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Anatomy - NEETMDS- courses
NEET MDS Lessons
Anatomy

The Parotid Glands

  • The parotid glands are the largest of the three pairs of salivary glands.
  • Each gland is wedged between the mandible and the sternocleidomastoid muscle and partly covers them.
  • The parotid gland is wrapped with a fibrous capsule (parotid fascia) that is continuous with the deep investing fascia of the neck.
  • Viewed superficially, the parotid gland is somewhat triangular in shape.
  • Its apex is posterior to the angle of the mandible and its base is along the zygomatic arch.
  • The parotid gland overlaps the posterior part of the masseter muscle.
  • The parotid duct (Stensen's duct) is about 5 cm long and 5 mm in diameter.
  • It passes horizontally from the anterior edge of the gland.
  • At the anterior border of the masseter muscle, the parotid duct turns medially and pierces the buccinator muscle.
  • It enters the oral cavity opposite the second maxillary molar.

 

Blood Vessels of the Parotid Gland

  • This gland is supplied by branches of the external carotid artery.
  • The veins from the parotid gland drains into the retromandibular vein, which enters the internal jugular vein.

 

Lymphatic Drainage of the Parotid Gland

  • The lymph vessels of this gland end in the superficial and deep cervical lymph nodes.

 

Nerves of the Parotid Gland

  • These nerves are derived from the auriculotemporal nerve and from the sympathetic and parasympathetic systems.
  • The parasympathetic fibres are derived from the glossopharyngeal nerve (CN IX) through the otic ganglion.
  • Stimulation of these fibres produces a thin watery (serous) saliva to flow from the parotid duct.
  • The sympathetic fibres are derived from the cervical ganglia through the external carotid plexus.
  • Stimulation of these fibres produces a thick mucous saliva.

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.

Genioglossus Muscle

  • Origin: Mental spine of the mandible.
  • Insertion: Dorsum of the tongue and hyoid bone.
  • Nerve Supply: Hypoglossal nerve (CN XII).
  • Arterial Supply: Sublingual and submental arteries.
  • Action: Depresses and protrudes the tongue.

Mesodermal Origin

Muscles

Innervation

Somitomeres 1, 2

Superior, medial and ventral recti

Oculomotor (III)

Somitomere 3

Superior oblique

Trochlear (IV)

Somitomere 4

Jaw-closing muscles

Trigeminal (V)

Somitomere 5

Lateral rectus

Abducens (VI)

Somitomere 6

Jaw-opening and other 2nd arch muscles

Facial (VII)

Somitomere 7

Stylopharyngeus

Glossopharyngeal (IX)

Somites 1, 2

Intrinsic laryngeals

Vagus (X)

Somites 2-5

Tongue muscles

Hypoglossal (XII)

o    English: all speech sounds produced by making exhaled air audible

o    Two ways of producing sound
    at larynx
    further up in vocal tract (tongue, lips)
    
o    How to produce sound at larynx
    changes in breathing: regulate airstream from lungs to atmosphere by changing movements of vocal folds, pharynx, soft-palate, tongue, lips and jaws
    
•    inhalation: take in greater volume more quickly, abduct folds

•    expiration: variable force; use muscles of inhalation to control rate of expiration, adduct

    How to vibrate vocal cords
    
•    NOT rhythmic contraction of laryngeal muscles: would be impossible b/c frequenceies of virbration
•    Changes in air pressure cause vibrations


    o    Adduct folds increase in subglottal pressure force folds apart folds sucked back together (Bernouilli effect)
•    The vibration of vocal cords disturbs airareas of low pressure (rarefaction) alternating with areas of high pressure (compression)
•    Changes in pressure sound at ears
•    Sine waves

    o    Changes in amplitudes: loudness

    o    Changes in frequency: pitch

    o    Normal sounds have fundamental frequency, overtones or harmonics

    o    Mass of folds: critical in voice
    Low pitch of lion’s roar: due to massive fibrous pad that forms part of vocal cords
    Men: more massive vocal cords
    Larger foldsslow vibrationdeeper voice

    o    Producing vowels and constants
    Most vowels are “voiced”: vocal folds produce sounds
    Consonants: can be “voiced” (Z) or “non-voiced” (S)
•    Use higher regions of vocal tract to control by stopping, restricting airflow from vocal folds; use lips, teethaperiodic sound

o    Vocal folds and resonators emphasize and deemphasize certain frequencies
    Never hear sounds produced at vocal foldsevery sound changed by passage thru vocal tract: sinuses/resonating chambers
    Howling monkeys: large hyoid bonepowerful resonator

    o    Age-related changes in voice
    
    Infant larynx is smaller, different proportions
•    Arytenoids are proportionately larger
•    Smaller vocal apparatushigher pitch
•    Larynx sits higher easier to breathe thru nose
    Abrupt change in larynx at pubertycan’t control voice
    Older adult: normal degenerative changes in lamina propria, ossification of thyroid cartilagechanges in fundamental frequency
    Lose your voice vocal fold are irritated
•    Can’t adduct foldsair escapes

o    Singing v. speaking
    Singing: greater thoracic pressure and uneven breathing with changes in resonators

    o    Whispering
    Intercartilaginous portions of vocal folds: open to allow air to escapelesser subglottal pressureslittle vibration of foldslittle tonal quality, low volume

    o    Falsetto
    Allowing only part of vocal folds to vibrate
    Increase range by training which part of vocal folds to vibrate

    o    Colds
    Mucus secretions add mass to folds—decrease in pitch, can’t adduct folds as well

    o    Surgeryscars, fibrotic changes can interfere with voice

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

The Scalp

  • The scalp consists of five layers of soft tissue.
  • It extends from the superior nuchal line on the posterior aspect of the skull of the supraorbital margins.
  • Laterally, the scalp extends into the temporal fossa to the level of the zygomatic arches.

 

Layers of the Scalp

  • The scalp proper is composed of three fused layers. It is separated from the pericranium by loose connective tissue.
  • Because of this potential areolar cleavage plane, the scalp is fairly mobile.
  • Each letter of the word "S C A L P" serves as a memory key for one of the layers of the scalp: Skin, Connective Tissue, Aponeurosis Epicranialis, Loose Areolar Tissue and Pericranium.

Layer 1: Skin

  • Hair covers the scalp in most people.
  • The skin of the scalp is thin, especially in elderly people, except in the occipital region.
  • The skin contains many sweat and sebaceous glands and hair follicles.
  • The skin of the scalp has an abundant arterial supply and good venous and lymphatic drainage systems.

Layer 2: Connective Tissue

  • This is a thick, subcutaneous layer of connective tissue and is richly vascularised and innervated.
  • It attaches the skin to the third layer of the scalp.
  • Fat is enclosed in lobules between the connective fibres.

Layer 3: Aponeurosis Epicranialis

  • This is a strong membranous sheet that covers the superior aspect of the cranium.
  • This aponeurosis is the membranous tendon of the fleshy bellies of the epicranius muscle.
  • The epicranius muscle consists of four parts: two occipital bellies, occipitalis and two frontal bellies, frontalis that are connected by the epicranial aponeurosis. 

Layer 4: Loose Areolar Tissue

  • This is a subaponeurotic layer or areolar or loose connective tissue.
  • It is somewhat like a sponge because it contains innumerable potential spaces that are capable of being distended by fluid.
  • It is this layer that allows free movement of the scalp proper, composed of layers 1-3.

Layer 5: Pericranium

  • This is a dense layer of specialised connective tissue.
  • The pericranium is firmly attached to the bones by connective tissue fibres called Sharpey’s fibres, however, they can be fairly easily stripped from the cranial bones of living persons, except where they are continuous with the fibrous tissues of the cranial sutures.

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