Chapter -04

Chapter
Page number
Anatomical points..........
Surface markings 378
X-rays .380
Cervical vertebra .382
Scalp .386
Face .388
Lacrimal apparatus ..393
..398
The neck region ...400
Posterior triangle ...400
Anterior triangle ...402
Deep fascia of neck ....405
Muscles of head & neck.. ....410
Glands of head & neck 415
Pituitary gland 415
Salivary glands 419
Thyroid gland 425
Parathyroid glands
— ......430
Meninges
Cranial fossa —
— 432
437
.......440
Venous sinus
Emissary vein 444
Orbit 445
Nose 449
Paranasal sinuses 456
459
Tongue
467
Ear.... 476
Tonsil 480
Hard palate 482
Soft palate 484
Pharynx
Larynx
Blood vessels of head & neck..
— 488
495
498
Cranial nerves
Bones & Joints of head & neck
— 509
512
Development of head & neck... 517
MCQ of Head & Neck

377

Scanned with CamScanner

 1

ENPEAWKW TOMY. 'WITEN (SAQ, MCQ &

Anatomical points

Bones

Atlas:
This is the atlas.
Jnatomical points:
is marked by groove for vertebral
1.Posterior arch is longer than anterior arch and posterior arch
artery & cervical spinal nerve, superiorly.
2. Posterior aspect of the anterior arch is marked by facet for the
dens.
constricted in the mid e.
3. Superior articular facets are elongated, concave, and often

Axis:
This is the axis.
A natomical points:
1. Dens, a bony projection from the body of the vertebra is at the front and above.
2. Body lies in front & spine behind.
3. Lower border of the anterior surface of the body projects downwards.

Typical cervical vertebra:

This is typical cervical vertebra.
Anatomical points:
1. Body of the vertebra lies anteriorly.
2. The superior surface of the body is convex transversely with a prominent lip on each side.
3. Oval superior articular facets are directed backwards & upwards.
4. Foramen transversorium present in each transverse process.
5. Spinous process is short & bifid which lies posteriorly.
6. Vertebral foramen is triangular.

7th cervical vertebra:

This is 7th cervical vertebra.
Anatomical points:
1. Body lies anteriorly & arch lies
posteriorly.
2. Spinous process is long, straight,
horizontal, not bifid & is directed posteriorlv
' C°n,ai"
4. f°ramen ,ranSVerSariUm'

Parietal bone:
This is parietal bone of right / left
side.
Anatomical points:
externally and internally, it VmtrkJd more projected and acute which is bevelled

PoZdd°fWnWardS’
2. f0rwards and slightVmeTallw meningeal artery and also angle iS
1 Sagittal by for d,e sigmoid sinus internally.
m the median plane. n it is
emally marked by a superior sagittal sinus which lies

Scanned with CamScanner

 t fetul A neck 379
Prontalbonoi
This is frontal bone.
tnatomical point*:
:3. .
spine which is pmjeelion
downwanb & fonvards.
o<?cIqh^I bone.
This is occipital bone.
Anatomical point*:
Squamous pa 'Vh’Ch 'S si,uatcd inferior|y in the median Plane’
Basilar nan is diXf/rorwards and upwards from the foramen magnum.
U C
b and c°nv™ty backwards.

Maxilla:
This is maxilla of right / left side.
Anatomical point*:
L Alxeolar process is marked by
sockets for the teeth and lies horizontally and inferiorly.
~ projects upwards from the anterior part of the body of the maxilla.
j. Palatine process of the maxilla is horizontal
and lies in the median plane.
Sphenoid bone:
This is sphenoid bone.
Anatomical point*:
1 . Superior surface of the greater wing of the sphenoid is deeply concave and is directed upwards.
2. Optic canal, which is situated in the lesser wing, lies anteriorly.
3. Pterygoid process which is situated at the junction of the body and greater wing projected
downwards.
4. Superior surface of the body of the sphenoid is almost horizontal.

Mandible:
This is mandible.
Anatomical points:
1 . Alveolar process (superior border of the body of the mandible) is marked by sockets for the roots of
the teeth and lies above and convexity of the body of the mandible is forwards.
2. Mandible lies slightly oblique and body is more or less horizontal.
3. From the posterior ends of the body, two rami are projected upwards on each side.

Zygomatic bone:
This is zygomatic bone of right / left side.

is thick and serrated which is directed anteromedially & slightly upwards.

2. Temporal process is
smooth, which is directed laterally and forwards.
3.
4. Temporal is ’concave
and is directed mediahy & backwards

Temporal bone:
This is temporal bone of right / left side.
_ ..
Anatomical pointe . .. pp._d forwards from the lower portion of the squamous part and is almost
1. Zygomatic process is directeu
horizontal.

Scanned with GamScanner

 — ENDEAVOUR ANA TOMY WK lYRITTE^
2. External auditory meatus Iles on (he lateral aspect.
(SA^JMCQ)

3. Squamous part, which is tint and thin, Iles above. Is .slender, pointed and is directed
4. Styloid process of temporal bone, a bony
projection, downwa^
forwards from the under surface of the bone.

Base of the skull;

lids is base of the skull.
Anatomical points: Infraorblral margin in front and upper
I. Erankfurt plane lies horizontally which extends from the
margin of the external acoustic meatus behind.
2. Orbital opening lies in front.
for teeth, lies inferiorly.
3. Alveolar process of the maxillae, which arc marked by sockets

Viscera
Tongue & others:
This is the viscera of tongue, larynx, trachea with its bifurcation, right & left principal bronchus,
pharynx, oesophagus, muscles of soft palate, thyroid gland, submandibular & sublingual salivary glands,
common carotid artery, some vessels & muscles and hyoid bone.
Anatomical points:
1. Tongue lies above and tip of the tongue (i.e. apex) is pointed and is directed forwards.
2. Dorsum of the tongue is convex and is directed upwards.
3. Trachea, containing C-shaped cartilages, is directed vertically downwards.
4. Oesophagus which is muscular tube and collapse antero-postcriorly and situated behind the trachea,
which as directed vertically downwards.

Surface markings
Parotid gland:
• Anterior border: It is represented by joining the following
points:
I. A point on the upper border of mandibular
condyle;
2. A point slightly above the centre of masseter
3. A point 2 cm below and behind the angle
muscle;
of the mandible.
• Upper border: Draw a curved line
with a concavity above across the lobule
following points: of the ear by joining the
I. Upper border of the
mandibular condyle;
2. Mastoid process.
• Posterior border: It is marked by a straight
line joining:
I. The tip of mastoid process;
2. A point 2 cm below and
behind the angle of mandible.
rotid duct:
1. A point at the
2. Another point
lower border of concha of the
midway between the ala of ear;
the nose and the red margin
The parotid duct is represented of the upper lip.
by the middle third
of a line joining these points.

Scanned with CamScanner

 ,rr-Q4: Head & neck
ini artorY in the faco:
— - 381
E^^Cpoint on the mandible at the
can be felt. antcro-infcrior angle of the masseter where the pu - ation of the artery
n A point about 1 .25 cm
lateral to angle of the
a point at the medial angle of thetheeye.
*•
mouth;
join these points by a wavy line
which should forwards almost to the ala of the
nose.
Thyroid gland:
• For Isthmus:
I . Take a point 1 cm below
the arch of cricoid cartilage and draw a horizontal line through it 1 .5
' on® across the trachea. It represents
a e ano icr point 1 .25 the upper border of the isthmus.
cm below the previous one and draw a horizontal line through it 1 .5 cm
long. It represents the lower
border of the isthmus.
• For lateral lobes:
1 . A point 1 can below the lateral
end of the lower border of the isthmus.
2. A point 2.5 cm lateral to the previous
3. Put a point on the anterior one.
border of the sternocleidomastoid at the level of laryngeal
prominence. It represents the upper
pole of the lateral lobe.
Join the lateral end of the lower border of the isthmus with the first
two points in succession, so that the line
presents a convexity below. It represents the lower pole of the lateral lobe.
Finally join the points for the
upper pole with the lateral ends of the upper border of the isthmus and another with the lateral ends of the
lower pole.

Common carotid artery:

• Right side:
1. A point on the stemo-clavicular joint.
2. A point on the anterior border of stemo-mastoid muscle at the level of upper border of thyroid
cartilage.
• Left side:
1. Take a third point, in addition to the upper two, slightly to the left of the middle of manubrium
stemi, that means, midway between the suprasternal notch and the steno-manubrial joint.
2. Join these points by a broad hand or double lines which represent the artery.

Internal carotid artery:

1 . A point on the anterior border of the sternocleidomastoid muscle at the level of upper border of thyroid
cartilage;
2. A point at the posterior border of the condyle of mandible.
Join these points by a broad hand or double lines.

External carotid artery:

1 . A point on the anterior border of stemo-mastoid muscle at the level of upper border of the lamina of
thyroid cartilage.
2. A point midway between the angle of mandible and the tip of mastoid process.
Join these points by italic T shaped double lines, which are gently convex forward in the lower half and convex
backward in the upper half.
Internal jugular vein:
1- A point on the lobule of the ear.
2. A point on the sternal end of the clavicle.
at its lower end between the sternal
Join these points by a broad band or double lines. And make a dilatation
the interior bulb.
and clavicular heads of sternocleidomastoid muscle to represent

Scanned with GamScanner

 382

X-rays

X-ray of skull occipito-mental view

Q. Identify the X-ray.

fdeptrficatkin: Plain X-my skull OM (occipito-mental) view.

Q- Shen* different paranasal sinuses.

Answer
Try to do yourself

Q. Mention the opening of different paranasal sinuses.

Answer
Opening! of paranasal sinus:
Frontal air tinut: The middle meatus of nose at the anterior end of the hiatus semilunaris either
through the infundibulum or through the fronto-nasal duct.
B. Maxillary air tinus: It opens into the middle meatus of nose in the
lower part of the hiatus semilunaris.
A second opening is often present at the posterior end of the
hiatus. Both openings are nearer the roof
than the floor of the sinus.
Sphenoidal air tinut: Each sinus opens into
spheno-ethmoidal recess of the corresponding half of the
nasal cavity.
D. Ethmoidal air utilises:
' sinus opens into the anterior part of the hiatus
semilunaris of middle nasal

>
^dteSmLto."’^16
The openings of the posterior
elh,noidal air sinus is
P1®5™* al the upper margin of the bulla of
ethmoidal air sinuses are located in the superior nasal meatus.
Q. Show the orbital cavity
Answer ''
TO) ourself.

Scanned with CamScanner

 ^rr Head & neck
—
q What *s *^e func*'on and clinical importance
383
of paranasal sinuses? [SUS I-I9N1
Ans"'er
J^f^Make the skull lighter.
2) Resonance to the voice.
3) Humidification of air (air

i
— from the nose.
.
infection of a sinus .
conditioning).
is known as
2) Carcinoma of the maxillarv cim.e ..
sinusitis. It causes headache andJ pcrsisie
.
.pnt. thick, purulent discharge

3) Frontal sinusitis can Produce

ethmoiditis
produce a hra
brain V™
abscess in
’hc mucosal lininS-
the frontal lobe. A similar abscess may result frnm
Irom

Q. What ty pe of bone the maxilla is?

Answer
Pneumatic bone

Q. What do you mean by pneumatic bones? Give example.

Answer
These bones contain air-filled spaces which are lined by mucous membrane.
Characteristics:
• Pneumatic bones are confined in close proximity to the nasal cavity.
• Spongy part of these bones is absorbed and forms a cavity, which is filled with air called sinuses.
Example: Maxilla, sphenoid, ethmoid etc.

Q. Mention the formation of nasal septum.

Answer
Formation of nasal septum:
A. Bonv part: Formed by-
I) Vomer
2) Perpendicular plate of the ethmoid bone
3) The nasal spine of frontal bone.
4) Rostrum of sphenoid and
5) Nasal crests of nasal, palatine & maxillary bones.
B. Cartilaginous part: Formed by-
1) Septal cartilage.
2) Septal process of inferior nasal cartilages.
C. Cuticular part: Formed by fibro-falty tissue covered by skin.

Scanned with CamScanner

 384 - ENDEA EOUR ANA TOMY FOR WRITTEN (SAQ, MCQ) &

X-ray of cervical spine lateral view

Q. Identify the X-ray.

Answer
This is the plain X-ray of cervical spine lateral view.

Q. Count the cervical vertebrae.

Answer
Try yourself.

Q. Write short note on: Articulation of 1st cervical vertebra. [DU-1 8N]
Q. What are the bones involved in atlanto-axial and atlanto-occipital joints? Mention the
movements of these joints.
Answer
Articulation of I*1 cervical vertebra (Atlas):
Atlanto-axial joint:
• Bones involved: Atlas & axis vertebra.
• Movement: Rotatory.
Atlanto-occipital joint:
• Bones involved: Atlas vertebra & occipital bone.
• Movement: Flexion and extension (noding movement).
Q. What do you mean by typical and atypical cervical vertebrae?
Answer
The 3 to 6 cervical vertebrae are typical because they have common features. The 1st, 2nd and 7
atypical because they possess special features for individual
identification.
Q. What do you mean by cervical rib?
Answer
Cervical rib: A cervical rib is a supernumerary or extra
rib which arises from 7th cervical vertebrae.

Scanned with CamScanner

 ^ter-04; Head & neck 385
A cervical nb can cause compression of
to thoracic outlet syndrome.
.
the lower Inink of brachial plexus ana ,ubc|avian
su artery and

arc the deformities of vertebral

Q What column?
Ans"cr
t Scoliosis
Kyphosis
,•
.«
Iumbar lordosis
Spina bi fida
Meningocele
• Meningomyelocele
• Spondylolisthesis
• Cauda-cquinc syndrome
• Disc prolapse

^Jay_Qfskull lateral view

Q. Identify the X-ray.

Answer
Identification: This is a plain X-ray skull lateral view.
Q. Show pituitary fossa.
Answer
Try yourself.
Q. Mention the content of pituitary fossa.
Answer
Pituitary gland.

Q. What type of bones are the skull bones?

Answer
Flat bone.

Scanned with CamScanner

 3«6

Q. What fl (he morphological chartcferhllc of fiaf bone?

Answer , , .jntf sor/nvy brme m»rfir»,
compact Ixme wl I in Ilie diploe
• Hal hono corula of Iwo plale’ of
the bone, of the vault ol Vnown at wf^
• The intervening spongy tlnue In
contains numerous veins.
and Kept*
. r
are exempt of to
.
Example: Moa of .he hone, of .he vaul. of .he .hull. riba. acmum.

Q. What do you mean by diploe?

Answer
The intervening spongy tissue In the bona of the vaul
r. . .. Vnown as the diploe which
contains numerous veins.

Cervical vertebra
[DU-16N]
Q. Write briefly on: Characteristic features of cervical vertebra.
Answer
Identification ,
_ are seven cervical
The cervical vertebrae are identified by the presence of foramina transversana. There
vertebrae, out of which the third to sixth are typical, while the first, second and seventh are atypical.
Typical cervical vertebrae:
> Bodv:
o The body is small and broader from side to side than from before backwards.
o Its superior surface is concave transversely with upward projecting lips on each side. The
anterior border of this surface may be beveled.
o The interior surface is saddle-shaped, being convex from side to side and concave from before
backwards. The lateral borders are beveled and form synovial joints with the projecting lips of
the next lower vertebra. The anterior border projects downwards and may hide the
intervertebral disc.
o The anterior aria posterior surfaces resemble those of other vertebrae.

> Vertebral foramen is larger than the body. It is triangular in shape because the
pedicles are directed backwards and laterally.
> Vfrifbr?! arch;
o ba'kWard’ "nd lal'ra"y' ’U|*rior 0,,<l lnfcrior vencbral
0 The laminae arc.relatively long and narrow, being thinner
0
above than below.
heeler proceiiea form articular pillars which project laterally
Junction of pedicle and the lamina. The superior articular facets are flat Thev are dlS at the

0
poilarlor rooli whlcl
rapreianted
i*end bHubc^^^
by the anterior
l!“h pracs" *“•anterior "nd
C0'l0,ran"'8,M The costal dement 1»
root anterior tub
it , H
d u
luherclo. Iha gnlerlor tuberde of II । ba' al'd lh» pe’”«Hor
luherc e becaute the common cwwld u h'“ l4/|W a'ul 8all8d 11,9 Mro"d
6 llw iplne la Ihon and bifid. The
notch fiK^ *' HHalnsl It.
h filled up by ilw llgwnium
mi Is *’
nuchas.

Scanned with CamScanner

Q. Write short note on: Articulation nf t’L • .
Q. What are the bones involved
movements of these joints.
Tadan “T o and
[DU’I8N]
atlanto-occipita! joints? Mention the
Answer
Articulation of 1“ cervical vertebra (Atlas);
Atlanto-axial joint;
• Bones involved: Atlas & axis vertebra.
• Movement: Rotatory.
Atlanto-occipital joint;
• Bones Involved; Atlas vertebra & occipital bone.
• Movement; Flexion and extension (noding movement).

Scanned with CamScanner

388 ENDEA VOUR AN A TOMY * OR
Scalp
clinical importance. [DU-O5J
the scalp with
» i
Q. Define scalp. [SUST-14Ju]Namc the layers of
CU-I5Ju,14Ju,12J, 08J,06J, SUST-06Ju/J]
Q. Draw and label different layers of scalp. [SU 9^ j $n/J.
'

6N, 1 5 Ju, CU-I J’ fhC 4 f ,cajP*

Q. Mention the layers of scalp. [DU- 1
Q. What are the layers of the scalp. Mention the
cm
SUST
[RU-16NJ5JJ3J, SUST-I5N] itnicallv important and why. friJ-09Ju
I
c
Q. Name the layers of the scalp. Which layer is
09Ju, RU-O8J11]
Answer
the sea p
The soft tissue covering the cranial vault is called
Lavers of scalp:
Skin: Thick & hairy. . .
en
2. Superficial fascia: More fibrous an proves
centre than at theperiphery of the
head. It
the proper medium for passage of vesse
nerves to the skin.
3. Epicranial aponeurosis / galea
aponcurofica
(deep fascia) with occipitofrontalis
muscle.
4. Loose areolar tissues.
5. Pericranium: It is loosely attached to the
bone but
firmly attached to the sutures.

Skin with hair

Superficial fascia with blood vessels

Epicranial aponeurosis
Loose connective tissue
:
— Pericranium
Diploe in between
outer and inner tables of skull
'
Dura mater
Emissary vein
Superior sagittal sinus
figure: Layers of scalp'

Scanned wi/th CamScanner

 .^r.n4: Head A neck
0!!!^
The scalp is a multilayered
389
'
K,,te:
Skin
structure withu‘ ycrs i can be defined by the word itsclf-
C. Connective tissue
Aponeurotic layer
L- Loose connective tissue
p. pericranium
of scalp;
fiinica.1 importance
is a common site for sebaceous evsts
b
2. Since the blood supply of scalp is ri J ..CCause abundance of sebaceous glands.
.?
in position & stitched; thev usiniu 1C avu'scd portions
need not be cut away. They can be replaced
3. Wounds of the skull bleed
fascia.
ZS"?' "P
ccausc * the
wc"'
vessels arc prevented from retracting by the fibrous
4. Bleeding can be arrested bv annlvinn
5. Because of the density of fascia sub
6. Inflammation of the fascia layer cause Jhf
’SSUrC tllc bonc-
are extensive.
bUt mUCh
nc/cr
7. The layer of loose areolar tissue iss known as pam'
wins which onen hm. . the dangerous area of the scalp because the emissary
8. cX
mav extend ini n°r int0°
infeCtions from 1116 scalP ^e cranial venous sinuses.
00sc c°nncctive tissue causes generalized swelling of the scalp. The
F00t l'1c nose ar|d 'nto the eyelids, causing black eye'.
9. w°Unde nf the -Ca i P j n°l ®aPc un'css the epicranial
d • °
u16 Pericranium aponeurosis is divided transversely.
1S adherent to surfaces,
ecau8^
Cephalhaematoma take the shape of the bone concerned.
collections of fluid deep to the pericranium known as

(Ref- A. K. Datta / 7,h 1 66, 67+ B.D. Chaurasia / 6th / 60-62|

Q. Explain anatomically- Scalp bleeding is profuse. [DU-06J, RU-19N,12J,05J, CU-I6M,15M.
14/12Ju]
Q. Explain anatomically - Scalp injury causes profuse bleeding. [DU-19NJ8N, CU-19NJ8N,
17M, RU-15NJ1J]
Q. Wound of scalp bleeds profusely but heal rapidly - explain. [SUST-14Ju]
Answer
Scalp injury causes profuse bleeding and rapid healing:
Scalp bleeding is profuse, because-
1 . The scalp has a rich blood supply.
2. When the scalp is cut, the dense connective tissue surrounding the vessels tends to hold cut vessels
open. This results in profuse bleeding.
Scalp wound heals rapidly because of its rich blood supply.
(Ref- Snell / 2nd / 873 1

q Explain anatomically - Collection deep to the pericranium takes the shape of concerned bone.
[CU-12Ju]
A,1swer
tabM the shanc of concerned bone:
Collection deep to the pericran
•
t
,raniu|nPknown as Cephalhaematoma take the shape of the bone
Collections of fluid de p P
surfaces of the adjacent bone.
concerned because the pericranium is
B of eyes. [CU-15M]
Q. Due to blow in forehead, why there » »»«
> । is blackening

Q. Write short note on: Black eye.I (-11.141 |2Ju,09Ju, RU-15N,O8Ju,O5M]

Q. What is black eye? [DU- I7N, »
Answer ... ...
musc|e has no bony attachment and it is connected with the root
. „. Bro
occ.ptto-fronU „K sutap0„eUroltc areolar tissue and
Black eye: Frontal bellies of
& upper eyelids. In
then it slowly track down into the
any
uppb1^ rcsull a black condition of eyelids, is known as black eye.
|Ref- oatja / 4*** / 6$|

Scanned with GamScanner

 390
Q. Explain anatomically- which layer of the scalp Is dangerous A why I1 ।
Q. Explain why 4th layer (loose areolar tissue) Is the dangerous ay
- (ell-

I9MJ8MJ5N. I3J) hv7 fSUST-l5M09JuJ

Q. Which layer of scalp is clinically important and why b
Answer
Danecrous layer of the scalp;
. ....
The layer of the subaponeurotic areolar tissue M
(4 * lay ) is called the dangerous
tsun)
or zone) of the scalp. Because emissary viens are opened here,
area (dangerous
transmit infection from the scalp t0
l||limatc|y it may causes death.
the intracranial venous sinuses which may produce throm o <
R p Chaurasia / 7* /Q|

Q. Explain anatomically: Why/ how- black eye is a

consequence of skull injury. [DU-I5M,
15/13/11/09J. 08J]
Answer
Black eye is a consequence of skull injury: may extend
die layer of loose connective tissue which
In skull injury, there is collection of blood in
anteriorly into the root of the nose and into the eyelids because
of having no bony attachments of the frontal
belies of occipitofrontalis muscle, causing ‘black eye’. A. K. Datta/ 4,h / 66,
[Ref- 67|

Figure: Attachment of frontalis muscle.

Q. Explain anatomically - why/ how - Blood in the loose

into upper eyelid. [DU-09Ju] connective tissue layer of scalp can enter
Answer
Explanation:
Frontal bellies muscle has no bony
eyelids. In any blow of the skull colleted attachment and it is connected with the
blood in the subaponeurotic loose root of the nose & upper
track down into the upper eyelids.
This result a black condition of eyelids connective tissue and then it slowly
is known as black eye.
IRef- A. IC Datta /4,h/ 66,67|
Q. Whaf is diploic vein? [DU-05J,
CU-06J, RU-13Ju]
Diploic vein:
The veins present in the diploe
of the cranial bones
are called diploic
[Note^ The cranial bones consist of veins.
vascular tissue known as diploe.] outer and inner tables of compact
substance in adults and a middle layer of

Scanned with CamScanner

 f: Head neck
391
(X
the blood supply of scalp. [DU-05J, CU-l si„ , , n,,
piH of venous drainarc
the plsn ramagc of
.
' U.O6J. SUST-12J.06JU
cikt nmAum J]
^(;hvfhe nf headi
ncck region. [RU-17M]

,jrt*l supply
^ASupratnxhlcan A branch of ophthalmic artery
arten which is a branch of internal Supra -orbital
artery. carotid
2. Supraorbital: A branch of ophthalmic
artery.
A Superficial temporal: A branch of frontal
branch of external carotid arterv. terr-poral artery|
frrhindthe auricle; x Poster' or
I. Posterior auricular: A branch of external
carotid artery. auricular artery
2 Occipital: A branch of external carotid Occipital artery
artery.

Figure: Artery supply of scalp.

X enons drainage:
In front of auricle:
1. Supratrochlear & supraorbital veins unite to form angular vein which continues down as facial
vein.
2. Superficial temporal vein joins the maxillary vein to form retromandibular vein, which divides
into anterior and posterior divisions.
3. Facial vein and anterior division of the retromandibular vein joins to form the common facial
vein that drains into the internal jugular vein.
Behind the auricle:
I . Posterior auricular vein, after joining with the posterior division of the retromandibular vein
drains into external jugular vein.
2. Occipital vein which drains into suboccipital venous plexus.
Besides, some emissary & diploic veins drain the scalp. These are -
1 . Parietal emissary vein.
2. Mastoid emissary vein.
3. Frontal diploic vein.
4. Occipital diploic vein.
[Ref- A. K. Datta / 4* /68)

Scanned with GamScanner

 222 ENDEAVOUR ANATOMY FOR WRITTEN (SAO. MCO) &
Q. Give the nerve supply of scalp.
Answer
MtnmilWlY Vf Ihc sculp;
On each side of the head, r 1^1, in front ofthe auricle and 5
the auricle. Out of 5 of each group,there arc 10 superficial nerves of which 5sin behind
ti

4 arc sensory & I is motor.

In front ofnuriclc Behind the auricle
’ supply ~
t
0 Supratrochlear branch of ophthalmic division I) Posterior division of great auricular (Q?C3)
of trigeminal nerve.
2) Supraorbital nerve.
branch of ophthalmic division of 2) Lesser occipital (C2) nerve.
trigeminal nerve. 3) Greater occipital (C2 dorsal ramus) nerve.
3) Zygomaticotemporal branch of zygomatic 4) 4. Third occipital (C3, dorsal ramus) nerve
branch of maxillary nerve.
4) Auriculotemporal branch of mandibular
division of trigeminal nerve. I
otor supply
Temporal branch of facial nerve.
I Posterior auricular branch of facial nerve?

A. K. Datta /4th /68]

Scanned with CamScanner

 rr,Q4: Head & neck

393

the steps of dissection of face.

Q Give
Ans"cr
of dissection of face;
a) Skin incision;
I. A 'ongitudinal incision
in the m d-
£eCs^cil^
3. An oblique
incision
the root of
from
lhePnose ’u7^^
thc symPhysis men,L
^8 8
4. One semicircular
5. One circular mcision
incisionXgfe^ the lower border of mandible to its angle.
ma^
along the
lateral?
b) Then thc flap of skin is reflected *8| f Uppcr & ,ower
of th*
W ”ds.
& ’ower lips
c) The superficial fascia is also musc,es of face come out.
reflected with
d) Then the superficial musc.es are
dea^X^
Q. Mention the peculiarities ofthe muscles efface
Answer
Peculiarities of the muscles of face:
1 . They are subcutaneous muscles.
2. Arise from the bones of the skull and inserted
into the skin
i 5. They also give the facial expression.

IRef- A. K. Datta/ 4th / 66, 67+ B.D. Chaurasia / 7* /64,651

Q. Write down the peculiarities ofthe skin ofthe face.
Answer
The peculiarities of the skin of the face:
1) The facial skin is very vascular. Rich vascularity makes the face bluish and blanches. Wounds of the
face bleed profusely but heal rapidly; the results of plastic surgery on the face are excellent for the same
reason.
2) Facial skin is very elastic and thick because the facial muscles are inserted into it. The wounds of the
face, therefore, tend to gap.
3) The skin ofthe face possesses numerous sweat and sebaceous glands. It is connected to the underlying
bones by loose connective tissue, in which are embedded the muscles of facial expression.
4) No deep fascia is present in the face. .
5) Boils in the nose and ear are acutely painful due to the fixity of the skm to the underlying cartilage.
|Ref- A. K. Datta / 4* / 70 + Snell / 8th / 731]
~ developmental background. [DU-l7N,08J,05Ju, CU-
rrface on the
devel^
। thp
Mention the nerve supply of
N’ 1 8N’ 1 5J' 1 4J11 2J’ 1 1,05 : ' [ 1 1 J,05J] Mention the cutaneous supply of face
n
Q. Mention
M °
the motor supply of fface. [K K u-
I7N. 15Ju]
according to its developmental backgroun • I
'

PP
|4J SUST.I4J_
Q. Draw and label the sensory nerve supply/ cutaneous
RU-15N] J

Ans
Mgrve supply of the face on developmental hackg -
frontonasal nromlneneen
.
I. Sensory nerve
The
provides generaTsensoryinnervation
„etvc (lhe nerve of the
from the frontonasal prominence,

Scanned with CamScanner

 394

provides general sensory rnnervn

“
*
Mfn^
, ph.ryngenl arch. '"""
f'“
" "'" ”
they .retire derivtives of the second

Opthalmic nerve
V Posterior primary
nerve
> [ rami of cervical
LJ- Maxillary nerve
tj- Auricular branch
f of nerve
- Mandibular nerve 1

rami

Figure: Sensory nerve supply of face.

Q. Explain anatomically: Why upper lip is known as danger area of face. [DU-08 J, CU-16M]
Q. Explain anatomically- Nasolabial area is dangerous area of face. [RU-lOJu]
Q. Explain anatomically- Dangerous area of face. [RU-13Ju]
Q. Why danger area of face is so called? [RU-15M,08J, CU-17N]
Q. Why & which is the dangerous zone of face? [RU-17N,07Ju, CU-14Ju]
Q. What do you mean by danger area of face? [DU-13Ju,12Ju, RU-15Ju,15M, SUST-I5N]
Q. Write short note on: Dangerous area of face.
Answer
Dangerous area of face:
Upper lip & lower part of nose is called the dangerous area
of face, because from this area infection can be spread in a
retrograde direction and these results in thrombosis of cavernous
sinus as a result of connection of facial vein with the cavernous
sinus.

|Ref- B.D. Chaurasia 1 7th /721

Q.
Why .Bfect.on the face ,s so
Answer
Because infection can be spread
cavernous smus as a result of connection from this area in a retrograde direction and results in thrombosis of
of facial vein with the
cavernous sinus.

Scanned with CamScanner

 ^ger-QA Head & neck 395
the blood supply of the
Q Give

Arteria!j!il!nb^artery,
Facial branch of externa!
Transverse facial artery, branch of °tld
...
•
• Arteries accompanying the
Supraorbital artery
cutaneou^n^'
nerves.
temporal artery.

Supraorbital artery
Dorsal nasal artery
Superficial temporal artery
Lateral nasal artery
- Infraorbital artery
Superior labial artery
Transverse facial artery
Inferior labial artery
Mental artery - Facial artery

Figure: Arterial supply of face.

Venousdrainage. The veins accompany the arteries and drain into the common facial and retromandibular
They communicate with the cavernous sinus.
veins.

|Ref- A. K. Datta / 4,h / 76 - 78 + B.D. Chaurasia / 7th / 71-721

Q. Why the facial artery is tortuous? [RU-07J]

Q. Explain anatomically / embryologically / histologically: Why the facial artery is tortuous?
[DU-14JJ3J]
Answer
Facial artery is tortuous due to some important causes-
• In the neck: The facial artery is tortuous because it has to accommodate itself to the movements of the
pharynx during deglutition.
• In the face: Here the facial artery is tortuous due to the need of accommodation of artery to the
movements of mandible, lips and cheeks.

Q. Describe the development of face. [DU-17N,1 Uu,10Ju,09Ju,08J,05Ju]

Q. State the process of development of face. [DU-19M,15J]

Q. WritTabXX^^ prominence of developing face. [DU-16M]

Q. Give the dTvehopmeit^offace with congenital anomalies. [DU-1 Uu,09Ju, RU-12J,08J,05Ju]

Answer
^ejopment of face; merging of five facial prominences around the stomodeum:
1 he face s deve oped by the fusion ana merging
1) One frontonasal prominence: It is
divided mto-
• Frontal prominence
. (two)
Medial nasal prominences (two)
. Lateral nasal prominences
2) Two maxillary prominences.
3) Two mandibular prominences.

Scanned with CamScanner

 396
The structure s arise from the prominences:
i Struduresjbrm^--- and lateral
Prominence
Frontonasal
Maxillary •
nasal prominences^ — of nose.
Medial nasal I Philtrum of uppgLllEr-
Lateral nasal Ala of
Aianaiouiar j Lower lip-
|
Developmental anomalies of face:

process.
b. Bilateral deft Up: Due to failure of
both
...
_
maxillary processes
nrocesses
fuse with the medial

to fuse with medial

nasal

nasal pr^
lateral and medial nasal
maxillary process to fuse with the
the
2. Oblique facial cleft: Due to the failure of

?Cle
ft lower lip: Due to incomplete fusion
of the mandibular process
3.
4. Macrostomia.
5. Microstomia. **■
|Rcf- Langman/ 1 1 / 2S0|

Figure: Different types of cleft lip.

Q. Explain - cleft lip is common in upper lip. [DU-06J]

Answer
Cleft lip is common in upper lip:
Cleft lip occurs due to a partial or complete lack of fusion of the maxillary prominence and mandibular
prominence. Upper lip develops by the fusion of right & left maxillary prominence, so there is more chance to
develop cleft lip defect due to impaired fusion. But lower lip develops from single mandibular prominence so
there is less chance to develop cleft lip.
Q. How cleft lip is formed? [RU-17M,08Ju, SUST-15J CU-18M]
Q’ H0W deft «P (DU.18M.I5N.
Answer

y of
prominence. Prominence to fuse with the medial nasal
prominence^ “ failure of lx’th m^'l'aiy prominences
io fuse with the medial nasal
ind^miX*0’
in the midline.
'S
Complete fusion of the two medial
nasal prominences

Scanned with CamScanner

 «6 neck
397
Q
deft pninte is formed? |sus7^^===
VnS ^fioii of cleft palate: Thr mu. . ,
r&^T^hc primitive pnhue is
devcIo^Ur^ r"” Pri'ni“vc ’ nnd Permanent.
process and the maxillary processes fusion
. of,bc globular swellings of the median nasal
C

• The permanent plate is dcvcloned f

the middle line. A failure ^,s’on °f the palatine processes of both maxillae across
effusion of lc
comPoncnt parts is known as the cleft palate.
give the lymphatic drainage of
face
Ans"cr
^mnhatic drainage of face;
Group
'

Oppcr territory GrcateTryirtTrr —-Aicaofdrainage of eyelids, Drains into

conjunctiva
. — latJS ’^'halves area.
pen t
Preauricular parotid
nodes.
Middle territory
lip, lateral n^a'f r311 of forcbcad, external nose, upper
°f eyelidS’ media'
Submandibular nodes.

["Lower territon Submental nodes.

Figure: Lymphatic drainage of face.

Q. Why during wound of face the gap is more but heal properly?
Answer
During wound of face, the gap is more but heals properly because there is no deep fascia in the face,
facial muscles are attached to the skin. So there is large wound gap.
The face wounds heal properly due to having rich vascularity.

Q. Write short note on: Intermaxillary segment. [CU-08J, RU-17N.08J]

Q. How intermaxillary segment is formed. Mention its different components and structure

Q. WHs
Answer
intenn^ Mention its components and structures derived from it. [SUST-13Ju]
Intermaxillary segment; f d bv/ the merging of the medial nasal prominences of the embryo is
The primordial mass of tissue ioni
called intermaxillary segment. It contnbu
I. Inter-maxillary portion of theuppe
W
p,
2. The pro-labial portion of the
3. The primary palate.
h gives rise to the pretnaxilla.

Scanned with GamScanner

 398 — MpEAMURAWT0)n^V£J!2I^
Lacrimal apparatus
Q. Describe lacrimal apparatus. [CU-06J]
Q. Name the differed parts of lacrimal apparatus
RU-13J • SUST-I5M1
SU
of |acrima|
Mention .P
Q. Define and enumerate the lacnmal apparatus.
SLST
Q. Draw and label lacrimal apparatus. [RU-I6N, 1 9. LO ]
Q. Write short note on: Lacrimal apparatus. [SUST-I9N.
Answer
Lacrimal apparatus: . ^rtcnrimal nr tear fluid are called lacrimal
concerned with secretion and drainage of lacnm
The structures
apparatus.
Components of lacrimal apparatus:
1. Lacrimal gland.
2. Lacrimal ducts.
3. Conjunctival sac.
4. Lacrimal puncta & canaliculi.
5. Lacrimal sac.
6. Nasolacrimal duct
A. Lacrimal stand: It is a ‘J’- shaped serous
gland situated chiefly in the lacrimal
fossa on the anterolateral part of the roof
of the bony orbit and partly on the upper Figure: Lacrimal apparatus.
eyelid. It has two parts -
> Larger orbital part &
> Smaller palpebral part.
B. Lacrimal ducts: About a dozen of lacrimal ducts open into conjunctival sac.
C. Con junctival sac: The potential space between the palpebral & bulbar parts is the conjunctival sac.
D. Lacrimal puncta & canaliculi: Lacrimal canaliculi begin at lacrimal puncta and open into lacrimal sac.
It is 10 mm long. It has two parts-
> Vertical part - 2 mm long.
> Horizontal part- 8 mm long.
E. Lacrimal sac: It is a membranous sac situated in the lacrimal groove. It is 12 mm long & 5 mm w ide.
It's lower enc continuous with the nasolacrimal duct.
F. duct: It is a membranous passage. It is about 1 8 mm long. It begins at the lower end of
^awlacrimal
lacnmal sac; runs downwards, backwards and laterally, and opens into inferior meatus of nose.
|Ref- A. K. Datta / 4* / 81-83 + B.D. Chaurasia / 7* / 75,76|
Q. Give the pathway of lacrimal fluid. [CU-06J]
Q. How lacrimal fluid passes through nose? [RU-I9MJ8M
14Jul
Q. Trace the pathway of tears. [RU-07Ju]
Answer
Pathway of lacrimal fluid/ tear:

IRef- A. K. Datta / / 8LS3 + B.D. Chaurasia / 7th / 75-76|

Scanned with CamScanner

 Sia^-04: Head & necK
399

The lac •

dXc
nerVC derived
from lacrimato^ nuc!^
nUclcus
both
of facial sen^r^
nerve Secreto™or
lacr™al by nerve; a branch of ophthalmic
fibres. Parasympathetic secretomotor

’1 4* 831
q. Give the pathway of secretomotor Th
rc of the gland. [CU-06J
IRef A‘ K"
'
Answer SUST-16M 15M1
parasympathetic fibres are secretomotor.
P
Zygoma I 2^ — ygomaticotemporal Ranelin ° Post8an81’onic fibres reach the maxillary nerve —
"* “* PterygOpalatinc TlirouSh facial nerve -» Greater petrosal nerve
nerve -♦ Supplies the lacrimal gland. nerve > Aa”communicating *
branch to lacrimal nerve Lacrimal -♦

IRef- A. K. Datta / 4,h 1 83 + B.D. Chaurasia / 7th 1 76|

q. Explain anatomically /embryoloeicallv / ..
infection of lacrimal sac. [RU-08Ju 05 J] 'St0 > •
Watering from eye due to chronic
Answer ’ -I
Watcrinc from eve due to chronic inf^Hnn nf u . ,
mthm S""13
of lacrimal sac occurs because in enronic
chronic inflammation Watenng from the eye due to chronic infection
nasolacrimal duct may obstruct.
Q. Give the functions of tear.
Answer
Functions of tear;
1. Flush the conjunctival sac & keep the cornea moist and transparent.
2. Provide nourishment of cornea.
3. Bactericidal.
4. Express emotion with outbreaks of tears.

IRef- A. K. Datta / 4*" /82)

Q. Give the development of lacrimal apparatus. [RU- 96J, CU-13J]
Q. Write the developmental source of nasolacrimal duct. [RU-13Ju]
Answer
Development of lacrimal apparatus:
head.
• Lacrimal gland & ducts: Develops from surface ectoderm ofcellular cord.
• Lacrimal sac & nasolacrimal duct: From solid ectodermal
[Ref- A. K. Datta / 4,h /84]

apparatus? [SUST-12Ju]
Q. What are the clinieal importances of lacrimal
Answer
Clinical importance dacryocystitis.
1 ) 1 nflammation of for anaemia and for conjunctivitis.
2) The palpebral examined
for jaundice.
3) The bulbar conjunctiva is e c diseases of the eye. It may be caused by infection or
4) Conjunctivitis is one of the
allergy. . _d in a grOove situated 2 mm from the edge of each eyelid.
5)
6) Trachoma is a
A
Foreign bodies are often
contagious
loageu
gran J
tjvitis caused by the trachoma virus. It is regarded as the

commonest cause of a inflammation of one of the glands of Zeis

swelling pointmg inwards.
7) Stye or hordeolum is
o g^d, causing a localized
8) Chalazion is inflammation

Scanned with CamScanner

 (SAQt MCQ)
400 ENDEl IOUR .4N.ITOMY FOR WRITTEN <*7^
The neck region
Q. Draw and label the formation of different triangles of neck. (RU-
Answer
The formation of different triangle of neck;

Figure: Triangles of neck.

Posterior triangle
Q. Write the steps of dissection of posterior triangle of the neck. [RU-18N,17/16M,1 1 J, CU-12J,
06J, SUST-05Ju]
Answer
Steps of dissection of posterior triangle:
1) An oblique incision from the mastoid process of the temporal bone to the sternal end of the clavicle.
The line of incision passing almost midway between the anterior and posterior margins of the
sternocleidomastoid muscle.
2) A transverse incision from the lower end of the medial 2/3"1 and
lateral 1 /3rd of the clavicle along its
upper border.
3) Another transverse incision from the upper end of the
1 * incision backwards for about 2 inch.
Q. Write down the boundary and contents of
posterior triangle of neck. [CU-17M
14JuJlJ, SUSTJ7NJ6NJ4JJ 3JJ 2JuJ 0J,09J,06Ju] 143 \ i j Ull-
Q. Name the subdivision of posterior triangle. ’ ’’
4 ’

[SUST-15M]
An”'!''
Posterior
b0aadar‘es of P0516™' ‘"angle with its content. [CU-IOJu,
triangle:
06J]

Bonn^TT" 3
Boundaries of posterior triangle:
•
nKk behind ,he “idomastoid muscle.

• priori?: Posterior border of

Posteriorly:^ Anterior border of sternocleidomastoid muscle
trapezius
• Inferiorly (base):, Middle 1/3 rd of
clavicle

Scanned with GamScanner

 Floor: The floor of the posterior
* Covering 421
the follow ing trianR1 *
muscles
1 . Splcnius capitis. - °” by the prevertehral •
layer of deep cervical fascia.
2. Levator scapulae.
3. Scalenus medics.
4.

upper part'calShe
X A smaller tower part. eahed thc SupnKlmteu’„ *"
CesB!iiSjLl|lt triangle:
„ auWavian triang,,
I. Occipital triangle:
Spinal part of accessory
The 3"1 & 4th cervical nerve.
Dorsal scapular nerve.nerves.
Four cutaneous branches
of
Upper part of the brachial the cervical plexus.
plexus.
Superficial cervical artery'.
Sometimes, occipital artery.
2, Supra-clavicular triangle:
• Third part of the subclavian artery.
• Subclavian vein.
• Terminal part of external jugular vein.
• Trunks of brachial plexus.
• Superficial cervical, suprascapular and dorsal scapular arteries.
• Postero-inferior group of deep cervical lymph nodes.
(Ref- A. K. Datta /4,b /90-941

Q
RU-UN 16M ?5M%D1o°]n,entS °f suboccipi,al [SUST-18N,l7M,I5Ju,14Ju.l U,

Q. Draw and label occipital triangle. [SUST-18N]

Q. Write short note on: Sub-occipital triangle. [RU-08Ju]
Answer
Sub-occipital triangle:
Suboccipital triangles are a pair of muscular triangles, situated on each side of the midline in the
suboccipital region.
Boundaries of each triangle:
• Supero-mediallp; Rectus capitis posterior major
• Supero-laterally: Superior oblique muscle.
• Inferiorly: Inferior oblique muscle.
• Roof:
> Medially: Semispinalis capitis.
x Laterallv: Longissimus capitis. • • • •
and the poster.or atlanto-occtp.tal membrane.
*
arch of atlas
• Floor: Formed by the posterior
Contents:
• Third part of vertebral artery. nerve).
• First cervical nerve (Suboccipital
• Suboccipital plexus of veins. |Ref- A. K. Datta / 4* / 102|

Scanned, with CamScanner

 Subclavian vein

Figure: Occipital triangle.

(Ans. hypoglossi). [RU-07J,05Ju]

Q. Write short note on: Ans. cervidis
opposite the
is. thin nerve root embedded in the anterior wall of the carotid sheath
This
common carotid artery.

^^conti n uati o n of the descending branch of the hypoglossal nerve.

the ventral rami of 1 nerve.
C
Its fibers are
derived from
2. Inferior root: Derived from ventral rami of C2 & C3 nerves.
Distribution:
I. Superior root: To the superior belly of the omohyoid.
2. Inferior root: To the-
• Sternohyoid.
• Sternothyroid.
• Inferior belly of omohyoid.
[Ref- Gray /40* /456|

°f dlssec,io" of anlcrior fiangle of neck. [RU- 1 9M,

An™"'
Steps
of dissection of anterior triangle of
1 6N, 13/1 1 / 1 0Ju,09J.06J J
neck:
A. Skin incision:
a. /longitudinal incision from the jugular notch to the symphysis
menti along the middle lineof

ra y upto the anterior

margin of the sternocleidomastoid

Scanned with CamScanner

 ^.04: Head neck
Then the superficial fascia is rm
n
01
structures -
a. Anterior cutaneous
rcflectcd a|Ong
— 403

b. Cemcal nerve
branch of fachI n
c. Anterior jugular vein C‘
’’
a”hat of sk'n by preserving the following

c Then the deep cervical fnreia ls lcc,cd as

n Give the
_
contents of anterior trUn
n Name the subdivision of anterior tr ^
. lRU’l6N]
that of skin*,. e

'■iHnnln
C°ntentS is s,udied

rotten .
Answer
. apputa.
The boundaries
of anterior trianyh-
The anterior median
plane
.•
,dne
of the neck. ‘ Posterior belly /
Laterally:
Sternocleidomastoid
Superiorly: Base of of digastric
the mandible and
a line joining the angle of the Superior belly &
mandible to the mastoid process of Omohyoid X JX*-" Carotid triangle
Posterior triangle A— Submental trinangle
Muscles of anterior triangle: a
• Four suprahyoid muscle: Muscular triangle_] <
1. The digastric Trapezius
2. The stylohyoid Sternocleidomastoid muscle
3. The mylohyoid and . Inferior belly of emebuoid
4. The geniohyoid
Figure: Anterior triangle.
• Four infrahyoid muscles:
1. Sternohyoid
2. The sternothyroid
3. The thyrohyoid and
4. The omohyoid.
Subdivisions of anterior triangle:
It is subdivided by the digastric muscle and the superior belly of the omohyoid into:
1. Carotid triangle.
2. Digastric triangle.
3. Submental triangle.
4. Muscular triangle.
|Ref- B.D. Chaurasia / 7* / 97-981

Q. What are the subdivisions of anterior triangle of neck?

triangles of neck. [RU-l4Ju,07J]
Q. Draw & label the formation of different
Answer
Please see above.
Q. Give the boundariesi of.
r
wny
.
r « I with contents. [CU-18M.17M,
carotid
RU-l9M,l5Ju,13/l 1/10/
ca||ell? [SUST.UJul
05Ju, SUST-16M, 15N/MJ4/1 1/07JUJ
Answer
Boundary of carotid triangle: ru^ctric muscle.
I) Sunerior!^ By posterior belly
2) AnteroinferiorlyL By super or b
y of^afomohyoid.
idomastoid muscle.
3) Posteriorly: By anterior belly ot
^ernu

4) Roof: Roof is formed by -

b) Superficial fascia containing-

Scanned with GamScanner

 404 —
• Transverse cutaneous nerve of neck
• Investing layer of deep cervical fascia.
5) Floor; Floor is formed by-
• Hyoglossus muscle,
• Thyrohyoid muscle.
• Middle constrictor of pharynx.
• Inferior constrictor of pharynx.

External carotid artery Accessory nerve

Styloid process
Internal carotid artery
Glossopharyngeal nerve Occipital artery
Pharyngeal branch of vagus
Outline of carotid triangle
Hypoglossal nerve Superior laryngeal
branch of vagus
Internal laryngeal nerve
Vagus nerve
External laryngeal nerve
Superior thyroid artery Inferior root of ansa cervicalis
Superior root of ansa cervicalis
Ansa cervicalis

Figure: Contents of carotid triangle.

Contents of carotid triangle:
1) Arteries:
• External carotid artery with its branches, (hence, it is called carotid triangle)
2) Feins:
• Internal jugular vein.
• Common facial vein.
• A pharyngeal vein.
• Lingual vein.

3) Nerves:
• Vagus nerve.
• Superior laryngeal nerve.
• Spinal accessory nerve:
• Hypoglossal nerve.
4) Carotid sheath with its contents.
5) Few deep cervical lymph nodes.
|Ref- B.D. Chaurasia / 7* / 99,100]
Q. Mention boundary and contents of the digastric
triangle. [RU-09J]
Digastric triangle:
Boundaries:
1. Above: Lower border of the
body
mandible and a line extending from the angle of
process. mandible to the
2. Below and behind: Posterior
belly of the digastric and stylohyoid
3. Below and in front: Anterior muscles.
belly of the digastric.
4. Floor: Mylohyoid, hyoglossus
and a part of middle constrictor
muscles.

Scanned with CamScanner

 .04: Head A neck

405

2. Posterior parts. 1101w„p^

Anterior part;

3. Facial artery. dbar 'Wh nodes.

4. Mylohyoid vessels and „
5. Apartofhypoglos’^.
Posterior part;
1. Lower part of thc parotid
2. External carotid artery. L d‘
3. Carotid sheath with its
content . •
nerve. internal carotid artery, internal jugular vein and vagus

[Ref- B.D. Chaurasia / 7'" / 97|

Deep fascia of neck

q. What are the layers of deep cervical fascia / Fascia colli?
Answer
Lavers of deep cervical fascia:
The deep cervical fascia is condensed to form the following layers
1) Investing layer
2) Pretracheal layer
3) Prevertebral layer
4) Carotid sheath
Q. Write shortly about pre-tracheal fascia. [RU-17M]
Q. Give.the attachments of different layers of deep cervical fascia / Fascia colli?
Q. Write short note on: Investing layer of deep cervical fascia. [CU-15M]
Q. Give the arrangement and attachment of investing layer of deep cervical fascial
/ ’
[SUST-07j]
-
Answer
Different layers of deep cervical fascia with their attachment:
A. Investing Layer:
It lies deep to the platysma, and surrounds the neck like a collar. It torms the roof of the
posterior triangle of the neck.
Attachments:
Superiorly:
protuberance.
> External occipitalline.
nuchal
> Superiorprocess
> Mastoid and the.
>
> iXei"™ °f ihe mandibie
endos6 the parotid gland
,he roas,oid proccss' the

mandible
fascia spli,s ,o

deep lamina b )hick

>
Inferiorly:
and'fomsthe stylomandibular
ligament.

> Spine of scapula.

> Acromion process.
> Clavicle.

Scanned with CamScanner

406 _ aww/j youn AM WHY fVH
> Mnnubrhim. , , „h,4M,M
> The fascia splits to enclose the suprasternal
,
and fupraclavicul p - -
• Z^w/erAv
> l.igamenlum nuchac.
> Spine of seventh cervical vertebra,
• Antcriorh't
> Symphysis menti.
Ilyoid bone.

^"‘^m^Xce of Hite fascia Is Ihal II encloses and suspends

the thyroid gland and „
false capsule.
Attachments:
• Superiorly:
Hyoid bone in the median plane.
>
>
Oblique line of thyroid cartilage.
> Cricoid cartilage, more laterally.
• Inferiorly: Below the thyroid gland it encloses the inferior thyroid veins, pallet beftirZ fe
brachiocephalic veins, and finally blends with the arch of the aorta.
• On cither side: It fuses with the front of the carotid sheath deep to the stemoclcidorr^rrzd
C Prevertebra I Fascia:
It lies in front of the prevertebral muscles, and forms the floor of the posterior triargfe of
neck.
Attachments:
• Superiorly: It is attached to the base of the skull.
• Inferiorly: It extends into the superior mediastinum where it is attached to the
longitudinal ligament and to the body of the fourth thoracic vertebrae.
• Anteriorly: It is separated from the phatynx and buccopharyngeal fascia bv
retropharyngeal space containing loose areolar tissue. *
• Laterally: It is lost deep to the trapezius.
D. Carotid sheath:
It is a condensation of the fibroareolar tissue around
and .menial carotid arteries and internal jugular
the main vessels of the neck. T™
vein and the vagus nerve. It is thino-.c —
arch of^ downwards al°"8 vessels from the base of the skull to the

(Ref- B.D. Chaurasia / 7“ /

81-84 + A. K. Datta /4* / 126-1281

Scanned with CamScanner

 ,j)4: Head & neck
407

Thyroid Trachea
Pretracheal layer Esophagus
Internal jugular vein
Sternocleidomastoid muscl
Carotid sheath Common carotid artery
Buccopharyngeal fascia
nerve

Scalene muscle
Investing layer

Trapezius muscle

Figure: Attachment of transv. Prevertebral layer

se section different layers of
deep cervical fascia.

Investing layer
Symphysis menti Ligamentum nwchae
Investing layer Prevertebral fascia
Hyoid bone
Pretrachial fascia

Trachea
Menubrium
Arch of aorta

Figure: Attachment of different layers of deep cervical fascia.

Q. Give the significance of deep cervical fascia. [RU=19M,06J]

Q. Write down the importance of deep fascia of neck. (RU-1 1 J]
Answer
Clinical significance of deep cervical fascia:
The deep fascia and the fascial spaces are important because organisms originating in the mouth, teeth,
pharynx, and esophagus can spread among the fascial planes and spaces, and the tough fascia can determine
the direction of spread of infection and the path taken by pus. It is possible for blood, pus, or air in the
retropharyngeal space to spread downward into the superior mediastinum of the thorax.
JRef- Snell / 8,h / 7451
Q. What is buccopharyngeal fascia and pharyngobasilar fascia.

Suwonharynpeal fascia: This fascia covers the superior constrictor muscle externally and extends on to the
superficial aspect of the buccinator muscle.
^hltyngobasilar fascia: This fascia is especially thickened between the upper border of superior constrictor
muscle and the base of the skull. It lies deep to the pharyngeal muscles.
[Ref- B.D. Chaurasia 1 7,h 1 85|

Scanned with CamScanner

 M
ENDEA FOUR ANATOMY FOR WRTTTE£^JS^•
408

Buccopharyngeal fascia
(posterior portion of
pretracheal layer)-

Investing layer

Infrahyoid muscles
Pretracheal fascia
Pretracheal space
Manubrium of sternun
TwttWn pr«nr**U*xa< !»/»»

space.
Q. Write short note on: Retrophary ngeal important?
surgically
Q. Why retrophary ngeal space is retropharyngeal space. [DU-lOJu]
of
Q. Give the clinical importance
Answer
Retropharyngeal space:
...
prevertebral muscles with its covering fascia
wall of pharynx and
The potential space between posterior
Gillete).
is called retropharyngeal space (of
Relations: fascia covering posterior pharyngeal
wall.
wail: Formed by buccopharyngeal to cervical pan of
• Anterior
Formed by prevertebral fascia covering prevertebral muscles attached
• Posterior wall:
vertebral column.
• Laterally: Related to carotidsheath and parapharyngeal space.
• Superiorly: Upto base of the skull.
• Inferiorly: Into superior mediastinum.

Contents:
• Retropharyngeal lymph nodes.
• Loose areolar tissue.
• Pharyngeal plexus of vessels and nerves.
Surgical importance:
• Pyogenic retropharyngeal abscess may form in this space.
• Tubercular cold abscess form behind prevertebral fascia.
Q. Explain anatomically/developmentally: Retrophary ngeal space is important for neck surgeon-Why?
[DU05JJ
Answer
Explanation:
The interval between the pharynx and the prevertebral
Clinical importance: fascia is called the retropharyngeal space.
I • This space is clinically important
because organisms originating in the mouth, teeth, pharynx and
direction8nf\an
direction of spread of infection and
P,anes and spaces, and the tough fascia can determine the
the path taken by pus.
mediZum the^tS^ of retropharyngeal space t0 sPread downwards into the superior

Scanned with CamScanner

 Head & neck
409
scribe carotid sheath. [CU-1 5 Ju Dl nn .
Q-
0' Scfmc
%u.
car0,id
SUST-15J, 07J]
Givc lhc
**RU‘°6J1
formation contents of carotid
sheath. (DU-18M, RU-18M,
note on: Carotid sheath. [SUST
Writc short
Q,'cr 1 I RM i n
^fl-15J,09J, CU-18/17M,15J,l3Ju]
*

^tidshralk condensation of
psJS^i^biilar the fibroarcolar
Iar ti«
t,ssue ^ound the
main vessels of the neck.

.. Medially By the fusion of these

fasciae
Laterally A mass of loose areolar
tissue connecting the pretracheal and prevertebral fasciae.
The sheath extends downwards along
the base of the skull to the arch of the
the
aorta.
Internal carotid artery
Relation:Anteriorly:
•
. Ansa cervicalis.
Posteriorly: Cervical sympathetic
piercing the carotid sheath:
chain. External carotid artery
Structures
7'
1) External carotid artery. Ansa cervicalis
2) Most of the tributaries of internal jugular vein
3) Glossopharyngeal nerve. Common carotid artery
4) Accessory nerve. Internal jugular vein
5) Hypoglossal nerve.
6) Cervical branches of the vagus nerve.
Contents: Vagus nerve
1) Common carotid artery.
2) Internal carotid artery.
3) Internal jugular vein & Figure: Carotid sheath with its contents.
4) Vagus nerve.
|Ref- B.D. Chaurasia / 7th / 85 + A. K. Datta 1 4th 1 129, 13O|
Q. Write short note on: Carotid body.
Answer
Carotid body:
This is a small, oval reddish brown structure situated behind the bifurcation of the common carotid artery.
Nerve supply:
1) Glossopharyngeal nerve (mainly).
2) Vagus nerve (partly).
3) Sympathetic nerves (partly).
Function:
It acts as a chemoreceptor and responds to the changes in the oxygen and carbon dioxide contents of the blood.

Q- Write short note on: Carotid sinus.

Answer
~~~Tbe termination of the common carotid artery or the beginning of the internal carotid artery shows a slight
dilatation, called carotid sinus.

hHhisregion, the tunica media is thin, but the adventitia is relatively thick.

Scanned with CamScanner

 ^
, N /S'
Nen e supply,
It receives a rich innervation IVom the
glossnphary i g ., .vmpMhe^c nei*®*’
Function:
,,
It acts as a baroreceptor and regulates blot .
|

Q. W rite down the importances of carotid body and carotid sinus. |IU I I
Answer
Please sec above

Muscles of head & neck

A action of muscles of
mastication In tabulated form.
Q. Give the origin, insertion, nene supply
. .. .r n_tion and ment.
(CU-I7M.10J. SUST-l5Ju.l4J,06Ju] development and their
4 action mentum
Q. Give tire muscles of mastication with nen e supply,
movements of mandible. |RU*05Ju] .Name the insert.on, nerve
origin, s„D«r»inn nerve ntnnk
supply
with nerve supply,
Q. Name the muscles of mastication form. |C - I
& action of any two of them in a tabulated
[C U-l 5N]
Q. Write short note on: Temporalis muscle. [RU-17M,09JuJ
Q. Write short note on: Muscles of mastication.
Answer
Must-In of mastication:
during mastication and speech are called muscles of mastication.
The muscJes that more (he mandible
They are:
The masseter
The temporalis
The lateral pterygoid, and
4. The medial pterygoid.
Development:
They develop from the mesoderm of the 1“ branchial arch, and are supplied by the mandibular neiye
which is the nerve of that arch.

Origin, insertions, nene supply and actions of muscles of mastication:

| Muscles Origin Insertion Nerve supply | Action |
Superficial layer: From Superficial fibres: fvlasseteric 11. Elevates the 1
Masseter anterior 2/3rd of lower border Lower part of the ramus tlerve, branch naandible
of zygomatic arch & maxilla. of the mandible. <3f anterior to close the mouth 1

Middle layer: From deep Middle fibres: ’division of pL Clenches the teeth.
mandibular
surface of anterior 2/3 rd & Middle part of the
posterior 1 /3rd of lower border ramus of the mandible. nerve.
of zygomatic arch.
Deep layer: From deep surface Deep fibres:
of zygomatic arch. Deep & upper part of
the ramus of the
mandible.
1. Temporal fossa.
Temporalis 2. Deep surface of 1. Anterior border & Anterior 1 . Elevates mandible
temporal medial surface of division
fascia. 2. Posterior fibres
coronoid process. of mandibular retract the protruded
2. Anterior border of nerve mandible
ramus of mandible.
Scanned wibh CamScanner
 prighT
"5iu^lcs- /. SPILorrtcialJtcq^^ -i

. , '"wrtlm, — — — ji i
411

tuberosity of maxilla Nerve supply Action

2. £raiA£mt from Nerve to 1 . Elevates the
media,
1
1
surface of lateral pterygoid
plate & palatine bone
medial
Pterygoid.
mandible.
2, Protrudes the
mandible
3. With its opposite
sided lateral
pterygoid, it produces

pterygoid
/. Upper
infratemporal surface &
crest
— Anterior
side-to-side movement
of mandible.
1 . Depresses chin.
of greater wings ofsphcno
erporr; From latera| ' mandible. division of 2. Protrudes the
^^
surface of lateral pterygoid
^Anterior
surface of
mandibular
nerve.
mandible.
3. With its opposite
plate.
anular
disc & capsule
0
‘temporomandibular sided medial
joint. pterygoid, it produces
[chewing of mandible.
|Ref- B.D. Chaurasia / 7*h / 1 1 8|
q. Mention the suprahyoid and infrahyoid muscles
with their nerve supply. [RU-15N 12Ju]
Q.Namc the infrahyoid muscles with their nerve supply.
q. Write short note on: Suprahyoid muscles. [RU-18M1
Answer
SUSPend lhe f- the skull, and comprise four pairs ofmuse.es -
2. Mylohyoid
3. Stylohyoid
4. Geniohyoid
Origin, insertion, nerve supply and actions of suprahyoid muscles:

Muscle I Origin Insertion Nerve supply Action

Digastric a. Anterior belly: The hyoid bone. a. Anterior belly: by D
1 epresses
from Digastric fossa nerve to mylohyoid. imandible

. (of the mandible when mouth is

b. Posterior belly: opened
from mastoid notch widely or against
of the temporal resistance; it is
secondary to lateral
bone pterygoid
b. Posterior belly: by b. Elevates hyoid
facial nerve. bone.
Facial nerve Retracts & elevates
body & greater
[Stylohyoid Posterior surface of Junction of the hyoid bone.
ctvIniH corms of hyoid bone Nerve to mylohyoid forms the Hoor ot
Mylohyoid Mylohyoid line of ^PosTFibers: body of hyoid the mouth & helps
mandible bone. in weight bearing
hMiddle & Anterior fibers: of the tongue.
median raphe, between
hone.
mandible&hyo!^*^--
••1

AnteriorsurSceof
body of — A branch of hypoglossal Protracts &
elevates the hyoid
Geniohyoid Inferior mental nerve containing C,
hyoid bone bone in
spine (genial nerve fibres.
swallowing.
tubercle)
(Ref- B.D. Chaurasia / 7,h / 135|

Scanned with CamScanner

 1U V) 4
I '/»/ HOIK IS 110)11 I OH II HUH V (S 1/1 I

OifOw'M
rnttiw- hUu
O tlifnittric
Kt"**! 1*1*1"
KurM hf^f

TJv/rp’W rarf Un ft
OwKut'iti muirfr ^hurolK
CrirOd wfilnat
9trnnphurr'i^ mutdf

muscles,
Figure: Suprahyoid and Infrahyoid
infrahwid muscles are strap muscles and consist
of lour pairs -
Mode _1 Insertion I Nerve supply
Ansa ccrvicalis.
J
I r
Depresses
>
the
।

.
1 'sternohyoid la. Posterior surface of
| Medial part of
1 lower border olf hyoid bone
manubrium Memi.
lb Adjoining part of clavicle <Si 1 hyoid bone.
posterior sternoclavicular
1 I ligament.
2. Sternothyroid ,a. Posterior surface of Oblique line of Ansa ccrvicalis. Depresses the
, manubrium stemi. thyroid larynx.
lb. Adjoining part of 1“costal cartilage.
I j cartilage.
J. Thirohyoid I Oblique line of thyroid Lower border of Cl nerve a. Depresses the
1 cartilage. the body & through hyoid bone.
| greater corms of 1 iypoglossal b. Elevates the
hyoid bone. nerve. larynx when
c. Hyoid bone is
fixed by the
suprahyoid
1J 1.. ! a 1 musc les.
1*1 VI.) V 1 V. >
H- Omohyoid a. Upper border of the scapula Lower border of i9. Superior Depress the
near the suprascapular notch. the body of the belly: by
1 b. Adjoining part of hyoid bone.
hyoid bone. superior root
suprascapular ligament. of ansa
ccrvicalis.
b'• Inferior hclly:
by inferior
root of ansa
ccrvicalis.
|Ref- Datta /4“71I2-INI

Scanned with CamScanner

 ~ 413
-f f-
2. Trapezius. [RU-18N.16M
10J]
,
18N.16M,13J,10J, SUST-07Ju]
Writc short note on: Sternocleidomastoid muscle (CU-19M,13Ju[
Q
A^^^ndeidomastoid muscle:
“ ,Cn<lin0US ”nd ariSCS from *•superolateral part of the front of the
2-
surface of the clavicle. "musculo,cndi™s and arises from the medial one-third of the superior

a thick tendon into the lateral

surface of the mastoid process, from its tip to its superior border.
, By a thin aponeurosis into the
lateral half of the superior nuchal line of the occipital bone.
NgryeSupplyi
(1) The spinal accessory nerve provides the motor supply.
(2) Branches from the ventral rami of C2,3 are proprioceptive.
Actions:
A. When one muscle contracts:
• It turns the chin to the opposite side.
• It can also tilt the head towards the shoulder.
B. When both muscles contract together:
• They draw the head forwards, as in eating and in lifting the head from a pillow.
• With the longus colli, they flex the neck against resistance.
• The reverse action helps in forced inspiration.
[Ref- B.D. Chaurasia / 7th / 85|

2) Trapezius:
Origin:
1. Medial 1/3"1 of superior nuchal line.
2. External occipital protruberance.
3. Ligamentum nuchae.
4. Spine of C7 to T1 2 vertebrae.
insertion:
rd
1. Lateral I /3 of clavicle scapula.
& upper lip ofcrest of spine of the
2. Medial border of acromion process
Nerve supply; (motor).
I • Spinal part of accessory nerve (proprioceptive).
2. Ventral rami of C3 and C4 nerves
Actions; scapulae.
1 • Elevates the scapula with levator
2. Retract the scapula with rhomboideus.
90°.
3. Abduction of the arm beyond / 4th / 115 + Gray / 40,h / 440, 460|
/ 6,h / 90 + A.K. Datta
IRef- B.D. Chaurasia

Scanned with GamScanner

 UI ENDEA FOUR ANA TOMY FOR WRITTENfS^ MCW

other side.
the head is bent to one side and the chin points to the
of the digastric muscle is the key
Q. Explain anatomically / clinically: Why posterior belly
muscle of the neck?
Answer
Posterior belly of the digastric muscle is the key muscle of the neck:
Posterior belly of the digastric muscle is the key muscle of the neck because this muscle acts as
guideline for the following structures:
1 . Lower part of parotid gland
2. External carotid artery
3. Internal carotid artery
4. Internal jugular vein
5. Glossopharyngeal nerve
6. Vagus nerve and
7. Styloid process

I Ref- A.K. Datta /4,h/ 114|

). Name the muscles attached to styloid process of temporal bone with their
nerve supply. [RU-
1 7N]
nswer
uscles attached to styloid process of temporal bone with their nerve supply;
Name of muscle Nerve supply
Stylohyoid By facial nerve
Styloglossus By hypoglossal nerve
Stylopharyngcus By glossopharyngeal nerve
|Ref-Grav/dn,h/ 441. 4421
Scanned with CamScanner
 Head & neck
415
Wrile,sshort note on: Tortic„||is or
T“r"co,"s or
w <
0•
wry mu-18Nj0Ju. SUST17M]
^rt£lliS-"r
jSnpoints
wryjodt; Torticollis or wry
to Ilie other side. This is a result
neck k a .
Types:
of spasm of
Although there arc many varieties of toni n-
th™^ 'n.which head is bent one side and the
to
SUPpHed by the sPinal accessory nerve.
^1. Rheumatic torticollis S depending on the causes the common types are -
Cause: exposure to cold or
draught.
2. Reflex torticollis:
Cause! inflamed or sunouratino •
nerve. cervica lymph nodes which irritate the
spinal accessory
3. Congenital torticollis:
Cause: birth injury.
4. Spasmodic torticollis:
Cause: central irritation.

|Ref- B.D. Chaurasia / 7,h / 90 1

Glands of head & neck

Q. Name the glands of head neck region.
Answer
Major glands of head neck region:
1 . Pituitary gland
2. Thyroid gland
3. Parathyroid glands
4. Parotid glands
5. Submandibular glands
6. Sublingual glands

Pituitary gland

Q. Describe the pituitary gland in short. [CU-15Ju,05J, RU-05J]

Q. Write down the position of pituitary gland. [RU-15N]
Q. Give the gross anatomy of pituitary gland.
Q. Mention the location of pituitary gland. [RU-13Ju]
Answer
base of the brain.
endocrine gland situated in the hypophyseal fossa in relation to the
Location; Hypophyseal fossa in relation to the base of
the brain

Shape; Oval.
Weight; 500 mg.
Length; 8 mm anteroposteriorly.
Parts;
dislails 1pars gla“
* 2. Intermediate lobe /pars
intermedia.
3. Tuberal robe / pars tuberails.

Scanned with GamScanner

4Ib
& ytUNhwophysIx (posterior pitiiitary)!
I . Posterior lobe I pars posterior / neural lobe.
2. Infundibular stem.
3. Median eminence.
Median eminence
Infundibular stem
Pars tuberaPs
pars n^rt/osa
Pars intermedia

Pandistali^^
Acidophil
Basophil cell
gland.
Figure: Parts of pituitary

Figure: Location of pituitary gland.

Q. Mention the blood supply of pituitary gland. [RU-13Ju,05J, CU-05J]

Answer
Blood supply of pituitary gland:

Capillary tufts in Median

eminence & upper infundibulum Superior hypophyseal artery
Trabecular artery to
lower infundibular

portal vessels Capillary tufts in lower

infundibular

Short portal vessels Anastomosis between superior

k inferior hypophyseal artery
Inferior hypophyseal artery
Figure: Blood supply of pituitary gland

Scanned, with CamScanner

 _^r-Q4: Head & neck —_
- 411
.
'^^Superior hypophyseal artery; brnn„.
inferior hypophyseal artery; hranc|,
f .
«rm|d ar1ery
Crna caro’ld
Hfnfe of arterial supply;
i^7Siipcrior hypophyseal arteries
artery,
sunnly ,hc
infundibulum via trabecular nrt.. • mcdian emin<*n, „ ,
- .
, Inferior hypophyseal XXX'.
infundibulum & supply „K
»l>kh form an .noria! ring Mound
Thc anterior lobe is exclusively
•
drainage:
supph^ P°rtal
y
vessels arising from superior hypophyseal arteries.
Short veins emerge on the surface
of the 8 n &
drains into neighboring dural venous sinuses.
. . , IWef-A.K. Datta /4* /2I3-2I6|
Q. Mention thc developmental sources of Pituitary
ni<. u
Answer gland. [RU-l5N.I3Ju,l2Ju,07Juj
Development of pituitary gland;
'Adenohypophysis: From Rathke’s noneh
stomodeum. upward growth from thc ectodermal roof of the
’
• Neurohypophysis: From a
downward g wth rfrom thc „floor of the
.L
diencephalon.
q. Mention the congenital anomalies of pituitary gland.
Answer IRU-07JulJ
Congenital anomalies of pituitary bland:

'
'
n^ea^^pop^s}s'
A small portion of Rathke’s pouch may
pharyngeal hypophysis. j persist in the roof of the pharynx as a
t y j

2- Craniopharyngiomas: Occur in or superior to the sella tursica from remnants of Rathke’ s pouch.

Q. Give the histological structure of pituitary gland. [RU-15N,07Ju]

Answer
Histological structure of pituitary gland:
Adenohypophysis:
1) Anterior lobe; It is enclosed by a dense fibrous capsule & is composed of aggregated cells interspersed
with capillaries.
Cells of anterior lobe:
A. Chromophil cells:
a. Acidophils:
i) Somatotrophs: Secret growth hormone (GH).
ii) Mammotrophs: Secret prolactin.
b. Basophils:
i) Corticotrophs: Secret ACTH.
ii) Thyrotrophs: Secret TSH
Gonadotrophs: Secret FSH & LH.
iii)
of
& Chromophobe cells: Consists secretory cells &
i. Degranulated
ii. Stem cells.
Supporting cells.
C. Folliculostellate cells: cells.
It contains basophils & chromophobe
2) Pars intermedia:
some acidophils & basophils.
3) Bars tuberalis: It contains

Scanned, with GamScanner

 fry PEA » Ol R ASA TOMY
FORjrRITT^

Neiiroh* popinsis; It contains-

(D 5«
(ii) ,4s

Figure: Histology of pituitary gland.

Q. Give the communication of pituitary gland. [RU-12Ju.10Ju.0SJu] 7N. 1 5M,10J.0SJu.07Ju^

[RU-1
Q. Give the connections of pituitary gland with hypothalamus.
SUST-ISM. I5MJ
Answer
Communication of pituitary gland:
through hypothalamo-hypophyseal porta]
• Adenohypophysis: It is connected with hy pothalamus anterior pituitary
vessels. They carry hormone releasing factors from hypothalamus to the
through hypothalamo-hypophyseal tract t
• \eurohypophysiy It is connected with hypothalamus
is a nenous pathway, through which secretion from hypothalamus reaches to the pituitary gland
released by terminal lobes.
|Rcf- Snell's Neuroanatomy / 7*
/388.^
Q. Write short note on: Hypothalamo-hypophyseal tract.
Answer
Hvpotbalamo-hvpophvseal tract:
Nerve fibers that travel from the supraoptic & parawntricular nuclei of the hypothalamus to the
posterior lobe of the hypophysis is called hypothalamo-hy pophysial tract
Hormones synthesized bv this tract:
1. Vasopressin: It is produced by the nen e cells of supraoptic nuclei.
2. Oxytocin: It is produced in the nen e cells of paraventricular
nuclei.
|Ref- Snell's Neuroanatomy 1 7* /3$$|
Q. Write short note on: Hypothalamo-hypophyseal
portal system.
Hypothalamohvpoph^eal portal system:
Long & short blood vessels that
capillary plexuses in the anterior lobe of connect sinusoids in the median eminence & infundibulum with
the hypophysis (pituitary gland) is
portal system. called hypothalamo-hypophxseal
This system begins & ends in capillaries
system. without going through the heart & is
therefore a true porul
Function:
The hypothalamo-hypophyseal
from the hypothalamus portal vessels carry
hypothalamic releasing and
to the anterior
pituitary. inhibitory hontxr.es.

I Ref- Snell’s Neuroanatomy 1

Scanned with GamScanner

 - JI*

Hillary body Opiie ehlavn

M^i.n eminence Artery
Primary capillary
plexus

Hypothalamic-
hypcphyaiaf
P°s»*rtor pinery portal vessels
gland Sinuses
Anterior pituitary
gland
Vein

Q. Explain anatomically- portal circul " .

,S ncccssary for functions of pituitary gland. (DU-
°^l
Portal circulation is ncccssan1 for functiA««c ..
adenohypophyZoTJ^^
The _
. rv gland;
hypophyseal portal vessels. They carry hormone rekS"? T* the hypothalamus through hypothalamo-
functions oFpituitary°7
gland. So. portal circulation is essential for hypothalarnus anterior pituitary
t0

|Ref- Snell’s Neuroanatomy / 7,h 1 389|

Salivary glands
Q. Enumerate the salivary glands. [RU-18M,15M,07Ju]
Q. Enumerate the salivary glands in our body. [RU-13Jul
Answer
Salivary glands:
A. Major salivary glands:
1 . Parotid glands
2. Submandibular glands
3. Sublingual glands
B. Minor salivary glands:
1 . Labial
2. Buccal
3. Palatoglossal
4. Palatal
5. Lingual

Q. Write short note on: Parotid gland. of parotid gland. [CU-06Ju]

Q. Mention the location and autonomic innervation
Answer
parotid gland: It is the largest salivary gland.
7 tonMl acoustic meatus, between
the ramus of the mandible & the
Situation; It is situated below the
L
externa
sternocleidomastoid.
height: About 25 gm.

Scanned with GamScanner

 External feature: It resembles a three-sided pyramid.
— ^^4
It has four surfaces -
1. Superior
2. Superficial
3. Antero-medial &
4. Poster medial
It has three borders:
a. Anterior
b. Posterior &
c. Medial.

the gland through auriculotemporal

1. Parasympathetic nerves are secretomotor to parotid gland. They reach
external carotid artery.
2. Sympathetic nerves are vasomotor. They arise from the plexus around the
3. Sensory nerves come from the auriculotemporal nerve.
[Ref- B.D. Chaurasia /7,h/ 1O8-I13|

Q. What are the structures found within the parotid gland? [RU- 1 8M, 1 5J, 1 1 J]
Q. Write down the structures present in parotid gland? [CU-18N,15J,13Ju]
Q. Name the structures within the parotid gland. [CU-06Ju, RU- 1 3 Ju]
Answer

Fascial capsule
Division of external
carotid arterg
Formation of
retromandibular vein
Fascial nerve

Figure: Structures within parotid gland

Structures within the parotid gland:
> Arteries:
Artery that enters the gland:
External carotid artery: Enters the gland through posteromedial border.
z Arteries that emerge from the stand:
• Maxillary artery: Emerges through its anteromedial surface.
• Transverse facial artery: Emerges through the anteromedial surface.
• Superficial temporal artery: Emerges through its
superior surface
> Veins.
> Vpinc. Ra, \JKStenOr
Retromendibular vein.
auricular artery- may arise within the gland.
°
> Nerves: Facial nerve with five terminal
branches.
|Ref- B.D. Chaurasia / 7,h / H 1 + A.K. Datta / 4,h / U0|

Scanned with CamScanner

 Het,d & neck - —
give the Hood supply „n<1 |yni h
drainage of parotid gland. ^Ptrficial temporal artery
A[lSWer
plogdjuiudLofjQaro^^ Transverse facial arery
-^TdrffrKl£«PPfv; By external carotid Maxillary artery
. artery <fc its branches.
Venous drainage: Veins drains into
external jugular vein.
Post auricular artery
Vernal carotid artery
Lymphatic drainage of parotid gland-
-‘Lymph drains first to the parotid nodes Superficial temporal vein
8nd from there to upper deep cervical nodes.
pcvclopment of parotid gland: Transverse facial va'n
'
> Gland proper, duct & alvenlr
develop from surface ectoderm
> Capsules develops fmm Retromandibular vein
mesenchyme.
> Stromas develops from
mesenchyme.
Figure: Blood Supply of parotid gland

|Ref- B.D. Chaurasia /7^/112-1131

Q. Give the developmental sources of parotid gland. [RU-15M]

Answer
Development of parotid gland:
r' Gland proper, duct & alveoli: Develop from surface ectoderm.
>Capsule: Develops from mesenchyme.
> Stroma: Develops from mesenchyme.
(Ref- B.D. Chaurasia / 7,h / 1111

Q. Give the secretomotor supply of parotid gland. [SUST-15Ju,l 1Ju]

Answer
Secretomotor supply of parotid gland: Parasympathetic nerve is secretomotor.
Mode of supply:
The preganglionic fibres arise from the inferior salivatory nucleus
I
Pass through glossopharyngeal nerve
I
Its tympanic branch
I
Tympanic plexus
I
Lesser petrosal nerve
I
Relay in the otic ganglion

„ . the auriculotemporal nerve & thus supply the gland.

Postganglionic throuuh
fibres pass tnrougn me
b b h
|Rcf- B.D. Chaurasia /7 / 112J

CU-1Un]
Q. Write short note on: Parotid duet. [RU.18N.12Ju,
Answer
of the gland.
£arotid duct: emerges f
trom the middle of the anterior border
It is a thick-walled duct, which

Scanned with CamScanner

 — =
Course:
- ENDEA FOUR A^\TOMY FOR WRITTEN (SAO, MCQ)~&^
Aller emerging, it runs forwards & slightly downwards on the masseter. At the anterior border of
the
masseter, it turns medially & pierces
a. The buccal pad of fat
-
b. The buccopharyngeal fascia &
c. The buccinator muscle.
> Then the duct runs forwards for a short distance between the buccinator & the oral mucosa. Finally jt
runs medially & opens into the vestibule of the mouth opposite the crown of the upper second m0|ar
tooth.
Relations;
> Superiorly:
• Accessory parotid gland.
• Upper buccal branch of the facial nerve &
• Transverse facial vessels.
> Inferiorly:
• Lower buccal branch of the facial nerve.
Function;
It carries saliva from the parotid gland to the vestibule of the mouth.
(Ref- A.K. Datta / 4,h / 140 + Snell 7 8,h / 787|

Q. What are the capsules of parotid gland?

Answer
Capsules of the gland:
> True capsule: The parotid gland is surrounded by an inner connective tissue capsule, is called true
capsule.
> False capsule: The parotid gland is also enclosed in an outer dense fibrous capsule derived from the
investing layer of deep cervical fascia, is called false capsule.
[Ref- A.K. Datta / 4th / 138|

Q. Give the histology' of parotid gland.

Q. Draw and label the histological structure of parotid gland. [RU-16N,13Ju]
Answer
Histology of parotid gland:
Each gland consists of numerous lobules which are held together by fibroareolar stroma in which
vessels and nerves ramify. The lobule is composed of-
a. The secretory end-piece: It is tubulo-alveolar and the acini are lined mostly by the seromucous (or
serous) cells.
b. Intercalated ducts: They are lined by low cuboidal or flattened epithelium often with myoepithelial
cells.
c. Striated ducts: They are lined by basally striated cells (simple columner epithelium).
d. Collecting ducts: The smaller collecting ducts unite to form two vertical ducts, upper and lower. The
vertical ducts join to form the parotid duct.

Scanned with CamScanner

 Figure: Histological
structure of parotid gland.
I Ref- Junqueira / 12,h / 281-285 + Gray/ 40,h /496 + A.K. Datta / 4'" / I4O|
Q. Mention the differences between serous and mucous acini.
[RU-I5M,1OJ,O8J,O7J]
Q. Draw and label the structure of serous and mucous acini. [DU-15M,
RU-15N]
Answer
Differences between serous and mucous acini:
Trail Serous acini '
Mucous acini
1) Lumen Smaller. Larger.
2) Shape of cells Pyramidal in shape. More cuboidal or columnar in shape.
3) Nucleus Rounded, present centrally. Flattened, present basally.

4) Arrangement of cells They form a spherical mass of cells Mucous cells are most often organized
called an acinus. as tubules rather than acini.
5) Nature of secretion Watery. Viscous, slimy secretion.
6) Secretion Serous cells produce digestive Mucous cells produce mostly mucins.
enzyme and other proteins.
7) Staining Deeply stained nucleus. Lightly stained nucleus.
Parotid gland. Sublingual gland.
8) Present in
9) Figure

Mucous acinus
Serous acinus
[Ref- Junqueira / 12,h / 281-285|

Scanned with CamScanner

 424
Q.
- — ENDEAVOUR ANATOM' FOR lURFTrF^
Explain anatomically / developmentally / histologically: why
jSAQ.MCQ^
inflammation of parotid gla^
painful. [DU-19M.I8M, 1 7M.I2Ju.06Ju) mtUMUul
(D
Q. Explain anatomically: Why/ how- Acute parotitis is painful.
Answer
Inflammation of parotid gland (parotitis) is painful: acute oarotitis) is extremelv PajnfilI
Acute inflammation of the parotid gland (acute sialadenitis USU3„V a
ne
result of stretching of the capsule and stimulation of the great auricular
•
capsule.
results in further turgor wt
mealtimes "hen the gustaton stimulus to the gland
[Ref- Gray
/40*/^
For more curiosity: (usually the parotid) caused by a specific vir^
1) Mumps is an infectious disease of the salivary glands
from the mouth cavity. An abscess may a($Q
A parotid abscess mav be caused by spread of infection
draining an infected area.
form due to suppuration of the parotid lymph nodes the facial nerve is preserved by
3) During surgical removal of the parotid gland or parotidectomy, plane of cleavage is defined by
removing the gland in two parts, superficial and
deep separately. The
tracing the nerve from behind forwards. complications are orchitis and
4) Viral parotitis or mumps characteristically does not suppurate. Its
pancreatitis. method.
5) A parotid abscess is best drained by horizontal incisions known as Hilton's
6) Mixed parotid tumour is a slowly growing tabulated painless tumour without
any involvement of the
facial nerve.
7) Malignant change of such a tumour is indicated by pain, rapid growth, and fixity’ with hardness,
involvement of the facial nene, and enlargement of cervical lymph nodes.

Q. Draw and label the histological structure of submandibular gland. [RU-19M, I SM]
Answer
Histological structure of submandibular gland:

Scanned with CamScanner

 04: Head A neck

<anic the
location lRU-10Ju.08J] ant| rc. ., r ,

thy^1°^'
»h°rt aboul Rro« anatomy of Bh"d.
Write h* thvrn*
J Write down the location and parts of F ,R,]* ’$ hi,06J|

^Givc parts of thyroid gland. |SUST-1 7NJ4^ *

^^nMomv
, ajliSBl ThJTOid
of thyroid gland:
gland is highly vascular
endocrine gland
from & sides of lower neck opposile the C,-T>

n is enclosed by pretracheal layer of deep cervical

fssc’3-
Left thyroid
pjrts: It has- gland
Right lobe
Loft lobe Right thyroid
3. Both lobes are connected by a narrow median gland
isthmus. Median isthmus
y Each lobe is conical in shapes, about 5 cm long. Each Trachea
lobe extends from the middle of thyroid cartilage to 4,h Figure: Thyroid gland.
or 5* tracheal ring. Each has -
• An apex.
• A base.
• Medial, lateral & posterolateral surfaces.
• Anterior & posterior borders.
Isthmus is 1.25 cm transversely and related to
2nd, 3rd & 4,h tracheal ring. It has-
>
a. Anterior & posterior surfaces &
b. Upper & lower borders.
Relation:
Stimothyroid
Stimokgroid Recurrent laryngeal nerve
„ False capsule
Sternocleidomastoid True capsule
Position of ligwwt of Berry
Trachta Parathyroid yland
Thyroid glands Common carotid artery
Internal jugular vein
Carotid shtath Vayus nerve
Sympathetic trunk
Prwcrttbral fascia

..
^Uonoflobe:
,i
. .v bv
superiorly by the
,
attachment
sternothyroid to the oblique line of the
the stemoinyi
ot .he
^7^.- It is limited
4 th or 5th tracheal
ring.
thyroid cartilage.
the 4tn
• T/ie Mentis on level with

Scanned with GamScanner

 426

• The lateral surface: It is covered by:

a) The sternohyoid.
b) The superior belly of the omohyoid.
c) The sternothyroid. .
d) The anterior border of the sternocleidomastoid.

The medial surface It is related to:

a) 7W rubes: trachea and oesophagus.
b) Two muscles: inferior constrictor and
cricothyroid.
c) 7W nerves: external lary ngeal and recurrent
laryngeal.
ry
of the superior thyroid
The anterior border: It is related to the anterior branch
The posterior border: It is related to:
a) The inferior thyroid artery
y id arteries;
b) The anastomosis between the superior and
inferior
c) The parathyroid glands; and
d) The thoracic duct only on the left side.
Superior laryngeal nerve
Internal laryngeal nerve
Hyoid bone External laryngeal nerve
Thyrohyoid membrane
Inferior constrictor muscle
Thyroid cartilage
Outline of lobe
Cricothyroid muscle of thyroid gland
Cricoid cartilage
Outline of isthmus -Oesophagus
ofthyroid gland Recurrent laryngeal nerve
Trachea

Figure: Relation of thyroid gland.

Relation of isthmus:
• The anterior surface: It is covered by:
a) The right and left sternothyroid and sternohyoid muscles
b) The anterior jugular veins
c) Fascia and skin.
• The posterior surface: It is related to the second to fourth tracheal rings.
• The upper border: It is related to the anastomosis between the right and left
superior thyroid arteries.
• Lower border: Inferior thyroid veins leave the gland at this
border.
[Ref- B. D. Chaurasia / 7,h / 1 44-146)
Q. Write short note on: Isthmus of thyroid gland.
[CU-1 IJu]
Answer
Dimension: Isthmus is 1 .25 cm transversely.
Relation of isthmus:
• The anterior surface: It is covered by:
d) The right and left
sternothyroid and sternohyoid muscles
e) The anterior jugular
f) Fascia and skin. veins
• The posterior surface: It is related
• The upper border. It is related to theto the second to fourth tracheal rings.
• Lower border: Inferior thyroid veins anastomosis between the right and left superior thyroid arten. s
leave the gland at this border.

Scanned with CamScanner

 ^pter-O^: Head & neck
-Waces and borders; It has-
Anterior & posterior surfaces
/ Upper & lower borders. *

Q. Give the venous drainage of thvrald 5 ”"'1' l00-14^

Q. Give the Mood supply ofth,™
I9N.I9/18M.I7N.I6N. 14J) d^lDU-BJ.09Ju. CU-IOJ. RU-I9M.I2J.09Ju.08). SUSP
Answer

External fanpujMl nerve

Anterior branch
Posterior branch
Ascending branch of
inferior thyroid artery
Scalenus anterior
Anastomosing branch Vertebral vessels
Outline, of thyroid gland ^Inferior thyroid artery
Suprascapular artery

Recurrent laryngeal nerved

Subclavian artery
Middle cervical ganglion
Carotid sheath
Figure: Arterial supply of thyroid gland (lateral view).

Q. How blood supply of the thyroid gland differs from that of the prostate gland? [SUST-I8M,
RU-lOJu]
Answer
Blood supply of the thyroid gland differs front that of the prostate gland.
by superior thyroid, inferior thyroid, arteria thyroidca ima.
• Arterial supply: Thyroid gland is supplied is supplied by the inferior vesicle
and numerous accessory thyroid arteries. Whereas, the prostate
middle rectal, and internal pudendal arteries.
form a prostatic plexus in the space between the true
venous <*™naL- The veins draining the prostate
• Venousdraliiage: mlo the mlerna| vertebra| venous p|exus.
the true and false capsules, and have no connection
veins oHlwthyroid don’t form any plexus between
with the vertebral venous plexus. |Ref- A.K. Datta /8“* /342)

Scanned, with CamScanner

 428 ENDEAVOUR ANATOMY FOR WRITTEN (SAQ^MCQ) & yjy
Q. Explain anatomically / clinically: Why superior and inferior thyroid arteries are important to
neck surgeon? [DU-09Ju, RU-09Ju,08J]
Answer
Explanation; . yro'.
para g ands
Superior and inferior thyroid arteries are important to neck surgeon, because e
; i
supen p
are
closely situated with these arteries. So, these arteries act as key to approach the 'nferior
parathyroid glands during operation, such as thyroidectomy, parathyroidectomy.
SUST 19M,17N, 15N/J,
Q. Give the development of thyroid gland. [DU-19N,18N,17M,12J,09Ju,
08Ju]
rniT 1R/17N, 1 5J , 1 1 Ju,09Ju, CU-1 4J.12Jul1
Q. Give the developmental sources of thyroid gland. [RU-1 8/
Q. What is ectopic thyroid?
Answer
along its pathway of descend, is known as
thyroid gland lies other than its normal position &
ectopic thyroid. Example - Lingual thyroid, mediastinal thyroid etc. (Ref- A.K. Datta / 4th /

CU-06J, SUST-05Ju]
Q. Name the congenital anomalies of thyroid gland. [DU-17M,
Answer
Congenital anomalies of thyroid gland:
I. Lingual thyroid.
2. Median (thyroglossal) ectopic thyroid.
3. Lateral aberrant thyroid.
4. Thyroglossal cyst.
5. Thyroglossal fistula.
6. Agenesis of thyroid gland.
[Ref- Snell / 8th / 820, 821]

Q. Write about thyroglossal cyst. [CU-19N,10Ju]

Q. What is thyroglossal cyst? [CU-19M,17N,15J,13Ju]
Q. Write short note on: Thyroglossal cyst. [CU-08J]
Answer
Thyroglossal cyst:
It is a cystic remnant of the thyroglossal duct, and may lie at any point along the migratory pathway of
the thyroid gland but is always near or in the midline of the neck.
Sites:
Although approximately 50% of these cysts are close to or just inferior to the body of the hyoid bone,
they may also be found at the base of the tongue or close to the thyroid cartilage.
Clinical importances:
As the cyst enlarges, it prone to infection and so it should be removed surgically.

[Ref- Langman / 12* /277]

Q. Why thyroglossal cyst is always in the midline of the neck?
Answer
[CU-14Ju,12Ju, RU-15M]
Thyroglossal cyst is always in the midline of the neck;
I t is a cystic remnant of the thyroglossal duct, and may lie at
the thyroid gland, therefore from the base of the tongue to any point along the migratory pathway of
the body of the hyoid. So, thyroglossal cyst is alw^Y5
near or in the midline of the neck.

Scanned with CamScanner

 ^^Tj^atomieally/ _ 429
dcvclopmcnta
histologically- why thyroid gland moves with
OT’elutiti^
vVhy
-13
thyr°id 8,and
Jul
nl0ves w,th deglutition?
[DU-09J, CU-19M.17M, RU-14J]
A^er „|an(l movcs with deglutition;
'•'JP^T^J^thyroid gland binds with larynx by pretracheal
lin & down with the larynx during deglutition. fascia & ligaments of Berry. Therefore, the gland
m1)Oves UP

Slowing thyroid opcraLn^X"^ o,voi“ n”y dcve,op

Answer , . , ,
HaafSSg” "f VI>ICC ™V dovolop following thyroid
•<> th= recurrent iaryngcai nerve on each
to tense the vocal folds L hirsen ™of ,hyroid“to,ny “P'™01' resulB m an

|Ref- Snell /8,h/ 8181

q. Draw & label the light microscopic I histological structure of thyroid gland. [DU-1 6M,1 5Ju,
07Ju, SUST-15J,08Ju, RU-19N,! IJu]
Q. Write briefly on: Structure of thyroid follicle. [DU-15J]
Q. Mention the histological structure of the thyroid gland. [DU-19N,18N, CU-09Ju]
Q. Draw & label a thyroid follicle. [RU-09Ju]
Q. Draw & label the histology of thyroid gland. [RU-18N,15Ju,14J,13Ju, CU-18N.15N/J]
Q. Write short note on: Histological structure of thyroid gland [DU-15M, RU- 1 7N, 1 5 J, 1 3 JI
Q. Write down the histology of thyroid gland? [DU-14J,13J,12J,09Ju, RU-16M,07J, SUST-
1 9N, 1 9M, 1 7N, 1 6N, 1 5N, 1 4J, CU- 1 7N, 1 6M]
Answer
Histology of thyroid gland:
> The gland is enveloped by an outer false capsule which derive from pretracheal fascia and inner true
capsule of loose connective tissue.
> This true capsule extends as septa into gland dividing it into many lobules.fibres which are lined by
> Each lobule contains numerous thyroid follicles embedded in the reticular
simple cuboidal to columnar cell depending on their activity. Lumen of follicle is filled with colloid
particles.
> Single or group of large parafollicular cells are found within the follicles, between the follicular cells
and basement membrane or in the interfoil icular connective tissue. They secrete thyrocalcitonin.

Figure: Histological structure of thyroid gland.

i
Scanned with CamScanner
 430 ENDEA VOUR ANA TOMY
Q. What do yon mean by goiter? [RU-19M]
Answer
Goiter:
—
EO. WRITTEN
-
(SAQ, MCQ) <&

Any enlargement of the thyroid gland is called goiter.

Parathyroid^lands
Q. Write in brief about parathyroid gland.
Q. Write short note on: Superior parathyroid gl
Answer
Parathyroid glands: Lobe of toroid gland
Gross structure:
The parathyroid glands are ovoid bodies Capsule
measuring about 6 mm long in their greatest diameter. Suspensory ligament of Berry
They are usually four in number and are intimately
relied to the posterior border of the thyroid gland,
lying within its fascial capsule.
Number of glands:
1. The two superior parathyroid glands: They
are the more constant in position and lie at the
level of the middle of the posterior border of
the thyroid gland.
2. The two inferior parathyroid glands: They
usually lie close to the inferior poles of the
— Ascending branch of
artery
inferior thyroid
Superior parathyroid gland

thyroid gland. They may lie within the fascial

sheath, embedded in the thyroid substance, or
outside the fascial sheath. Sometimes they are
found some distance caudal to the thyroid
gland, in association with the inferior thyroid
veins: or they may even reside in the superior
mediastinum.
Blood Supply:
The superior and inferior thyroid arteries.
Lvmph drainage: Figure: Location of parathyroid gland within thyroid.
Deep cervical and paratracheal lymph nodes.
Nerve supply;
Superior or middle cervical sympathetic ganglia.
Functions of the parathyroid gland:

and the reabsorptio^ of dietary calcium from the small intestine I

3. It also strongly
kidney,
diminishTtTnXS reabsorption of phosphate
n of the ™ney.
m the proximal convoluted tubules of the

IRef- A.K. Datta /4th/ 166, 167 + Snell /8,h/82H

Scanned with CamScanner

 Figure: Histology of parathyroid gland.

Q. Give the development of parathyroid gland.

Q. Name the developmental anomalies of parathyroid gland.
Q. Give the source of development of parathyroid gland. [RU-17M,14J,08J,06J]
Answer
Development of the Parathyroid Glands;
Developmental sources:
The pair of inferior parathyroid glands’. From the third pharyngeal pouch
> The pair of superior parathyroid glands’. From the fourth pharyngeal pouch.
Developmental processes:
The pair of inferior parathyroid glands-. The pair of inferior parathyroid glands develop from the third
pharyngeal pouch on each side as the result of proliferation of endodermal cells. As the thymic
diverticulum on each side grows inferiorly in the neck, it pulls the inferior parathyroid with it. so that it
finally comes to rest on the posterior surface of the lateral lobe of the thyroid hand near its lower pole
and becomes completely separate from the thymus.
2. The pair of superior parathyroid glands-. The pair of superior parathyroid glands
develop from the
fourth pharyngeal pouch on each side as the result of proliferation of endodermal cells. These loosen
final position on the posterior aspect of the
their connection with the pharyngeal wall and take up their
about the level of the isthmus.
lateral lobe of the thyroid gland on each side, at
Developmental anomalies of parathyroid glands. ....
. Absence and hypoplasia ol'the parathyroid
glands.
glands.
• Hypoplasia of the parathyroid
• Ectopic parathyroid glands.
Q. Why parathyroid gland is more vital for life?
[RU-08J]
Answer
Parathyroid gland is more vital for f because the parathyroid gland secretes the hormone
Parathyroid gland is
"’.^Xm
parathormone which controls the met
of calcium and phosphorus.

Scanned with GamScanner

 432

Meninges
Q. Write short note on: Meninges.
Answer
Meninges:
of membranes which is called the
The brain, as well as the spinal cord, is surrounded by three layers
meninges.
Layers of meninges of brain:
1 • Dura mater, A tough, outer layer which consists of two layers:
> Outer periosteal layer and
> Inner meningeal layer.
2. Arachnoid mater: A delicate, middle layer.
3. Pia mater. An inner layer firmly attached to the surface of the brain.
Layers of meninges of spinal cord:
layer.
1. Dura mater, A tough, outer layer which consists of only meningeal
2. Arachnoid mater: A delicate, middle layer.
3. Pia mater. An inner layer firmly attached to the surface of the spinal
cord.
[Ref- Students Gray /3M /830|

Figure: Layers of meninges.

Q. Write short note on: Duramater. [DU-09J]
Answer
Duramater:
The duramater is the outermost, thickest and toughest
membrane covering the brain.
A. Cranial dura mater: The cranial dura
1 . The outer periosteal layer: It
consists of outer endosteal and inner meningeal layers.
acts as inner periosteum of skull bones. It does not continuous
with the duramater of the spinal cord.
2. The inner meningeal layer:
It is a dense,
continuous with the spinal duramater. strong, fibrous membrane covering the brain and is
Folds of cerebral duramater:
1. Falx cerebri.
2. Tentorium cerebelli.
3. Falx cerebelli.
4. Diaphragma sellae.

Scanned with CamScanner

 3. Spinal dura mater:
It consists of meningeal 433
laver n i
from the foramen magnum to the
lower bo^ ?rms a envelon
junctions of duramater:
a. The dural septa restrict the displacement
CF
° the sec°nd sacral vertebra^ SP'nal 11 extends

the head is moved. nt of th

th® ubram
•
associated with ace i rat,on &
b. The venous sinuses ofthe cranial cavity a • deceleration, when
|Rcf- A.K. Datta /3« / |89.19| 'ayerS °f dura mater.
+ D‘
Chaurasia / / 196 +
7,h M
N^™natomy /7‘/428|
Q. What are the folds of cerebral duramater’ Dcscr,be
D u
Q. Give the attachments of folds of ccrebr-il them
Cbral ri du™™ter. [RU-19N]
brief.
Answer
Folds of cerebral duramater:
> Falx cerebri.
> Tentorium cerebelli.
> Falx cerebelli.
> Diaphragma sellae.
A. Falx cerebri:
it isa crescent shaped downward projection of meningeal dura mater
from the dura lining e the calva that
passes between the two cerebral hemispheres.
Attachment:
1 . Anteriorly: to the crista gall i of the ethmoid bone and frontal crest of the frontal bone.
2. Posteriorly: it is attached to and blends with the tentorium cerebelli.
B. Tentorium cerebelli:
It is a horizontal projection of the meningeal dura mater that covers and separates the cerebellum in the
posterior cranial fossa from the posterior parts of the cerebral hemispheres.
Attachment:
> Posteriorly: to the occipital bone along the grooves for the transverse sinuses.
border of the petrous part ofthe temporal bone.
> Laterally: it is attached to the superior tentorium cerebella are free, forming an oval
> The anterior and medial bordersasofthe which the midbrain passes.
opening in the midline, known tentorial notch through
C
*^Sl midline projection of meningeal dura mater
in the posterior cranial fossa.

ofthe occipital bone.

to the internal occipital crest
>
>
Superiorly to the
Its anterior edge is free and ^^Jeen
is between the two
cerebellar hemispheres.

“SSralprojectionisth^
^Th”7mall horizontal shelf
sphenoid
turcica of the *
bone. There a"
of meningeal durah^ the base °f lhe
through which

pituitary g
passes the infundibulum, connecting the
blood vessels.

Scanned with CamScanner

434 l!NinMVOURAN^^

Figure: Folds of dura mater.

Q. Give the arterial & nerve supply of duramatcr.

Answer
Arterial supply of dura mater: .
The outer layer is richly vascular. The inner meningeal layer is more fibrous & requires little blood supply.
1. Vault: Vault is supplied by the middle meningeal artery.
2. Dura lining the anterior cranial fossa: By meningeal branches of the anterior ethmoidal, posterior
ethmoidal & ophthalmic arteries.
3. Dura lining the middle cranial fossa: By middle meningeal, accessory meningeal, internal carotid
arteries and by meningeal branch of ascending pharyngeal artery.
4. Dura lining the posterior cranial fossa: By meningeal branches of vertebral, occipital & ascending
pharyngeal arteries.

Posterior meningeal artery

Meningeal branch from

Middle meningeal artery ascending pharyngeal artery
Anterior meningeal
Middle meningeal artery
Meningeal branch from
occipital artery
Maxdiary artery Meningeal branch from
vertebral artery
Ascending pharyngeal artery3
Occipital artery

re: Arterial supply of meninges.

Scanned with GamScanner

 A neck
pniv of cerebral dura mater:
—-
of the vault has only a few sensory
1 Opthalmic division of
nerves which arc derived mostly from the trigeminal nerve
ophthalmic division of trigeminal nerve. Cranial nerves (Falx cerebri)
Dura of the anterior cranial fossa is supplied
mostly by anterior ethmoidal nerve & partly
by maxillary nerve.
Dura of middle crania! fossa is supplied by
the maxillary nerve and by branches from
the mandibular nerve & from the trigeminal
ganglion.
4) bum of posterior cranial fossa is supplied by
recurrent branch from spinal nerves C^Cz.
Ci & by meningeal branches, of the 9,h &
!0'h cranial nerves. Onthalmic
or trigeminal nerve
(Ref- Students Gray/ 3"* / 830-832) (tentorium
cerebelli)

Mandibular division of Opthalmic division

trigeminal nerve of trigeminal nerve
Maxillary division of
trigeminal nerve

Figure: Nerve supply of meninges.

Q. Write short note on: Falx cerebri.

Answer
Falx cerebri:
It is a crescent shaped downward projection of meningeal dura mater from the dura lining the calva that
passes between the two cerebral hemispheres.
Attachment:
1. Anteriorly: To the crista galli of the ethmoid bone and frontal crest of the frontal bone.
2. Posteriorly: It is attached to and blends with the tentorium cerebelli.
Contents:
1. Superior sagittal sinus.
2. Inferior sagittal sinus.
3. Straight sinus.
)Ref- Students Gray/ 3 /831 1

Q. Write short note on: Tentorium cerebelli.

Answer
Tentorium cerebelli: that covers and separates the cerebellum in the
It is a horizontal projection of the meningeal dura mater
hemispheres.
Posterior cranial fossa from the posterior parts of the cerebral
Attachment: grooves for the transverse sinuses.
Posteriorly: to the occipital bone along the
2. Laterally: it is attached to the
superior border of the petrous part of the temporal bone,
of the tentorium cerebella are free, forming an oval
3. rhe anterior and medial borders
as tentorial notch through which the midbrain passes.
opening in the midline, known
Contents:
4. Transverse sinus
5. Superior petrosal sinuses &
6. Straight sinus. [Ref- Students Gray/ 3rd /831+ B. D. Chaurasia
/6* /197|

Scanned with CamScanner

 EXDEA FOUR ANATOMY FOR
WRITTEN (SAQ^MCQ)
436

Figure: Diaphragma sellae.

Q. Write short note on: Arachnoid mater.

Answer
lines, but is not adherent to, the
Arachnoid mater: The arachnoid mater is a thin, auricular membrane that
inner surface of the dura mater. From its inner surface thin processes or trabeculae extend downward, cross the
subarachnoid space, and become continuous with the pia mater.
Unlike the pia. the arachnoid does not enter the grooves or fissures of the brain, except for the
longitudinal fissure between the two cerebral hemispheres.

Q. Write short note on: Pia mater.

Answer
Pia mater:
The pia mater is a thin, delicate membrane that closely invests the surface of the brain. It follows the
contours of the brain, enteringthe grooves and fissures on its surface, and is closely applied to the roots of the
cranial nenes at their origins.

Q. Explain anatomically- why inner layer of cranial dura is divided into different folds? [DU-
16N,12Ju]
Answer
Inner laver of cranial dura is divided into different folds:
The dural folds restrict the displacement of the brain associated with acceleration & deceleration, when
the head is moved.

Q. Write short note on: Meningocele. [CU-14Ju]

Answer
Meningocele: (or, meningeal cyst)
Meningocele is one type of congenital defect in which the meninges protrude
opening. from a spinal or skull
Causes:
Spina bifida
Defect in the development of skull
Teratoma and other tumors of the sacrococcyx and of the presacral space
Currarino syndrome.
Clinical features:
A sac or cyst covered by skin.
Contains CSF. So, it reveals a positive
Interference with spinal cord or nerves transillumination
is not common, but
test.
may occur.

Scanned with CamScanner

q Give the boundaries of anterior cranial fossa,
answer
p.,c boundaries of anterior cranial fossa:
. Anteriorly and on the side:
1 , By the frontal bone.

• Posteriorly:
I The free posterior border of the lesser wing of the sphenoid
2. The anterior clinoid process and
3. The anterior margin of the sulcus chiasmaticus.
> ,
• Floor: bone, and
1 . In the median plane, it is formed anteriorly by the cribriform plate of the ethmoid
or jugum
2. Posteriorly by the superior surface of the anterior part of the body of the sphenoid
sphenoidale.
of the frontal bone, and is
3. On each side, the floor is formed mostly by the orbital plate
completed posteriorly by the lesser wing of the sphenoid.
|Ref- B. D. Chaurasia/ 7* / 22 1

Frontal crest
Crista galli — t
- Foramen cecum
Foramen of
Orbital part of cribriform plate
frontal bone
Cribriform
plate-
Body of sphenoid
Lesser wing of sphenoid
Anterior clinoid pro
Figure: Anterior
cranial fossa.

Scanned with CamScanner

 Q- Give the
that lie in this IWsa*
»«•«•"hM »«♦ the lm|«» t»wt Mm'lum A
. . .
Q. Name the tbnmUm. of mMdk m>«hl fK«« with the Mrm wrw |MM lh««t«h thuw for,
htt^4
IRU'PNJ4J|
Answer
Boundaries of middle cranial l\^t
• J^fynyrAv
I . i'ostvi ior border of the lesser wing ot the sphenoid.
2. Anterior clinoid process.
3. Anterior margin of sulcus chiasmaticus.
flWtwfrc
I . Superior bonier of the petrous temporal bone,
2 I he dorsum sellae of the sphenoid,
• Laterally;
I . Greater wing of the sphenoid.
2. Anteroinferior angle of the parietal bone.
3. The squamous temporal bone.
Important structures in middle cranial fossa;
I . Temporal lobe of the brain w ith meninges.
2. Cavernous sinus with its contents.
3. I lypophysis cerebri.
4. Structures passing through the foramina in the middle cranial fossa.
Foramina present in this fossa:
I. Superior orbital fissure.
2. Foramen rotundum.
3. Foramen ovale.
4. Foramen spinosum.
|Ref- B. I). Chaurasla/7*/23,24|

Chiasmatis sulcus Middle clinoid process

Tuberculum sellae
— Optic canal
r Foramen rotundum

Greater wing of sphenoid

Opening of carotid canal
Hypophyseal —
fossa ^-Groove for the middle
meningeal artery
Posterior clinoid process -
nen lacerum.
Groove for hiatus for Foramen ovale
lesser pertosal nerve Trigeminal impression Foramdn
Groove and hiatus spinosum
Tegmen tympani for greater petrosal nerve
5 Arcuate eminence

Figure: Anterior cranial fossa.

Scanned with CamScanner

 ^^cribc Infratemporal fossa.
A ^njoral fossa; space which communicates with
the pterygopalatine fossa through the
illary fissure.

^1) M It is formed by-

Thc infratemporal surface of the
greater wing of the sphenoid and
A small part of the squamous
temporal bone.
2) Floor: It is open.
3) Medial walh By-
• The lateral pterygoid plate and
• The pyramidal process of palatine
bone.
4) Lateral wall: By the ramus of the
mandible.
5) Anterior wall: By-
• The infratemporal surface of the Figure: Infratemporal fossa.
maxilla and
• The medial surface of the zygomatic bone.
6) Posterior wall: It is open.

I. Temporalis and medial & lateral pterygoid muscles.

2. Mandibular nerve.
3. Auriculotemporal nerve.
4. Chorda tympani.
5. Inferior alveolar nerve.
6. Otic ganglia.

Q. Give the contents of the petrous part of temporal bone. [RU-15M]

Answer
Contents of the petrous part of temporal bone:
I) Trigeminal ganglion.
2) Greater petrosal nerve.
3) Lesser petrosal nerve.
4) Succus and ducats endolymphaticus.
5) Dura mater.
Tensor tympani.
7) Auditory tube.
|Ref- A.K. Datta / 4,h /24-27]

Scanned, with CamScanner

 440 ENDEA VOUK ANATOMY WK

Venous sinus
Q» Mendon the dural venoux xlnunef with their location, How I* doe* communicate with
extracranial venous xlnuxcx. [RLLI9M, SUST-I9M, DUA)6Jl
Answer
-Lhe dural venous sinuics; . .
The dural venous sinuses arc endothelial-lined spaces between the ou e per,
meningeal layers of the dura mater, and eventually lead to the internal jugular vein
Dural venous sinuses includc-
I) 'Ilie superior .sagittal sinus. Siperior sagitta! sinus
Inferior sagittal sirus^
2) Inferior sagittal sinus. Great WtbrA /fa,
3) Straight sinus. Superior petrosa! sinu
4) Transverse sinus,
Stratyt fauc
5) Sigmoid sinuses.
6) Occipital sinuses sinus.
7) The confluence of sinus. Spl-Jinoparietal drus 4—" CorBucr^ce or fatf,/;.
8) The cavernous sinus. Cavernous sinus
9) Sphenoparietal sinus. Inferior petrosal sinus Occipital sinus
10) Superior petrosal sinus. Sigrnoid SinuSCS Trar&vrst sir^M
1 1) Inferior petrosal sinus.
12) Basilar sinus. Figure: Dural venous sinuses.
Peculiarity of the sinuses:
1) There is no muscle in the walls of the sinuses.
2) There is no valve in these sinuses.
Location of dural venous sinus:
Venous sinus Location j
1) The superior sagittal sinus Superior border of falx cerebri. J
2) Inferior sagittal sinus Inferior margin of falx cerebri. |
3) Straight sinus Junction of falx cerebri and tentorium cerebelli.
4) Transverse sinus Horizontal extensions from the confluence of sinuses along the posterior
and lateral attachments of the tentorium cerebelli. .
5) Sigmoid sinuses Continuation of transverse sinuses to internal jugular vein; groove of
parietal, temporal, and occipital bones.
6) Occipital sinuses In falx cerebelli against occipital bone.
7) The confluence of sinus Dilated space at the internal occipital protuberance.
8) The cavernous sinus Lateral aspect of body of sphenoid, crossing sella turcica
9) Sphenoparietal sinus Inferior surface of lesser wings of sphenoid.
10)Superior petrosal sinus
11) Inferior petrosal sinus
Superior margin of petrous part of temporal bone.
Groove between petrous part of temporal bone and occipital bone ending
in internal jugular vein.
_____——
-
-
12) Basilar sinus Clivus, just posterior to sella turcica of sphenoid.

Communication with extracranial venous sinuses:

_
—
Emissary veins make connection between venous sinuses & extracranial veins.

|Ref- Students Gray/ 3rd

Scanned with CamScanner

 ML
"
„
sinus Is huge WW1W
|w nr i|M
is in "w
»"•«r .1. My „r
CL1^[Kw «f ’"«» >’ b'™«l by Mostal |»y«
or.lgnm.lw
rn 1Mml Ml >M « .Mtal wall b„m«| by ,«„1,^1 ^,r
extensions
c Ulteriorly: it extends upto the mcdlnl end of superior
orbital Ihsure
o Posterior^ it extends upto the apex of the petrous part of temporal
bone.
lining of cavernous sinus;
'
Cavernous sinus has endothelial lining. Wltar n<rv< Abducent nerve
Internal carotid arteryi
Sire: Il is about 2 cm long & I cm wide. Oculomotor nirvt |
Mtnrfl carotid artery Pura uwatrr
Tributaries:
mIIm I
4. From the orbit:
• Superior ophthalmic vein (in
Di'opra<|M4
figure SOV).
• Inferior ophthalmic vein (in
figure 1OV).
• Central vein of retina (in figure

I
CVR).
B. From the brain: 7
• Superficial middle cerebral vein
(in figure SMCV).
• Inferior cerebral vein. | Sphenoidal sinus
C. From the meninges: Cavernous sinus
• Sphenoparietal sinus. Opthalmic division of trigeminal nerve
• Frontal trunk of middle
meningeal vein. Maxillary division of trigeminal nerve

|Ref- B. D. Chaurasia / 5,h /101 1 Figure: Cavernous sinus with its relation.

. Optic tract
Anterior perforated
substances
Internal carotid
artery
Oculomotor nerve- Hypophysis cerebri
Trochlear nerve Meningeal duramater
Opthalmic nerve Sphenoidal air sinus
\_Temporal lobe
Maxillary nerve
Abduucent nerve
Mandibular Internal carotid artery
nerve
Figure: Relations of cavernous
sinus.

Scanned with GamScanner

 (SAQJHCQ)
442 ENDEI I 'OUR JAJ TOMY FOR WRITTEN
For more curiosity
Relations of cavernous sinus;
Structures outside the sinus:
o Superiorly;
• Optic tract.
• Internal carotid artery.
• Anterior perforated substance.
o Inferiorly;
• Foramen lacerum.
• Junction of the body and greater wing of the sphenoid bone.
o Medially;
• Hypophysis cerebri.
• Sphenoidal air sinus.
o Laterally: Temporal lobe with uncus.
o Anteriorly:
• Superior orbital fissure.
• Apex of the orbit.
o Posteriortv:
• Apex of the petrous temporal bone.
• Crus cerebri of the midbrain.
Structures in the lateral wall of the sinus:
1. Oculomotor nerve.
2. Trochlear nerve.
3. Ophthalmic nerve.
4. Maxillary nerve.
5. Trigeminal ganglion.
Structures passing through the centre of the sinus:
1. Internal carotid artery with the venous and sympathetic plexuses around it.
2. Abducent nerve: inferolateral to ICA.

Q. Write briefly on: Cavernous sinus-its communications and clinical importance. [DU-19M,
14Ju]
Q. Give the communications and clinical importances of cavernous sinus. [SUST-15Ju,l Uu]
Answer
Communications:
The cavernous sinus drains:
1) Into transverse sinus through the superior petrosal sinus.
2) Into internal jugular vein through inferior petrosal sinus.
3) Into the pterygoid plexus of veins through the emissary veins.
4) Into the facial vein through superior ophthalmic vein.
5) The right & left cavernous sinuses communicate with each other through the anterior &
posterior intercavernous sinuses and through the basilar plexus of veins.
Clinical importance:
Thrombosis of the cavernous sinus may be caused by sepsis in the dangerous area of the face, in
nasal cavities and in the paranasal air
sinuses. This gives rise to nervous and venous symptoms.

Scanned with CamScanner

 nd^Hcad & neck
arc the causes and effect, of
cavcrno|1,, -
oCcW"01* sinus jhrombn.... ""’"'•’“W (CU.Mjll .r~
fS^mbosis
r
of the
I and m -he
cavities paranasal air

sinus
sinus
bc «"“<< by
sepsis in u,e
da 8Cr0U’ a,a
fltjcH^tsa^SSSS Ihromho.i.. face. In u,e
^^Tbis gives nse to nervousandvenous
q. Describe the supenor sagittal sinus.
Answer
sagittal sinus;
f^ior
is a dural venous sinus,
I. which occupied the u
begins anteriorly at the crista
2^
"
Termination:
gain by
e t,ny meningeal
°f ,he 6I« “-bri.
veins
It terminates near the internal occipital n™ k
left (rarely) transverse sinus. P otuberance by
becoming continuous >k the
k
Interior of superior sagittal sinus? The int^r' r
I. Openings of superior cerebral °f S'nUS Presents-
" nght ^usua,,y) or

veins
2. Openings of venous lacunae:
3. Arachnoid villi & granulation nrts^
4. Numerous fibrous bands. J mg m to ,acunae & the sinus.

Figure: Cavernous sinus with its relation.

Tributaries:
Superior cerebral veins.
• Parietal emissary veins.
Venous lacunae, usually 3 on each side.
Occasionally, a vein from the nose.
AfiPlied anatomy*
Or dip]o^lrOrnbOS,S the suPerior sag,tlal s,nus may caused by the spread of infection from the nose, scalp

|Ref- B. D. Chaurasia / 7^ / 202J

Scanned with
CamScanner
 44 4 — _ EXDE4 1 OUR ANATOMY FOR H RHTEN (SAQ, MCQ)^^.
Q- Write short note on: Sigmoid sinus.
Anr*er
Sigmoid ^inos:
It is the direct cortirus^on of the cas emeus sinus.
Shape: It is S-shiped.
Number: 2 tn number. right & left
Termination: It ends into the superior bulb of the internal jugular vein.
Tributaries:
I Mastoid & condylar emissary veins
2. Cerebellar veins &
3. Internal auditory vein.
Clinical importance: . . . .
Thrombosis of the sigmoid sinus is always secondary to infection m the middle ear (otitis media) or in
the mastoid process (mastoiditis).
(Ref- B. D. Chaurasia / 6* / |%]

Emissary vein
Q. What do you mean by emissary vein? Give its clinical importance? [RU-1 7N]
Q. Write short note on: Emissary vein. [DU -05J, CU-08J]
Q. Explain: Emissary veins are important anatomically' and clinically. [RU-15Ju,13J]
Answer
Emissary *ein: The veins which establish communication between the extracranial veins and the intracranial
v enous sinuses passing through the apertures in the wall of the cranium are called emissary veins.
Peculiarities: Emissary vein Diploic vein
> No muscular tissue in the wall but formed
by endothelium.
> Devoid of valves.
> Blood can flow' in both directions.
Example:
> Mastoid emissary' vein.
> Parietal emissary' vein.
> Posterior condylar emissary vein.
> Occipital emissary' vein.
Function:
1 . Intra-cranial venous pressure is balanced by
these veins.
2. Congestion of sinuses can be relieved by
applying leeches.
Clinical importance: Figure: Emissary vein.
from exter>or into the intra cranial sinuses through the emissary veins and ma)
ma/
lead to thrombosis of the
sinuses, thereby endangering life.

Scanned with CamScanner

Chapter^: Head & neck
far nt ore curiosity

Afferent important emissary veins am

Emissary veins '^edhei^
'“jT^Mastoid emissary vein
, Between sigmoid
auricular vein. sinus & posterior
—
ronnnj
2. Parietal emissary vein
•>upenor
veins of scalp. sagittal sinus & Parietal foriiue^L
[jTOccipital emissary vein Betw een
confluence of sinus t
occipital veins. &
4. Condylar emissary vein
Between sigmoid sinus fc
5. Venous plexus
suboccipital plexus. Posterior ani\ hr ferz— er_
Sigmoid sinus &.
vein. Internal jugular
6. Plexus of emissary vein
7. Internal carotid venous
Cavernous sinus & pterygoid plexus.
plexus
Cavernous sinus & Internal jugular Fcrarr.en c. a.;.
vein. Carotid canal
8. Two or three small veins
Cavernous sinus & pharyngeal veins.IFemen
9. /Unnamed vein Same vessels. lacerur:
10. Unnamed vein Sphenoidal fan
Confluence of sinuses &. occipital Foramen caecu
vein.

|Ref- A. K. Datta / 4* / 213|

Orbit
Q. Write boundaries and contents of orbit [DU-05Ju, SUST-11L08J]
Q. Write down the contents of orbital cavity. [CU-18N]
Q. Give the boundary and contents of bony orbit [RU-14J]
Q. Write short note on: bony orbit [RU-19M]
Answer
Orbit:
Orbits are pyramidal cavities, situated one
on each side of the root of the nose that provide
sockets for the rotatory movements of eyeball.
It has-
> An apex.
, . > A base.
> Roof
> Floor
> Medial wall.
> Lateral wall.
Orhital axis: Axis of each orbit is directed
backwards and medially.
Boundaries of the orhit:
“J
Orbital plate of frontal bone.
Lesser wing of sphenoid.
Floor: By- body of the
Orbital surface of the
maxilla.

Scanned with CamScanner

 ,nrEN(SMMcox
446 ENDEAR
> Orbital surface of the zygomatic
bone
> Orbital process of palatine bone.
C. Medial walk Bv-
> Frontal process of maxilla.
> Lacrimal bone.
> Orbital plate of ethmoid.
> Body of sphenoid.
D. Lateral walk By-
> Greater wing of sphenoid.
> Frontal process of zygomatic bone.

Contents of orbit:
I) Eyeball.
2) Fascia:
• Orbital fascia &
Bulbar fascia.
3) Muscles: Extraocular.
4) Vessels:
Ophthalmic artery,
Superior & inferior
ophthalmic veins,
Lymphatics.
5) Nerves:
Optic Figure: Contents of orbit.
Oculomotor
Trochlear
Abducent
Branches of ophthalmic nerve &
Sympathetic nerves.
6) Lacrimal gland.
7) Orbitalfat.

I Ref- A. K. Datta / 4th / 224-226|

Q. Name the structure passing through the superior orbital fissure. [DU-05Ju, SUST-08J]
Q. Write short note on: Superior orbital fissure.
Answer
Superior orbital fissure:
The superior orbital fissure is an oblique cleft and communicates with
the orbit.
Boundaries: The fissure is bounded-
> Abwand mediallYi by the lower surface of the lessor
orhitJ 8e
> Below and laterally: by the medial margin of the ta surface of greater wing
> Medially: by the body of sphenoid.
Subdivisions:
The fissure is subdivided by the attachment of common tending.
intermediate and medial. ’end,nous ™8
• . .
into three parts- lateral,
Structures passing through the superior orbital fissure?
Through the medial part:
> Inferior ophthalmic vein
Through the intermediate part:
> Abducent nerve
> Nasociliary nerve

I
Scanned with CamScanner
 > Both division of
oculomotor nerve
jjthc lateral parti
’Ophthalmic
y Trochlear nerve (frontal and lacrimal
nerve
y Superior ophthalmic branch)
y Recurrent vein
y Orbital
meningeal branch of lacrimal
branch of middle artery
meningeal artery .

Frontal branch of IRef- A.K Daita /4*/6l|

the ophthalmic nerve Trochlear nerve
Lacrimal branch of °Ptic nerve
the ophthalmic nerve " Optic canal
Superior ophthalmic vein Optkalmic artery
Superior orbital fissure Superior branch of
Abducent nerve oculomotor nerve 1

Nasociliary branch of ophthalmic nerve

Inferior branch of
oculomotor nerve
Inferior orbital fissure Inferior ophthalmic vein

Figure: Structures passing through superior orbital fissure.

Q. Name the extraocular muscles with their nerve supply. [DU-17N,l6M,08Ju,05J, RU-08Ju.
07Ju] and actions. [DU-18N.05J, CU-15Ju, RU-1 8N,12J]
Q. Write short note on: Extraocular muscles. [RU-19N]
Answer
Extraocular muscles:
A. Voluntary muscles:
J) Four recti:
a. Superior rectus,
b. Inferior rectus,
c. Medial rectus,
d. Lateral rectus.
2) Two oblique:
a. Superior oblique.
b. Inferior oblique.
3) Levator palpebrae superloris.
B. Involuntary muscles^
1) Superior tarsal.
2) Inferior tarsal.
3) Orbitalis.
SO-4, LR-6 all are 3/
f Remember:
of cxtraocular muscles:
4th cranial (Trochlear nerve).
by the
Superior oblique is supplied 6th cranial (Abducent nerve). nerve (oculomotor nerve).
Lateral rectus is supplied by the by the 3rd crantal
are supplied
The remaining extraocular muscles
* Scanned with CamScanner
 Depression
Figure; Actions of extraocular muscles.

Actions of ctfraocular muscles:

Muscle
Functions
In primary position Abducted eye Adducted eye
I) Superior oblique Depression Only intortion Only depression
Abduction
Intortion
2) Inferior oblique Elevation Only extortion Only elevation
Abduction
Extortion
3) Inferior rectus Depression Only depression Only extortion 1
Adduction
Extortion
4) Superior rectus Elevation Only elevation Only inUjflion
Adduction
Intortion ]
S) Medial rectus Only adduction •
6) Lateral rectus Only abduction * *
7) Levator palpebrae Elevation of upper eyelid.
superloris
8) Superior tana! Elevation of upper eyelid.
9) Inferior tarsal Depression of the lower eyelid,
!0j Orbitalis Its action is uncertain,
-
|Ref- B. D'Chaurasia 17* 1212+ A. K. Datta

Q. How optic nerve is formed? [SUST-05Juj

Xnswer
formation of optic nerve:
Optic nerve is mule up of the axons of the cells in the ganglionic layer of the retina,

Scanned with CamScanner

 .-04: Head <6 neck
—
ahr intraocular muscles
hsT 06J]
with their
nerve sunnK
PP y i .. n'’ —J. RU-lSJu,
“
I

Muscle*
j^phincter
ip„pill»c of irt^_
»vuiwinotor
(parasympathetic)' ~7; — . Action
(-‘>nMticts pupiC^ ——
J Dilator
ofiris
pupillac

V Ciliary muscles
Cervical sympathetic.
"Oculomotor (parasympathetic).
Mates pupil?
Controls shape of lens.
——
I Ilelps in accomodation
by laxing of suspensory
1 -ligaments & increasing the thickening of lens.
IHef- A.K. Datta / 4* / 25<H52|
q. What is squint? [RU-07J]
Answer
1. is the condition in which two eyes appear to
look in different direction,
ft is caused by the injury to one of the nerves supplying
the extraocular muscles.
Tvpes;
1. Conco,njtant_squint:\X is congenital. There is no restriction in
movement & no diplopia
2. Paral\'twsqumt:\n his condition, movements of the eyeball are limited, diplopia Vertigo
arc
present. The lead is turned the paralyzed muscles & there is a false orientation of the field of vision.

IRcf-B. D. Chaurasia / 7* 1 216|

Nose
Q. Describe the lateral wall of nose. [DU-19M,07Ju]
Q. Write down the features of lateral wall of nose with diagram. [CU-19N,I7N,I3J]
Answer
Lateral wall of nose:
shelf-like bony projections called
The lateral wall of the nose is irregular owing to the presence of three
conchae.
Formation:
by the following bones:
a) lloamart: It is formed from before backwards
• Nasal.
• Frontal process of maxilla.
• lacrimal. of ethmoid with superior and middle conchae
• Labyrinth conchae.
• Inferior nasal plate of palatine bone.
• Perpendicular
• Medial pterygoid plate.
b) Lsrlilanitiotis part: cartilage.
• Upper nasal cartilage.
• Lower nasal cartilages.
•3 or 4 small alar covered with skin.
by fibro-fatty tissue
c) Cuticular part: It is formed

Scanned with CamScanner

 moyilta
Frontal process of
Lacrimal honeconcha
Superior
Middle concha
Uncinate process
of ethmoid
Nam! bone —
Lateral process of
septal cartilage
Major alar — X Medial pterygoid pteul
cartilage of Sphenoid VOnf,
Minor alar Perpendicular plate
cartilage palatine hone
Inferior concha
of nose.
Figure: Formation of lateral wall

Inferior conchae
Middle conchae
Superior conchae

Atrium Superior meatus I

Vestibule Middle meatus
Inferior meatus
Opening of nasolacrimal
duct
Figure: Relation of lateral wall of the nose.
Relation:
The lateral wall separates the nose from:
(a) Ilie orbit above, with the ethmoidal air sinuses.
(b) The maxillary sinus below; and
(c) 'Hie lacrimal groove and nasolacrimal canal in front.

[Ref- B. D. Chaurasia / 7th 1 2^8'249'

Scanned with CamScanner

 ^^r^Ji£^-^LJ2eck
the artery
supply Of |a( |
—
lnneJJ,°[’””:jcu l«N|
^Gi« the blood supply ,nt|

^sujplY of lateral wall

otno<f. or"»’e- IOU-I2J. CU-15N]
SUDDh:
''^tero-surcrior
• Anterior
quadrant- By-
ethmoidal
^nor ethmoidal
• Posterior ethmoidal £
• Facial arteries.
jnt^Mcrior quadrant By branches
from-
• Facial artery
• Greater palatine arterv
f
pgstcro-yupcrior quadrant: By-
• Sphenopalatine artery.
d Postcro-inferior quadrant: By-
• Branches from greater palatine
artery.

Venous drainage:
Branches from facial artery
The veins form a plexus which drains Figure: Arterial supply of lateral wall of nose.
into -
Facial vein.
Pterygoid plexus of veins.
Pharyngeal plexus of veins.
Nen e supply of lateral wall of nose:
General sensors nenes: are distributed to whole of the lateral wall.
• Anterosuperior quadrant: Bv
anterior ethmoidal nerve, branch
of ophthalmic nen e.
• Anteroinferior quadrant: By
anterior superior alveolar nerve,
branch of maxillary' nerve.
• Posterosuperior quadrant: By
posterior superior lateral nasal
branches from pterygopalatine
ganglion.
• Posteroinferior quadrautL By
anterior palatine branch from
the pterygopalatine ganglion.
Special sensory nerves:
Olfactory' nerve. It is distributed to
the upper part of the lateral wall just
below the cribriform plate ot the
ethmoid upto the superior conchae. |Kef- II. 0. Chaurasia / 7'* / 253 1

Scanned with CamScanner

 -
<) How rhe nasal septum is
'
r,DU.ouciw^i^^ ' '5J’ ^■'’'W4
formed. [
6M'

I4MI2 l0nSJ.07t)605JuJ | - SUST-l6M,l5Ju,09j]

. RU.| 7N.08Ju.07Ju.
septum. •
Q. Write short note on: Nasal
of nasal septum. |
‘
sUST-l 7N, 1 5N. 1 3J]
'
Q. Write the formation [RU-09Ju]
of nasal septum. L*
Q. Mention the formation of bony part
Answer
Va^l septum: . .
between the two halves of the nasal cavity
uy.
N^Heptum is a median osteocartilaginous partition ocn
Formation of nasal septum:
A. Rons part: Formed by-
I) Vomer
2) Perpendicular plate of the ethmoid bone
3) The nasal spine of frontal bone.
4) Rostrum of sphenoid and
5) Nasal crests of nasal, palatine & maxillary bones.
B. Cartilaginous part: Formed by-
1) Septal cartilage.
2) Septal process of inferior nasal cartilages.

C. Cuticular part: Formed by fibro-fatty tissue covered by skin.

|Ref- B. D. Chaurasia/7lh/250|

Scanned with CamScanner

 neck

/ bio*1 supply and none sUpp|v —

!7\VNj4ju
453
| short note on: Little's area of the « |jj GSJ Cy

tOts lining epithelium, blood

supply
’^ST-IO))
I Ration the sensory Innervation of nasal ,enl . 15N.I2J.07Jo,
"m*
| |e\!.l~, 0°Jl h,f hL,M,*'««rea?
(DU-I6M.09J.RIJ-
epithelium of nasal septum;
jS^^tified ciliated columnar epithelium.
. -nppb of nasal septum;
TrtcHjllMU
Z'-^ntero^uncnor nan: is supplied bv-
artery).

o Pastem-infcrior nan: is supplied by -

> Sphenopalatine arte? (branch of
maxilla? arte?).
vmpus drainage: The veins form a plexus which Hmme
sph^opalatine vein. .
°rIy ,nt0 lhe fac,al vcin & Posteriorly into
^^oid venous plexus through

Vene supply of nasal septum:

General sensory supply:
Arise from trigeminal nerve which is
distributed to whole of the septum:
' Antero-superior part: by internal
nasal branch of anterior ethmoidal-
nerve.
r
Postero-inferior part: by nasopalatine
branch of die pterygo-palatine
ganglion.
Postero-superior part: by medial
superior nasal branch of the

.
posterior
pterygo-palatine ganglion.
-a.
are confined .he upper part or o!f^ b d cu„„sia ,7-n50|

Scanned with CamScanner

 rm
451 ENDEAVOUR ANATOMr I
Utti*'s arn^ [DU-OOJ. SUST- 1 7M. R U-09J] SUST-l8N,05Ju]
o' wx**
.
“
» IDU-I6M.
rhe clinics importance ofLitth^ area’ IJ, SUST-IOJ]
O*u
V- nre shon nofc on: Little area of now. fRU-l
Answer
SUpp,y’ns lbc ^sa]
Antov-inferior ptrt of the nasal septum, where aMStom^^.^ Xa of nose
cj\7^ form a vascular plexus (Kisselbach’s plexus) is known
as Li
This xts is highly \
Clinical importance of Little’s area: _;,tax;s.
ft is the commonest site of bleeding from the nose o ep
/251 + Snell
|Ref- B. D.Chaurasra/7 /3*,^
. Htle’s area is called the danger area of fac_,
Q. Explain from vour know ledge of anatomy why 1Lit
[DU- 1 4Ju. RU-I5J]
Answer
L ink's area is called the danger area of fag:
it j exposed t0 d j
Ninety pereen. ofnose bleeds
(ep.st^^
effect of insrmaton current. Alternatively, it can be arguea, 5
r'
nose-picking. Ac: Ais «n vascular area of nasal mucosa is within reach of the probm, finger. For
^ctk^ nmhmo

these reasons Little's area is called the danger area of face.

Q. What is epistaxis? [DU-13J, CU-15NJ3J]

Epistaxis:
Bleeding from the nose is called epistaxis.

Q. Write short note on: Nasal conchae. Superior coneku

Answer
basal conchae:
The nasal conchae are curved bony
projections arises from the lateral wall of the nasal
cav-in and is directed downwards and medially.
The following three conchae are usually found:
(a) The inferior concha: is an independent
Middle concha
Inferior concha
bone.
(b) The middle concha: is a projection from Spheno-ethmoidal ruus
the medial surface of the ethmoidal Superior concha - Superior meatus
labyrinth.
(c) The superior concha: is also a projection
Middle concha ^-Middle meatus
from the medial surface of the ethmoidal Inferiorconcha
labyrinth. This is the smallest concha
I
situated just above the posterior pan of the Hard palate
middle concha.
Figure: Concha and meatus of the nose.

JRef- B. D. Chaurasia/7th/252-^
Scanned, with CamScanner
 ^HeadA neck
are the itructurci that open Intn.k .
C^||c short "otcon: Meatui of the nose. ' "Oh. nose? (DU-I2J
CU 15J
..-w

freeb
^'>7
nasal
,bc
of the nos.
envoy proper. 'h'

QfjaZcrior nmUux Il lies undemearh the inferior c^r.

mm II: The nasolacrimal
duct
’n<1
.
*
"
. ,ar8«' three meatuses
Thcjniddlc mentis It lies underneath the middle conch, n
(a) The ethmoidal bulla is a rounded elevenon P^uced by thefoUowirg fca^
sinuses.
(b) The hiatus semilunaris is a deep semicircular «..1
(c) The infundibulum is a short passage at the
l . ..
underlying

anterior’end the^ato.
of
middle ethmoidal

Structures open into it:

(a) The opening of the frontal air sinus is seen in the
anterior part of th. hiatus semilunaris.
(b) The opening of the maxillary air sinus is located in the
posterior part of the hiatus
semilunaris. It is often represented by two openings.
(c) The opening of the middle ethmoidal air sinus is present at the upper margin of the bulla,

y The superior meatus: It lies below the superior concha. This is the shortest and shallowest of the three
meatuses.
Structures open into it: The openings of the posterior ethmoidal air sinuses.
y The sphenoethmoidal recess: It is a triangular fossa just above the superior concha.
Structures open into it: Opening of the sphenoidal air sinus.
[Ref- B. D. Chaurasia 1 7* / 252J53|

Scanned with CamScanner

 456

Paranasal sinuses
CU-I IJ]
.
Q. Name the paranasal smus. IRN. RU-I9N.I5N.I IJu,09Ju.05Ju,
(SLST-18
• kikt
of paranasal sinuses. [RU-17N,|
sinuses, /up h
Q. Give the communications of paranasal
13J. CU-08J) 5N, 1 1 Ju. 05Ju, SUS I -06Ju]
the functions of paranasal sinus . rcil-12J
[ • RU-1
Q. Write down naranasal air sinttM,
drainage of any hso of the paranasal
sinuses
Q. Mention the lining epithelium and sites of

of anatomy how pneumatic bones

communicate with n.Wl
Q.
Q. Enurn craFcVhc^paranasal
air sinuses with their draining sites.
[SUST-I9N.
[RU-l9NJ4JlhSlJST-l7M]
Q. Name the paranasal sinuses. Give their function. ,,w,
some craniofacial bones. [ -I5N|
Q. Explain anatomically: why air sinuses are present in
5Ju, 1 3J, SUST-1 5J. 1 JJ J
Q. Write short note on: Paranasal air sinuses. [CU-1
Answer
Paranasal sinuses:
some bones around the nasal
,
cavities.
..
.. of
All them
Paranasal air sinuses are air filled spaces present within
open into the nasal cavity through its lateral wall.
Name of the naranasal sinuses:
I) Frontal air sinus.
Maxilk w air sinus.
Sphenoidal air sinus.
4) Ethmoidal air sinuses (anterior, middle and posterior)
Functions:
1) Make the skull lighter.
2) Resonance to the voice.
Lining: Pseudostratified ciliated columnar epithelium.

Communication:
Frontal air sinus:
> Frontal air sinus opens into the middle meatus
of nose at the anterior end of the hiatus
semilunaris either through the infundibulum or
through the fronto-nasal duct
B. Maxillary air sinus:
It opens into the middle meatus of nose in the
lower part of the hiatus semilunaris. A second
opening is often present at the posterior end of Figure: Paranasal sinuses.
the hiatus. Both openings are nearer the roof
than the floor of the sinus.
G Sphenoidal air sinus:
Each sinus opens into spheno-ethmoidal recess
of the corresponding half of the nasal cavity.
D. Ethmoidal air sinuses:
et^mo’^a* s,nus °Pens into the anterior part of the hiatus semilunaris of middle nasal
mea^K
HlCaluo.
F

* e“lmoidal air sinus is presen' at ,hc “PP" "W" of ,he 1,11113 °f

P gs of the posterior ethmoidal air
sinuses are located in the superior nasal mealus-
[Ref- B. D. Chaurasia / 7,h / 254-2^1
Scanned with GamScanner
 n4: Head & neck

Frontal $inu$
Middle concha (cut)
Agger nasi ‘HvwU przrj
I Atrium ^henaetlr^dal rtux
tyflw.dol Sirus
girtus semilunaris- ^perior corda (cut)
Vestibule Optrjrg
Opening of ^^^r et^wMal sirus
nasolacrimal duct H*ddU sirus
'e Maxillary sinus
nm'

1 ,08Ju’ RU',5M» CU-I7N.I5N,

answer SUST-O6J]
Mat illan' air sinus:
fhe maxillary sinus is the largest of all the paranasal sinuses
which lies tn the body of die maxilla.
Communication^
The opening of the maxillary air sinus is located in the
posterior part of the hiatus semilunaris of
middle nasal meatus. It is often represented by two openings.
Shape:
It is pyramidal in shape.
Size and measurement: The size of the sinus is variable. Average measurements are-
r Height: 3.5 cm.
> Width: 2.5 cm.
r Depth (anteroposteriorly); 3.5 cm.

Features:
It has-
a. An apex,
b. A base.
c. Four surfaces:
> Orbital.
> Alveolar.
> Facial.
> Infratemporal.
arteries.
Atlerial supply; Facial, infraorbital and greater palatine
of veins.
^ousjrainage: Into the facial vein and the pterygoid plexus
^nLQhatic drainape: Into the submandibular nodes. superior alveolar nerves.
^HLsudd|v: Infraorbital, and anterior, middle and posterior |Ref- B. D. Chaurasia / 7
/ 255|

Q- What is sinusitis?
Answer
^HlMtis! Infection of a sinus is known as sinusitis.
Scanned with CamScanner
 458 ENDEA VQUB. diH
Q. Why maxillary sinusitis is more common? [RU-17MJ5MI^
Q. Explain anatomically/ developmentally/ histologically-- 3X1 ar? Comaiox^
infected. [CU- 1 8N, 1 5J, 1 3Ju]
Answer
Maxillary sinusitis is more common because-
1) Drainage of the sinus is difficult because its ostium lies at a
higher level than its floor,
2) Another factor is that cilia in thee lining mucosa are destroyed
by chronic infection.

RU- u]
Q. Give the applied anatomy of maxillary air sinus? [DU-19M,
Answer . . .
maxillary air sinus
Applied anatomy of maxillary air sinus: Sinusitis is common in
1 ) Drainage of the sinus is difficult because its ostium lies at a
higher level than its floor.
chronic infection.
2) Another factor is that cilia in thee lining mucosa are destroyed by

Q. How maxillary hiatus is reduced during living condition? [RU-14Ju]

Answer
Reduction of maxillary hiatus during living condition:
Maxillary hiatus is reduced during living condition by the following factors-
1. Uncinate process of ethmoid bones.
2. Ethmoidal process of inferior nasal concha.
3. Descending process of lacrimal bone, from the front
4. Perpendicular plate of palatine bone, from behind.
5. It is further reduced by thick mucosa of the nasal cavity.
|Ref- A.K. Datta / 4* / 270-271]

Q. Mention the development of paranasal air sinuses.

Answer
Development of paranasal air sinuses:
The paranasal sinuses develop as mucous diverticula of the nasal cavity' and invade the neigKxrrg
bones at the expense of the diploic tissue.
All sinuses are present in rudimentary form at birth, except the frontal sinuses which start devekpasa
two or three years after birth. They enlarge rapidly during the ages of 6 to 7 years, i.e. time of er^ox
of permanent teeth and then after puberty.
From birth to adult life the growth of the sinuses is due to enlargement of the bones; in old age it is is
to resorption of the surrounding cancellous bone.
[Ref- B. D. Chaurash / 7* 1 2411

Scanned with CamScanner

 . rhe tongue is a solid conical muscular
tM oral cavity and partly in the pharynx°rga"’ Partially bytheT^^^^™
UC0US
of- tongue.
C n and lies
the functions
0 writedown [DU-08Ju]
p>T]7acts as an organ of taste.
in mastication, deglutition
„2 It helps and speech
n is sometimes utilized in gestures and X, , ’
in moistening the lips, and acu f“ial exPrc«ion.
4 It helps
5) m some lower animals (e.g. dog) it is used
dam°'
as a
P'aCin8 lh' W ’tamps
6) Sometimes tongue-prmts
for personal identification.
^
displaying8 thee pattern
•”««» Ungual papillae are used

Clinically, it acts as a mirror in various disturbances of alimentary

fin medico-legal purposes

tract.
(Ref- A.K. Datta / 4* / 278 1
q. Write down the name of muscles of tongue their nerve supply (SUST-1 8M1
Q. Name the extrinsic and tntrmsic muscles of tongue with their actions. [DU-16M
q. Name extrinsic muscles of the tongue. [CU-1 4Ju, 1 OJ] 1 ’ 1 1 JulJ
Answer

showing muscles of tongue.

Figure: Cross section of
tongue

Scanned with GamScanner

 WWMfSAQiMCOi
460
m
Mm„,w „f tonaac <n aMh batfaf the.W*
1
.

—
Muscles
Extrinsic muscles.
I _LL - ,
tongue ana ma^
•Gcnioglossusus It depresses the side of
the
•Hyoglossus I
of the tongue. j
I It depresses the side and upward.
• Chondroglossus It retracts the tongue backward and narrows the oro-pharyngcalis^
'
• Styloglossus I
It elevates the base of the
tongue ~
• Palatoglossus I
tongue- '
Intrinsic muscles They alter the xhapeofjhe tongue and make the dorsal surface con,- |
• Superior longitudinal They reduce the length of the ~
• Inferior longitudinal
» Transvcrsu.s linguae
side to side.
They shorten the
• — dnrsal surface convex.
longue.
(he dorsal Lfaee concave^
• Vcrticalis linguae side to side.
|Ref-A.K. Datta M-nao-a,!
except palatoglossus, which is supplied by
M the muscles of tongue are supplied by hypoglossal nerve
cranial part of accessory nerve.
muscle on tongue? [SUST-l4Ju]
Q. Explain - What will he the effects of paralysis of gcnioglossus
Q. Why gcnioglossus is called the safety muscle of tongue?
Answer
Effects of paralysis of gcnioglossus muscle on (onguc/Gcnioglossus is called the safety muscle of tongue
The gcnioglossus is called the ‘safety muscle of the tongue’ because if it is paralysed, the tongue will
fall back on the oropharynx and block the air passage.
|Ref- B.D. Chaurasia / 7‘* /279]

Q. Give the blood supply of tongue.

Answer
Blood supply of tongue;
Arterial supply;
• It is chiefly derived from the lingual artery, a branch of the external carotid artery.
• The root of the tongue is also supplied by the tonsillar and ascending pharyngeal arteries.
Venous drainage:
• The deep lingual vein is the largest and principal vein
of the tongue.
• Along with two venae comitantes accompany . $
the lingual artery, and one vena coml
accompanies the hypoglossal nerve, it forms
facial vein or in the internal jugular vein.
the lingual vein which ends either in the co

Scanned with CamScanner

 0
- - Ut
n thC peculiarities of lymphatic
^00 drainage of tongue.
lrainafico£^^ [DU-15MJ
^i^^vThejongue:

—
^7 * Drains bilaterally to
, . mlleft
. the submental
halves of the nodes.
> JSSSS*
Sill n-- remaining part ofnnt^i—
-
>
iat »cs drain
drains bi|a,„.,r
into th^ *>
^^Wa^lytothewne^
> toJugul<H)mohyoid nodes.
Apex of
the tongue
__ Anterior Z/5
of
tongue
/A Posterior 1/3
i II

Submental
nodes Jugulodigastric
rode
Submandibular Upper deep
nodes cervical node

lugulo-
omohyoid node
Figure: lymphatic drainage of tongue
Importance of lymphatic drainage:
cervical
I . Tip of the tongue presents richest lymph drainage. A cancer affecting the tip spreads to all
lymph nodes of both sides.
2. Lymphatics do not accompany the blood vessels.
place and the lymphatics pass bilaterally.
3. In the middle line of the tongue a free decussation takes
of common carotid artery is known as the
principal
4. A group of lymph nodes situated at the bifurcation
lymph nodes of the tongue.
A.K. Datta / 4* / 284|
[Ref- B.D. Chaurasia / 7A / 278 +

[DU-19M, CU I9M]
Q. Draw and label the histology of tongue.

Scanned with CamScanner

 „ - rMfY WRITTEN (SAQ, .

ENDEAVOURA?!^^^
j
462
Q. Describe the nerve supply of tongue. un(j. [D(J-19NJ7MJ5JJ3j
Q. Give the nene supply of tongue on dcvclopmcn |7NJ7/16M,I5M,14Ju,10Ju/i
I U. RU-19MJ7HI5MJ3JJ 1J.10J.08J.07J.06J,
19N.ISN. 17N. 15N/J, 14/11Ju.1 1J,09J,08J,07Ju/J,06JJ
y- br of tongue b
P led
,
histologies
Q. Explain anatomically/ developmentally/
lingual nerve. [DU- 15M, 1 2J] .
,c |onguc. [CU-l3Ju,l2Ju]
Q. Write down the development of epithelium o -linn|ied by glossopharyngeal nervt
Q. Explain developmentally- Posterior 173rd of tongue is suf
|

[DU-09J]
Q. Give the source of development of tongue. [DU »
08Ju,06J,05J, SUST-07J. CU-O6JUJ
Answer
Nene supply of tonguc on developmental background^
> Motor supply: Muscles of the tongue arc devck)pe occjpital myotomes. So, they
fe supp|ied by craniaI pan
innervated by the hypoglossal nerve except palatogi
accessory' nerve through pharyngeal plexus.
> Sensorysupply:
• . nylons from two lateral lingual swellings and
ra,
medial swelling, the tuberculum impar of 1 phaiyng arch. Soepn^tion
by lingual branch of mandibular nerve (nerve of 1 arc ). by ."7
k c^rriwi ku
orda
tympani branch of facial nerve. .
• Posterior 173rd including vallate papillae;. Develops from hypobranchial eminence, L-erefor-
the 3rd arch. So, its general & taste sensations are carried by glossopharyngeal nerve (nerve of
3rd arch). . ..
• Extreme posterior part: Develops from 4th pharyngeal arch. So, this part is innervated by
superior laryngeal branch of the vagus nerve (nerve of 4 arch).
> Sympathetic supply; By superior cervical ganglion.

Figure: Nerve supply of the tongue.

Q. Explain anatomically / developmentally
/ histologically: why anterior
supplied by mandibular nerve, [DU-07Ju] lingual 273rd of tongue is
Answer nerve. [DU-17N,06Ju]
Anterior 273rd of tongue is supplied by
mandibular nerve / lingual nerve:
Anterior 2/3rd excluding vallate papillae
swelling, the tuberculum impar of 1 develops from two lateral lingual
pharyngeal arch swellings and one
division of trigeminal nerve. So, general which is supplied by lingual nerve, branch of mandib^
nerve. sensation of the mucosa is
carried by lingual branch of mandibular

[Ref- Langman / 12*7275,2^

Scanned with CamScanner

 scribe '»<>“cv,:l0P™«»‘«r.n,crtl,r
Oa^uu^,
P
' «rlbc.1’« ,h' Pr0"M °r ‘‘'''iopmcnt
„f . ""’"»11«. |du'141
J^.e a«v«lopmen< of
ton*^ *
1 noy arc develop c
from the occipital
> o- Myotome?.

o
anomalies of tongue: P aryngeal arch-
n.Kionmcnt1'1
•^Tongue lie
Macroglossia

0. Explain anatomically: Why/ how- Posterior nn^ tki^i «r tongue

t
is supplied
glossopharyngeal nerve. [DU- 09J] by
Answer
Posterior one third of tongue is supplied by glossopharynpeal nerve;
Posterior 1 /3 including vallate papillae develops from hypobranchial eminence, therefore, the 3"* arch
innervation of which comes from glossopharyngeal nerve. So, its general & taste sensations are carried by
glossopharyngeal nerve.
[Ref- Langman / 12* / 275, 276|

Q. What will happen to tongue, if right hypoglossal nerve is injured? [DU-1 1 Ju, 08Ju]
Answer
If right hypoglossal nerve is injured, muscles of the tongue on the right side are paralyzed.

Signs and symptoms:

.
>
.•
If the lesion is infranuclear:
There is gradual atrophy of the right half of
Muscular twitching is also observed.
the tongue or
.
hemiatrophy.

>
.•
If the lesion ix supranuclear
There is paralysis without
wasting

The tongue becomes stiff, sma

resu|ting )n dcfKt„e
|Ref. B.D. Chaurasla ; T“ / 2781
RU-I7N.I6M,
,
T-l 8N,1 5Ju,I2J.08J,
Q- What is tongue tie/ankyloglossla? [DU-1
)U-l4Ju]
12Ju.09Ju.06J.CU-16M.MJuJ
Q- Give the congcnital/developmental »n"nl
a|ks „f tongue. (C
not freed from the
Answcr ... wilich, the tongue is
anomaly of tongue in
causes disturbance of speech. In
the most
fite-tlc/ankvloglossinj H is a
shortening o
linguae which
o ongue.
n°or of the mouth due to extends to the tip BD Chaurasia 1 4 / 253)
[Ref-
c°ntmon form of ankyloglossia, the fr

Scanned with CamScanner

 s.

464
(Dlhl.Vu) L17M. SUST-08JJ
nr tongue? tongue. [VI
structure of
An^
Q e

masses
occupy the interior nf L
of skeletal muscletransversely nnd
1) ”P of
compact Inngitudlnnlly.
chkny in 1
between muscle fibres.
mucous, serous and mixed are present
epithelium.
*
squamous
k lined bj stratified surface of the tongue.
1 Die of small eminences cn|fcj
Fhc mucn^$ ’S on the lower
by a great number
membrane. They nre valine 'nr
5) Its dorsal covered anteriorly by mucous
aweroti pnpilluc.
6) Each papilla
aiir.j.? * Emiamon of lamina propriafoliate papillae nnd filiform
Thcy ar0 most Serous on
ciroumx W’Uae. °f ,hC PaP,llae'
f$
Carrol-shaped ta T h
** collections oflymph
lingual tonsils and smaller
8) ^c
nodules.
yaJlatc papillae
c third of the tongue shows many
Datta /4* /279 2«m
1 2,h / 252 + A.K.
Iw. / 12
|Rcf-Junqucira/
Q. What is lingual papilla? [SUST-l4Ju]
Q. Write short note on: Papillae.
Answer
Papillae / lingual papillae:
Each papilla is a projection of lamina propria covered by
mucous membrane on the dorsum of the
that assume various forms and functions.
tongue which is characterized by a great number of small eminences

Tvnes of papillae:

Median glossoepiglottic Md Vallecula • , e u

Lateral glossoepiglottic told
Palatopharyngeal Md
Lymphoid follicles of
pharyngeal part of the dorsum

Foramen caecum
Palatoglossal Md Sulcus terminalis
Foliate papillae
Circumvallate papillae

Filiform papillae^
Fungiform papillae
Figure: Dorsum of lite tongue showing
different types of papillae.
Four types are recognized:

—
1)
EilUoanj.^i!^ They are very numerous,
affecting rhe enure dorsal surface of the have an elongated conical shone and are highly kenili^
buds .and their role ,s mechamcai in anterior two-thirds of lite tongue Their epithelium lacks'^
2)
providing a rough surface
thXihliesHmovemem
’long the sides and tip of the |
Scanned with CamScanner
 n4jj£lliA
These arc V^rly
5 and contain tastedeveloped in adults
buds. Affecting the margin
.a (H<^^7u^udson
l^hal^bC W the human MC 'hc
k5"' nt the tongue
^n#l
^4 4enU"
uv bottom receives
^|ublc to stimulate the tongue. Ahey
the ducts of
serous
taste buds.
normally largest lingual
form a
salivary glands V^haped Une
front of
papillae, and
In

the secretion ^ust beforehave

d*
of which
makes the
1 11* 1
151* A.K Datta I
A*।*”»
L°W«r bp

Fungiform papillae
M wstibule

Filiform papillae

ulcus terminate
follicles of
P^r^ul part of t^rsum
Circumvallate papillae Foramen caecum
Figure: Dorsum of the tongue showing — 1
different types of papillae.
n Write about the area of distribution of taste bud. Give its histological
features with diagram.
[CU-15Ju,l 1 Ju]
q Write short note on: Taste buds.
Answer
Taste buds:
Taste buds are modified epithelial cells arranged
as spherical masses, each containing 50-75 cells, within
the stratified epithelium of the tongue and the oral
mucosa.
Distribution:
Epithelium covering the tongue (numerous on
the sides of the vallate papillae).
2) Inferior surface of soft palate.
3) Palatoglossal arches.
4) Posterior surface of the epiglottis.
5) Posterior wall of oropharynx.
Qfienjnjv EaCh Opens on the surface of the
epithelium by an aperture known as the gustatory pore.
Features; Figure: Taste bud.
(taste) cells
0 About half the cells are elongated gustatorycells, stein ceHs.
u
2) Other cells present are slender supportive imma
th
’
ough openingg called the taste pore.
i an open
3) At the apical ends of the gustatoiy cells microvilli Wdry
4) The base of the bud is penetrated by the afferent
gus |Ref. Junqueira / 12 /252)

Scanned with CamScanner

 WRITTEN
466 KN DEA Vi
Q. What nrc the types of tnstc sensations?
Answer of taste sensation:
Types of sensations; Taste buds detect nt least five broad cn eg,or|cs
I) Metal ions (salty).
2) Hydrogen ions from acids (sour).
3) Sugars and related organic compounds (sweet).
4) Alkaloids and certain toxins (bitter).
5) Certain amino acids such as glutamate (umami).

Q. Trace the taste pathway. [RU-17M,14Ju,06J]

nnthwav from anterior 2/3* Of
Q. Mention the location of 1”, 2nd and 3rd order neuron of taste pan
tongue. fRU-09Ju]
, , FRU-13J]
Q. Mention the situations of the 1“ order neuron in the tast nnthwav.
P*
Answer
Pathway of taste sensation;

The sensory nerve fibers from the taste buds on

the
tympani branch of die facial nerve, and those from the anterior two thirds of the tongue travel in the chorda
posterior third of the tongue
glossopharyngeal nerve. The fibers from areas other reach the brainstem via the
than the tongue reach the
brainstem via the vagus nerve.
On each side, the myelinated but relatively
slowly
gustatory portrnn of the nucleus conducting taste fibers in these three nerves unite in the
tractns solitarius in the medulla oblongata.
From there, axons of second-order neurons V

ascend in the in^ihtpmi

oosternmfXi
ventral posteromedial
. and pass directly. to the
P5113*™ medial lemniscus
i।
.ho
nucleus of the thalamus.
From the thalamus, the axons of die
third-order neurons pass in tho that •
somatosensory cortex in the ipsilateral
postcentral -n " .
thalam,c radiation to the face arcaotr the
iey also pass to
the anterior the insula-
part of

Scanned with CamScanner

r
fh^
Head & neck
—
S.plsin anatomrcally - Referred pain is fcl, jn
tongue*
AgL nain is felt in the ear in dis^, nf p^trrln,
nar
S^^eferrcdlhepain isfelt the car
in
P^ienoi’'’’““f the
upply t0 both rc810ns- tongue, as ninth nerve |s common

[Ref- BD Chaurasia / 6'" / 268]

Ear
q What are the parts of externa] ear?
Answer
The external car consists of:
'
The auricle or pinna.
b. The external acoustic meatus.

q. Write short note on: Auricle / Pinna.

Answer
Auricle / pinna:
Formation:
The greater part of it is made up of a single crumpled plate of elastic cartilage which is lined on both
sides by skin. However, the lowest part of the auricle is soft and consists only of connective tissue covered by
skin, called lobule.
The blood supply:
1) The posterior auricular artery.
2) Superficial temporal arteries.
Nene Supply:
Lateral surface:
> Upper two-thirds: by the auriculotemporal
nerve.
> Lower one-third: by the great auricular nerve.
Medial surface:
> Upper two-thirds: by the lesser occipital nerve
> Lower one-third: by the great auricular nerve.
The root of the auricle: by the auricular branch of
the
Figure: Parts of pinna.
vagus.
The auricular muscles: by branches of the facial
nerve.
[Ref: BD Chaurasia/ 7'”/ 283^84|

is very painful. [DU-07J]

Q. Explain anatomically- Why externa. ear infection
Answer
External ear infection is very painful: So, any infection of
underlying bones and cartilage.
and nxeu
Skin of the external ear is adherent
external ear is painful but allows little swe ing.
chaurasia / 7* / 286 1

Scanned with CamScanner

 4«l_====zj^12^^
Q. Explain anatomically: Why/how- otitis externa h very pnlnh: I
Answer
Otitis externa is ven painful: ^11
10 <ho «IJ»c«"
Otitis externa is extremely painful; since thc ,kln 1«
collection of exudates produces tension.
|Ref- A.K. Datta / 4*

Q. Write short note on: Tympanic membrane [DU-0SJ.07J.

SUST-MJu. CU-I5M.I2J.O6J. Ru.

Q. AXX hlX^I
I8MJ6M, SUST-18M.08J]
fnnction anti development of
tympanic membrane. (D(J.
,’r,,nc‘ rrll nH
Q. Give thc development and blood supply of tympanic mem ..... . .
Q. Write briefly on: location, parts A functions of tympanic
tympanic membrane. [S S M5Ju,
Q. Write thc structure, development and nerve supply of
13Ju]
Q. Mention the functions of tympanic membrane. [DU-I3JJ
Answer
Tympanic membrane: . „ ,
meatus & thc middle car.
Tympanic membrane is a thin, translucent partition between external acoustic

Shape: Oval shaped.

Measurement: 9x10 mm.

Position: The membrane is placed obliquely making an acute angle of about 55° with the floor of the external
acoustic meatus.
Surfaces:
1) Outer: Outer surface is lined by thin skin.
2) Inner: The inner, surface provides attachment to the handle of thc malleus.
Parts: It has two parts-
!) Pars tensa: Greater part of the membrane and
2) Pars flaccida: The part between the two malleolar folds.
Structure/Histology:
Pars tensa is composed of the following three layers:
1) Outer cuticular layer: composed of skin.
2) Middle fibrous layer: It contains radial, circular, and parabolic
fibers.
3) Inner mucous layer: lined by a low ciliated columnar epithelium.
Pars flaccida is composed of the following Iwo layers:
1. Outer cuticular layer: composed of skin.
2. inner mucous layer: lined by a low ciliated
columnar epithelium.

Scanned with CamScanner

 > Outer surface: By the deep auricular branch nf •„

* by posterior

Venous drainage:
> Veins from the outer surface drain into the external jugular vein.
> Veins from the inner surface drain into transverse sinus and into the venous plexus around the
auditory tube.
Lymphatic drainage: Lymphatics drain into the preauricular & retropharyngeal lymph nodes.

Development:
Layers of tympanic membrane Developmental source
1. Outer cuticular layer Ectoderm of Is' pharyngeal cleft
2. Intermediate fibrous layer Surrounding mesenchyme
3. Inner mucous layer Endoderm of I51 pharyngeal pouch
Nerve supply:
branch of the vagus nerve.
> Outer surface: By auriculotemporal nerve & by the auricularnerve through the tympanic
> Inner surface: By the tympanic branch of glossopharyngeal
plexus.
part of the car.
function: It makes vibration of air or sound that transmits to the other / 323, 324)
+ A.K. Datta /4
|Rcf- BO Chaurasia 1 7* / 285-286

Q- Mention the developmental sources of tympanic . yh tympanic

P membrane is
9- Explain anatomically / histologically /
CU-1 uuj
developed from all three germ layers. [DIM U.
Answer
^Xlgpincnlal sources of tymmniic membnine:
Developmental source
-Layers of tympanic membrane _
-LPutcr cuticular layer —
-^Intermediate fibrousjayer
-Idnncr mucous layer

Scanned with GamScanner

——=~
Q. Give the boundary, communication,
ENDEA VOUR /bV4 TOMY FOR WMITEH (SAQ, MCQ^.
development and contents of middle ear cavity
clinical importance. [DU-19N,15J,06Ju.05J, RU-19N.I8N,09Ju.05J.
Q. Write short note on: Middle ear cavity. [SUST-1 8N. DU-08Ju] SUST-lTNLtWJ.O?^^
Q. Write briefly on: Middle car cavity. [DU-14J]
Q. Mention the content of middle car cavity. [DU-I5M. RU-16N,I5Ju.12J.08J. SLST-1 Uu.Qj_
15J]
Q. State the boundary’ and contents of middle ear cavity. [DU-18/17NJ UuJOJ. SUST-I5Xj
10J]
Answer
Middle car cavity: . part of the tempera! booe ber^
netrous p
The middle ear is a narrow air-filled space situated in the petrous %
external car & internal ear.
Synonym:
Tympanic cavity, tympanum.
Diameter:
Its vertical & anteroposterior diameters are both about 15 mm.
Boundaries of middle car cavitv:
1) Roof: By tegmen tympani.
2) Floor: By a thin plate of bone
separating the middle ear from jugular
fossa.
3) Anterior wall: By
> Canal for tensor tympani.
> Opening of auditory tube.
> A thin plate of bone which
forms the posterior wall of
carotid canal.
4) Posterior wall: By -
> Aditus to antrum.
> Pyramid.
> A thin plate of bone which
separates it from mastoid
antrum.
Figure: Middle ear.
5) Medial watt; By •
> Promontory.
> Fenestra cochleae.
> Facial canal.
> Fenestra vestibuli.
> Sinus tympani.
6) Lateral wall: By -
r Tympanic membrane.
Squamous part of temporal bone.

Scanned with CamScanner

 11 Round
xerve —(J windowI 9 ’ Chorda
I JM Tywpamc branchtywpani
of
nerve
ylossophrynyeal nerve
Chorda tympani nerve
Figure: Boundary and relation of
middle ear cavity.
Contents:
1. Three small bones (ossicles): malleus, incur, stapes.
2. Ligaments of car ossicles.
3. Muscles: tensor tympani & stapedius.
4. Vessels supplying & draining the middle ear.
5. Nenes: Chorda tympani and tympanic plexus.
6. Air.
Arterial supply;
> Main arteries:
1) Anterior tympanic branch of maxillary artery.
2) Posterior tympanic branch of stylomastoid branch of posterior auricular artery.
r Small arteries:
1 . Superior tympanic branch of middle meningeal artery.
2. Inferior tympanic branch of ascending pharyngeal artery.
3. Tympanic branch of artery of pterygoid canal.
4. Caroticotympanic branch of internal carotid
artery.

5. Petrosal branch of middle meningeal artery.

pterygoid plexus of veins.
Xenous drainage; Veins drain into the superior petrosal sinus &
^£i£lopment: From first pharyngeal pouch.
function: . •
1 ar
’• It transmits sound waves from thefrom the y P liquid borne vibration in internal ear.
, It transforms air-borne vibration ossicles.
The intensity of sound waves is
increase.

Scanned with CamScanner

 472
Q. Give the formation of bony and membranou j
*
development. ISUSTJ SMI
,
Q. Give the components of memhranons Inby rln^/internal car
JSUST-I6MJ5M,O7J|
Answer
— labyrinth:
The bonx labvrinth or otic capsule is the rigtd, bony r of the Inner ear In the temporal
Parts; It consists of three parts:
• The vestibule
• Semicircular canals, and
• Cochlea
These are cavities hollowed out of the substance of the none.
. <jnC(j by periosteum.

Contents;
• Clear fluid
• The perilymph
• Membranous labyrinth
Membranous labyrinth: Membranous labyrinth consists of!
’
membranous sacs ^Tc,s within the bony labyrinth and is filled with endolymph.
Components; The membranous labyrinth presents:
The cochlear duct within the bony cochlea.
•
The saccule and utricle within the vestibule.
•
Three semicircular ducts within the corresponding bony canal.
•
Functional components: The membranous labyrinth possesses two separate functional components-
I. The cochlear duct for hearing (auditory system)
2. Hie saccule, utricle and semicircular ducts for balancing (vestibular or labyrinthine system).
Function:
1. The saccule and utricle monitor the static equilibrium and linear acceleration;
2. The semicircular ducts are concerned with the kinetic equilibrium and angular acceleration.
[Ref- A.K. Datta /4* /339,344)

Figure: Membranous labyrinth.

Development of inner ear:

* w“k 4 »f embryonic development from the auditory placode.
f glves rise 10 ,he
Mneltansg
ganglions.
biP«laf neurons of the cochlear and vestibular
*
oro"0’ embryOnic '"esoderm, it forms the auditory

Scanned with CamScanner

 1
*22
equilibrium?
1» nerve of
*n>"cr‘ —lUhrlumi
nerve it called the nerve of equilibrium.
|Ref- BD Cbaeratta / 7* /

^hnt is orR«n
of ISUST-I5NJ 1JU]
0 structure of organ of Corti. [SUST-07J1
J' Give the »o.e on: Organ „r Conf. (SUST-lj/l
«h»rt U,oWu,O8J)

nmin of CoeUs

Cochlear nerve

Vestibular membrane
Cochlear duct
Membrana tectoria
Quter hair cell
Supporting cells
J- Basilar membrane
/Tunnel of organ of corti
Inner hair cells

Figure: Organ of corti.

Composition: It consists of -
• Inner & outer rod (pillar) cells
• Inner and outer hair cells
• Supporting Deiter’s and Hensen’s cells &
• Membrana tectoria.

of bipolar cells located in the spiral ganglion.

Theorgan of Corti is innervated by peripheral processes
Eunction: . .. .
response to sound vibrations.
impulses tn
They are the receptive end organs that generate nerve
(Ref- A.K. Datta / 4* / 3411

RU-IOJ,O7Ju]
Q. Write short note on: Auditory tube/ Eustachian tube. [DU-IOJu,O6J,O5Ju,
RU-I6N]
•
^^‘ion the function of auditory tube. [DU-I5N,
Answer tube):
;: pharyngo-tympanic or eustachian channel which communicates with the lateral
aud>tory tube is a mucous lined osseocartilaginous
Wall Of naso-pharynx with the anterior wall of the tympanic cavity.
^S£ljoiE It is directed downwards, forwards and medially.

Scanned with CamScanner

 474
-Ltengrn: tacn tune is aooui jo mm wo-
long and lies in the petrous part f
Component parts: It has two parts- n js 12 mm
I- Osseous part: It forms the lateral l^o™* long & |(es |n
.
, t|)e tube. It is about 25 mm
temporal bone. medi 9/3rd of & the apex of the petrous tempor .
2- Eibro-cartilaeinous part: It forms the sphenoid
sulcus tubae (a groove between the
greater wing
bone).
Lining epithelium: Mallei Middle ear
The bony part is lined by non-< flattened Incus
or cuboidal epithelium. Internal ear
The cartilaginous part is lined by ciliated
columnar epithelium.
Blood supply;
> Arterial supply: The tube is supplied by -
a. Middle meningeal artery.
b. Artery' of the pterygoid canal
c. Ascending pharyngeal branch of external
carotid artery’.
> Venous drainage: The veins drain into the
pterygoid and pharyngeal venous plexuses.
Lymphatic drainage: Lymphatics drain into retro¬ Tympanic
pharyngeal and upper deep cervical lymph nodes. membrane
Cartilage
Nen e supply;
1 • At the ostium: By pharyngeal branch of
pterygopalatine ganglion. Eustachian
Cartilaginous part: By mandibular nerve.
-• tube
3. Bony part: Glossopharyngeal nerve through
ty mpanic plexus.
Figure: Eustachian tube.
Function:
It maintains equilibrium of air pressure on either side of the tympanic membrane for proper vibration of
sounds.
Development: From first pharyngeal pouch.
Clinical importance:
I. The tube acts as a channel for spreading of infection from the naso-pharynx to the tympanic cavity.
This is called otitis media. This is more common in children.
2. Sometimes the tube is blocked due to inflammation of tubal tonsil. This produces disturbance of
hearing.
|Ref-A.K. Datta /4"*/ 301-3031
Q. Exphi" why auditory tube connects middle ear cavity
with . [DU-I8/16N.13JU, 1 1 Ju)
Explanation:
Auditory tube connects middle ear cavity with
either side of the tympanic membrane for proper * ma'ntain eclui,ibrium of a'r
vibration of sounds ° Presslire

Scanned with CamScanner

 -
T

Jthc
incus stapes
— Mil Air vibrates the tvm™ oc ,Tlcmhrnnc
Perilymph of scab * U,c
organ of Corti (auditory receptor).
P?
Depolarisation nr.i .
^lymph
,
-* Imnul..
of the scal^’X^Xr^
.

^.s-- Interior colliculus Inmidbrai^S'"T*' Sld'

thalamu^^X
Aud'lory radiation Primary auditory
cortex (mlerprelonon of
sound). * of
m 'he
sound)
- ^"or,
Secondary
(Ref-Sncll Neu^*/348-3501

Figure: Auditory pathway.

Q. What is otitis media? [SUST-17M, RU-18N,10Ju]

Answer
Otitis media;
Acute infection of the middle ear is known as otitis media. It produces bulging and redness of he
tympanic membrane Pathogenic organisms can gain entrance to the middle ear by ascending through the
auditory tube from the nasal part of the pharynx.

Q. Expiain anatomically - Why otitis media I.common In children? (DU-i7N.i5J.07Ju.06Ju. KU-

15M,I4Ju,08Ju, CU-15J, SUST-I7MJ
«■ ^Phln anatomically - Why chronic suppurative
,
„ftM| Is common |n
Is media (CSOM)
children? [DU-19N,10J, l<U-10Ju] rCU-l9N,19M,18/l7N.I5N,13J]
Explain why middle car infection in is common in Mildren?
children? (LU IW

’•
Explain otitis
why children are more vulnerable to develop media. (KU I

f 2. in middle air (otitis media) or chronic suppurative otitis media (CSOM) is common to ebhdmn
length.
due to

> Shorter length (18 mm); which is half of the adult

More horizontal in direction.

Scanned with CamScanner

 & - -
> Wider in diameter.

Q. Explain anatomically - pressure on Ilic each side of (lie tympanic membrane h mehitmn^
[DU-12J]
Answer
Pressure on the each side of the tympanic mcmhrnnr h nudnllllmtll
Auditory tube connects middle car cavity with nasopharynx to maintain equilibrium of mr
either side of the tympanic membrane for proper vibration of sounds.

Tonsil
Q. What is Waldeyer’s lymphatic ring? [DU-19M, RU-I9NJ8MJ5NJ IJ,OHJf SUSP
1 4Ju, 1 3J, 1 2Ju,07J]
Q. Give its clinical importances. [DU-19M, SUST-14Ju]
Q. Write short note on: Waldeyer’s lymphatic ring? [CU-I8M, RU-l5Ju,l3AIOL0W/)6/u, SIJS'h
17N]
Answer
Waldeyer’s ring:
In relation to the oropharyngeal isthmus, there are several aggregations of lymphoid tivwe that
constitute the Waldeyer’s lymphatic ring.

Retropharyngeal
nodes '*> Pharyngeal tonsil

Tubal tonsil
Jugulodigastric
nodes \
Palatine tonsil

Jugular chain^^QZit Lingual tonsil

ofnodes
Submandibular nodes Submental nodes
Figure: Waldeyer’s ring.

Formation of Waldeyer’s ring:

> Anterior wall: Lingual tonsil.
> Lateral wall: Palatine and tubal tonsils.
Posterior wall: Naso-pharyngeal tonsil.
Function / Clinical importances:
Waldeyer’s ring helps in defensive mechanism of the respiratory and alimentary systems by
the entry' of micro-organisms from the external environment.

(Ref-AJC Ditto'

Scanned with CamScanner

 Q. G'*
location and clinical importance
.
the location of palatine tonsil, mi i ? fMatlne tOn.,n
—
tonsil.™^
Nl_

tf^sltort note on: Pnlntinc

tonsil):
RU' I«MJ
^nctonsi^
j^Thepalatine tonsils are a pair of
lymphoid tissue, situated
almond-
d masses oflateral
^Hy in thesituated in the Wal1 Of ,be oro’Pharynx.
ation: It is tonsilar fossa
palatoglossal & palatopharyngeal Palatoglossal ar^
be* Soft palate
arc^-
it is almond shaped Polatopt-argrgul arch

—
Surfaces: Two surfaces -
- i Medial surface: The medial surface of the
tonsil is covered by stratified squamous
epithelium. This surface has 12 to 15
Tonsil
Posterior 1/5 of torgue

crypts. The largest of these is called the Figure: Location of

intratonsillar cleft. palatine tonsil
2. Lateral surface: It is covered by a sheet of fascia which forms the
capsule of the tonsil.
Pharyngobasilar
fascia
Superior Palatine tonsil
constrictor
Buccopharyngeal—
fascia
External
_
palatine vein
Intratonsilar
cleft

Tonsil

Tonsilar artery

Tongue

Figure: Palatine tonsil

Borders; Two borders -

a. Anterior &
b. Posterior.

Allies: Two poles -

a- Upper &

but when
2- During surgical removal of tonsil, the para [>atta
301|
e
hemorrhage.
47;

Q. (Jive the boundaries of tonsilar sinus or fossa.

Answer
Boundaries of tonsilar sinus or fossa:
> In fr^nC Palatoglossal arch containing the
corresponding muscle.
Behind: Palatopharyngeal arch containing the
muscle of the same name.
/(new By the soft palate where both arches
meet.
> Base; By the dorsal surface of the posterior one-
third of the tongue.

Figure: Tonsilar fossa.

(Ref- A.K. Datta / 4* / 291, 299|

Q. How tonsilar bed is formed. [CU-16M,15N/J]

Answer
Formation of tonsilar bed;
The bed of tonsil is formed from within outwards by»
> Pharyngobasilar fascia
> Superior constrictor & palatopharyngeus muscles
> Buccopharyngeal fascia
> Lower part of the styloglossus
> Glossopharyngeal nerve.
(Ref- BD Chaurasia / 7,h / 237-238,

Q. Give the location, histological structure & development of palatine tonsil. [DU-12Ju, 07J, CU-
15Ju, RU-05Ju, SUST-07J,06J]
Q. Give the histological structure of palatine tonsil. [CU-12Ju, RU-17M,12Ju]
Q. Draw' and label the histological structure of the tonsil. [SUST-18N, RU-17N,! 1 J]
Answer
Location:
It is situated in the tonsilar fossa between the palatoglossal & palatopharyngeal arches.
Histological structures:
>
Both the free surface and the crypts are lined by non-keratinized stratified squamous epithelium.
>
Attached surface (lateral surface) is covered by a connective tissue capsule.
>
Free surface (medial surface) is pitted by 10-20 tonsillar crypts.
>
The tonsil consists of numerous lymphatic follicles which surrounds the tonsilar crypts
>
Each follicle presents a germinal centre composed of lymphoblasts from
which lymphocytes appear in
the crypts and are washed out in the saliva as salivary corpuscles.
Development:It is developed from endoderm of second
pharyngeal pouch.
(Ref- A.K. Datta /4,h/ 300, 301,

Scanned wi’tti CamScannei?

„ nve the blood supply of palatine tonsil. [DU-14Ju,l2Ju,
Q
^rite
down the artery supply of palatine tonsil.
[DU-I9M,
RU-I6M. SUST-lUu 0711
CU-18N]
q Mention the blood supply, lymphatic drainage and nerve supply of palatine tonsil

supply: It is supplied by four sets of arteries:

1 interior tonsillar artery: from
/ Posterior tonsillar artery: fromdorsal lingual branch of lingual artery
ascending palatine branch of facial and ascending
pharvngeal arteries.
3 Superior tonsillar artery: from the greater palatine branch of maxillary artery
4. Inferior tonsillar artery: from the facial artery.
Venous drainage: Veins drain into the pharyngeal venous plexus via the paratonsilar vein.

noac.
pass to the jugulo-digastric
Lymphatics nerves. Chaurasia/^/238'
palatine 300 + BD
Glossopharyngeal & lesser |Ref- A.K.
Datta /4,h/

Scanned with CamScanner

 ^0 _
Q. What is quinsy? (RU-07J)
Answer

n me ltw5 fom^ in «< mn^r cnpeuie and mpw(or

^11«
constrictor muscle covered by phsnngo-basilar fascia.

A ^iltat (q-m^y) h by of infection front the patalne Um.ll to the

connecthr tissue outside the capsule, especially as a consequence of tonsi 1 1 •
IRef-Snell/g*,^
Q. HTiat is adenoid? [SUST-17N]
Answer
Adenoid:
.......
Excessive hypertrophy of the lymphoid tissue, usually associated with infection, causes the
L

pharyngeal tonsil to become enlarged; they arc then commonly referred to as adenoid.
Consequence of adenoids;
Marled hypertrophy blocks the posterior nasal openings and causes the patient to snore loudly at
night and to breathe through the open mouth.
|Ref- SneU/8*/793|

Hard palate
Q. How hard palate is formed. Give its
lining epithelium.
Answer
Hard palate:
It is a partition between the nasal & oral cavities.
Formation:
> Anterior 2^: Formed by the palatine
process of maxilla.
> Posterior l/f*: Formed by die
horizontal plate of palatine bones.
Lining epithelium:
The upper surface of the bony palate is
covered by die ciliated columnar epithelium.
The lower surface is lined by the keratinized
Figure: Hard palate.
stratified squamous epidielium.

|Ref- A.K. Datta / 4,h / 274 +

BD Chaurasia/7*' ^

Scanned with CamScanner

 Alveolar Arch
of maxiIIa
Inttrnaxi^
suture.
Palatomaxillary -
suture
Irtterpatatw suture
Purawwlal process
Polahnt hint
of palatine bone
crest
- jpMr foramen

Greater palatine
artery
nerve

Greater
palatine
ner/e

Lesser
palatine
VXJ5
Greater
artery palatine
foramen
Lesser
palatine
foramen

Lesser
palatine
Uvula nerve

Branches from ascending palatine

artery of facial artery and artery
branch of ascending pharyngeal

Figure: Formation of hard palate.

of bard palate. [SUST-WMBfl
Q* Describe the blood supply, nerve supply & development
Answer
^mLsupply of hard palate: h of maxillary
artery.

nasopalatine bran
!!Sa£«>li: By greater palatine &
the upper
retroptay^1^
|Ref-BD
^Matic drainapc: Drains mostly to

Scanned with CamScanner

 482 HNDKA YOUR ANATOMY TOR mTT£NJSAQi MCOj
Development:
> Primary nalate: I'rom Iniermnxlllnry xcgtmml.
> Secondary nalate: From Intermaxillary prominence.
|Ref- Langman/
12*..
2J[|
Q. Write short note on: Intcrmnxillnry xegmciit. |RU*O8JJ
Answer
Intciimnilhny segment}
The structure formed by the Ibslon of medial growth of maxillary prominences and two medial
prominences is the intermaxillary segment,
Components of intei ininllliny segment; It is composed of-
> ,-t labial component: Forms the filtrum of the upper lip.
> An upper law component; Which carries the four incisor teeth.
> .-I palatal component: Forms triangular primary palate.
(Ref- Langman/ 12*

Soft palate
Q. Write short note on: Soft palate. [RU-15M,l2Ju,IOJu]
Q. What is soft palate? [SUST-I9MJ6N]
Q. Write briefly on: formation and nerve supply of soft palate. [DU- 13 J]
Answer
Soft palate:
The soft palate is a mucous covered fibro-
Median rephe
musculo-glandular fold suspended from the posterior \ /Soft palate
margin of the hard palate and extends backwards and Inferior free border
downwards between the nasal and the oral parts of
the pharynx. Uvula
Formation: Palatopharyngeal arch
Its anterior third is fibrous, middle third
muscular and posterior third glandular.
Palatoglossal arch
Presenting parts;
1. Two surfaces:
> Anterior surface Tongue
> Posterior surface
2. Four borders:
> Upper border
> Lateral borders
> Lower border Figure: Soft palate.
Composition of the soft palate:
It consists of a bilaminar fold of mucous membrane which contains the following structures-
I. Palatine aponeurosis
2. Five pairs of palatine muscles
3. Nerves and vessels
4. Palatine glands and sometimes upper end of palatine tonsil.
Lining epithelium:
It is lined by the non-keratinized stratified squamous epithelium
except the upper part of posterior
surface where the mucous membrane is ciliated columnar epithelium.

[Ref- A.K. Datta /4* /274,

2^ |
Scanned with CamScanner
 . n the functions of soft palate.
o?lcnt
Separates the^
’• Vnol
the nose.
enter
Xlps in speechby the moftrfteatumof various second „t
WaHow.
ktrine sneezing, the blast of air is
4
’ ithout damaging the narrow nose.appropriately divided and
nd not into the nose. Similarly during .
coughinsgit d™«Ta^h'
b
rccls and
a,T
of sofl Pa'atc Wum into the m™^
me the with lhcir
Ans"*r
^jiicrlcs of soft palate:
'
T Tensor veli palatini
> Levator veli palatini
> Musculus uvulae
> Palatoglossus
> Palatopharyngeus
\cne supply:
*
All the muscles of the soft palate are supplied
by the cranial part of
hannceal plexus except tensor veli palatini which is supplied by mandibular
the accessory nerve via the
division of trigeminal nerve.
|Ref-BD Chaurasia / 7* /231|
f

Chorda tympani nerve

Auditory tube
Auriculotemporal nerve Spine of sphenoid
Levator veli palatini
Posterior nasal at
Tensor veli palatini

Pterygoid hamulus
Palatine aponeurosis
Palatoglossus
Musculus uvulae Palatopharyngeal
Tongue
Figure: Muscles of soft palate.
IJ1
Q- Explain anatomically - soft palate paralysis
Q- What happens when soft palate is paralyzed? [RU- ysis.J .
Q- Why nasal regurgitation occurs in soft palate para
Answer nose, and thus it prevents
^iLPillate nasal regurgitation:of swab> g t0
paralysis causes it shut off the ,^1
phase impalrei
Soli palate is elevated in the buccal of soft palate par f
foods from entering the nose. But in case
regurgitation of foods occurs during swallowing.

Scanned with GamScanner

 ,Hf
vas„. nerve pnlV- f R*J-09JuJ
Q. Explain anatomically- Nasal rcg»rglb»R°n
Answer
nene
,
pn.«X
„
ve l pa
. . ra
mi its, >
Nasal regurcitnllon occurs In vnrnv contraction of levator
nt son palate h.nen^^^«P
is
vagus nerve is injured, the
sot
paralyzed A regurptanon of

-
palate. When the
through nose.

Answer
Soft palate is elevated during swallowing the food bolus against the hard palate ft
Buccal phase of swallowing begins with the
comp .
mission
o p O'
.
of
shut off This prevents the
causes elevation of soft palate and eventually, nasal part
food and drink into the nasal cavities. , to the oropharynx. Then. *>
lhc
Next, the tongue retracts in Pos,cr,°r
a muscles, which also elevates the uvula and
posterior tongue is lifted by the styloglossus and pa latog . elevates to 1prevent the bolus from reflux^
palate elevates
the nasopharynx to prevent nasal aspiration. Titus, the soft
into the nasal cavity'.

Pharynx

Q. Give the gross anatomy of the pharynx.

Answer

Phary nx is a wide musculo-membranous tube situated behind the nose, mouth

& larynx.

Length: 12-14 cm.

Width:
> Upper part is w idest (3.5 cm).
> Middle part is narrow.
> Lower part is the narrowest part of GI tract (except for the vermiform appendix).
Boundaries:
> Superiorly: Base of the skull including-
• Anterior part of the body of the sphenoid.
• Basilar part of the occipital bone.
> Inferiorly: Continuous with esophagus at the level of C6 vertebra.
> Posteriorly: Prevertebral fascia separating it from cervical spines.
> Anteriorly: Communicates with nasal cavity, mouth cavity & the larynx.
> On each side: Communicates with middle ear cavity through auditory tube.

IRef- A.K Datta / 4,b / 289 + BD Chaurasia / 7* /2351

Scanned with CamScanner

 Figure: Pharynx with its boundary and communication.

and communication of pharynx.

Q. Write down the parts [DU- 1 0Ju], innervation
of pharynx with their extension and nerve
Q. Mention the lining epithelium and various parts 1 8N,18M,17M]
supply. [DU- 1OJu, RU- 1 9M,1 8M, 1 7M,15 Ju, 13 Ju,08Ju,07Ju, SUST-
Q.Give the nerve supply of pharynx. [DU-1OJu]
Answer
farts of pharynx: of soft palate.
Nasoplrarvnx: From posterior nasal aperture to inferior border epiglottis.
' Oropharynx: From the inferior border of soft palate
to the upper border of the
junction (lower border
' Larynuopharynx: From the upper border of epiglottis
to pharyngo-oesophageai
of cricoid cartilage).

epithelium.
* Nasopharynx: Pseudostratified ciliated columnar stratified squamous epithelium.
QlSgharynx & larvnponharvnx: Non-keratinized .
. . .
pharynx;
by the cranial part
of accessory nerve ph^nge^
All pharyngeal muscles are supplied supplied by the
except the ttylopharyngeus
which is
laryngeal and external laryngeal
nerves.
y constrictor is supplied by the recurrent conveying frbeB of the
ganglion,
Dy the pharyngeal
branch of pterygopalatine
maxillary nerve. nerve.
Qro-nharvnx: By the glossopharyngeal
laryngeal nerve.
31 Lmnao-pharynx: By the internal

Scanned with GamScanner

 486 - ENDEA FOUR ANA TOMY FQR WRITTEN (SAQa MCQ)
Q. Explain anatomically/ histologically/ developmentally- Nasopharynx is lined with
pscudostratilled columnar epithelium. [DU-1 1 J]
Answer
Nasopharynx h lined whh pscudost ratified columnar cpllhclium: •
Upper respiratory tract is lined with pscudostratified columnar epithelium. Nasopharynx is a part of
upper respiratory tract, so it is lined with pseudostratified columnar epithelium.

Q. Give the structure of the pharynx. [DU-lOJu]

Answer
Structure of the pharynx; The wall of the pharynx presents from outside inwards the following coats-
n. Areolar coat: It is known as the buccopharyngeal fascia. ,
h. Muscular eoaf: It consists of striated muscles which are arranged in outer circular and inner
longitudinal layers. .
c. Submucous coat; It is thickened in the upper part to form the pharyngobasilar fascia or pharyngeal
aponeurosis.
d. Mucous membrane: The pharynx is lined by non-keratinized stratified squamous epithelium except
nasopharynx which is lined by the ciliated columnar epithelium (respiratory epithelium).
[Ref- A.K. Datta /4th /292-2%|

Q. Name the muscles of pharynx with their nerve supply. [RU-12Ju,l 1 Ju]
Q. Give the muscles of pharynx with their arrangement. Mention their nerve supply and actions.
[SUST-14Ju]
Answer
Muscles of pharynx according to arrangement:
Circular layer (constrictor muscles):
1. Superior constrictor
2. Middle constrictor
3. Inferior constrictor
Longitudinal layer:
1. Stylopharyngeus
2. Palatopharyngeus
3. Salpingopharyngeus

Nen e supply of muscles of pharynx:

AU pharyngeal muscles are supplied by the cranial part of accessory nerve via the pharyngeal plexus,
except the stylopharyngeus which is supplied by the glossopharyngeal nerve. In addition, the inferior constrictor
is supplied by the recurrent laryngeal and extemaO laryngeal nerves.

[Ref- A.K. Datta / 4,h / 293[

Actions of muscles of pharynx:
> Constrictor muscles:
As soon as the bolus of food is received in the pharynx, the
elevator muscles relax, the pharynx
escends, and the constrictors contract upon the bolus, and convey it
Ihey also have respiratory mechanical effects.
downward into the esophagus.

Longitudinal Muscle layer:

/• Stylopharyngeus:
• Elevates the larynx
• Elevates the phaiynx

Shwh pharynX t0 permit Passa8e °f a large food bolus, thereby facilitating

2. Palatopharyngeus:
Bolus of food is prevented from passing into the nasopharynx.

Scanned with CamScanner

 ^====:=====^ 487
}'

..
"^Rmse the pharynx and larynx during deglutition /
Laterally draws the pharyngeal walls up
.
(swa'lowing)
it opens the pharyngeal orifice of the nharvno
This allows for the equalization of pressure
pharynx.
betweXh' durin8 ’"allowing
°"w«n the audttoty
canal and the

Figure: Muscles of pharynx.

Q. Write down the blood supply of pharynx.

Answer
Blood supply of pharynx:
> Arterial supply: By-
I. Ascending pharyngeal branch of external carotid artery.
2. Ascending palatine & tonsilar branches of facial artery.
3. Dorsal lingual branch of lingual artery.
4. Greater palatine, pharyngeal & pterygoid branches of maxillary artery.

' Venous drainape: Veins drain into-

I. Internal jugular vein &
2. Facial vein.
|Ref- BD Chaurasia / 7,h / 243|

«•Wjjl is nasopharynx? Give its important features on roof, posterior and lateral wall. [SUST-
An^688^0^ description of nasopharynx. [DU-17M]behind the nasal cavity & above the soft
palate.
This is the upper part of the pharynx situated
resembles the nose structurally as well as functionally-
,s
v, respiratory in function & no food normally enters it. natent
Walls are rigid & non-collapsible, so that the air passage is kep p
J8.
> 'S lned
i. It by ciliated columnar epithelium.
is supplied by the trigeminal nerve' pharyngeal
' TKmUCousOfmembrane S t|ie posterior median
•
ffaseta &
pharyngobasdar
^1 the nasopharynx is formed by the

Scanned with CamScanner

 endeaVOUR AmT-^-
EQ&JW2IEI
488
Communication: ,
ca ty trough the
posterior nasal apertures.
Anteriorly: it communicates with the nasal isthmus.
> with the oropharynx at the pnary B
> 7^wFit communicates
following .
> The lateral wall- presents the auditory tube.
a. The pharyngeal opening of
b. The tubal elevation.
c. The salpingopharyngeal fold.
d. The levator veli palatini.
e. Pharyngeal recess.
|Ref- BD Chaurasia / 7* /

and laryng P
Q. Compare between nasopharynx, oropharynx
Answer ,
laryngop a .
Comparison between nasopharynx, oropharynx and
| Oropharynx [ Laryngopharynx^
Particulars Nasopharynx
1. Situation Behind nose.
—- Behind oral cavity.
| Behind larynx.
Upper border of
2. Extent Base of skull (body of Soft palate to upper border
of epiglottis. epiglottis to lower
sphenoid) to soft palate. border of cricoid
cartilage.
Anteriorly: with oral cavity Inferiorly with
3. Communications Anteriorly with nose.
Above: with nasopharynx esophagus.
Below: with laiy ngopharynx
Pharyngeal branches of IX and X nerves. IX and X nerves.
4. Nerve supply
pterygopalatine ganglion.
5. Lining epithelium Ciliated columnar Stratified squamous non- Stratified squamous
epithelium. keratinized epithelium. non-keratinized
epithelium.
6. Function Passage for air Passage for air and food. Passage for food.
(respiratory function).
[Ref- BD Chaurasia /7*/ 236|

Larynx •/’

Q. How the skeleton of larynx is formed? [CU-15Ju,06J, SUST-06Ju, RU-05J]

Q. Mention the types of laryngeal cartilages. [DU-1 5J]
Q. Write short note on: Cartilages of larynx. [RU-15N]
Q. Enumerate the different cartilages of larynx with their types. [DU-1 1J 08J CU-17N rJJOJu.
09Ju, SUST-19N,18M,17M,15J,08Ju, RU-07Ju,05Ju]
Answer
Skeleton of the larynx:
framework °f The larynx contains nine canifages. of
which

2)
Zp^of^^0^
Scanned with CamScanner
 e n£d
^•J

V<wl h'rptiwent ThyroM

Mrtildje tylfbttli
^ifom Mrtlbyu
CorMaU wtllaqt!
Arytf^oiri cartilage
Muscular pretest
cf aryttneid Mold cartilaqc
' ..I
Comiculatt ctriilagt
Figure: Formation of larynx. 1' laurel ( nrlllagrs of Lit ym
lllcf. 11,1) Clniuin»m / 7"* / 262 * A. K. thuhi / 4* / M4|
q Give the clinical importances of upper border of thyroid curtlhiKc.
Answer
Chnical importances of upper border of thyroid cartilage;
The point of bifurcation of common carotid artery Iles just beneath the slcrnoclddonunlold at Um hvd
of upper border of thyroid cartilage, which is a convenient site to take the carotid pulse.
Q. Name the intrinsic muscles of larynx with their nerve supply. [DU-I6N, SIJSTd J/O«Ju|
Answer
Intrinsic muscles of larvnx:
1 ) Cricothyroid (the only muscle outside the larynx).
2) Posterior cricoarytenoid.
3) Lateral cricoarytenoid.
4) Transverse arytenoid (only unpaired intrinsic muscle).
5) Oblique arytenoids.
6) Aryepiglotticus.
7) Thyroarytenoid.
8) Vocalic.
9) Thyroepiglotticus.

' All intrinsic muscles of the larynx are supplied by the recurrent laryngeal nerve except lor the unco-
thyroid which is supplied by the external laryngeal nerve.
n com ary gu
.
Fransverse arytenoid presents double nerve Recurrent laryngeal and
" supply:

A„^™c ,h« extrinsic muscles of larynx with their nerve supply. [DU-I6N. SUST-I5JU.I J/0Wu|
Ulrinsjc^Uh£les of larynx with their nerve supply:
Nerve jupp!y
2

Glossopharyngeal nerve
Cranial accessorynerye
Cranial acccssory_nerv^
Ansa cervical 1.2JI
(C

Scanned with GamScanner

 Rima glottidit
Aryepiglottic part of
oblique arytenoid

Superior thyroid
irrttr&id. VocaliS Saccule
rfutdt, rruSCle Thyro -epiglottic part of
thyro -arytenoid muscle
Muscle
Posterior
crcurtrUrP’d
LaUra! ligament
cricoarytenoid
rruictc
Figure: Muscles of larynx.

Q. Describe the interior of larynx. [DU-16N, I5N/J,

. <xr/f f 1 1, RU-17N, 1 6N, 1
2Ju, CU- 1 9M, 1 8M,17M,

Q. Draw and label interior of larynx. [RU-I9N, SUST-19N,

1 8N,
\pg_Qgj
SUST- 1 Uu
[DU 08J, SUST 1 Ju,08Ju,
ORI
Q. Give rhe snbdhhions of laryngeal cavity with its lining epithel.um.
0/ rof r- io Ini
Q. State the characteristic features of the interior of the larynx. [
Q. Write short note on: Interior of larynx. [DU-19N,I7N,O6J, RU-lOJu]
faterior of brvnx: The cavity of the larynx extends from the inlet of larynx to the lower border of cricoid
carriage. The interior of the larynx presents three pairs of mucous folds, from above downward —
I) Aryepigfooic

3) Seat
Parti of brvax:
k is divided into 3 parts by paired upper
vexridar folds and Vruw vocal folds. Epiglottis
. , Lppfr part (VrAtdule of lary nx):
It extends from the inlet to the
vestibular folds. The gap between the
Aryepiglottic fold
vestibular folds is known as rima Laryngeal saccule
Middle part of cavity
. In:xrmedialr part of larynx (Sinut of Vestibule
larynx):
It extends from vestibular folds Laryngeal Vestibular fold
to vocal folds. The gap between ventricle
vrxal folds is know as rima glottldis.
the Infraglottic space
A Vocal fold
small recess between the
vestibular & Cricoid arch
vocal folds is iinia of larynx.
From ,t a small diverticulum
passes
e^»ard called saccule of larynx. Figure: Interior of larynx.
’> Uetumui^Ba! (BfnThnic Mnl. .f
Extends from vocal folds ,Q y
of cncl)

Scanned with CamScanner

 flfegd & neck
Y
*«»*-}Jtiuamous
rface &• uPt*T
S
ha'f,of epithelium. The
° * S^»
re*of the
ov" corfs area is covered «7W«Jic fokfe &x«l
',J> by ciViaied
coVurro ep^tr-v
cocfa
0113 4*1
p^'
of Hrynx/
interior of larynx. '
{RU-BJuJ
313
*
IJu]

Hyoid bone ”
|
I Tip of greater
cornu I
Epiglottis
I
Superior cornu
Thyroid cartilage I
I
Corniculate cartilage
Thyroepiglottic ligament
Arytenoid cartilage
'
Inferior cornu
Cricoid cartilage
.Trachea

Figure: Cavity of larynx.

Q.How laryngeal inlet is formed?

Q. Write short note on: Laryngeal inlet.
Answer
Laryngeal inlet:
The anterior wall of the laryngo-pharynx presents
the h-yngeal inlet in the upper part through which it
ronmunicates with the laryngeal cavity.
Boundaries:
' dbove and in front: By the upper margin of the
epiglottis;
' Below and behind: By the inter-arytenoid fold of
v
mucous membrane;
Qn each side: By the ary epiglottic fold.

The inlet is lined by the non-keratinized stratified

epithelium.
hi
Figure: Landed inkc
Closure of thne ,n el during deglutition takes place
•

lid; instead, it moves

bv tli? up
“OWonic folds. a
^eniTSI"On of
°n,S ^Oes n°t Tall back to close the
laryngeal inlet like
posterior third of the
the
tccgue.
c°mes i contact with the dorsal surface of

Scanned with CamScanner

 492
ANATOMY FOR
~ nen* suPPh oflannt.
ISUSTA9N.07Ju.06Ju]
[SUST-08Ju,07Ju,06J]
v’Ood * epithelium and nerve[DUASN.
supply of larynx.
SUSTA7NJ6NJ I JuJ IJJOJngj,,
O Mmu*11’hc ^^"PPfy of the hnnt DU-OM, SUST-O8Ju,O7Ju,O6J] ।
On™?"""''^PPl'
q
ofhnnx. ]RUA9N.
,hc’en,or? nene supply of
l5Ju,09Ju]
larynx. IRUA6N, [SUST-09Ju, RU-I5J qjj .
of larynx.
q. Mentis C ncnt supply of mucous membrane
”
Artcriat supply . artery, branch of
superior thyroid artery
laryngeal
of inferior thyroid
8' superior artery
> Bclowr,Caf cords: Inferior laryngeal artery, branch
thyroid vein,
laryngeal vein drains into superior thyroid vein.
^uPcnor
> Below*™? a cords: Inferior lary ngeal vein drains
into inferior
IRef- BD Chaurasia /7»,^
Nerve supply of larynx:
Sensory:
> Mucous membrane above the vocalfolds’. By
internal laryngeal nerve.
Below the vocalfolds: By recurrent laryngeal nerve.
Motor:
All intrinsic muscles of the larynx are supplied by the
recurrent laryngeal nerve except for the
>
crico-thyroid which is supplied by the external laryngeal nerve.
Transverse arytenoid presents double nerve supply: recurrent laryngeal
and internal laryngeal
nerves.
[Ref- A.K. Datta / 4* /313]

Q. Whet will be the effects if recurrent laryngeal nerve is paralyzed?

Q. Mention the clinical importance of nerve supply of larynx.
Answer
Effects of recurrent laryngeal nerve lesion:
I Unilateral complete section: Speech is not greatly affected because the other vocal fold compensates.
2. Bilateral complete section: Breathing is impaired because the rima glottidis is partially closed, and
speech is lost.
3 • Unilateral partial section: Greater degree of paralysis of the abductor muscles.
4 . Bilateral partial section: Acute breathlessness (dyspnoea) and stridor.

[Ref- Snell / S*11 / 808)

Q. Mention the lining epithelium of larynx. [CU-lOJu]
Q. Give the histology of larynx. [SUST-1I Ju]
Answer
Lining epithelium of larynx/ histology of larynx:
The anterior surface & upper half of the posterior
are covered by stratdted squamous epithelium. surface of epiglottis, aryepiglottic folds & vocal w*
Ilie rest of the area is covered
Mucous glands are only absent over vocal cords. by ciliated columnar epitheli*

[Ref- A.K. Datta M*'

3131

Scanned with CamScanner

 r acc of
^‘iine^03”00’ cpi^
“ epieloMi,
, -rf.ce of epiglottis
is lined by nnnK. h- . J

'of epiglmtis is
enic examination of the lining epithelium^/100'^'
^Xny of .
cuboidal or low columnar.
amerior surfa« o'f .^““^Ither
folloSUfm’ h^ause
ep'elo“k has
'
Basal cells are 8
, superficial cells arc flattened (squamous) which
•
4
|h£SC features are present in non-keratinized stratified .quamousepithe|iuni 4 "Seated.

"’ef-J«nqOeira;||./73 75[
short note on: Rima glottidis.
0 ^Vrite
Answer tfidis'
cleft between the vocal folds and vocal processes
of the arvM
rima glottidis. It is the narrowest antero-posterior cleft of the laryngeal
cavity ^ Cart'lageS is as

Boundaries:
s^yifront: Angle of the thyroid cartilage.
> Behind: Inter-arytenoid
side: Vocal
fold of mucous membrane.
fold and vocal process.
> On each
Parts: It has two parts-
T Anterior intermembranous part
2. Posterior intercartilaginous part.
Sagittal diameter:
> 23 mm in males and
> 17 mm in females.
Lining: It is lined by non-keratinized stratified squamous epithelium and is devoid of submucous coat.

Q. What is vocal cord? What are the movements of vocal fold? [SUST-13Ju,l Uu]
Q. Write briefly on structure and functions of vocal cord. [DU-19M.16M]
Q. How vocal cord is formed? [SUST-1 1 J]
Answer
Vocal cord (vocal fold):
It is the organ of phonation which is pearly white in colour, lined by stratified squamous epi e mm,
devoid of submucous tissue, and contains vocal ligament medially and vocalic muscle laterally.
Movements of vocal fold:
1. Abduction
2. Adduction
[Ref- A.K. Datta /4,h/ 31]

Q- Explain , urvnpeal nerve paralysis causes hoarseness

anatomically- How unilateral recurren ry
of voice?
Q- Explain [DU-17M,07J]

_
Answer
Unilateral reeurren, ,ar7neeal nerve
larvngeal nerve paralysis causes hoarsen
anatomically- Why unilateral recurrent ry g
of voice? [DU- 14J J]

When only one recurrent laryngeal nerve is p ‘

Nation is possible but there is hoarseness of voice. nChaurasia/7“,/2S9|
[Ref- B.D Ch

Scanned with CamScanner

 421 - ENDEAR
left ,urrcnt laryngeal nerve varies? [ru.
reci
Q. Explain nnnlomirnlly. Why course of right
and
OW.CU. 1 7M]
Answer . . of the distal part Of
<^m£±LlMLnn<L^^ to disappearance the
Course of right and let! recurrent laryngeal nerve
va
subclavianartery. On the left si^ 6*
aortic arch. The right recurrent laryngeal nerve hooks aroun
nerve remains In place and hooks around the llgamcntum artcrio [Ref- Langman / 12,h

Q. Whnt In honrscncss of voice? [RU-07Ju]

Answer
lloaixncM of voice; variations of periodicity and intensity of
I loarscncss is defined as roughness of voice resulting from
consecutive sound waves.
Causes;
I . Congenital.
2. Acute and chronic laryngitis.
3. Edema of the larynx.
4. Laryngeal trauma or foreign body.
5. Inhalation of irritant gas or fumes.
6. Recurrent laryngeal nerve injury.
7. Laryngeal carcinoma.
8. Hypothyroidism (myxoedema).

Q. Write short note on: Pyriform fossa. [DU-06J, CU-15Ju,06J, RU-19N,18N,17M,15N,O5J, SUST-
17M.15NJ
Q. Write down importance of piriform fossa. [DU-19M,17N,14Ju, CU-15M]
Q. Mention the boundaries and importance of pyriform fossa. [CU-18M, DU-15Ju,08Ju]
Q. What is pyriform recess? Give its boundary and clinical importance’s. [SUST-14J]
Answer
Pyriform fossa/Pyriform recess; It is a mucous covered deep depression in the lateral wall of the
laryngopharynx, one on each side of the inlet of the larynx.
Boundaries:
> Medially; by the aryepiglottic fold.
> Laterally: by the thyroid cartilage & the thyrohyoid membrane.
Importance:
I . it acts as a catch-point for foreign body.
1

1
anesthesia of the supraglottic part of the larynx and loss
pu“ f0SSa 'S an,fiC,a"y decpened by ,hc

IRef- BD Chaurasia
of —
couXe^™7
£ hide the
/ 217 + A-K.
foreign bodies may lodge in*
damaSed W“h
precious materials from the

; + /Wj|

Scanned with CamScanner

 neck

leal
ISUST-
artery
irst and largest branch of the first n»«
dCStined Chieny 10
*> b£
r .
'hC
^.n «rt=bral
1«E»d' * s"bdivided into four nan,
First or cervical part 1 ls"
i.
2. Second or vertebral part
3. Third or sub-occipital part
4. Fourth or intra-cranial part

-vertebral
Althc lower border of pons, it unites with opposite
artery to form the basilar artery.
I Ref- A.K. Datta /4,h / 186, 187] Vertebral artry
Common
Subclavian carotid artery
artery Innominate
artery
Figure: Vertebral artery.
Q. Give origin, course, termination and branches of internal carotid artery
q. Write down the different parts of internal carotid artery. [CU-08Ju]
Answer
Internal carotid artery;
Origin: It arises from the bifurcation of the common carotid artery, at the level of the upper border of thyroid
cartilage opposite the disc between Cl & C4 vertebra.
Course & termination:
At its commencement the artery dilates to form the carotid sinus. Each artery passes straight upward
through the neck within the carotid sheath, enters the skull through the carotid canal in the parlous part of
temporal bone, and ends in the middle cranial fossa by dividing into anterior & middle cerebral arteries.
Parts and branches; The entire course of the internal carotid artery may be subdivided into four parts-
Cervical part: In the neck it lies within the carotid sheath. This part gives no branches.
are
2. Petrous part’. Within the petrous part of temporal bone, in the carotid canal. Branches
> Carotico-tympanic branch
> Branches to pterygoid canal
Cavernous part: Within the cavernous sinus. Branches are-
> Inferior hypophyseal arteries
r Meningeal branch
sinus. Branches
the brain after em g g from the cavernous
Cerebral part: 'Phis part lies at the base of
are
> Superior hypophyseal arteries
J” Ophthalmic artery
Posterior communicating artery
Anterior choroid artery
Anterior cerebral artery / 153|
/
> Middle cerebral artery.
|Hcf.A.KD”''“'4"'/ 222-123 + BD Chaurasia

Scanned with CamScanner

Q. Whl »re the I.mik*"
nf •rttrff lpl1
Q. I nnmrr»rr .hr br»Kl>« ' ||)(J.t5N.
1
CU-I2>“I
Q « rife brirn.

of in**rl^d*o,Wb,n’naofth^
L^AJIWMlS® H <1^»«”" .he ..Asunceorihe P^id
cnur<>
I^iil temporal ^llmy ^'t' Itde^rib^ Balk 7 ^aped curved
o^m’nencemrnl to termination
Superftral temporal artery
Parillory artery ! Posterior auricular artery

Occipital artery
Facial artery

Liruual artery Ascending pharyngeal artery

Superior thyroid. artery

Figure: External carotid artery.

Branches: External carotid artery provides altogether eight branches-
One from medial side'. Ascending pharyngeal artery.
Three from the front:
> Superior thyroid artery
> Lingual artery &
> Facial artery
Two from behind:
> Occipital artery &
> Posterior auricular artery
Two terminals:
r Superficial temporal artery &
Maxillary artery
h is .he Chiefs^ supping lhe
slnlctures in fron, of neck & in fac,

|Ref-A.K. Datta/ 4^1 1 ^1181

Scanned with CamScanner

 tc on- Middle mcnlngcnl artery. [SUST-06J]
»H«ry h clinically M
|mpor(,nL
of the first part of the maxillary
artery.
. Within the cranial cavity it gives off the following branches-
n Ganglionic branches.
A petrosal branch
3) A superior tympanic branch
4) Temporal branches
5) Anastomotic branch

The middle meningeal artery is of Ercat

ismm,..511^1 imPortancc, because it th.

"c—
source of extradural haemorrhage, which
involved. 71k -SSS
side. Rarely, the parietal or posterior branch is implicateTcau^^
of the
opposite
|Rcf- B.D Chaurasia /5*/ I2OJO1|

n
U
.
Write briefly on: Origin, termination and area of linage of infernal jugular vein. [DU-I5J.
drainage •

SUST-15J]
Internal jugular vein. [SUST- 1 4J]
q, Write short note on:
Answer

—
Origin: . . .
It is the direct continuation of the sigmoid sinus.

Course: compartment of
a continuation of the sigmoid sinus at the base of the skull in the posterior
• It begins asforamen, subclavian vein to
the jugular and ends behind the sternal end of the clavicle by joining the
form the brachiocephalic vci.i,
bulb, and the termination is marked by another
• The origin is marked by a dilatation, the superior
dilatation, the inferior bulb.

Tributaries:
1. Inferior petrosal sinus
2. Pharyngeal veins
Common facial vein
4. Lingual vein
5. Superior thyroid vein
6. Middle thyroid vein
7. Sometimes occipital vein , , dd.
right lymphatic duct on t ic con r
8. Thoracic duct on left side, or
Give the development of subclavian artery. sllhciavjan artery. (SUST- 1
4Ju]
Q- Write down the sources of development of right subclavian
Answer
7th intersegmental
artery.
»f subclavian artery: the left
e subclavian simply arises from
> y, e r,ght subclavian arises, proximal to distal:
0 Aortic arch IV the 7th intersegmental arteries)
the 4th and
o Right dorsal aorta (between
artery
o Right 7th intersegmental

Scanned with CamScanner

 493 ^yp

foramina and fissur-_

and past throughwhich
brain
Cranial nerve*. which
w "tv di^rihuted in the head
leave
and neck
the
except the vagud nerve, also supply,
*thc
structures in the thorax and abdomen.
The cranial nen es arc named as follows:
I. Olfactory
2. Optic
3. Oculomotor
4. Trochlear
5. Trigeminal
6. Abducent
7. Facial
8. Vestibulocochlear
Q. Glossophanngeal
10. Vagus
11. Accessory
12. Hypoglossal.

Accessory oculomotor
(Edinger -Westphal) nucleus
Red nucleus Oculomotor nucleus

Motor nucleus
Trochlear nucleus
of trigeminal nerve Principal sensory nucleus
of trigeminal nerve

Superior and inferior

Abducent nucleus
salivatory nucleus Vestibular nucleus

Nucleus ambiguus Posterior dorsal nucleus

of vagus nerve
Spinal nicleus of
accessory nerve Hypoglossl nucleus

^g^e: Nucleus
of cranial
nerve.

Scanned with CamScanner

 neck
nerves arising front m| ~
n „ the cranial nerve arises from hm:/

a different cranial ncrv<:s with their X

Name
or’^mfe
-JUlureand^raniaLexj^ Cr»nia| exit

Forebrain J^atur^
Sensory
Forebrain
Midbrain -Sensory ^hmoid
|V Midbrain Sot®
Trigeminal ~Pons -Mofor_
V Mixed
orbital figure ^P0"0'

VI Abducent Pons
Facial Pons Motor
viT Mixed
VIII Vestibulo-cochlear Pons Sensory
Glosso-pharyngeal Medulla oblongata —^n^LacousticmeatuT
Mixed .Jugular
Vagus Medulla oblongata foramen
Mixed Jugular foramen
^xT Accessory Medulla oblongata Motor Jugular foramen
xn Hypoglossal | Medulla oblongata Motor Hypoglossal canal
Q.Name the different cranial nerves with their functional type. [RU-09J]
Answer
Cranial nerves with their functional type and main function:

Name Fuitcuunal
Number components Function
1 Olfactory Sensory Smell
11 Optic Sensory Vision
III Oculomotor Motor • Raises upper eyelid
• Turns eyeball upward, downward and medially
• Constricts pupil
• Accommodates eye. laterally
IV Tmrhh»nr
i r ucfiimi Motor Assists in turning eyeball downward and
Trigeminal lorehead, scalp, eyelids,
Sensation from cornea, skin of
‘

V Sensory
1.Ophthalmic
mucosa-of nasal cavityandparana^^
uivijiun
nose, and ||iu±
nose aim — mnYilla• teeth of upper
maxillary sinus, and
2. Maxillary
division
Sensory
J?aw
nalate.
mucous membtmre of nose, the
—-r—- n mvlohvoid, anteuoi
3.Mandibular
division
Motor Motor to .muscles °“^^btinnand^^
Sensory Sensation from sun and temporomandibuiar

rvr~ Abducent Motor

Motor to iaicl
eyeball laterally —— I

i —
Scanned with CamScanner
 500
Fondtonal
Numhi•r N«mc component*

___
VII / at ia! i Motor M&nrto muscles of fa* aod «apcdt» -
, posterior bell? of
Sensory j Taste from anterior 2T of torque, from fw Z

^Secretomotor—
1 — i and palate.
‘
Parasympathetic mnenauon to
— arid
tublingual wlivary glands. the laormal gland. and tfasflj
parasympathetic
LVIII 1 c\tihiilo-cochlcarjvesdbuhn i of nose and palate.
Vestibular sensation from tMride, saccule anc
j Sensory semicircular canals related to position arid mwemere
|- . . j head.
Cochlear:
Sensory
j Hearing. ___ _
IX (ilosso-pharyngcal .Motor Motor to sly lophar.ngeus that assists with swzToa np

1
1 Secretomotor Parasympathetic innervation to parotid gland.
parasympathetic
i
1 Sensory General sensation and taste from posterior 1 .7" of
and pharynx; carotid sinus (baroreceptorp and caroid
body (chemoreceptory.
X Vagus Motor Motor to constrictor muscles of pharynx, imrrnsic
muscles of larynx, and muscles of palate except tensx
veil palatini and striated muscles in superior 23^ of
esophagus.
Sensory Visceral sensation from base of tongue, pharynx. lanrx~
trachea, bronchi, heart, esophagus, stomach, and
Taste from epiglottis and palate.
Sensation from auricle, external acoustic meatus, and
— XI
-
/ Accessory: fMotor
dura mater of posterior cranial fossa.
Motor to muscles of soft palate (except tensor \e5
(Zranial root palatini), pharynx (except stylophanngeus). and larynx
(except cricothyroid).
sipinal root fi4otor Motor to sternocleidomastoid ^nd mnsrlvS.
XII / hypoglossal dotor (GSE) Motor to muscles of tongue (except palatoglossus)
controlling its shape and mo\ ement.
|Ref- Snell’s Neuruanatomy / 7* /333-3341

Scanned with CamScanner

 Figure: Attachment of cranial nerves to the ventral surface of brainstem

Q. Enumerate the cranial nerves carrying special senses of our body with their functional
component. [RU-08J]
Answer
Cranial nerves carrying special senses of our body with their functional component:
Name of the nerves Special senses
Olfactory Smell
Optic Vision
Facial Taste from anterior 2/3“ ot tongue
Vestibulocochlear Henring and equilibrium
Glossopharyngeal Taste from posterior 2/3 oftongue
Vagus _ Taste from epiglottis,--

Q.Givc the location, relation, branches, and

ga innervations of ediar)
Q' Mention the
ition* and pos

—
Iocs preganglionic connections T.l4J)
n ganglion. [CU-1 5Ju, 1 1 Ju] nnrasympathetic ganglia- I
Give connections and distributions of any one ..|5M,13Ju)
^riie short note on: Ciliary ganglion/ganglla. [SUSI

I his is a peripheral parasympathetic gang 10 P

lateral rectus mwscle.
.. he optic
h is situated near the apex of the orbit betwee
i—
Scanned with CamScanner
 £1
502

Preganglionic ppnncpffons pf c||ian’ nucleus of

mKi-us same side/ opposite
or sam r- side ->
pretectal nucleus Edinger Westphal
Nene fibre from
Oculomotor nene of same side' opposite side Ciliary
ganglion.
Structures supplied by ciliary ganglion/
I) Motor rpot; Supply the sphincter pupillae & the ciliary
muse
2) SmnrMi b contains sensory fibres from the eyeballL my the djIatQr P ae.
3) Sympathetic root: It supplies the blood vessels of the eyeball.

Branches:
The panglion gives of 8 to 10 short ciliary nerves.
[Ref- B.D Chaurasia /6,h/24>2|3|
Q. Mention the origin, course and termination of optic nerve. [
Answer
Optic nene:
Origin:
layer of the retina.
The optic nen e is formed by fibers from the cells in the ganglionic
Coarse & termination:
• The optic nene leaves die orbital cavity through the optic canal and unites with
the optic nerve of the
opposite side to form the optic chiasma.
cross the midline and enter the
• the chiasma, the fibers from the nasal (medial) half of each retina,
In
(lateral) half of each retina, pass
optic tract of the opposite side, while the fibers from the temporal
posteriori) in the optic tract of the same side.
• Most of the fibers now terminate by synapsing with nervecells in the lateral geniculate body.
• A feu of the fibers pass to the pretectal nucleus and the superior colliculus of the midbrain and are
concerned with light reflexes.
• The axons of the nerve cells within the geniculate body leave it to form the optic radiation, and
terminates in the visual cortex (area 17), which occupies the upper and lower lips of the calcarine sulcus
on the medial surface of the cerebral hemisphere.
[Ref- Snell’s Neuroanatomy /7"’/ 336|

Q. Mention the origin, course, distribution and functional component of oculomotor nerve. [DU-
08J]
Answer
Origin and course of oculomotor nerve:
• The oculomotor nerve emerges from the anterior surface of the midbrain.
• It passes forward between the posterior cerebral and the superior cerebellar arteries.
• It then continues into the middle cranial fossa in the lateral wall of the
cavernous sinus.
• Here, it divides into a superior and an inferior ramus, which enter
the orbital cavity through the superior
orbital fissure.
Distribution of oculomotor nerve:
• The oculomotor nerve supplies the following extrinsic muscles of the eye-
> Superior rectus
> Medial rectus
> Inferior rectus, and
> Inferior oblique.
< The levator palpebrae
superioris
intrinsic mu^ks^ ganS**on an^ the short ciliary'
nerves it also supplies the following
> The constrictor pupillae of the iris
< Ciliary and
muscles.

Scanned with CamScanner

 jleadAjjeck
.nnlnoncnLo£o£il!on^
efferent (GSE)
'i*0™1 c,Tcrcnl <OVE)
'
eyelid.
R,^ e)cball upward, downward and medially.
* A^trictspuP’1

"’''■Sw.Ne,™
oriRin’ coursc’
* f ,nand«bular
nerve. [SUST-
^j^urscand termination of trigeminal nerve:
-^^ngeminal nerve leaves the anterior aspect of the pons as a n

. root
The nen e passes fonvard out of the posterior cranial fossa and rest. nn u.

. the petrous part of the temporal bone in the middle cranial fossa.
C
surfacc of thc aPex of
The large sensory root now expands to form the crescent-shaped trigeminal r

.
K ganglion, u-
a pouch of dura mater called the trigeminal or Meckel cave which lies within
Theophthalmic. maxillary, and mandibular nerves arise from theanteriorborderoflheganglion
> oj^habmc nerve.- contains only sensory fibers and leaves
orbital fissure to enter the orbital cavity.
the skull thro JX™
> The maxillary nerve: also contains only sensory fibers and leaves the skull through the
foramen rotundum.
> The mandibular nerve: contains both sensory and motor fibers and leaves the skull through the
foramen ovale.
Di<tribution of trigeminal nerve:
• The sensory fibers to the skin of the face from each division supply a distinct zone.
• The motor fibers in the mandibular division are mainly distributed to muscles of mastication.
[Ref- Snell’s Neuroanatomy 1 7* 1 343, 344|

hlis tngemma! neuralgia? [SUST-19M, CU-I8M]

^^^[.neuraIpfa. of the trigeminal nerve
I his • ~ pains in the second and third
divisions
^ory, usuallvy in pahen,S0vera^ 50 years.
u
^^^^Weristics: division of the trigeminal
nerve territory.

•
U16 2nd and
!n brief but repetitive.
• Severe. . .
.
tngemma
• within the
Ap^^ ^ancinat>ng pain. by touching trigger zones
• Pain may be precipitated IDavidson/2ht/ll7l|
or by eating.

Scanned with CamScanner

 MC

•,16M,15MJ2Ju] offacial
504 endca!^
n n(| distribute
Q. Write down the origin, course, termination
nene. [DU-I5J,I3Ju, CU-05J)
Answer
Origin of fncinl nene;
1. Motor nucleus.
2. Superior salivatory nucleus.
3. Upper part of the nucleus of tractus sohanus. erVg.
4. Upper part of the spinal nucleus of the tngc
roots are attached
00t, The two
nerve.
Course of fncinl nen e: tor root &
a
the 8th cranial
The facial nerve is attached to the brainstem by < nons just med1
the lateral part of the lower border o [T)eatus. In the
meatus, the motor

Ilie two roots then run laterally & forwards to sensory root interv
in
root lies in a groove on the 8t in the petrous temporal
k whjch lies
At the bottom of the meatus, the two roots fuse to
fort
bone.
I U • rn three parts
by two bends. The first part is
Within the facial canal, the course of the nerve can be
Pr°mOnlOry
directed laterally above the vestibule, the second part ru
vertically downwards benm the promontory.
kehjnd
part is directed
the stylomastoid
foramen.
,= shuil by passing through
The nerve leaves

Then it crosses the lateral side of the base of the styloi

•i It ,enters the posteromedial
surface of parotid

gland. Behind the neck of the mandible, it divides into ive

Proce^’.
er uranches which emerge along the anterior
border of parotid gland.
Branches & distribution:
Within the facial canal: . mIirosa| elands of nose, palate & pharynx.
I. Greater petrosal nerve: Supplies the lacrimal gland, mucosal gian h 1 '

2. Nerve to stapedius: Supplies the stapedius muscle.

two thirds of the
3. Chorda tympani: Supplies the submandibular & sublingual glands and the anterior
tongue.
At its exit from the stylomastoid foramen:
I. Posterior auricular: Supplies-
a) Auricularis posterior,
b) Occipitalis &
c) Intrinsic muscles on the back of the auricle.
2. Digastric: Supplies posterior belly of digastric.
3. Stylohyoid: Supplies stylohyoid muscle.

Terminal branches:
1. Temporal: Supp1ies - Temporal branch Facial nerve
• auricularis anterior Zygomatic branch
• auricularis superior
• intrinsic muscles on the “Pper buccal branch
lateral side of the ear
• frontalis
• orbicularis oculi & Lo^er buccal branch
• corrugatorsupercilii. Mandibular branch
2. Zygomatic: Supplies the
orbicularis oculi. Cervical branch
FWun- Branches of facial nerve

Scanned with GamScanner

 ^jleadA^ ,
i.
SuV?''cS muscles in the vicinity
muscles ofabove
i. •supplies &below
*• the lower the
lip & parotid ducts
7 •• • ’
chin.
1,0,1
bciwccn th
I inmortaH££l lesion of facial nerve; Be|Ps ,
^"^Oftt.
•

ln supranuclear lesion of facial nerve- Th, i P* Sy>

, „ •,
of facial nerve with their In^ ParaW
. Same the nuclei
the structures supplied by facia ^10 «,071, CU h'01’ and distHh P
n Enumerate the
: Enumerate
} Ghc the
nuclei of facial
distribution of facial nerve. (SUST-14JU
-erve^»
U]
U. S&M 1
qo.
ion.

'
A^.^.^e:
Nuclei
^^innwtor nucleus Deep in the reticular Location
formation of the lower pan of
the pons.
^Pa^ympathetic motor nucleus Posterolateral to the main motor
• Lacrimal / lacrimatory nucleus nucleus.
• Superior salivary nucleus
nucleus (nucleus of tractus solitaries)- '

-^Eetrrthem^^
Distribution of facial nerve:
> The motor nucleus: It supplies the muscles of facial expression, the
auricular muscles the stapedius
the posterior belly of the digastric, and the stylohyoid muscles.
> The superior salivatory nucleus: It supplies the submandibular and sublingual
salivary glands and the
nasal and palatine glands. The lacrimal nucleus supplies the lacrimal gland.
> The sensory nucleus: It receives taste fibers from the anterior two-thirds of the tongue, the floor of the
mouth, and the palate.

Q. Mention the functional components of facial nerve. [SUST-14/13/12/10Ju,09Ju,08J.07J, CU-

15M,14J,1 1 Ju,08J]
Answer
Functional components of facial nerve:
1) Special visceral efferent
2) General visceral efferent
3) Special visceral afferent
4) General visceral afferent
5) General somatic afferent.
SUST-l8/17N,16M.I4JU109J,07J]
fRU‘,5Ju>°W. CU- 1 9N, 1 0Ju,08J,05J,
^ExPlain nlL the
’ff T™^franuclear 0CCUr in Be,,’s Paby?
[RU-06J]
nerve? [CU-l4Ju,12Ju,l 1Ju]
0 ,Whaf
What are the ’ of lesion of facial
within the facial canal? [DU-1 1J]
will ha Eac’a' nerve is injured
A
/ rite ”
rl»0tc on: Bell’s palsy. [DU-I2JU]
short n
usually in the facial canal, from
ca
of facial nerve,in the face which are toget er
*ower motor neuron lesion
gothic reom^-^
cause s ,n development of characteristic symptoms &
s Palsy.
signs

lures:
paraljz
B°lh upper & lower part of ipsilateral side of face will be
Scanned with CamScanner
 506 ENDEAVOUR \MTQi
2) Face becomes asymmetrical, distorted & is drawn up to the
normal side.
3) Affected side is motionless. . • .e
4) Any attempt to smile draws the mouth up to the norma .
5) Drooping of lower ey elid will occur & eyes cannot be c -
6) Upward and outward rotation of eyeball during nttemp 0
(Bell’s phen
7) Transverse wrinkles disappear from the forehead.
S) During chewing, foods accumulate between teeth & chec .
O) Articulation of lips will be affected & production of speec i
difficult.

Q. Why upper part of face escapes in upper motor neuro„ lesion (UMNL) of facial nerve? [Db.
09JU.07J]
Answer
Upper part of face escapes in UMNL of facial nen e:
Facial motor nucleus supplying the upper part of face is con roiled by upper motor neuron (UMN) of
both side of cerebral cortex. So, unilateral upper motor neuron lesion o ‘ nerve results in paralysis of lower
part efface of opposite side only. Upper part escapes due to bilatera con

Q. Why- In lower motor neuron lesion (LMNL) of facial nerves both upper and lower muscles of
the face are paralyzed? [DU-06J]

In lower motor neuron lesion (LMNL) of facial nerves joth upper and lower
paralyzed: Neurons of motor facial nucleus that innervate lower part of face are con r m“sc*^ y re ra|
cortex of one side. Unilateral lower motor neuron lesion (LMNL) of facial nerve resu ts in para ysis o ot
upper and lower part of face of same side.

Q. Differentiate the upper motor neuron lesion from lower motor neuron lesion of facial
Q. Differentiate the upper motor neuron lesion from lower motor neuron lesion. nerve.
Q. Explain supra and infra-nuclear lesion of facial nerve. [CU-15M,14Ju]
[SUST-15M]
Answer
Features of supra and infra-nuclear lesion of facial nerve:
Supra-nuclear lesion of facial nerve -• Infra-nuclear lesion of facial nerve

1) Wrinkling present on affected side.

2) Eye ball can be closed. tn affected side.
3) Only lower part of the 2) Eye ball
face is involved. remained
4) No hyperacusis or taste is Both upper and opened on affect sides.
3)
5) Usually associated with affected.
hemiplegia. Hyperacusis andlower
taste
parts are
involved^
5) Not may be affected.
Q. How will you test a
associated with hemiplegia.
patient of facial
Answer nerve palsy? [RU-08J]
To examine motor
function: Ask the patient to-
1) Wrinkle his forehead
2) Close the eye forcibly
against
resistance

Scanned with GamScanner

 4) Blow out the cheeks with your mouth closed
5) To whistle

To examine sensory function:

Taste sensation of the anterior 2/3* of tongue by testing-
I) Tip of the tongue by sweat
2) Side by sour
3) Posterior part by bitter
4) All over the tongue by salt.

^’5 nuc'e*
nl9 h1110cranial Bjossopharyngcal nerve. Name the branches with area of innervation by
nerve. [CU-05J]
Answer
Nuclei of glossophary ngeal nerve: 3 nuclei -
1) Motor nucleus:
a. Main motor nucleus (nucleus ambiguus).
b. Parasympathetic motor nucleus- Inferior salivatory nucleus.
2) Sensory nucleus: Nucleus of tractus solitarius.
Branches with area of innervation by 9111 cranial nerve:
Branches . Supplied area .

Tympanic branch 1) Tympanic cavity

2) Tympanic membrane
3) Mastoid antrum
4) Mastoid air cells
5) Most of the auditory tube
Carotid branch 1) Carotid body
2) Carotid sinus
Phary ngeal branches 1) Buccopharyngeal fascia overlying the middle constrictor muscle
2) Mucous membrane of the pharynx
Muscular branch 1) Stylopharyngeus muscle
Tonsillar branches 1) Palatine tonsil
2) Soft palate
Lingual branches 1) Vallate papillae
2) Area in front of sulcus terminalis
3) Taste and general sensation from posterior 1 /3rd of the tongue
[Ref- A.K. Datta /4th/ 184, 185]

Q. Name the nuclei of vagus nerve. [SUST- 1 0J,08Ju]

Answer
Nuclei of vagus nerve: 3 nuclei-
I) Motor nucleus:
a. Main motor nucleus (nucleus ambiguous).
nucleus).
b. Parasympathetic motor nucleus (Dorsal
2) Sensory nucleus: Nucleus of tractus solitarius.
|Ref- Snell’s Neuroanatomy 1 7lh / 352 1

Q. Enumerate the functional component of vagus nerve. [SUST-l5Ju,10J,08Ju,06J]

Answer
Functional component of vagus nerve:
1) Motor:
• General visceral efferent (GVE)

Scanned with GamScanner

 50N
• Special x i'crral effermt (SVT )
^own;
• Grneml xicceml afTcrcnt (GVA)
• Special % Kccral fitTcrcm (SV A)
• General commie afferent (GSA)
|Ref- Snell’s Neuroanatomy / 7* r jj4|

Q. Give the ,upph of rcccacoh nerve. |DU- 1 OJu)

Answer
Supph of accesson nrn c;
o Spina! root of ncccscon ntnt; .
1 1 Motor to muscles of soft palate (except tensor veli
palatini).
2 ) Pharynx ( except sty lophan ngeus). and
3) larynx (except cricothyroid).
muscles.
o Cranial root of accexxon ntn c: Motor to sternocleidomastoid and trapezius
|Ref- Snell’s Neuroanatomy / 7* /354. 3551

Q. Give the formation and distribution of accessory nerve. [SUST-12Ju]

Q. W rite short note on: Spinal root of accessory nerve. [DU-10J, RU-07J, CU-12Ju]
Answer
Spinal ront of accexxon nme: The spinal root is formed from axons of nerve cells in the spina] rruclcus.
which is situated in the anterior pray column of the spinal cord in the upper five cervical segments. The spina]
nucleus is thought to receive corticospinal fibers from both cerebral hemispheres.
Distribution <if the spinal root of accessory nerve:
I) The sternocleidomastoid muscle.
2) The trapezius muscle.
|Ref- Snell’s Neuroanatomy /7* /355)
Q. Name peripheral parasympathetic ganglia. [SUST-14J,! 1 Ju]
Answer
Peripheral parasympathetic ganglia:
I. Ciliary ganglion
2. Otic ganglion
Q. Write the name of cranial nerves that have parasympathetic nuclei and mention these nuclei
1SUST-18M]
Answer
C ranial nenes that have parasympathetic nuclei:

| Cranial nerve Parasympathetic nuclei Functions/DLstributioh’ a

Oculomotor Ciliary ganglia Pupil constriction
Accommodation
Facial Pterygopalatine ganglion Lacrimal gland
Mucosal glands of nose/palate
Mandibular ganglion Submandibular gland
Sublingual glands
Glossopharyngeal Otic ganglion Parotid gland
Zygomatic salivary gland

Scanned wrth CamScanner

 Chapter-04: Head A neck
509
Bones & Joints of head & neck
Q. Write short note on: Fontanelles. (RU-| | j Qgj 050
Q. hat do you mean by fontanelle? [R(J-l4Ju] '
Answer

angles of botn panetai bones. They arc six in number W round in the vault of the neonatal skull at the four
-
• Lnpaircd anterior and posterior fontanelles and
Pairs of sphenoidal (or antero-latcral)
fontanelles and mastoid (or postero-lateral) fontanelles.
Time of closure and fate of the fontanelles;
Fontanelle Time of closure
Anterior fontanelle Fate
—Between 1 8 months and 2 years Bregma
Posterior fontanelle During 3 to 4 months
Sphenoidal fontanelles Lambda
During 3 to 4 months Pterion
Mastoid fontanelles ___] At the end of the 1 a year Asterion
Importance of fontanelles:
1) The fontanelles permit reduction of circumference of the fetal skull during
the act of parturition by
partial overlapping of the bones of the calvaria without undue compression to the
underlying brain.
2) The fontanelles of the neonates allow growth of the brain which takes place during
first year of life.
(Ref- A.K. Datta / 4,b / 53, 64|

Figure: Fontanelle.

Q. Write short note on: Pterion. [RU-13Ju,09Ju]

Answer
. „ . , . , _
Pierion: It is the H-shaped suture at the antero-inferior (sphenoidal) angle of parietal bone where four bones
adjoin cadi other: frontal, parietal, sphenoid & temporal bone.

^“"mX’bl^ch of middle meningeal vessels and the stem of the lateral sulcus of brain lie beneath the
Pterion So anv iniurv to pterion may tear middle meningeal artery and produces extradural hematoma.
As a rnsuh: Z symptoms of compression of brain might develop with paralysis of movement o. the
opposite side of the body.
2) In is an important landmark for neurosurgery.
nrn.,
3) Sensory aphasia may develop due to destruction o ernic c

|Ref- A.K. Datta / 4,h / 50|

Scanned with GamScanner

 Answer . . ;
.
. 4 in dze by the
foHow'nS
In the Articulated skull the maxillary hiatus is reduced of |acnmal bon
Uncinate process of the ethmoid and descending pn
Maxillary process of inferior nasal concha from be behind.
•
>
> Maxillary process of perpendicular plate of palatine [Ref- A K Datta 1 4* / $

Q. Describe the temporomandibular joint. [RU-07Ju]

Q. M rite short note on: Temporomandibular joint. [R ’n(jjbular joint. [RU-15J, SUST-
*

Q. Mention the formation, movement and type of temporom.

I6M.I5M.I2Ju] . , each movement. [SUST-16M,
Q. Mention its different movements and muscles rcsponsi
15M.ll.lu]
Answer
Temporomandibular joint:
Type: Condylar type of synovial joint.

Formation:
o Abair: Temporal articular tubercle & anterior part of
. toss
mandibular f „...
.

o Below: Mandibular condyle.

1 ) Articular surfaces of both bones are covered with fibro-carti
age.
2) The joint cavity is divided completely by an articular disc into an
upper menisco-temporal
compartment and a lower menisco-mandibular compartment.
Supports of joint?:
1 ) Fibrous capsule.
2) Lateral temporomandibular ligament.
3) Sphenomandibular ligament.
4) Stylomandibular ligament

Scanned with CamScanner

 ^Wtislocl^ Lockjaw is the
inability to open mouth.

nodding movement? [RU-07Ju,05J]

Q What is .
Ans^er . The ^ex,on and extend
Flexion and extension take place aroun^™^
na a
of atlanto-occipital joints
transverse are
axis. Atlanto-occipital jointscalled nodding
are called the
expression.
‘yes’ or positive
joints of
|Ref-A.K. Datta /4*
/203|
the types of joint in between the atlas and axis. [RU-O8J11]
Q Mention
AnSW^f in between the atlas and axis:
joints
^-p^eparate synovial joints, median one and two lateral that connect the atlas and
the a™ th,.
e
joints are called the joints of ‘no’ or negative expression.
atlanto-axial
Types of joint in between the atlas and axis:
Median atlanto-axial joint: Pivot type of synovial joint.
joint: Plane type of synovial joint.
b Lateral atlanto-axial
|Ref- A.K. Datta / 4“ / 204|
Q. Describe about first cervical vertebra. [SUST-08Ju]
Answer
First cervical vertebra: It is also known as the atlas because it supports the globe of the head.

I) The atlas is a ring of bone, and consists of a pair of lateral masses connected by a short anterior arch
and a long curved posterior arch.
2) It is devoid of body (centrum) and spine.
3) The anterior arch presents an anterior tubercle in front for the attachment of anterior longitudinal
ligament. Posteriorly it presents a median facet for articulation with the dens of the axis.
4) The longer posterior arch corresponds to the lamina of other cervical vertebrae.

Q. Explain from your knowledge of anatomy why/how death caused by hanging? IDU-HJu]

Snism Of death eansed by hanging: A hanging may induce one or mom of the
conditions, some leading to death:
foW^
compresses lower part of medulla, that
• Dislocation of odontoid process of 2* cervical vertebra that mmnresses
causes damage to the vital centers.
• Closure of carotid arteries causing cerebral hypoxia.
Closure of the jugular veins.
in the caroti a
* Induction of carotid sinus reflex death, which reduces e-wheat when the pressure
ls high,
causing cardiac arrest.
* breaking of the neck (cervical fracture) causing trauma i. __:nai COrd injury or even ecapi
Closure of the airway.

Scanned with CamScanner "

 512

Development of head & neck

ro c n ( ev opmen of
Q. Explain anatomically I developmentally- Neural crest plays a great
head & neck region. [DU-05J]
Answer
Neural crcu plavs a great role in development of head & neck region!
The cells of the neural crest develop from neuroectoderm of brain an
g < '
.
nt0 the
developmen c
pharyngeal arches and rostrally into the facial region and contribute in the * •

Structures develop from neural crest: . .

a. In head and hock regions the}’ form midfacial and pharyngeal arch skeleta s ru
b. All other tissues in head and neck regions developed from neural crest are-
• Cartilage
• Bone
• Dentin
• Tendon
• Dermis
• Pia and arachnoid
• Sensory neurons, and
• Stroma of glands
• Neurons of the 5th, 7*, 9th, and 1 0th cranial sensory ganglia.
Therefore, neural crest plays a great role in development of head & neck region.
[Ref- Langman / 12* / 260|

Q. What is phary ngeal arch? [CU-14Ju,l 1 Ju, SUST-16M.15N/M] How the pharyngeal arches are
formed? [RU-09J, 05J]
Answer
Pharvngeal arch:
A core of mesenchymal tissue covered by surface ectoderm on the outside and by epithelium of
endodermal origin inside is called pharyngeal arch.
She: They are situated in the ventro-lateral wall of pharyngeal gut.
Number: Initially they are of six pairs, later the 5th layer disappears.
Formation of pharyngeal arch: It consists of two components-
a. Muscular components: From mesenchymal tissue derived from paraxial and lateral plate
mesoderm. The muscular components of each arch have their own cranial nerve, and arterial
component.
b. Skeletal components: From neural crest cells which migrate into the arches.
[Ref- Langman / 12,h / 262-265|
Q. How pharyngeal arch, pouch and cleft are formed? [DU-1 1J]
Answer
Formation of pharvngeal arch, pouch and cleft:
• Pharvngeal arches: Pharyngeal arches appear in the fourth and fifth weeks of development and
contribute to the characteristic external appearance of the embryo.
• Pharyngeal clefts: Initially, pharyngeal arches consist of bars of mesenchymal tissue separated by deep
clefts known as pharyngeal (branchial) clefts.
* Pharyngeal pouches: Simultaneously, with
development of the arches and clefts, a number of
outpocketings appear along the lateral walls of the pharyngeal
gut known as the pharyngeal pouches.

|Ref- Longman / 12th /

Scanned with CamScanner

 Ml
Q. Give the derivative* of pharyngeal arche* In fabnhfed M3
O5Ju. CU-MJU.05J. RU-O5J] form. IDIM5N
1
' |l| ni not rr»«
5N.| .
3J.12J.99J/r7Ju.VJv.
Q ,„h„ „ „ba|„H
Q Che the drrlolhn »1 > P^’OHral srchc. IM9M.1 |w,
Q Che .W
"J * (<
7M. SI'ST-ISJu
(RU-l’M.IJJu,IO). SUST-I9M.I6M.I5M
||)M
1 1) OUI
0-
srS KWh' l<
” ' "si" lluf' '
I • W.)
”rch ln <»l’"la«d form. |CIM»M.I’)u.l
U».
q. Name of 2M branchial arch.
the derivatives
(SUST- 1 3JuJ
Q. Mention the nen related to each pharyngeal
es
arches. (R< J- 1 1 Ju]
Q. W rite short note on: First pharyngeal arch. [RCLI8M.
Q. Write short note on: 2nd phary ngeal arch. |RU- 1 Uu. SUST-I5J.08J]
Answer SUST-I5NJ
|>rrhnthc* of pharyngeal arches;

Pharyngeal am r ^’cne supply Muscles Skftctofi

Mandibular arc h Trigeminal: maxillary a. Muscles of mastication
( 1 " arch ) and mandibular divisions 1 Maxillary process:
(temporal, masseter, medial, Premaxilla, maxilla,
lateral pterygoids) zygomatic, part of
b. Mylohyoid temporal bone.
C. Anterior belly of digastric 2. Mandibular process:
d. Tensor palatine Meckel's cartilage,
c. Tensor tympani mandible, malleus,
incus, anterior ligament
1 of malleus,
sphenomandi bular
ligament.
Hyoid arch Facial nerve a. Muscles of facial 1. Stapes
(2nd arch) expression (buccinator, 2. Styloid process of
auricularis, frontalis, temporal bone
platysma, orbicularis oris, 3. Sty lehy oid ligament
orbicularis oculi) 4. Lesser hom & upper j
l b. Posterior belly of digastric portion of body of
C. Stylohyoid hyoid bone
d. Stapedius
Search <Jossopharyngeal nerve stylopharyngeus Greater hom & lower poruun
of body of hyoid bone.
4* arch Superior laryngeal a. Cricothyroid Laryngeal cartilages (thyroid,
b. Levator palatine cricoid, arytenoid,
L
(j
”ranch of vagus nerve

Recurrent laryngeal
।
c. Constrictors of phary nx
1 ntrinsic muscles of larynx
corniculate cuneiform)

! .branch of vagus nerve

|Ref- Langrnan / 12* / 264-2b5|

Scanned with CamScanner

 Ml
__ _ ....
uvmv / on ii khiUN iHAVi
11 vuk ia*,
-
mi ui 4 I ha
•- -J
lx . J

-— —
r

.
HirtiynuMpHiihli
Aitoiy hlldHllHlHWl HpllhHlMIHf
Npivm Ini ftlib^htl^l
CaHlIrtUO* •PlimyofFml HMI
Pud Mb Wllh
CctodRimnl
epithelium - t<tlnHt MM
OrMlW#
. UA., I1f(l HHl

Mcnenchymnl Unniin
In din ntvh dlh riH>li
I niyilMfll
oilllon

MaxiIIAiy —
process ULuxJ.uk.' ftMllw lyithphhlfi
Mnhdibulfir
process let hi
.Mtillmif tube
outKlonj
Meatus f‘:>
. thilMtlnt tbhiil
Ihl'erlar ywtilhtirbld
flluhtl
J, fhlJMUt
SVrv/fzd ilhut
Suynwlur ywalhtjrvM
Wtyl'Amo brahdkM
bodif
Figure: Pharyngeal arches.

Q. Mention the congenital malformations of pharyngeal arches. | R U-O5J, CU*05J|

Q. What is branchial cyst? [CU- 1 9M, 1 4Ju]
Q. Write about the branchial fistula. [CU- 1 8N, 1 7/1 6M, 1 5J, 1 3Jti j
Answer
Congenital malformations of pharyngeal arches;
a) Branchial fistulas:
1. External branchial fistulas:
They occur when the second nharyngcal arch falls Io grow cmidnlly over the h. 4* artb
leaving remnants of the 2nd,3,d. and 4"' dolls In contact with the surface by a narrow canal. Huch a
fistula, found on the lateral aspect of the neck directly anterior to the sternocleidomastoid muscle,
usually provides drainage for a lateral cervical cyst.
2. Internal branchial fistulas:
They arc rare, and occur when the cervical sinus Is connected to
small canal, which usually opens in the tonsillar region. the lumen of the pharynx V/ a
b) Branchial cyst:
It is a painless cystic swelling situated anywhere
frequently found close to, the angle of the beneath the sternocleidomastoid muscle, but I*
mandible.
|Htf- Langman /

Scanned with CamScanner

 ..r-MdUS^^
about the position and developmental causes of branchial fniah.
[CW
=
1J«5
5’5

of branchial r^tula^
pa^^r^^al
1 ’
branchial fistulas:
Such a fistula, found on the lateral aspect
of the neck, directly antericr » t
sternocleidomastoid muscle, usually provides drainage for a lateral cervical cyx
Internal branchial fistulas:
It usually opens in the tonsillar region.
...^ntal cause of branchial fistulas:
^^y^rnal branchial fistulas:
They occur when the second pharyngeal arch
fails so grew
leaving remnants of the 2nd, 3rd, and 4“ clefts in corset with the
surface by
2 internal branchial fistulas:
They are rare, and occur when the cervical sinus is ccrr.ecte
to the teen cf
small canal.
Q. What is pharyngeal pouch? Give the derivatives of pharyngeal poaches. [DC-llM.lSJJZL
IOJu,O9J,O7Ju, 06Ju, CU-16M,14J,10JuZJt RU-17NJ5N/JJ2JxO9J. SCST-IT'* : '.xTM.
07Ju]
Q. Write down the derivatives of pharvngeal pouches in a tabulated form. rCU-t9KIM.-'6\.
I5N/JU.14J]
Q. Write the derivatives of 1” & I"4 branchial poaches. [SCST-l4JxCU-I & I7V IfX J]
Q. Give the derivatives of 1* pharyngeal pouches. [SUST-I9MtI6M.0«Jb]
Q. Name the derivatives of Is* pharyngeal pouch. (RC-13Ja]
Q. Name the derivatives of I"*1 branchial pouch. [SUST-i5NJ3Ja]
Q. Write short note on: Phary ngeal pouches. [CL-10J]
Q. Write short note on: 1“ and 2** Phary ngeal pouch. [CU-I3J]
Q. Write briefly on: derivatives of branchial poach. [Rt-15Ju.I Ua]
Answer
Pharvngeal pouch: These are endodermal lined spaces in between two afacera pcaryujgex nenes terrain .
Number:
There are 5 pairs of pharyngeal pouches.
The last one of these is aty pical and often considered as part of the fixte
Structures developed from pharvngeal/' branchial txtaches:

[Ref- Lxsrrxa 12* 2» . 2t^1

Scanned with CamScanner

 <16

Figure: Pharyngeal pouch and clefts.

Q. What do vou mean tn pharvngcal cleft? [RU-09J] n~,

u,
[DU-18MJ6/I5N.14J.09J. / u. . .
Q. U rife down the derivatives of phary ngeal cleft.
09J]
Answer
Pharvngcal cleft:
These are ectodermal lined spaces lie between the two adjacent pharyngeal arches externally.
Oerivathes of phan ngeal clefts:
There are four pharyngeal clefts, of which only one contributes to the definitive structure of the
embryo. First pharyngeal cleft gives rise to external auditory meatus and ectodermal lining of tympanic
membrane. Rests are obliterated.
|Ref- Langman 1 12* 1 269|

Q. Write short note on: Craniosynostosis. [SUST-I I Ju]

Answer
Craniosynostosis:
It is a category of cranial abnormalities which is caused by premature closure of one or more -n»s II
occurs in 1 in 2500 births.
The shape of the skull depends on which of the sutures closed
prematurely
• Early closure ofthe sagittal suture (57% of cases) resuhe in > - - ,
the skull becomes long and narrow (scaphocephaly). ^’P113 exPanS!On’
• Premature closure of the coronal suture results in a Short’ h,Sh
tower skull.
u- .
, „
skull, .
known as acrocephaly, or
• If the coronal and lambdoid sutures close
craniosynostosis, known as ? S‘de °nly’ a5*™0161™
plagiocephaly, results

Scanned, with CamScanner

 MCQ of bond & Nock
ih<HI<| til ((l Q. Middle car |DIM9M]
Jto tif •HHMl < a) l> lined by stratified
squamous epithelium
b) through ndiUK
>*l Wirt) communicates with mastoid
t)
niht) ant mm
। i hnf'ial c) Is innervated by mandibular nerve
,। (» < ipilul ntUl\
attny d) contains ossicles
jj optrfludrtm c) communicates with laryngopharynv
Ans. a) F, b) T. c) 1 . d) T, c) F

. of - |I)U-19N| Q. Thyroid gland- [DU-10M]

(
V
,j
•
w ,ido Ct '» inu
turuhslifaMiic lymph node a) develops irom midline endodermal thyroid
H palatine tonsil diverticulum
thymus
b) is enclosed within pretracheal fascia
v)
c) is situated opposite the 5“ cervical to r
<h tubal Wnvil
C) vallate papilla thoracic vertebra
d) receives arterial supply from middle thyroid
Ans. a) F. b) T. «)
F, d) T. c) F. artery
c) is drained by thyroid veins
q. Structures passing through jugular
Ans. a) T, b) T, c) F, d) F. c) F
torimen include- [DIJ-I9N]
a) glossopharyngeal nerve
b) hypoglossal nene Q. Muscles responsible for depression of
0 intenor pelrosal sinus Temporomandibular joint include- [Dl-lOW
di mandibular nene a) anterior belly digastric
cj vagus nene b) geniohyoid
c) lateral pterygoid
Aos. a) T. b) F, c) T. d) F, c) T. d) masseter
c) temporalis
Q. Muscles derived from 1“ pharyngeal arch
Ans. a) F, b) F. c) T, d) F. c) F
include- [DIM9NJ
a) anterior belly of digastric muscle
b) buccinator muscle Q. Facial nerve supplies the following
c) levator veil palatine muscle
glands- [DU-19M]
d) muscles of mastication a) parotid
t) posterior belly of digastric muscle
b) submandibular
c) sublingual
Am. a) T, b) F, c) F. d) T, e) F. d) lacrimal
c) parathyroid
0- Middle meatus of the lateral wall of the Ans. a) T, b) T, c) F, d)T.c)F.
nose receives drainage from the following
Hructures- [DU-I9N] Q. Lateral wall of the nasopharvni <how»-
<0 frontal air sinus jDU-IOM)
bj maxillary air sinus a) opening of the auditory tube
c) nasolacrimal duct b) palatine tonsil
d) posterior ethmoidal air cell c) lingual tonsil
c) sphenoidal air sinus d) salpingopharyngeal told
An«- a) T, b) T, c) F, d) F, c) F. e) palatopharyngeal fold
F, d) T, e) F
Ans. a) T. h) F, c)

Scanned with CamScanner

 buds arc i"
518 Q, Tasteepiglottis
pharyngcnl pouch n)
Q. Derivatives of 3"1 hl gum
include- [DU-I8N] e) nnsopharyns
of tongue
a) auditory tube d) papillae
gland
b) inferior parathyroid c) soil palate lf
c) palatine tonsil F, <0
a) T. b)
of larynx -
gland
superior parathyroid [Du.
d) Ans.
e) thymus
Cricothyroid muscle
Ans. a) F, b) T, c)
F, d) F, c) T. Q.
IHMI placed externally on the
. ,
laryngeal wall

Q. Following parts
of the face develop from n) Is vocal cord
b) lenses the by Internal laryngeal
nerve
maxillary prominence- [DU-18N] supplied arch
a) bridge of the nose
c) Is pharyngeal
front 6lh voenl cord
d) develops of
b) cheek c) causes adduction
c) forehead F, c) F.
c) F, d)
b)T,
d) medial part of upper lip Ans. m) T,
e) lateral part of upper lip supplies the followlnp
Facial nerve
Ans. a) F, b) T, c) F, d) F, e) T. Q.
[DU- 1 KM [
muscles- belly of digastric
wall of a) anterior
Q. Cranial nerves related to lateral
cavernous sinus include- [DU-I8N] b) masseter
a) oculomotor c) orbicularis ocull
b) opthalmic d) platysma
c) maxillary c) superior rectus
d) facial a) F, b) F, c) T,
d)T, c) F.
e) trochlear
Ans.
tn the i»„l(o
Ans. a) T, b) T, c) T, d) F, e) T. Q. Cranial nerve attached
Q. Infratemporal fossa contains- [DU-18N]
a) lingual nerve b) glossopharyngeal
b) maxillary nerve c) hypoglossal
c) pterygopalatine ganglion d) trigeminal
d) pterigoid muscle e) ^cstibulo-cochlcar
e) pterigoid venous plexus
An’">^b)F.c)F.d)Tc).r
Ans. a) F, b) F, c) F, d) T, e) F.
Q. Middle meatus of the lateral wall of nose
Q. Maxillary air sinus- [DU-18N] receives drainage from- [DU-I7N]
a) appears after birth a) Ethmoidal air cells
b) lightens the skull b) Frontal air sinus
c) is lined by stratified squamous epithelium c) Maxillary air sinus
d) opens into lateral wall of the nose d) Nasolacrimal duct
e) is supplied by superior alveolar nerve e) Sphenoidal air sinus
Ans. a) F, b) T, c) F, d) T, c) T.
Ans. a) T, b) T, c) T, d) F, c) F.
Q. Pterion is the meeting place of the Q. Inferior orbital Fissure transmits- [DU-
following bones - [DU-1 8M] 17N]
a) fontal
b) parietal a) Frontal nerve
c) temporal b) Infraorbital vessels
d) maxilla c) Mandibular nerve
c) zygomatic d) Orbital branch of pterigopalatinc ganglion
e) Zygomatic nerve
Ans. a) T, b) T, c) T, d) F, e)
T.
Ans. a) F, b) T, c) F, d) T, c) T.

Scanned with GamScanner

 WffA —.—_
-developing f’om "^nnd — 519
I

0.
''"“
rh*'’’.‘w" m"Kle
M auditory tnhe
h•J
rricothyn’Id muvclc h) inferior
of focinl expression parathyroid gland
Muulc’ c) palatine
tonsil
belly of dlgamlc muscle
Posterior superior parathyroid
^Stapcdio’ muscle C) thymui
gland

b)F. 0 T. d) T, e) T. Am. «)F, h)T, c) F, d)

<n<.i -)F. P. e) f
i Hard
palnfc h formcd by following Q. Middle car cavity
contains- [DILI7M|
a) chorda tympani
nerve
„) Ethmoid h) auriculotemporal
nerve
b) Frontal c) tympanic plexus
of nerve
c) Maxilla d) stapedius muscle
dl Palatine c) stylopharyngeus muscle
e) Zygomatic
Ans. a)T, h) F,c)T. d)T, e) F
T, e) F.
Ans. »1 F. b) F. c) T. d)
Q« Extraocular muscles are supplied by- (DU-
q. Cranial nenes attached to the ponto-
medullan junction include- (DU- 1 7N] a) oculomotor nerve
a) Glossopharyngeal b) trigeminal nerve
b) Facial c) abducent nerve
c) Trigeminal d) trochlear nerve
d) Vagus e) opthalmic nerve
e) Vestibulocochlear
Ans. a) T, b) F, c) T, d) T, c) F.
Ans. a) F. b) T, c) F, d) F. e) T.
Q. Following arc the muscles of mastication-
Q. Parts of the face developing from fronto [DU-16N]
nasal process include- [DU-I7M] a) Buccinators
a) bridge of the nose b) Temporalis
b) cheek c) Masseter
c) forehead d) Digastric
d) medial part of upper lip c) Lateral pterigoid
e) lateral part of upper lip
Ans. a) F, b)T,c)T,d) F,e)T.
Ans. a) T, b) F, c) T, d) T, e) F.
Q. Maxillary nerve supplies the skin of - [DU-
Q. Nasal septum is formed by the following I6N]
bones- [DU-17M] a) Temporal region
a) cribriform plate ethmoid bone b) Auricle
b) perpendicular plate of ethmoid bone c) Lower eyelid
c) perpendicular plate of palatine bone d) Cheek
d) septal cartilage e) Upper lip
e) vomer
Ans. a) F, b) F, c)T, d)T,e)T.
Ans. a) F, b) T, c) F, d) T, c) F. [DU-I6N]
Q. Carotid sheath surrounds-
Q. Cavernous sinus communicates with- [DU- a) Common carotid artery
17M] b) Internal carotid artery
a) cavernous sinus of opposite side c) External carotid artery
b) pterygoid venous plexus d) Internal jugular vein
c) sigmoid sinus e) External jugular vein
d) e) F.
straight sinus Ans. a) T, b) T, c) F, d)T,
e) veins of orbit
A«s. a) T, b) T, c) F, d) F, c) F.
Scanned with GamScanner
 (SAO. MCOi A
ENDEA I OUR ANATOMY FOR WRITTEN
substance of
the Q. Blood vessels within the
Q. Following cranial nerves pass through
opening of middle cranial fossa- |DU-I6N]
parotid glands arc- [DU-I6MJ
a) External carotid
artery
a) Trigeminal
b) Abducent b) Maxillary artery
c) Glossopharyngeal c) Common facial vein
vein
d) Vagus d) External jugular vco.
e) Accessory e) Retro-mandibular vein
F, e) T.
Ans. a) T. b) T. c) F, d) F. e) F. Ans. a) T, b) T, c) T. d)
Q. Cranium consists of the following boncs- Q. Sternocleidomastoid muscle is attached to
[DU-16N] the- [DU- 1 6M]
a) Temporal a) Manubrium stemi
b) Ethmoidal b) Clavicle
c) Occipital c) 1"
- rib
d) Lacrimal d) Occipital bone
e) Palatine c) Parietal bone
d) T, e) F.
Ans. a) T, b) F, c) T, d) T, e) T. Ans. a) T, b) T, c) F,

Q. Cranial venous sinuses are devoid of- [DU- Q. Auditory tube- [DU-16M]
16N] nasopharynx with the tympanic
a) connects
a) Endothelium cavity
air pressure on both
b) Fenestration b) maintains equilibrium of
c) Smooth muscle sides of tympanic membrane
d) Fibroustissue c) has lateral cartilaginous part
e) Valves d) is made of elastic cartilage
e) is lined by stratified squamous epithelium
Ans. a) F. b) T, c) T, d) F, e) T.
Ans. a) T, b) T, c) F, d) T, e) F.
Q. Middle ear cavity contains- [DU-16N]
a) Malleus Q. Facial nerve supplies the following
b) Incus muscles- [DU-16M]
c) Stapideus muscle a) Buccinator
d) Tympanic membrane b) Orbicularis oculi
e) Auditory tube c) Levator palpebrae superioris
Ans. a) T, b) T, c) T, d) F, e) F. d) Masseter
e) Stepedius
Q. Following nerves are related to the
mandible- [DU-16M] Ans. a) T, b) T, c) F, d) F, e) T.
a) Mandibular nerve
b) Lingual nerve Q. Following air sinuses are open into the
c) Hypoglossal nerve middle meatus of nose- [DU-16M]
d) Inferior alveolar nerve a) anterior ethmoidal
e) Auriculotemporal nerve b) posterior ethmoidal
c) middle ethmoidal
Ans. a) F, b) T, c) F, d) T, e) T.

Q. Investing layer of deep cervical fascia d) sphenoidal

splits to enclose the following glands- [DU- e) frontal
Ans. a) F, b) F, c) T, d) F, e) T.
a) Parotid
b) Sub-mandibular Q. Carotid sheath contains- [DU-15N]
c) Sub-lingual a) internal carotid artery
d) Thyroid b) external carotid artery
e) Parathyroid
c) internal jugular vein
ns. a) T, b) T, c) F, d) F, c) F. d) external jugular vein

Scanned wi/th CamScanner

 "ea~
=
‘^^rior
^T.hjF.c)
>•!«•’" ***n
T.d)F.e)F
d) h« internal
laryngeal
mucous membrane nerve beneath its
M e) is the site for impaction
nerve pa«x through of foreign bodies
Hrurchc* of trigeminal Ans. a) F. b) T. c) T.d) F,
tf^hmlnc foramina or n»sne- [DU-I5N] e)T.
* foramen ovale
a) Q- Jugular foramen
stylomastoid foramen
। jugular foramen
nerves- [DU- 1 5 Ju] transmits following
a) mandibular
j) Miperior orbital fissure
h) facial
f ) inferior orbital fissure
c) glossopharyngeal
Ant. a) F, h) F. c) F.d)T. e) F. d) vagus
e) accessory
q paired venous sinuses arc- [DU-I5N] Ans. a) F, b)T,c) F, d)F.e)T.
a) cavernous sinus
h)sigmoid sinus
sagittal sinus Q. Followings are the branches
c) superior of external
d) occipital sinus carotid artery- [DU-15Ju]
a) ophthalmic artery
e) superior petrosal sinus
b) facial artery
Ana. a). b),c), d). e) . c) lingual artery
d) superior thyroid artery
Q. Danger area of the face comprises of- [DU-
15N] e) occipital artery
aj upper lip
b) angle of mouth Ans. a) F, b) T, c) T. d) T, e) T.
c) lower part of nose
d) medial part of cheek Q. Lateral wall of cavernous sinus is related
e) lower eyelid to- [DU- 15 Ju]
a) optic
Ans. a) T. b) F, c) T, d) F, e) F. b) occulomotor
c) trochlear
Q. Salivary glands receive secretomotor fibres d) ophthalmic
HDL-I5N] e) facial
a) trigeminal Ans. a) F, b) T, c) T, d) T, e) F.
bj facial
c) glossopharyngeal
d) vagus
Q. Face is characterized by the presence of-
e) hypoglossal [DU-!5Ju]
a) sweat gland
Ans. a) F, b) F, c) T, d) T, e) F. b) sebaceous gland
peD^ c) deep fascia
6M] Q. Muscles of the tongue are attached to the d) loose connective tissue
following bones- [DU-15N] e) smooth muscle
a) mandible Ans. a)T, b) T, c) F, d)T,e) F.
b) maxilla Q. Carotid sheath surrounds- [DU-15Ju]
c) hyoid a) common carotid artery
dj mastoid process b) internal carotid artery
e) styloid process c) external carotid artery
Ans. a) T, b) F, c) T, d) F, e) T. d) internal jugular vein
e) external jugular vein
Q. Piriformis fossa- [DU-15N] Ans. a)T, b) T, c) F, d)T, e) F.
a) is situated in the oropharynx
b) lies on each side of inlet of larynx
c) is related laterally to palatine tonsil

Scanned with CamScanner

 (SAQt MCQ)_&
FAVOUR ANATOMY FOR WRITTEN
epithelium
Q. Following crnninl nenes nrc nttnehed nt e) lined with cilliated columnar
the pontomcdullnry junction- [DU-l5Ju] T, c) F.
Ans. a) F, b) T, c) F, d)
a) trigeminal
of
b) abducent
Q. Followings nrc the derivatives
developing
c) facial
frontonasalpromonancc of facC-
d) vestibulocochlear
c) glossopharyngeal [DU-I5M]
a) forehead
Ans. a) F. b) T, c) T, d) T, e) F. b) bridge of nose
c) checks
Q. Skeletal muscles of the head neck region is d) lateral potion of upper lip
supplied by follow ing cranial nerves- [DU- e) philtrum of upper lip
I5M]
a) oculomotor Ans. a) T, b) T, c) F, d) F, c) T.
b) maxillary
c) facial Q. Folds of dura matter arc attached to the -
d) glossopharyngeal [DU-15M]
e) vagus a) margins of foramen magnum
b) internal occipital crest
Ans. a) T, b) T, c) T, d) F, c) F.
c) margins of superior orbital fissure
Q. Deep cervical fascia encloses- [DU-15M] d) superior border of petrous part of temporal
a) larynx
bone
b) sternocleidomastoid muscle
e) tuberculum sellae
c) thyroid gland Ans. a) T, b) F, c) T, d) F, e) T.
d) submandibular gland
e) cervical part of oesophagus Q. Middle cranial fossa has following
Ans. a) T, b) T, c) T, d) F, e) F. foramen- [DU-15J]
a) foramen cecum
Q. Following arc the synovial joints in the b) jugular foramen
head and neck region- [DU-15M] c) foramen lacerum
a) atlanto-occipital joint d) foramen spinosum
b) median atlanto-axial joint e) foramen ovale
c) lateral atlanto-axial joint Ans. a) F, b) F, c) F, d) T, e) T.
d) joints between laminae of adjucent cevical
vertebrae Q. Following structures open into middle
e) joints between spines of adjacent cervical meatus of nose- [DU-15J]
vertebrae a) nasolacrimal duct
Ans. a) F, b) T, c) F, d) T, e) F. b) posterior ethmoidal air sinus
c) sphenoidal air sinus
Q. Facial vein- [DU-15M] d) middle ethmoidal air sinus
a) is located on deep fascia of face e) maxillary air sinus
b) is devoid of valves Ans. a) F, b) F, c) T, d) F, e) T.
c) is tortuous
d) drains lateral nasal wall Q. Pituitary gland is related closely to- [DU-
e) is connected with the cavernous sinus
I5J]
Ans. a) F, b) F, c) T, d) T, e) T. a) sphenoidal air sinus
b) optic chiasma
Q. Pyriform fossa is- [DU-I5M] c) thalamus
a) situated in the oropharynx d) cavernous sinus
b) located on each side of inlet of larynx e) medulla oblongata
c) related to internal laryngeal nerve beneath its
Ans. a) F, b) F, c) T, d) T, c) F.
mucous membrane
d) the site for impaction of foreign bodies

Scanned with CamScanner

 -523
Q. Regarding mandible-
a) it develops from
[DU-l4Ju]
Meckel’s cartilage
b) It is the first bone to ossify
buccinator c) it completely ossify from
from membrane
b) platysm“ membrane
d) The mental foramen lies near the
c) mylohyoid upper border
d) messetor in new bom
C) medial pterygoid e) it provides attachment to muscles
of
mastication
AnS.a)F,b)F,c)F,d)T,e)T. Ans. a) F, b) F,c)F,d)T, e)T.
q. Paired dural
venous sinuses include- [DU
,5J] • •
a) occipital
. Q. Foramen magnum transmits- [DU-14Ju]
a) Lower part of medulla
b) superior petrosal b) Anterior spinal artery
c) superior sagital c) Vertebral artery
d) sigmoid d) Basilar artery
e) transverse e) Hypoglossal nerve
F, d) T, e) T. Ans. a)T, b)T,c)T, d) F, e) F.
Ans. a) F, b) T, c)

Q. External oblique muscle- [DU-15J] Q. Deep structures of submandibular region

a) is supplied by lower six thoracic spinal nerves include- [DU-14Ju]
b) extends vertebral column a) Hypoglossus muscle
c) provides support to abdominal viscerae b) Genioglossus muscle
d) assist in forceful inspiration c) Submandibular gland
e) develops from paraxial mesoderm d) Parotid gland
e) Internal carotid artery
Ans. a)T,b)F,c)T, d) T, e)F.
Ans. a) T, b) F, c) T, d) F, e) T.
Q. Cranial root of accessory nerve supply the
following muscles- [DU-14Ju] Q. The atlas vertebrae- [DU-I4J]
a) Trapezius a) Is devoid of body
b) Stylopharyngeus b) Possess odontoid process
c) Palatoglossus c) Is grooved on the superior surface by the
d) Levator vali palatini vertebral artery
e) Tensor tympani d) Has a long spinous process
e) Allows nodding movement at its articulation
Ans. a) T, b) F, c) T, d) T, e) F.
with occipital bone
Q. Nasopharynx communicates with- [DU- Ans. a) T, b) F, c) T, d) F, e) F.
14Ju]
a) Nasal cavity Q. Cranial nerves innervating the salivary
b) Middle ear cavity glands arc- [DU-14J]
c) Oropharynx a) Facial
d) Oral cavity b) Glossopharyngeal
e) Larynx c) Vagus
Ans. a) T, b) T, c) T, d) F, e) F. d) Cranial part of accessory
e) Hypoglossal
Q. Epidural space of vertebral canal- [DU-
14Ju] Ans. a) T, b) T, c) F, d) F, e) F.
a) Intervenes between periosteum and spinal
duramater Q. Internal jugular vein- [DU-14J]
sigmoid sinus.
b) Extends up to lower border of S2 vertebrae a) Begins as continuation of
c) Is traversed by ligamentum denticulum b) Lies in the carotid sheath.
vena cava.
d) Contains internal vertebral venous plexus c) Terminates in the superior jugular vein.
e) Is clinically important d) Communicates with external

Ans. a) T, b) F, c) F, d) T, e) T.

Scanned with GamScanner

 An
c) Kerch ex IhorRck dtui in the neck. d) middle ethmoidal
Ans. a) T. b) T, c) F, <t) F. c) T.
e) posterior ethmoidal
F, d) T. e) F.
Ans. a) f. h) F, c)
Q. Extrinsic muscles of tnnguc- |I)IL|4J|
h supplied by
a) Protrude tongue Q. Tympanic membrane
h) Make dorwl Mirfnee of tongue
convex branches from- [DU-l3Ju|
c) Hec ate tongue a) facial nerve
d) Make dorsal xmfAcc of tongue
concave from h) mandibular nerve
side to side c) maxillary nerve
c) Elongate tongue d) glossopharyngeal nerve
Ans. a) T. h) T. c) F. d) F. c) T. c) vagus nerve
Ans.a)F, b) F, c) F, d)T, c) T.
Q. Structures pasting between superior and
middle constrictors of pharynx Include- |I)U- 1 4J] Q. In the scalp- [DU-l3Ju|
n) Glossopharyngeal nerve
a) walls of blood vessels
are firmly attached
b) Internal laryngeal nerve with fibres of dense connective tissue layer
c) Recurrent lanngcal nerve b) emissary veins are present in loose areolar
d) Sts lophan ngcits muscle tissue layer
e) Levator vali palatini c) aponeurotic layer is muscular at its middle
Ans. a) T. h) F. c) F. d) T. e) F. part
d) epicranial aponeurosis is attached to the
Q. Maxillary prominence of developing face superior nuchal line
contributes to formation of- [DU- 1 4J] c) pericranium layer is intimately adherent at
a) Cheeks sutural line
b) Philtrum
Ans. a) T, b) T, c) F, d) T, c) F.
c) Lateral portion of upper lip
d) Alae of nose Q. Middle ear cavity contains following
c) Tip of nose nerves- [DU-13J]
Ans. a) T. b) F. c) T, d) F. e) F. a) chorda tympany
b) facial
Q. Oropharvnx communicates with- [DU- c) vestibular
13Ju] d) cochlear
a) nasal cavity e) tympanic branch of glossopharyngeal nerve
b) audirory tube
Ans. a) T, b) T, c) T, d) T, e) F.
c) nasopharynx
d) oral cavity Q. Following structures pass between the base
e) piriform fossa of the skull and upper border of superior
Ans. a) F, b) F, c) T, d) T, e) T. constrictor muscle- [DU- 13J]
a) auditory tube
Q. Palatine tonsil is related to the following b) levator palati muscle
nerves- [DU-13Ju] c) glossopharyngeal nerve
a) lingual d) internal laryngeal nerve
b) auriculotemporal e) recurrent laryngeal nerve
c) internal laryngeal Ans. a) T, b) F, c) T, d) F, e) T.
d) facial
e) glossopharyngeal
Q. Palatine tonsil is- [DU-13J]
Ans. a)T, b) F, c) F, d) F,e)T. a) a secondary lymphoid organ
b) located in the lateral wall of nasopharynx
Q. Middle meatus of nose receives the c) lined with stratified squamous epithelium
opening of folloging sinus- [DU-1 3Ju] d) covered by taste buds
a) frontal e) developed from 3rd pharyngeal pouch
b) sphenoidal
c) anterior ethmoidal Ans. a) T, b) F, c) T, d) F, c) T.

Scanned with CamScanner

 O. Knllowlng nerves arc locnlci| ln |h
,Mill of cavernous sinus* |I)U*I3J| ’crnl
' d) optic
10 oculomotor
t) trochlear
j) opthalmlc
mandibular
c)

An«. ») > • b> T- c> T* d) 1 • •) F.

ncrve
q. Candid sheath contains* |DU-I3J1 bJ
n) internal jugular vein
b) external jugular vein
c) common carotid artery
SjssH pharynx arI
d) external carotid artery
c) internal carotid artery
A"’">T.MT..)P.d)F,„T
Ans. a) T, b) F. c) T. d) F, c) T. few tbXhS
Q. Arteriovenous anastomoses arc found In-
J ^'portion ofZX,.P
c) tip Of the nose
a) car lobule d) alae of the nose
b) fingertip e) bridge of the nose
c) upper eyelid
Ans. a) T, b) F, c) T, d) F, e) T.
d) upper lip
c) check
Q. Middle ear cavity contains the following
Ans. a)T, b)T, c)T, d)F,e)F. nerves- [DU- 12Ju]
a) tympanic branch of glossopharyngeal nerve
b) chorda tympani nerve
Q. Adenohypophysis- [DU-12Ju] c) auriculotemporal nerve
a) develops from ncuroectoderm
d) auricular branch of vagus
b) contains neurosensory materials e) tympanic plexus of nerve
c) rests on the body of sphenoid bone
d) is related to cavernous sinus Ans. a) F, b)T,c)F, d) F. e)T.
e) when enlarges may compress optic chiasma
Q. Cranial nerves present in the lateral wall
Ans. a) F, b) F, c) T, d) F, e) T. of the cavernous sinus are- [DU-I2J]
a) oculomotor
b) trochlear
Q. Following muscles act on the c) ophthalmic
c^poromendibular joint- [DU-12JulJ d) abducent
a) masseter e) facial
b) buccinator
c) pterygoid muscle Ans. a)T,b)T,c)T,d)F,e)F.
d) platysma is attached to the-
c) digastric Q. Epicranial aponeurosis
^ns. a) T, b) F, c) T, d) F, e) F. external occipital protuberance
b) highest nuchal line
Q- Thyroid gland is- [DU-12Ju] c) zygomatic arch
a) covered by pretracheal fascia by suspensory d) supercilliary arch
b) attached to the cricoid
cartilage e) superior temporal line
ligament of Berry.
secretions outside the AM.»)T,b)F,c)F.<*)T.«)T.
c) the gland which stores
cells
by the branches of internal carotid
d) supplied
artery

Scanned with CamScanner

 526 e^deavQLL ANATOMY
foramen transmits - [DU- 1IJ]
Q. Jugular artery
Q. Infratemporal fossa contains-
|DIM2J| .i)intcni.il carotid vein
at otic ganglion b) internal jugular
b) Ptengep* ganglion c) accessory
nerve
c) ptengoid xvnous plexus d) deep facial
vein
sinus
d) chorda-tj-mpanx' nene c) inferior petrosal
e) T.
c> hngual nene T, c)T, d) F.
Ans. a) F. b)
4ns. a) T. b) F. c) F. d) T. e) F. nerve - [DU-I IJ]
laryngeal
Q. Following parts of car arc developed
from Q. Recurrent of 6,h branchial arch
nerve
a) is the
ectoderm- [DU-I2J]
b) is a motor nerve muscle
a) organ of corti cricothyroid
supplies
b) cochlear duct c) 6,h aortic arch of right side
c) semicircular canal d) winds round the produces hoarseness of
d) ossicles c) palsy on one side
e) tympanic caxity voice
F, d) F, e)T.
Aas. a) T. b) F. c) F. d) F, c) T. Ans. a) T, b)T, c)
gives to - [DU-l]n
Q. Vocal fold is- [DU-I2J] Q. Maxillary prominence '
a) least x-ascular a) ala of the nose
lip
b) devoid of submucosa b) medial aspect of upper
c) lateral aspect of upper
lip
lined with pseudostratified ciliated columnar
epithelium d) cheek
d) supplied bx external laryngeal nerve e) crest of the nose
e) proxided xxith skeletal muscle
Ans. a) F, b) F, c) T, d) T, e) F.
Ans. i) T. b) T. c) F. d) F, e) T.
Q. Parathyroid glands - [DU-10J]
Q. Atlanto-axial joints are folloxving types of related to anterior border of thyroid eland
synoxial joints-[DU-l 1Ju] Sb) are
develop as endodermal outgrowth
a) Plane c) develop from pharyngeal pouches
b) Pix ot thyroid
c) Hinge
d) Ellipsoid
c) Condylar

Ans. a) T, b) T, c) F, d) F, e) F. Ans. a) F, b) T, c) T, d) T, e) T.

Q. Folloxving paranasal air sinues open into Q. Internal auditory meatus transmits -[DU-
the middle meatus of nose-[DU-l 1Ju] 10J]
a) Sphenoidal a) seventh cranial nerve
b) Frontal b) labyrinthine artery
c) Posterior ethmoidal c) great petrosal nerve
d) Anterior ethmoidal d) deep petrosal nerve
e) Middle ethmoidal c) eighth cranial nerve
Ans. a) F, b) T, c) F, d) T, c) T. Ans. a) T, b) T, c) F, d) F, e) T.
Q. Stapedius- [DU-I IJ] Q. The parasympathetic innervation
a) is a muscle of the middle ear
b) is a non-striated muscle
controlling the salivary glands arises from
c) develops from 2nd branchial arch -[DU-10J]
a) facial nerve
d) is supplied by mandibular division
of b) glossopharyngeal nerve
trigeminal nerve
e) prevents hyperacusis c) vagus
d) oculomotor
Ans. a)T,b)F, c)F,d) F.c) T. e) trigeminal :
Ans. a)T,b) F, c) F, d) F,e)F.
Scanned with CamScanner
 Head & neck - —
. ^temporal fossa contains - [DU-10J]
.) maxil,aO'
nervc 527
b) mandibular nerve
c) lingual nerve
d) otic ganglion
e) pten gopalatine ganglia

A^.)F.b)T,c)F,d)T,^
•>)
Commu£«
aditus
with ma Tm’ 'F1'1"1'"1’
"h
through
n Nasal rnucosa continuous with the lining
ofthe- [DU-10J] ')
Communicates with laryogopha^
a) paranasal sinuses
b) nasopharynx A"’-»)F,b)T.c)F.d)T.e)F.
c) lacrimal sac
d) gums
e) oral cavity Q’VboXTJ^
a) Maxilla
Ans. a) T, b) T, c) T, d) F, c) F. b) Zygomatic
c) Occipital
Q. Cranial nenes containing branchiomotor d) Parietal
—
fibers are [DU-09Ju] e) Temporal
a) Occulomotor
b) Trochlear
Ans. a) T, b) T, c) F, d) F, e) F.
c) Facial Q. Cavernous sinus communicates with -
d) Glossophanngeal [DU-09J]
e) Hxpoglossal a) The veins of the orbit
Ans. a) F. b) F, c) T, d) T, e) F. b) Sigmoid sinus
c) Cavernous sinus of opposite side
Q. Vertebral artery - [DU-09Ju] d) Pterygoid venous plexus
a) Is a branch of 3"* part of subclavian artery e) Straight sinus
b) Passes through cervical part of vertebral canal Ans. a) T, b) F, c) T, d) T. e) F.
c) Occupies a groove on the anterior arch of
atlas Q. Pituitary gland- [DU-09J]
d) Passes in to the cranial cavity through a) Overlies the body of sphenoid bone
foramen magnum b) Lies anterior to optic chiasma
e) Unites with the other vertebral artery to form c) Is derived from primitive foregut
basilar artery d) Veins drain into dural sinuses
e) Secretions of posterior lobe affect blood
Ans. a) F, b) F, c) F, d) T, e) T. pressure

Q. Interna) auditory meatus transmits - [DU- Ans. a)T, b) F,c)F, d)F,e)T.

09Ju] Q. Parts of membranous labyrinth
are- [DU
a) 7“ cranial nerve 09J]
b) Labyrinthine artery a) Utricle
c) Greater petrosal nerve b) Perilymph
d) 8th cranial nerve c) Cochlear duct
e) Deep petrosal nerve d) Vestibule
e) Ampulary crest
Ans. a) T, b) F, c) T, d) F, e) F.
Ans. a)T, b)F, e)T,d)T,e)F.
Q. Frontal air sinus - [DU-09Ju] suboccipital triangle are-
a) Lightens the frontal bone Q. Contents of
b) Is lined by simple squamous epithe’,U,P [DU-09J]
c) Opens into middle meatus of nose a) Vertebral artery
ethmoidal infundibulum b) Suboccipital nerve
d) Appears before birth

Scanned with CamScanner

 A 17)4

W — KXDEii ()t ft .4X4 roML.

a
develop* from
fulltm ln^

c) Subowipital plexus of win*

roid eland
O- Parathynpral ponchc^ [DH-07J]
d) Subclavian artery phary
d) Occipital artery a) I*
b) 2”
c) J-
d) 4*
Q. Mlird cranial nrnn arc- f I )l J-09J) e) 5*
e) F.
c) T. d> T.
H Inpeminal An*, a) F. b) F.
11 AMuccnl foHowmE
develops
d) Accessory Q. Upper lip [Dl’-O7^
e| Optic prominences-
Ab*. .
T, b) T. c) F. d) I e) F.
a) frontonasal
b) maxillary
c) medical nasal
Q. Hard palate is formed In’ follow Ing bone -
d) lateral nasal
I DI '-09JJ e) mandibular
Maxilla
a)
c) T. d) F. c) F.
b) Frontal Ans. a) F. b) T.
c/ iJhmotd contains
of the temporal bone
di Palatine Q. Petrous part
el Zygomatic - [DU-07J]
Ao*, a) T. b) F. c) F. d) T. c) F. a) cochlea
b) semicircular canal
Q. Foramen ovate transmits the- [DU-07Ju] c) pterygopalatine ganglia
a) Mandibular nerve d) greater petrosal nerve
b) Lesser petrosal nen e e) facial nerve
c) Emissary vein e) T.
d) Middle meningeal artery Ans. a) T, b) T, c) T, d) T,
e) Venous plexus
Q. Tbe facial nen e supplies-
[DU-07J]
An*. a) T, b) T. c) T. d) F. e) F. a) Parotid gland
b) Lacrimal gland
Q. Paired venous sinuses are- [DU-07Ju] c) Submandibular gland
a) Cavernous d) Auricular muscles
b) Transverse e) Muscles of soft palate
c) Straight
d) Occipital Ans. a) T, b) T, c) T, d) F, e) F.
c) Sigmoid
Q. Unpaired venous sinuses are-JDU-D&n
Ans. a) T, b) T. c) F, d) F. e) T. a) Occipital
b) Superior sagittal
Q. Muscles of soft palate are- [DU-07Ju] c) Superior petrosal
a) Tensor veli palatine d) Transverse
bj Levator veli palatine e) Straight
c) Musculus uvulae
d) Vocalis A“«)T,b)T.c)F,d)F,e)T.
e) Transverse arytenoids
Q. The cranial nene / nen es within the orbit
Ans.a)T,b)T,c)T,d)F,e)F. are- [DU-06J]
Q. Muscles of soft palate are- [DU-07J] a) Optic
a) tensor yeti palatine b) Oculomotor
b) levator yeti palatine c) Trochlear
c) musclulus uvulae d) Facial
d) vocalis e) Accessory
e) transverse arytenoids
Ans. a) T, b) T, c) T, d) F, e) F.
ns. a) T, b) T, c) T, d) F, e) F.

Scanned with CamScanner

 rhapter-04: Head & neck -
q Branches of subclavian artery arc - [DU- Q.
— ~

Branches
-
of external carotid artery - [DU-
529

06J] , ..
a) Vertebral artery a) superior thyroid
b) Internal thoracic b) ascending pharyngeal
c) Thyrocervical c) vertebral
d) Thoracoacromial d) lingual
e) Axillary e) ophthalmic
Ans. a) T, b) T, c) T, d) F, e) F. Ans. a) T, b) T, c) F, d) T, e) F.
Q. Muscles of soft palate arc - [DU-06J,05Ju] Q. Waldeyer’s ring consists of - [DU-05Ju]
a) tensor veli palatini
a) Palatine tonsils
b) levator veli palatine
b) Lingual tonsils
c) musculus uvulae c) Submental lymph nodes
d) vocal is d) Tubal tonsils
e) transverse arytenoid e) Occipital lymph nodes
Ans. a) T, b) T, c) T, d) F, e) F. Ans. a) T, b) T, c) F, d) T, e) F.
Q. Internal auditory meatus transmits - [DU-
Q. The paired dural venous sinuses are -
06J,05Ju]
a) 7dl cranial nerve
[DU-05J]
a) cavernous sinus
b) Labyrinthine artery
b) sigmoid sinus
c) Great petrosal nerve
c) straight sinus
d) Deep petrosal nerve
d) occipital sinus
e) 8th cranial nerve e) inferior sagittal sinus
Ans. a) T, b) T, c) F, d) F, e) T.
Ans. a) T, b) T, c) F, d) F, e) F.
Q. Paired venous sinuses are - [DU-05Ju]
a) cavernous Q. Sensory supply of the tongue pass through
b) transverse - [DU-05J]
a) Facial nerve
c) straight
d) occipital b) Glossopharyngeal nerve
e) sigmoid c) Vagus nerve
d) Hypoglossal nerve
Ans. a) T, b) T, c) F, d) F, e) T. e) Maxillary division of trigeminal nerve
Ans. a) F, b) T, c) F, d) F, e) F.

Scanned with GamScanner