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Anatomy

The Soft Palate

  • 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.

  • Skull 
    Cranium
    o    Superior portion formed by the frontal. parietal, and occipital bones
    o    Lateral portions formed by the temporal and sphenoid bones
    o    Cranial base formed by the temporal. sphenoid, and ethmoid bones
    o    Fontanels-soft spots in which ossification is incomplete at birth

    Frontal bone
    o    Forms the forehead
    o    Contains the frontal sinuses
    o    Forms the roof of the orbits
    o    Union with the parietal bones forms the coronal suture

    Parietal bones
    o    Union with the occipital bone forms the lambdoid suture
    o    Union with the temporal bone forms the squamous suture
    o    Union with the sphenoid bone forms the coronal suture

    Temporal bones
    o    Contains the external auditory meatus and middle and inner ear structures
    o    Squamous portion-above the meatus: zygomatic process-articulates with the zygoma
    o    to form the zygomatic arch 

    •    Petrous portion
    o    Contains organs of hearing and equilibrium 
    o    Prominent elevation on the floor of the cranium

    •    Mastoid portion
    o    Protuberance behind the ear

    o    Mastoid process
    •    Glenoid fossa-articulates with the condyle on the mandible
    •    Styloid process-anterior to the mastoid process; several neck muscles attach here
    •    Stylomastoid foramen-located between the styloid and mastoid processes; facial nerve emerges through this opening
    •    Jugular foramen-located between the petrous portion and the occipital bone: cranial nerves IX. X, and XI exit
     

 

  • Articulations

    Classified according to their structure, composition,and movability
    •    Fibrous joints-surfaces of bones almost in direct contact with limited movement
        o    Syndesmosis-two bones united by interosseous ligaments
        o    Sutures-serrated margins of bones united by a thin layer of fibrous tissue
        o    Gomphosis-insertion of a cone-shaped process into a socket

    •    Cartilaginous joints-no joint cavity and contiguous bones united by cartilage
        o    Synchondrosis-ends of two bones approximated by hyaline cartilage
        o    Symphyses-approximating bone surfaces connected by fibrocartilage

    •    Synovial joints-approximating bone surfaces covered with cartilage; may be separated by a disk; attached by ligaments 
        o    Hinge-permits motion in one plane only
        o    Pivot-permits rotary movement in which a ring rotates around a central axis
        o    Saddle-opposing surfaces are convexconcave. allowing great freedom of motion
        o    Ball and socket - capable of movement in an infinite number of axes; rounded head of one bone moves in a cuplike cavity of the approximating bone

    Bursae
    •    Sacs filled with synovial fluid that are present where tendons rub against bone or where skjn rubs across bone
    •    Some bursae communicate with a joint cavity 
    •    Prominent bursae found at the elbow. hip, and knee'

    Movements
    •    Gliding
        o    Simplest kind of motion in a joint
        o    Movement on a joint that does not involve any angular or rotary motions
    •    Flexion-decreases the angle formed by the union of two bones
    •    Extension-increases the angle formed by the union of two bones
    •    Abduction-occurs by moving part of the appendicular skeleton away from the median plane of the body
    •    Adduction-occurs by moving part of the appendicular skeleton toward the median plane of the body
    •    Circumduction
        o    Occurs in ball-and-socket joints
        o    Circumscribes the conic space of one bone by the other bone
    •    Rotation-turning on an axis without being displaced from that axis
     

The Medial Wall of the Orbit 

  • This wall is paper-thin and is formed by the orbital lamina or lamina papyracea of the ethmoid bone, along with contributions from the frontal, lacrimal, and sphenoid bones (L. papyraceus, "made of papyrus" or parchment paper).
  • There is a vertical lacrimal groove in the medial wall, which is formed anteriorly by the maxilla and posteriorly by the lacrimal bone.
  • It forms a fossa for the lacrimal sac and the adjacent part of the nasolacrimal duct.
  • Along the suture between the ethmoid and frontal bones are two small foramina; the anterior and posterior ethmoidal foramina.
  • These transmit nerves and vessels of the same name.

The Oral Cavity

  • The oral cavity (mouth) consists of two parts: the vestibule and the mouth proper.
  • The vestibule is the slit-like spaced between the cheeks and the lips and the teeth and gingivae.
  • It is the entrance of the digestive tract and is also used for breathing.
  • The vestibule communicates with the exterior through the orifice of the mouth.
  • The oral cavity is bounded:
  • Externally: by the cheeks and lips.
  • Roof of oral cavity: formed by the palate.
  • Posteriorly: the oral cavity communicates with the oropharynx.

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.

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.

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