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NEET MDS Synopsis - Lecture Notes

📖 Anatomy

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The Parotid Glands
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 Palate
Anatomy

The Palate

  • The palate forms the arched roof of the mouth and the floor of the nasal cavities.
  • The palate consists of two regions: the anterior 2/3 or bony part, called the hard palate, and the mobile posterior 1/3 or fibromuscular part, known as the soft palate.

 

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 Scalp
Anatomy

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.

Classified on functional Basis

Anatomy

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