the posteroinferior aspect of the lateral side of the eyeball.

The Eye and Orbit

  • The orbit (eye socket) appears as a bony recess in the skull when it is viewed from anteriorly.
  • It almost surrounds the eye and their associated muscles, nerves and vessels, together with the lacrimal apparatus.
  • The orbit is shaped somewhat like a four-side pyramid lying on its side, with its apex pointing posteriorly and its base anteriorly.

 

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.

Classified on functional Basis

Secretion ,Protection and waterproofing, Absorbtion, Transport, Sensory

Secretion

Glandular epithelium’s 3 types:

- Exocrine - with ducts

- endocrine - without ducts

- mixed exo-endocrine

Exocrine glands: One cell

- goblet cells

- In lining epitheliums of respiratory tract and GIT

- Secretes musin (protein) Musin + water = mucus, Mucus is a lubricant

More than one cell

 Simple:  Has a single duct,

  • Acinar - mucus glands of the penile urethra
  • Tubular - cripts of Lieberkuhn
  • Coiled tubular - sweat gland
  • Spiral tubular - Gland of Moll
  • Branched tubular - mucous glands of the pyloric region
  • Branched acinar - sebaceous gland in the skin

Compound

  • Consists of a branched duct with numerous secretory end organs
  • Compound tubular - Brünners glands
  • Compound alveolar - mammary, prostate, pancreas, parotid
  • Compound tubuloalveolar - submandibular-, sublingual salivary glands

Endocrine glands

Secrete directly into the blood

One cell :  mast cells,  in soft CT,  near capillaries,

secrete - heparin - histamine

More than one cell

Cells can be arranged in the following ways:

  • Cords - adrenal glands, parathyroid, anterior pituitary
  • anastomosing cords with dilated blood capillaries in-between
  • Isles - pancreas
  • Follicles - thyroid
  • cells line a follicle filled with non-cellular material

  • The six muscles rotate the eyeball in the orbit around three axes (sagittal, horizontal and vertical).
  • The action of the muscles can be deduced by their site of insertion on the eyeball.
Muscle Action(s) on the Eyeball Nerve Supply
Medial Rectus Adducts CN III
Lateral Rectus Abducts CN VI
Superior Rectus Elevates, adducts, and medially rotates CN III
Inferior Rectus Depresses, adducts, and laterally rotates CN III
Superior Oblique Depresses, abducts, and medially rotates CN IV
Inferior Oblique Elevates, abducts, and laterally rotates CN III

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