NEET MDS Lessons
Anatomy
Initially, four clefts exist; however, only one gives rise to a definite structure in adults.
1st pharyngeal cleft |
Penetrates underlying mesenchyme and forms EAM. The bottom of EAM forms lateral aspect of tympanic cavity. |
2nd pharyngeal cleft |
Undergoes active proliferation and overlaps remaining clefts. It merges with ectoderm of lower neck such that the remaining clefts lose contact with outside. Temporarily, the clefts form an ectodermally lined cavity, the cervical sinus, but this disappears during development. |
The Laryngopharynx
- The laryngeal part of the pharynx lies posterior to the larynx.
- It extends from the superior border of the epiglottis to the inferior border of the cricoid cartilage, where it narrows to become continuous with the oesophagus.
- Posteriorly, the laryngopharynx is related to the bodies of C4 to C6 vertebrae.
- Its posterior and lateral walls are formed by the middle and inferior constrictor muscles, with the palatopharyngeus and stylopharyngeus internally.
- The laryngopharynx communicates with the larynx through the aditus or inlet of the larynx.
- The piriform recess is a small, pear-shaped depression of the laryngopharyngeal cavity on each side of the inlet of the larynx.
The Temporomandibular Joint
- This articulation is a modified hinge type of synovial joint.
- The articular surfaces are: (1) the head or condyle of the mandible inferiorly and (2) the articular tubercle and the mandibular fossa of the squamous part of the temporal bone.
- An oval fibrocartilaginous articular disc divides the joint cavity into superior and inferior compartments. The disc is fused to the articular capsule surrounding the joint.
- The articular disc is more firmly bound to the mandible than to the temporal bone.
- Thus, when the head of the mandible slides anterior on the articular tubercle as the mouth is opened, the articular disc slides anteriorly against the posterior surface of the articular tubercle
The External Nose
- Noses vary considerably in size and shape, mainly as a result of the differences in the nasal cartilages and the depth of the glabella.
- The inferior surface of the nose is pierced by two apertures, called the anterior nares (L. nostrils).
- These are separated from each other by the nasal septum (septum nasi).
- Each naris is bounded laterally by an ala (L. wing), i.e., the side of the nose.
- The posterior nares apertures or choanae open into the nasopharynx.
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.
- Provides a rigid support system
- Protects delicate structures (e. g., the protection provided by the bones of the vertebral column to the spinal cord)
- Bones supply calcium to the blood; are involved In the formation of blood cells (hemopoiesis)
- Bones serve as the basis of attachment of muscles; form levers in the joint areas, aIlowing movement
The Cheeks
- The cheeks (L. buccae) form the lateral wall of the vestibule of the oral cavity.
- They have essentially the same structure as the lips with which they are continuous.
- The principal muscular component of the cheeks is the buccinator muscle.
- Superficial to the fascia covering this muscle is the buccal fatpad that gives cheeks their rounded contour, especially in infants.
- The lips and cheeks act as a functional unit (e.g. during sucking, blowing, eating, etc.).
- They act as an oral sphincter in pushing food from the vestibule to the oral cavity proper.
- The tongue and buccinator muscle keep the food between the molar teeth during chewing.
Sensory Nerves of the Cheeks
- These are branches of the maxillary and mandibular nerves.
- They supply the skin of the cheeks and the mucous membrane lining the cheeks.