The anatomy of the nasal cavity and paranasal sinuses. The skeletal and smooth muscle tissues. The development of the pharyngeal gut.

The anatomy of the nasal cavity and paranasal sinuses. The skeletal and smooth muscle tissues. The development of the pharyngeal gut.

The anatomy of the nasal cavity and paranasal sinuses.

Nasal Cavity:

*For step by step amazing pictures of the nasal cavity: http://home.comcast.net/~WNOR/lesson9.htm

Borders:

• ant = nasal bone (ant nasal aperture = piriform aperture)
• sup =
  
  • (ant) nasal part of frontal bone
  • (middle) body of sphenoid,
  • (post) body of sphenoid,
    
  • the roof of the nasal cavity also has the cribriform plate of ethmoid bone, conveying fibers of CN I
• med = septum nasi – made by perpendicular plate of ethmoid sup/post, vomer inf/post, and septal cartilage ant
• inf = hard palate, made of palatine process of maxilla (ant), and horizontal plate of palatine bone (post)
• post border = outlet = choanae, that lead to nasopharynx
  • lat = med pterygoid plate
  • med = vomer
  • sup = body of sphenoid
  • inf = horizontal plate of palatine bone

There are two parts to the nasal cavity, the nasal vestibule, and the nasal cavity itself

The line that divides the vestibule from the rest of the nasal cavity is limen nasi, which is the alse the line between the cutaneous and mucosal part of the nasal cavity

On the sagittal section of the head, you can find limen nasi, by looking for where the nose hairs stop – and you will be transitioning into the mucosal part.

Medial Wall
The nasal cavity itself is further subdivided into two regions:
upper 1/3 = olfactory part, for smelling
lower 2/3 = respiratory part, for breathing

The medial wall of the nasal cavity is pretty lacking in any features, just mention what makes up the septum.
CLINCIAL NOTE – the nasal septum can be deviated (bent) to one side or the other, if bent so far that it touches the lateral wall, can require surgery, because will affect breathing.

Lateral Wall
The lateral wall is much more complicated, having three projections coming from it, the nasal concha.

There are 3 nasal concha – sup, mid, inf.
Function of the nasal concha: is to spin the air within the nasal cavity, in order to:

• to help warm the air,
  
• as well as aid in filtering it
  
• adding moisture to the air.

Above the superior nasal concha, is the sphenoethmoid recess – the sphenoid sinus opens into this space

between each concha, are the nasal meati.
Superior nasal meatus – B/w the superior and middle concha
2 things open here :

1. the posterior ethmoid air cells (one of the paranasal sinuses)
2. sphenopalatine foramen – thru it, go the sphenopalatine a, and post/ sup nasal n

Middle nasal meatus = B/w middle and inf concha
This area is a bit more complicated.
There is a bony projection (bulge) into this area, made by middle ethmoid air cells – called the ethmoidal bulla.
Below the ethmoidal bulla is the uncinate process, a horn shaped bony projection.
Leading into the uncinate process is the ethmoidal infundibulum, that contains the fronto nasal duct. This duct leads from the frontal sinus, and allows it to empty into the middle nasal meatus.

B/w the ethmoidal bulla and the uncinate process is a half moon shaped space = semi lunar hiatus.
3 Things open here:

1. Into the hiatus, the frontal sinus opens ( via the fronto nasal duct),
   
2. maxillary sinus opens into the post part of the hiatus,
   
3. ant/ mid ethmoid air cells also open here.

So all together that is 4 things that open in the middle nasal concha.

Inf nasal meatus =  below the inf nasal concha,
2 things open here:

1. Nasolacrimal duct opens here in to the ant part of the meatus, draining excess tears into the inf nasal meatus – this is  why your nose runs when you cry a lot.
2. Incisive canal – we mentioned this before in the oral cavity, is the connection b/w nasal and oral cavity, has nasopalatine n/a here.

Blood Supply of Nasal Cavity:

• post lat nasal and post septal br (sphenopalatine a)
• ant post/ethmoid a (ophthalmic a)
• Gr palatine a (desc palatine a)
• Septal br of sup labial a (facial a)
• Lat nasal br (facial a)

Huge venous plexus drains the nsals mucosa —> flow into sphenopalatine, facial, and ophthalmic v, plays a major role in warming air before it goes to lungs

Innervation of Nasal Cavity:
Respiratory region: SS

• Post/inf part of nasal cavity = nasopalatine n (V2) to septum, post lat nasal branches (gr palatine n) to lat wall
• ant /sup part = ant/post ethmoidal n (nasociliary n of V1)

Olfactory region = CN I

* For innervation of mucosal glands of Nasal Cavity, please see topic #3

4 Paranasal sinuses:

Function:

• decrease the weight of the facial skeleton
• vocal resonance – why your voice changes when you have a cold/sinus infection, and your sinuses fill
• moisten and warm air

1. Frontal Sinus – located w/ the frontal bone, behind the root of nose, innervated by supraorbital n of V1

2. Maxillary sinuses –  largest paranasal sinuses
Borders:
roof = floor of orbit
floor = alveolar process of maxilla
apex = zygomatic bone
base – inf/lat wall of nasal cavity

CLINICAL NOTE – maxillary sinus drains by an opening maxillary ostium in to middle nasal meatus, but this opening is located high on the walls, so sinus does not fully drain – can get infected easier = sinusitis

Blood supply = sup alveolar a (Maxillary a)
Innervation = br of ant/mid/post superior alveolar n (V2)

3. Ethmoidal sinuses (air cells)
located lat to most superior part of nasal cavity. If you pinch the bridge of your nose, the ethmoid sinuses would be located post to your fingers.

Innervation = by ant/post ethmoid n (nasocilary n of C1)

4. Sphenoid sinus
located in sphenoid bone, part of roof of nasal cavity
Clincial NOTE – b/c of this sinus, the roof of nasal cavity is weak. If broken in a fight, can cause to the leakage of sinus contents or even CSF out of the nose
Innervation = by post ethmoidal a and post ethmoid n

Histology: The skeletal and smooth muscle tissues.

Smooth Muscle

all musc tissue consist of elongated cells = fibers
cytoplasm of musc cells = sarcoplasm
contains a # of myofibrils, made of actin & myosin
surrounding cell membrane = sarcolemma

Smooth muscle

found in numerous organs = uterus, SI, LI, stomach, a/v, trachealis
contain contractile actin and myosin filaments
not arranged in regular cross striated pattern
appear smooth and non striated
involuntary motion
small, spindle, fusiform in shape – single central nucleus
actin/filaments attach dense bodies (adheron aggregates) to sarcolemme plaques

Function:

• exhibits spontaneous, wave – like activity
• ureters, uterine tubes, digestive organs: produces peristalsis
• a/v = regulate luminal diameters

connected w/ gap junctions – rapid ionic communications
regulated by SNS/PNS
influence the rate and force of contractility

Contraction:

1. Sarcoplasmic reticulum release Ca2+
2. Ca/calmodulin complex forms
3. which activates MLCK (Myosin light chain kinase)
4. this PO4’s myosin –> myosin attaches to actin = contraction

Skeletal muscles
long multinucleated cells w/ peripheral nuclei
very regular formation of myosin & actin in cytoplasm
contractile filaments form distinct cross striation patterns = dark A bands, light I bands

3 CT layers:
Skeletal musc surrounded by dense irregular CT = epimysium
less dense, irregular CT = perimysium – comes inside and divides interior of muscle into fascicles (bundles)
endomysium = CT fibers that go around individual fibers
w/in cell = 4-5 myofibrils
groups of 8-9 myocytes = fascicles

has neuromuscular spindles – CT capsule, contain musc fiber called intrafusal fibers, & n. endings, surrounding fluid filled space

Other features:

• No cell junctions
• well developed ER & T tubules
• voluntary innervation
• all or non contraction
• NO mitosis
• grows in response to demand
• limited regeneration
• made by myoblasts of para-axial mesoderm

Contraction:
Thick (A) = Myosin – tail region of globular head
Thin (I) = Actin – twisted chains
1. when myosin head attached to actin – no ATP present
2. ATP binds to head –> ATP becomes ADP + P, head moves away from actin
3. fibers slide past each other
4. length of sarcomere decreases
5. I & H band disappear

Embryology:The development of the pharyngeal gut.

The primitive gut forms during the 4th week of the development as a result of cephalocaudal and lateral folding of the embryo. This endoderm lined cavity is incorporated into the embryo, while the yolk sac and the allantois remain temporarily by outside the embryo. The endoderm of the primitive gut gives rise to the epithelium and glands of the digestive tract. The muscular and fibrous elements of the digestive tract are derived from the splanchnic mesoderm. The epithelium at the cranial and caudal extremities of the digestive tract is derived from the ectoderm of the stomodeum and the proctodeum (anal pit).
Formation of the gut tube Formation of the primitive gut Formation of the ventral abdominal wall Formation of the ventral abdominal wall	1. Foregut 2. Hindgut 3. Midgut 4. Central nervous system 5. Tracheobronchial diverticulum 6. Heart 7. Liver bud 8. Buccopharyngeal membrane 9. Vitelline duct 10. Allantois 11. Cloacal membrane 1. Yolk sac 2. Surface ectoderm 3. Amniotic cavity 4. Neural groove 5. Splanchnic mesoderm 6. Somatic mesoderm 1. Yolk sac 2. Surface ectoderm 3. Amniotic cavity 4. Neural tube 5. Splanchnic mesoderm 6. Somatic mesoderm 1. Gut endoderm 2. Intraembryonic coelomic cavity 3. Amniotic cavity 4. Dorsal mesentery 5. Splanchnic mesoderm 6. Somatic mesoderm 7. Neural tube

The primitive gut is divided into four parts: a) the pharyngeal gut which extends from the buccopharyngeal (oropharyngeal) membrane to the respiratory (tracheobronchial) diverticulum;

5. The anatomy of the oral cavity and salivary glands. The histology of the tongue and salivary glands. The development of the oral and nasal cavities.

Anatomy of the oral cavity and salivary glands.

General Info:

Borders:

• roof = palate (hard, soft)
• floor = tongue, mucosa, geniohyoid and mylohyoid m
• Lat/ant
  • Outer fleshy wall = cheeks, gums
  • Inner bony wall = teeth and inner aspect of gums
• communicates posteriorly with oropharynx

Divided into 2 areas: the oral vestibule, anterior to the teeth and buccal side of gingiva (gums) & oral cavity proper, which is the space behind the teeth and gums

Oral Vestibule = Cheeks, Lips, Gingivae

Lips

• Lips contain the orbicularis oris m, and sup/inf labial m, a/v/n.
• Covered externally by skin externally, and mucosa internally.
• Epithelium of skin transitions from normal skin –> red vermillion portion –> to inner mucosal layer. The border line b/w skin and red portion = transition zone.

Structures to identify in relation to the lips:

• upper lip = b/w nose & opening of oral cavity
• nasolabial grooves = seperate lips from cheeks, 1 cm lat to angle of mouth
• philtrum = a shallow depression below the nose, bordered by 2 lateral crests – not everyone has one
• lower lip = b/w opening of oral cavity and labiomental groove, separating lower lip from chin.
• labial frenula = a mucosal membrane fold that attaches the lips to the ant surface of the vestibular gingiva (gums facing the oral vestibule) — NOTE diff from lingual frenula, that attaches the tongue to the floor of the mouth

Blood supply = sup/inf labial a (facial a)

• upper lip = br of facial/ infraorbital = sup labial br
• lower lip = br of facial/mental a = inf labial br

Innervation

• upper lip = sup labial br of V2
• lower lip = inf labial br of mental n from V3 (mental n comes from inf alveloar n)

Lymph Drainage = submandibular/submental lymph nodes

Cheeks

over lie the zygomatic process
contain the buccinator m – that holds cheeks taught when exhaling forcefully
contains the buccal fat pad (of Bichat)
Blood Supply = buccal br of maxillary a (terminal br of ext carotid), n = buccal br of mandibular n (V3)

Gums

are fibrous tissue covered with mucosa
hold teeth in place
supplied by many a/v/n

Blood Supply

• upper (maxillary) lingual gingiva of incisors, canines = nasopalatine n,a/v – most ant, this makes sense because nasopalatine structures go through incisive foramen at most ant part of hard palate
• upper (maxillary) lingual gingiva of premolars, molars = gr. palatine n, a/v – post, makes sense b/c gr. palatine structures go through gr palatine foramen at post/lat part of hard palate
• lower(mandibular) labial buccal gingiva of incisors, canines, premolars = inf alveolar n/a/v
• lower(mandibular) labial buccal gingiva of molars = buccal n
• lower(mandibular) lingual gingiva = lingual n/a/v

*Teeth is another topic, please refer to that

Palate

Made up of hard and soft palate

Hard palate
is bony and makes up the ant 4/5 of the palate = palatine process of the maxilla, and horizontal plate of palatine bone
border b/w nasal and oral cavity
@ midline of hard palate, running back from incisive foramen = palatine raphe – where the 2 palatine shelves fused in embryonic life

3 foramina:
Incisive foramen (ant/med) = nasopalatine n/a/v

• In the netter, it looks like sphenopalatine a goes through there, but do not say this in a test, it will be considered incorrect.
• NOTE – makes the location of the fusion b/w primary/secondary palate in embryonic life

Greater and Lesser Palatine foramen (post/lat) – right next to 3rd molar (wisdom tooth) = the gr/lsr palatine n/a/v go through them.

• Gr palatine structures run ant and supply hard palate
• Lsr palatine stuctures run post and supply soft palate
• The a comes from desc palatine a, a br of maxillary a

Soft Palate

• is fibromuscular fold that makes up post 1/5 of palate
• moves agains the pharyngeal wall to close oropharynx while swallowing or speaking
• as mentioned earlier, supplied a/v/n by lesser palatine structures.
• Laterally, is continuous with palatoglossal and palato pharyngeal folds
  • These folds are form the lateral border to the exit of oral cavity = Isthmus of Fauces, that leads to Oropharynx (More on that in pharynx)
  • b/w them is the tonsillar bed = palatine tonsils
  • CLINCAL NOTE – are frequently inflamed and removed, along with pharyngeal tonsils (see pharyn) aka adenoids

• CLINCAL NOTE = Since lingual gingiva is connected to mucosa of soft palate, can inject anasthetic there to numb soft palate
• Has numerous palatine glands, that secrete mucus

Blood Supply: Gr and Lsr palatine a (more the 2nd one), Asc palatine a (Facial a), Palantine br of Asc Pharyngeal a

Innervation : SS = lsr palatine n, SM = CN X

Venous Drainage: hard and soft palate v drain in pterygoid venous plexus

NOTE that Hard palate has no SM innervation – no musc there.

Muscles of Palate: all innervated by CN X via pharyngeal plexus – except Tensor Veli Palatini (V3)

• Tensor Veli Palatini – tenses soft palate, has a large tendon that strengthens the soft palate = palatine aponeurosis
• Levator Veli Palatini – elevate soft palate
• Palatoglossus – elevates tongus (Just uses palate as an origin site, doesn’t do anything to palate itself)
• Palatopharyngeus – elevates pharynx, to help close off nasopharynx from oropharynx in swallowing
• Uvulus – @ termination of soft palate, no real function, but helps to identify issues with CN X, b/c if this doesn’t move when saying, “Ahhh”, then poss malfunction w. CN X

Tongue

• is almost purely made of muscle
• the ant 2/3 is called the oral part = originates from 1st pharyngeal arch
• post 1/3 = pharyngeal part, orginates from 3rd arch, behind terminal sulcus of tongue
• @ midline of terminal sulcus is foramen cecum, the remnant of thyroglossal duct
• root = from 4th arch
• Has midline sulcus on dosal surface = location of fusion of 1 lateral swellings of ant tongue over tuberculum impar.

Function: aid in speaking, allow for movement of food toward oropharynx and within oral cavity
Parts:
Body – most of the tongue
Apex – pointed ant part
root – part fixed to hyoid bone and mandible, is located behind palatoglossal fold, location of lingual tonsils.

Taste Buds: SEE HISTO

The inferior surface of tongue has a very thin mucus membrane, so can see many veins, and is attached to floor of mouth via another mucus membrane fold = lingual frenulum. – Basically keeps tongue in mouth while allowing apex to move about

Muscle of Tongue = all innervated by CN XII, except palatoglossus, which we already said is innervated by Pharyngeal plexus, via CN X

Intrinsic m – change the shape of tongue itself
Sup/Inf Longitudinal, Transverse, Vertical

Extrinsic m – change position of tongue

• Genioglossus – protrudes and depresses tongue
• Hyoglossus – depresses and retracts tongue
• Styloglossus – retracts and elevate tongue
• Palatoglossus – elevates tongue

How to remember them? Gay Hats STYLe Perfectly

Basic Taste sensations:
Sweetness = apex
Saltiness = lateral side
Sourness & bitterness = posterior part
Umami = used to taste the unusual tastes in cheese, meat, asparagus, & tomatoes

Blood Supply:

• Lingual a from Ext carotid a, emerges @ lever of gr. horn of hyoid bone in carotid triangle
• Pathway: runs deep to hyoglossis (lateral lingual groove), and lies on middle pharyngeal constrictorm
• Br = dorsal lingual, suprahyoid,sublingual a, terminates as deep lingual a ( on top of genioglossus m)

Lymph Drainage:

• Post 1/3 = deep cervical lymph nodes
• Medial ant 2/3 = inf deep cervical lymph nodes
• lat ant 2/3 = submandibular l.n
• apex = submental l.n

Innervation of Tongue:

• Ant 2/3:  SS = CN V3 via Lingual n, VS = CN VII via Chorda Tympani
• Post 1/3: SS/VS = CN IX
• Root: SS = CN X, no taste buds here, so no VS

Salivary Glands:

For contents of saliva and function = See HISTO

Parotid

Location: Retromandibular Space = Parotid Bed
Borders:

• ant = Masseter m, Ramus of mandible
• post = SCM, post digastric m
• sup = zygomatic arch
• inf = fascia b/w SCM and mandible
• Lat = open

General Info:
covered by dense fibrous capsule from investing fascia of neck
secretes serous saliva
largest of the glands

Duct Pathway:
From widest part of gland –> across masseter and deep to it –> lat/ant to Buccal fat pad –> peirces Buccinator m, and opens @ 2nd maxillary (upper) molar

Structures Passing through It:
Ext Carotid a – giving 2 terminal branches = Maxillary a, Superficial temporal a
Superficial Temporal v & Maxillary v combine to give Retromandibular v
Facial n peirces it and gives 5 terminal branches  – DOES NOT innervate the gland
Auriculo temporal n – carries PNS post synaptic fibers with it to increase secretion of gland

Blood supply:
from branches of external carotid and superficial temporal a = Transverse facial a
Veins follow a and drain into Retromandibular v

Lymph Drainage:
superficial and deep cervical lymph nodes

Innervation:

• Tympanic n arises from CN IX and emerges from jugular foramen
• n enters the middle ear via the tympanic canaliculus in petrous part of  temporal bone
• tympanic n forms the tympanic plexus — and lesser petrosal n emerges from this plexus
• lesser petrosal leaves skull via foramen ovale
  
• PNS fibers from it synapse in otic ganglion
• post ggl fibers from ggl RUN W/ auriculotemporal n (from V3) to supply parotid gland

*Parotid and Submandibular gland separated by stylomandibular lig b/w styloid process & angle of mandible

Submandibular Gland
Located:  below mylohyoid & mandible

General Info:
Has Superficial and Deep part (deep part located b/w mylohyoid and styloglossus)
secretes a mix of serous and mucus saliva

Duct Pathway:
ducts runs thru lat space of tongue w/ Hypoglossal n and lingual n = lateral lingual groove —> then eventually goes to and open lat to frenulum, b/w mylohyoid and styloglosses
lingual n loops under duct in the lateral lingual groove

Blood Supply: sunmental a (Facial a), V run with a.

Lymph Drainage: deep cervical l.n. –> jugulo-omohyoid nodes

Innervation:
Pre ggl PNS fibers from CN VII by chordatympani –> submandibular ggl –> post ggl fibers run w/ lingual n
SNS post ggl fibers come from sup cervical ggl

Sublingual Glands
Location: b/w mandible and genioglossus m

General info:
smallest of the 3 glands
secretes both mucus and serous, but more mucus

Duct Pathway: duct opens @ floor of oral cavity w/ submandibular duct, just below mucus membrane of tongue, lat to frenulum

Blood Supply : Submental and sublingual a (from facial and lingual a)

Innervation:
Pre ggl PNS fibers from CN VII by chordatympani –> submandibular ggl –> post ggl fibers run w/ lingual n

SNS post ggl fibers come from sup cervical ggl

Histology of the tongue and salivary glands.

Slide #38-39 Tongue * H&E

Structures to Identify:
#38

• circumvallate papillae
• serous gland (Von Ebner’s)
• CT
• Taste bud (also visible in palate, pharynx, esoph)
• ducts
• str. musc bodies
• lingual

#39

• lingual papillae
• fungiform papillae
• filliform papillae
• bundle of nerves
• sk m fibers
• adipose tissue

General info:
muscular organ in oral cavity
core = CT and bundles of sk musc fibers
distribution and random orientation of sk musc in tongue
allows inc movement during chewing, swallowing, speaking

Surface:
epith on ventral surface is smooth
epith on dorsal surface is irregular b/c of papillae – which are folds of mucosa pushed up by mounds of LP underneath
covered by str. squamous epith – partial keratinized – very fire-like

Filiform papillae

• most numerous & smallest papillae
• conical shaped
• cover entire dorsal surface of tongue
• NO taste buds

Fungiform papillae

• less in #
• larger & broader than the filiform papillae
• mushroom like shape
• ant region of tongue
• b/w filiform

Circumvallate papillae

• much larger than any of others
• about 8-12 located in post region of tongue, just next to sulcus terminalis
• have deep furrow’s next to each papillae = where von Ebner’s glands open
• Von Ebner’s glands = serous lingual glands

Foliate papillae

• not many, lateral side of tongue
• not picture on either slide

Taste buds
located in epith of foliate & fungiform papillae, lateral side of circumvallate papillae
have an apical opening = taste pore

3 types of cells:

1. have neuroepithelial taste cells w afferent n. fibers coming from them (VS)
   • VS innervation:
     • ant 2/3 = facial n (CN VII)
     • post 1/3 = CN IX
     • epiglottic region = CN X
   • most in #
   • elongated w/ light cytoplasm
   • oval and light nucleus
   • apical surface extended w/ microvilli that protrude thru taste pore
   • base forms synapses w/ processes off sensory neurons
2. also in taste bud = sustenacular (support) cells
   • elongated w/ darker cytoplasm
   • slender & darker nucleus
   • also have microvilli, but no synapse @ base
   • connected w/ tight jxns
3. base of taste bud = basal cells, thought to be stem cells for taste cells
   • small cells in basal portion of taste buds
   • near basal lamina

5 types of tastes :
sweet, bitter, umami  = G protein
salty, sour = ion channel

Core of Tongue: musc + CT
Extrinsic m: – changes position of tongue

• genioglossus m
• styloglossus m
• hyoglossus m
• palatoglossus m
• * all innervated by CN XII all except palatoglossus (pharyngeal br of CN X = pharyngeal plexus)

Intrinsic m: – changes shape of the tongue

• longitudinal
• transverse
• vertical

Connective Tissue Septa

• CT b/w musc = a/v , nerve fibers
• lower half of tongue & b/w musc fibers = seromucous lingual glands
• ant/ post seromucous glands exist – each have interlobular ducts
• interlobular ducts combine to form one lingual excretory duct

Histology of Salivary Glands:

Function of saliva:

• source of Ca2+ & PO4 for tooth development
• moisten oral mucosa
• moisten dry foods to aid swallowing
• release IgA
• controls bacterial flora by releasing lysozymes
• buffer contents of oral cavity – b/c of its inc HCO3 concentration
• digest carbs by releasing alpha amylase

Slide #40 Parotid gland *H&E

Structures to Identify:

• serous glands
• intercalated ducts
• striated ducts
• adipose cells
• excretory ducts
• CT
• n. bundles (br of Cn VII)

Easy to identify:
loads of adipose
only serous acini
looks like bubble bath

General Info:
located ant/inf to ext ear
largest of salivary glands
only serous

Lobules
entire gland surrounded by CT capsule
from CT capsule, comes CT septa that splits the gland into lobules
located w/in CT septa = arteriole, venule, interlobular excretory ducts, & adipose cells
occasional plasma cells may be seen in CT surrounding ducts = produce Igs taken up & resecreted by acinar cells

Serous acini = Secretory part

• made up of only serous acini = secretory cells
• pyramid shaped cells are arranged around a lumen
• spherical lumen located @ base of basophillic cytoplasm
• small lumen
• surrounded by thin, contractile myoepithelial cells – branches of CN VII found here
• secretory protein rich substance stored in zymogen granules
• stains in H&E better

Conducting system = Duct system

1. acini empty into intercalated duct
   • (squamous/ low cuboidal epith)
   • posses carbon anhydrase activity
   • secrete HCO3-
   • absorb Cl-
2. striated ducts
   • (larger lumina, lined by simple columnar epith w/ basal striations)
   • basal striations formed by deep infoldings of basal cell membranes
   • absorb Na+
   • secrete K+ HCO3-
3. interlobular excretory ducts
   • (pseudostratified epith)

Slide #41 Submandibular gland *H&E

Structures to Identify:

• mucus acini
• serous acini, demilunes
• adipose cells
• duct system = intercalated, striated, excretory ducts
• myoepith cells
• adipose
• a/v

General Info:

• compound tubuloacinar gland
• mixed gland = serous (2/3), mucus acini (1/3)
• duct opens lat to frenulum in oral cavity
• find adipose cells w/in lobule
• find a/v in CT septa

Conducting system:
same as parotid gland

Secretory portion:
Serous acini:

• pyramid shaped cells are arranged around a lumen
• spherical lumen located @ base of basophillic cytoplasm
• small lumen
• surrounded by thin, contractile myoepithelial cells – branches of CN VII found here
• secretory protein rich substance stored in zymogen granules
• stains in H&E better

Mucus acini:

• lightly stained w/ H&E, stained pink w/ PAS
• larger lumen
• cytoplasm is pale b/c loss of mucin during slide prep
• columnar cells, w/. flattened nuclei @ periphery
• may have serous semilunes
• surrounded by myoepithelial cells that help secretory units drain content

Slide #42 Sublingual gland *PAS w/ H background

Structures to identify:
mucus acini
ductal system

General info:
mixed tubuloacinar gland – more MUCUS (2/3) than serous (1/3)
b/c Mucin is made of carbs, stains well w/ PAS staining
cannot see serous very well

PAS reaction:
periodic acid = breaks carbs –> aldehydes
aldehydes react w/ Schiff base = magenta color

Ductal system a bit different:

• not very many intercalated and striated ducts, b/c the high amount of mucus can cause the ducts to be blocked
• and the saliva is modified minimally
• many more interlobular septa (and ducts) than in parotid or submandibular
• numerous lymphocytes & plasma cells

Embryology: Development of the oral and nasal cavities.

Nasal Cavities:

• On both sides of frontonasal prominences, there are forming 2 lateral thickenings of surface ectoderm = nasal placodes
• @ 5th wk = nasal cavity and nasal projection begins to form (nose)
  • nasal placodes fold inwards (”invaginate”) to form nasal pits
  • around nasal pit, there is a ridge of tissue = nasal prominences.
  • Picture a bowl – the actual bowl is nasal pit, and the rim of the bowl is the nasal prominences
  • The nasal prominences are split into lat & medial nasal prominences
• @ 6th wk = nasal pits deepen and penetrate into mesenchyme below
• Oronasal membrane – separate pits from oral cavity, via choanae,
  
• swelling on lat wall = sup/mid/lat conchae
• Paranasal sinuses = are pockets off nasal cavity, grow into neighboring bones – grow through puberty
• Ectoderm @ nasal placode = olfactory epith = make the sustenacular, basal, ciliated cells

Oral Cavity

• Lip formation  = see previous topic

Palate:

• Primary palate
  • formed from medial growth of maxillary prominences
  • the medial nasal prominences also merges deeper to form intermaxillary segment
  • forms philtrum of upper lip, 4 upper incisors, palate ant to foramen incisive
• Secondary palate
  • formed by 2 palatine shellves, a downward growth from maxillary segment
  • turns horizontal  @ 7th wk to fuse at midline, and then fuses ant with primary palate @ location of incisive foramen
• Primary & ant Secondary palate together form hard palate
• post secondary palate forms soft palate and uvula

Mouth:

• from surface depression called the stomodeum (ectoderm)
  
• meets foregut (endoderm)  post = oropharyngeal membrane

Tongue:

• Ant 2/3 = oral part of tongue
  • Originates from most 1st pharyngeal arch
  • there are 2 lat swelling, and 1 medial swelling (tuberculum impar)
  • lat swellings grow over the medial one and meet in midline = median sulcus
  • has the filiform, fungiform, circumvallate papillae
  • b/c from 1st arch – SS = CN V = mandibular n
• Ant 1/3 = pharyngeal part of tongue
  • behind foramen cecum & linea terminalis
  • from originally 2nd, 3rd arches – 3rd overgrows the 2nd.
  • from 2 medial swellings = copula (2nd arch), hypobranchial eminence (3rd/4th arch)
  • has lingual tonsil w/ it
  • b/c from 3rd arch – SS = CN IX
• Root of tongue
  • epiglottis & very back of the tongue
  • from post part of the hypobranchial eminence
  • from 4th arch, so SS = CN X
• Muscle of Tongue develop from occipital somites,  so innervating by CN XII, except palatoglossus (CN X)

4. The muscles and fasciae of the head and neck. The histology of the hypophysis. The development of the face.

4. The muscles and fasciae of the head and neck. The histology of the hypophysis. The development of the face.

Flash Cards:

Anatomy: The muscles and fasciae of the head and neck

Muscles of the Face:

These are mainly the muscles of facial expression. What are they? Look above at the flash cards, or at this one.

Sorry, I know it’s a bit unclear, but it’s the best I could find at the moment.

Muscles of Facial Expression:

General Info:

• are subcutaneous, and very close to the surface
• all innervated by CN VII = facial n.
• develop from mesenchyme of 2nd pharyngeal arch – (Hence why that CN VII innervation makes sense)

1. Occipito-frontalis (Epicranialis) – elevate eyebrow,wrinkles forehead (surprise)

• if you use just frontalis (frontal belly of epicranialis) = furrows eyebrows medially
• use both bellies = lift eyebrows, move scalp

2. Orbicularis Oculi

• has 3 parts: palpebral (just over the eyelid itself) = close eyes gently,
• orbital (around the whole eye) = close eyes tightly, or used to squint
• lacrimal (medially) = draws tears out, so capillaries can drain them

3. Auricularis m –

• ant, mid, post. – not all people have this muscle
• allows movement of the auricle, retract and elevate ear

4. Levator Labii Superioris m – elevate upper lip, dilate nares (disgust)

5. Zygomaticus Minor m – elevate upper lip

6. Zygomaticus Major m – draws angle of mouth up (smaller smile – like the fake one you give when you are in a bad mood)

7. Depressor Septi m – constricts nares

8. Risorius m – retracts angle of mouth more ( smile widely, a big cheesy grin)

9. Depresser Anguli Oris – depresses angle of mouth

10. Corrugater Supercili m – draws eyebrows down and medially (anger, frowning)

11. Procerus m – wrinkles skin over forehead (sadness)

12. Levator Labii superioris aleque nasi – elevate ala of nose, upper lip

13. Levator Anguli Oris m – elevate angle of mouth medially

14.Buccinator m – holds cheeks tight when blowing hard

• named after the word for trumpet, so when someone can blow into a trumpet, without inflating their cheeks, they are using their buccinator m.
• If you use only one, you can pull mouth to one side, like in a half-smile.

15. Orbicularis Oris – closes lips, and purses them (like for a kiss, or around a straw)

16. Depresser Labii inf m – pulls down lower lip

17. Mentalis m – elevates & protrudes lower lip, wrinkles chin

18. Nasalis m – pulls ala of nose towards septum, wrinkles nose (think the movie/show Bewitched)

• Dilator naris m – open nostrils
• Compresser naris m – constrict nostrils

19. Platysma – lowers mandible, can also help in frowning,  tenses skin of lower face and neck

To test yourself on m. of fascial expression: http://www.ivy-rose.co.uk/Topics/FacialMuscles.htm

For Muscles of Tongue, Palate, Pharynx, Larynx, etc – please refer to those topics in question. Those are technically muscles of the head & neck  too, but we doubt they are involved with this topic.

Fascia of Neck

• Superficial Cervical fascia
  • subcutaneous CT
  • cutaneous n, a/v/lymph, superficial lymph nodes
  • enlcose platysma
• Superficial (investing) layer of deep fascia
  • surround deeper parts of neck
  • encloses SCM & Trapezius m
  • also encloses the submandibular gland & makes fibrous sheat of parotid gland
  • has suprasternal space – ant jugular v, and arch of jugular v.
  • attached Sup = mandible, mastoid pr, ext occipital protuberance, sup nuchal line
  • Inf = acromion process, scapular spine, clavicle, manubrium
• Prevert fascia of deep fascia
  • cylindrical & encloses vert column & m. w/ it
  • covers Scalene m & deep m of back
  • extends laterally into axillary sheath – has axillary a/v and brachial plexus
  • attaches to ext occipital protuberance & basilar part of occipital bone & cont w/ endothoracic fascia & ant longitudinal lig of vert
• Carotid Sheath
  • Contents: Common & Int & Ext carotid a, Int jugular v, CN X, n to carotid sinus, deep cervical lymph nodes
    
  • DOES NOT contain SNS Trunk, which is post to Carotid sheath & ant to prevert fascia
  • blends w/ prevert, pretracheal investing layers & also attaches to base of skull
• Pretracheal Fascia of Deep Fascia
  
  • invests larynx & trachea, esoph
  • encloses thryoid gland & contributes to carotid sheath formation
  • has thin musc layer of infrahyoid m
  • connects w/ Buccopharyngeal fascia superiorly
  • Sup = Thyroid & Cricoid cart
  • Inf = Pericardium
• Buccopharyngeal fascia
  • covers buccinator m & pharynx
  • attached to pharyngeal tubercle & pterygomandibular raphe
• Pharyngobasilar fascia
  • fibrous coat in wall of pharynx
  • b/w mucus mem & pharyngeal constrictor m

Superficial & Lat M of the Neck

• Platysma – (CN  VII) – depress lower jaw, lip, and angle of mouth
• SCM – (CN XI) – 1 of them, turns face to opposite side, bringing chin to opposite shoulder, w/ BOTH = flex head, raise thorax

Muscles of Posterior Triangle (will discuss later)

• Splenius Capitis
  
• Levator Scapulae
  
• Scalenus m
  

Muscles of Anterior Triangle

Suprahyoid m:

• Mylohyoid (Mylohyoid n of V3) – elevate hyoid & floor of mouth, lowers mandible, makes up floor of mouth
• Geniohyoid (C1 via Hypoglossal n) – elevate hyoid and floor of mouth, rest above the mylohyoid
• Stylohyoid (CN VII ) – elevate hyoid
• Digastric (ant belly = Mylohyoid n of V3, post belly = CN VII) – elevate hyoid & floor of mouth, depresses mandible,

Remember that muscles that originate from 1st arch = CN V, and 2nd arch = CN VII

Infrahyoid M: all innervated by Ansa Cervicalis, except THYROHYOID (C1 via Hypoglossal n), together they anchor the hyoid bone, scapula, clavicle, and lower the hyoid bone and larynx for swallowing

Superficial muscles:

• Sternohyoid m – depresses hyoid & larynx
• Omohyoid m – depress and retracts hyoid & larynx

Deeper muscles:

• Sternothyroid m – depresses thryroid cartilage and larynx, is wider and just underneath sternohyoid
• Thyrohyoid m – depressed and retracts hyoid & larynx

Deep Neck Muscles:

Lat/Ant Vertebral muscles

Lateral Vertebral m

NOTE – Can mention Scalenus Tent, Hiatus, Subclavian a, Scaleno Tracheal Fossa here. See Flash Cards @ Beg of Topic.

• Ant Scalene m (C5-C8 ) – elevate 1st rib, bend neck
  • From transv. process of C3-6 –> scalene tubercle of 1st rib
• Mid Scalene m (C5-C8 ) – elevate 1st rib, bend neck
  • From transv. process of C2-7–> upper surface of 1st rib
• Post Scalene m (C6-C8 ) – elevate 2nd rib, bend neck
  • From transv. process of C4-6 –> outer surface of 2nd rib

Ant Vertebral m

• Longus Capitis (C1-4) – flex, rotate head
  • transv processes of C3-C6 –> inf surface of basilar part of occipital bone
• Longus Colli – (C2-6) – flex, rotate head – NOTE same as longus cervicis
  • ant tubercle of atlas –> Bodies of T3 and transv processes of C3-C6
• Rectus Capitis ant (C1-2) – flex, rotate head
• Rectus Capitis lat (C1-2) – flex head laterally

SubOccipital & Deep Neck M

• Suboccipital region flash card listed above, triangular region just below the occiput of the skull,
• all muscles innervated by suboccipital n (C1)
• Extend, rotate and flex head laterally.
• Rectus capitis posterior major – spinous process of C2 –> lat part of inf nuchal line
• Rectus capitis posterior minor – post tubercle of Atlas –> medial part of inf nuchal line
• Obliques capitis superioris- spinous process of C1 –> medial part of inf nuchal line
• Obliques capitis inferioris – transverse process of C1 –> occipital bone b/w nuchal lines

NOTE:  Layers in order in back m (That is, if you were to peel off the muscles layer by layer) – Trapezius, Semispinalis & Longissimus Capitis, Splenis Capitis, then these muscles, with the suboccipital triangle w.in them.

Suboccipital Triangle

Borders:

• med = rectus capitis post major
• lat = obliques capitis sup
• inf = obliques capitis inf
• roof = semispinalis m
• floor = post atlanto-occipital membrane, post arch of atlas

Contents: Vertebral a/v, Suboccipital n. NOTE – KNOW PATHWAY OF VERTEBRAL A!!

In Aqua is the location of the Suboccipital Triangle

Histology: Hypophysis.

Slide #31 Hypophysis *H&E

Structures to Identify:

• adenohypophysis
• neurohypophysis
• pars distalis
• pars intermedialis
• pars tuberalis
• pars nervosa
• CT capsule
• acidophils
• basophils
• chromophobes
• capillaries
• Herring bodies
• Dura mater (may not be able to see) – dense CT
• reticular fibers
• brown pigment

General Info:
Hypophysis has 2 major subdivisions: ant lobe = adenohypophysis, post lobe = neurohypophysis
is located in sella turcica of sphenoid bone
connected by stalk (tuber cinerum) to base of brain (hypothalamus)

Adenohypophysis – divided into 3 parts: pars distalis (most ant), pars tuberalis, pars intermedia
* Embryo: derived from invagination of ectoderm of oropharynx toward the brain = Rathke’s pouch, placode plate, becomes part of roof of oral cavity
Neural system in ant lobe:
since it does not develop from neural tissue, has rich a/v system that connects it w/ hypothalamus of brain via portal system
Neurons in hypothalamus synthesize hormones that have direct influence on cell functions of adenohypophysis
Axons of those neurons extend and terminate on 1st capillary bed of ant lobe – and then release hormones there

Pars distalis – bulk of ant lobe
have clusters of cells w/ layers of fiber between them

contains 2 types of cells:
Chromophobes – inactive cells, euchromatic nucleus, pale cytoplasm

Chromophils – active, hormone producing cells
2 types of them:

Acidophils (40%  of cells in ant lobe)
reddish pink = eosinophillic
2 types:

Somatotropes (GH cells) –

• oval w/ round nucleus + eosinophillic vesicles in cytoplasm
• (+) by Growth Hormone, (-) by somatostatin
• GH secreted while sleeping, important to keep healthy cells in order for them to go thru mitosis
• hypothalamus hormones regulate GH
• NOTE – Targets of acidophillic cells (secrete hormones w/ general effect), are not endocrine cells

Lactotropes (PRL cells) –

• large polygonal cells w/ eosinophillic vesicles of prolactin, oval central nuclei
• (+) by TRH + VIP (synthesis secretion)
• (-) by Dopamine – secretion

Basophils – bluish purple cytoplasm (all have round eccentric nucleus)

Corticotrophs (ACTH release)

• polygonal, produce precursors of ACTH
• (+) by CRH from hypothalamus

Gonadotropins (FSH + LH release)

• regulated by GnRH (Gonadotropin releasing hormone) from hypothalamus
• LH =
  • (+) production of corpus luteum
  • (+) testosterone secretion
• FSH = stimulates spermatogenesis, follicle release

Thyrotropins (TSH release) –

• large stimulate thyroid gland production of thyroid hormones (T3 + T4)
• regulated by TRH (Thyroid releasing hormone) from hypothalamus
• acts on follicular cells of thyroid

Pars Intermedialis

• surround small cystic cavities  representing residual lumen of Rathke’s pouch
• lined by epitheloid cells w/ a/v outside of them
• contain basophils + chromophobes in nests surrounding inner cavity = colloid
• fluid filled colloid contains pre-hormones stored there
• if need hormones, cells take back the pre-hormones , edit, then reject

Pars tuberalis

• ext of ant lobe along pituitary stalk, highly vascular region
• contains hypothalamus – hypophyseal portal system *talk about later*
• cells form cellular columns, not clusters, but parallel rows of cells and fibers
• To understand ant lobe:
  • need to know hormone regulation of hormone production
  • released by paracellular neurosecretory neurons in hypothalamus – regulates the hormone production of ant lobe
  • releasing factor – inc secretion
  • inhibiting factor – dec secretion
    

Posterior lobe = neurohypophysis

General Info:

Pituicytes

is downgrowth of CNS
CNS has 2 cell types: neurons, glial cells

• both are present in neurohypophysis
• but glial cells called pituicytes here

NO cell bodies of neurons here, but yes, axons of them are present
cell bodies of neurons located in nuclei of hypothalamus, axons are longer and terminate in walls of sinusoids in post lobe

NOTE – axons carry hormones continously, but these are only released sporadically
so hormones need to be stored = in Herring bodies
NO HORMONES PRODUCED IN POST LOBE

Appearence: homogenous appearence, pinkins lines = axons
post lobe has 3 parts: median eminence, infundibulum, parsa nervosa

1. Median eminence = @ base of hypothalamus
2. Infundibulum = part of post lobe that extends up to hypothalamus
3. Pars nervosa = largest part of post lobe

Pars Nervosa

• contains secretory vesicle = Herring bodies – difficult to distinguish these from a/v
  • contain oxytocin, vasopressin from hypothalamus,fibroblasts, mast cells, pituicytes
• Pituicytes = oval or round nuclei, and brown pigment in cytoplasmic vesicles
  • have processes to perivascular spaces = support
• GFAP = glial fibrillary acidic protein –> specific intermediate filaments
• Vasopressin (ADH)  – controls BP, contraction of smooth m in a./arterioles (VC = inc BP)
• Oxytocin = neural stimulation
  • contraction of uterine smooth m during orgasm, mestruation, birth
  • contraction of myoepith cells in mammary gland –> milk ejection in lactation

Hypophyseal Portal (circulatory) System:
a “portal” system is any system of arterial supply that makes 2 arterial capillary beds
Originates from superior/inferior hypophyseal a

Sup Hypophyseal a

• Superior hypophyseal a enters the hypophysis superiorly and supplies pars tuberalis, medial eminenece, conar skin
• In the median eminence, it makes the primary (1st) capillary bed, then reforms and then makes a second capillary bed in the ant lobe itself
  • primary capillary bed is where the axons from hypothalamus neurons synapse and release hormones – the releasing/inhibiting factors mentioned earlier
  • the secondary capillary bed carries secretions of hypothalamus from med eminence –> infundibulum –> pars distalis
• Once the releasing/inhibiting factors from hypothalamus are secreted into pars distalis, they will bind to specific receptors  on cells (chromophils) and cause them to either release or inhibit the release of the hormone they produce.

Inf Hypophyseal a

• Inf hypophyseal a enters hypophysis inferiorly and supplies pars nervosa, makes ONE capillary bed – therefore not part, technically, of the portal system
• unmyelinated axons from nuclei in hypothalamus release the oxytocin, ADH in the sinusoids of pars nervosa, and the hormones are then stored in nearby Herring bodies (@ axon terminals)

Sinusoids of pars nervosa  are fenestrated :

• meaning they have a discontinous endothelium = allows transport b/w cells and sinusoids more free
• they have NO BASEMENT MEMBRANE  – simply are resting on reticular fiber meshwork

Blood drains through hypophyseal v –> cavernous sinus –> systemic circulation
some thru short portal v from parts distalis –> pars nervosa –> hypothalamus

Slide #32 Hypophysis *AZAN (Azocarmine blue, anahiline red)

Structures to Identify:

• dura mater = bluish dense CT
• acidophils
• basophils
• reticular fibers
• Herring bodies
• brown pigmentation

Ant lobe
basophillic cells have complete blue cytoplasm
acidophillic cells are red
bluish line represent reticular fibers that belong to the CT stroma
v. homogenous look

Post lobe
bluish bodies and fibers are Herring bodies and their axons
brown pigmentation  = lipofusin – aging pigmentation in nerve tissue

Slide is designed to show Herring bodies (blue) + blood vessels (red) can be easily distinguished

Embryology:The development of the face.

• @ 4th wk = facial prominences form, formed by 1st pharyngeal arch from neural crest cells
  • Maxillary prominence – forms lat to stomodeum, the primordial mouth
  • Mandibular prominence – forms caudal (below) to stomodeum
  • Frontonasal prominence – is a growth of mesenchyme that makes the upper border of the stomodeum = forehead, orbital area
    
  • On both sides of frontonasal prominences, there are forming 2 lateral thickenings of surface ectoderm = nasal placodes
• @ 5th wk = nasal cavity and nasal projection begins to form (nose)
  • nasal placodes fold inwards (“invaginate”) to form nasal pits
  • around nasal pit, there is a ridge of tissue = nasal prominences.
    
  • *Picture a bowl – the actual bowl is nasal pit, and the rim of the bowl is the nasal prominences
  • The nasal prominences are split into lat & medial nasal prominences
• @ 6th-7th wk = Maxillary prominences grow
  • the future cheeks/zygomatic areas are growing
  • this pushes the medial nasal prominences towards each other
  • maxillary prominences & med. nasal prominences fuses
  • This forms the upper lip
• lower lip & jaw = mandibular prominences
• Nose is formed by 5 areas
  • frontal part of frontonasal prominence = bridge of nose
  • 2 medial nasal prominences = crest of nose, tip
  • 2 lateral nasal prominences = sides, ala of nose
• Nasolacrimal duct
  • starts off as groove b/w med/lat nasal prominences = nasolacrimal groove
  • the ectoderm in the floor of this groove – forms epithelial cord, that then detaches from the groove
  • this is the future duct – it will later open up into a canal
  • the upper part of it is widen up to form lacrimal sac
  • Deeper, med/lat nasal prominences fuse.