NEET MDS Lessons
Anatomy
->The sides and base of the skull are formed partly by these bones.
->Each bone consists of four morphologically distinct parts that fuse during development (squamous, petromastoid, and tympanic parts and the styloid process).
->The flat squamous part is external to the lateral surface of the temporal lobe of the brain.
->The petromastoid part encloses the internal ear and mastoid cells and forms part of the base of the skull.
->The tympanic part contains the bony passage from the auricle (external ear), called the external acoustic meatus. The petromastoid part also forms a portion of the bony wall of the tympanic cavity (middle ear). The meatus and tympanic cavity are concerned with the transmission of sound waves.
->The slender, pointed styloid process of the temporal bone gives attachment to certain ligaments and muscles (e.g., the stylohyoid muscle that elevates the hyoid bone).
->The temporal bone articulates at sutures with the parietal, occipital, sphenoid, and zygomatic bones.
->The zygomatic process of the temporal bone unites with the temporal process of the zygomatic bone to form the zygomatic arch. The zygomatic arches form the widest part of the face.
->The head of the mandible articulates with the mandibular fossa on the inferior surface of the zygomatic process of the temporal bone.
->Anterior to the mandibular fossa is the articular tubercle.
->Because the zygomatic arches are the widest parts of the face and are such prominent facial features, they are commonly fractured and depressed. A fracture of the temporal process of the zygomatic bone would likely involve the lateral wall of the orbit and could injure the eye.
The Hard Palate
- The anterior bony part of the palate is formed by the palatine process of the maxillae and the horizontal plates of the palatine bones.
- Anteriorly and laterally, the hard palate is bounded by the alveolar processes and the gingivae.
- Posteriorly, the hard palate is continuous with the soft palate.
- The incisive foramen is the mouth of the incisive canal.
- This foramen is located posterior to the maxillary central incisor teeth.
- This foramen is the common opening for the right and left incisive canals.
- The incisive canal and foramen transmit the nasopalatine nerve and the terminal branches of the sphenopalatine artery.
- Medial to the third molar tooth, the greater palatine foramen pierces the lateral border of the bony palate.
- The greater palatine vessels and nerve emerge from this foramen and run anteriorly into two grooves on the palate.
- The lesser palatine foramen transmits the lesser palatine nerve and vessels.
- This runs to the soft palate and adjacent structures.
The Nose
- The nose is the superior part of the respiratory tract and contains the peripheral organ of smell.
- It is divided into right and left nasal cavities by the nasal septum.
- The nasal cavity is divided into the olfactory area and the respiratory area.
NEUROHISTOLOGY
The nervous system develops embryologically from ectoderm, which forms the neural plate
Successive growth and folding of the plate results in the formation of the primitive neural tube.
The neuroblasts in the wall of the tube differentiates into 3 cell types:
Neurons: conduction of impulses
Neuroglial cells: connective tissue and support of CNS
Ependymal cells: Lines the lumen of the tube.
- Specialized neuro-ectodermal cells which lines the ventricles of the adult brain
- Essentially also a neuroglial cell
Basic Unit = neuron
Exhibits irritability (excitability) and conductivity
A typical neurons consists of:
Cell body : Has nucleus (karyon) and surrounding cytoplasm (perikaryon) which contains organelles cell's vitality
Dendrites: Several short processes
Axon:One large process
Terminates in twig like branches (telodendrons)
May also have collateral branches projecting along its course. These exit at nodes of Ranvier
Axon enveloped in a sheath, and together forms the nerve fiber
Classification:
May be done in different ways, i.e.
Functional = afferent, efferent, preganglionic, postganglionic, etc.
Morphological = shape, processes, etc
A typical morphological classification is as follows
a. Unipolar: Has one process only Not found in man
b. Bipolar (so-called ganglion cell):Has two processes Found in sensory systems, e.g. retina olfactory system
c. Multipolar: Has several process Most common in CNS
Cell bodies vary in shape, e.g. stellate (star) , pyramidal
d. Pseudo-unipolar: Essentially bipolar neurons, but processes have swung around cb and fused with each other. They therefore enter and leave at one pole of the cell.
Typical neuron:
- Has 2 or more dendrites
Close to the cb the cytoplasm of dendrites has Nissl granules as well as mitochondria
Only one axon Arises from axon hillock, Devoid of Nissl granules, Encased in myelin sheath
No additional covering except for occasional foot processes of neuroglial cells
May branch at right angles
Branches at a node of Ranvier is known as a collateral
Ends of axons break up into tree-like branches, known as telodendria
Axons may be short (Golgi Type II) e.g. internuncial long (Golgi Type I) e.g. pyramidal neuron
Nucleus Central position Large and spherical
Chromatin is extended and thus not seen in LM. This allows the nucleolus to be prominent
Cytoplasm (perikaryon)
Surrounds nucleus May be large or small, shape may be round, oval, flattened, pyramidal, etc
Contains aggregates Nissl granules(Bodies) which is also sometimes referred to as rhomboid flakes
aggregation of membranes and cisternae of rough endoplasmic reticulum (RER)
numerous ribosomes and polyribosomes scattered between cisternae
(Polyribosome = aggregate of free ribosomes clumped together)
responsible for ongoing synthesis of new cytoplasm and cytoplasmic substances
needed for conduction of impulses
highly active in cell protein synthesis
resultant loss of power to divide which is characteristic of neurons
- Golgi network surrounding nucleus (seen in EM only)
- Fibrils made up of:
- neurofilaments
- microtubules
Tubules involved in:
1. plasmic transport
2. maintenance of cell shape
3. essential for growth and elongation of axons and dendrites
Neurofilament:
1. provide skeletal framework
2. maintenance of cell shape
3. possible role in axonal transport
(Axonal [axoplasmic; plasmic] transport may be antero- or retrograde. Anterograde transport via neurotubules is fast and moves neurotransmitters. Retrograde transport is slow and is the reason why viruses and bacteria can attack and destroy cell bodies. E.g. polio in the ventral columns and syphilis in the dorsal columns).
- Numerous mitochondria
- Neurons lack ability to store glycogen and are dependent for energy on circulating glucose
Impulses are conducted in one direction only
Dendrites conduct towards the cb
Axons conduct away from cb
Synapses:
- Neurons interconnect by way of synapses
- Normally the telodendria of an axon synapse with the dendrites of a succeeding axon
axo-dendritic synapse
This is usually excitatory
- Other types of synapses are:
axo-axonic
May be excitatory and/or inhibitory
axo-somatic
May be excitatory and/or inhibitory
dendrodendritic
Usually inhibitory
- Synapses are not tight junctions but maintain a narrow space the so-called synaptic cleft
- The end of an telodendron is usually enlarged (bouton) and contains many synaptic vesicles,
mitochondrion, etc. Its edge that takes part in the synapse is known as the postsynaptic membrane and no
vesicles are seen in this area
- Synapses may be chemical (as above) or electrical as in the ANS supplying smooth muscle cells subjacent to adjacent fibres
Gray and White Matter of Spinal Cord:
- Gray matter contains:
- cb's (somas) of neurons
- neuroglial cells
- White matter contains:
- vast number of axons
- no cb's
- colour of white matter due to myelin that ensheathes axons
Myelin:
- Non-viable fatty material contains phospholipids, cholesterol and some proteins
- Soluble and not seen in H&E-sections because it has become dissolved in the process, thus leaving empty spaces around the axons
- Osmium tetroxide (OsO4) fixes myelin and makes it visible by staining it black. Seen as concentric rings in cross section
- Myelin sheath (neurolemma) is formed by two types of cells
- Within the CNS by Oligodendrocytes
- On the peripheral neurons system by Schwann cells
- Sheath is formed by being wrapped around the axon in a circular fashion by both types of cells
Neuroglial Cells:
- Forms roughly 40% of CNS volume
- May function as: 1. support
2. nurture ("feeding")
3. maintain
Types of glial cells:
Oligodendrocytes:
- Small dark stained dense nucleus
- Analogue of Schwann cell in peripheral nervous system
- Has several processes which forms internodal segments of several fibres (one cell ensheathes more than one axon)
- Provides myelin sheaths in CNS
- Role in nurturing (feeding) of cells
Astrocytes:
Protoplasmic astrocytes:
- found in gray matter
- round cell body
- large oval nucleus with prominent nucleolus
- large thick processes
- processes are short but profusely branched
- perivascular and perineurial foot processes
- sometimes referred to as mossy fibres
Fibrous Astrocytes:
- found in white matter
- polymorphic cells body
- large oval nucleus
- long thin processes
Microglia:
- Neural macrophages
- smallest of the glial cells
- intense dark stained nucleus
- conspicuously fine processes which has numerous short branches
Cerebral Cortex:
Consists of six layers which are best observed in the cortex of the hippocampus
From superficial to deep:
- Molecular layer:
- Has few cells and many fibres of underlying cells
- Outer granular layer:
- Many small nerve cells
- Pyramidal layer:
- Pyramidally-shaped cells bodies
- Inner granular layer:
- Smaller cells and nerve fibres
- Internal (inner) pyramidal layer:
- Pyramidal cells bodies
- Very large in the motor cortex and known as Betz-cells
- Polymorphic layer:
- Cells with many shapes
Cerebellar Cortex:
Consists of three layers
Connections are mainly inhibitory
From superficial to deep
- Outer molecular layer:
- Few cells and many fibres
- Purkinje layer:
- Huge flask-shaped cells that are arranged next to one another
- Inner granular layer:
- Many small nerve cells
Motor endplate:
Seen in periphery on striated muscle fibres
- known as boutons
- has no continuous myelin covering from the Schwann cells
- passes through perimysium of muscle fiber to "synapse"
- multiple synaptic gutter (fold) in sarcoplasma of muscle fiber beneath bouton
- contains numerous synaptic vesicles and mitochondria
Ganglia:
- Sensory Ganglia:
(e.g. trigeminal nerve, ganglia and dorsal root ganglia)
- No synapse (trophic unit)
- pseudo-unipolar neurons
- centrally located nucleus
- spherical smooth border
- conspicuous axon hillock
- Surrounded by cuboidal satellite cells (Schwann cells)
- Covered by spindle shaped capsular cells of delicate collagen which forms the endoneurium
- Visceral and Motor Ganglia (Sympathetic and Parasympathetic):
- Synapse present
- Ratio of preganglionic: postganglionic fibres
1. Sympathetic 1:30
Therefore excitatory and catabolic
2. Parasympathetic 1:2
Therefore anabolic
Except in Meissner and Auerbach's plexuses where ratio is 1:1000 '2 because of parasympathetic component's involvement in digestion
- Preganglionic axons are myelinated (e.g. white communicating rami)
- Postganglionic axon are non-myelinated (e.g. gray communicating rami)
- small multipolar cell body
- excentrally located nucleus
- Inconspicuous axon hillock
- satellite cells few or absent
- few capsular cells
- 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.
-> This bone forms much of the base and posterior aspect of the skull.
-> It has a large opening called the foramen magnum, through which the cranial cavity communicates with the vertebral canal.
-> It is also where the spinal cord becomes continuous with the medulla (oblongata) of the brain stem.
-> The occipital bone is saucer-shaped and can be divided into four parts: a squamous part (squama), a basilar part (basioccipital part), and two lateral parts (condylar parts).
-> These four parts develop separately around the foramen magnum and unite at about the age of 6 years to form one bone.
-> On the inferior surfaces of the lateral parts of the occipital bone are occipital condyles, where the skull articulates with C1 vertebra (the atlas) at the atlanto-occipital joints.
-> The internal aspect of the squamous part of the occipital bone is divided into four fossae: the superior two for the occipital poles of the cerebral hemispheres, and the inferior two, called cerebellar fossae, for the cerebellar hemispheres.
Connective Tissue
Functions of Connective tissue:
→ joins together other tissues
→ supporting framework for the body (bone)
→ fat stores energy
→ blood transports substances
Connective tissue is usually characterized by large amounts of extracellular materials that separate cells from each other, whereas epithelial tissue is mostly cells with very little extracellular material. The extracellular substance of connective tissue consists of protein fibers which are embedded in ground substance containing tissue fluid.
Fibers in connective tissue can be divided into three types:
→ Collagen fibers are the most abundant protein fibers in the body.
→ Elastic fibers are made of elastin and have the ability to recoil to original shape.
→ Reticular fibers are very fine collagen fibers that join connective tissues to other tissues.
Connective tissue cells are named according to their functions:
→ Blast cells produce the matrix of connective tissues
→ Cyte cells maintains the matrix of connective tissues
→ Clast cells breaks down the matrix for remodeling (found in bone)