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The Role of the Tensor Veli Palatini Muscle in the Development of Cleft Palate-Associated Middle Ear Problems
Clin Oral Invest DOI 10.1007/s00784-016-1828-x REVIEW The role of the tensor veli palatini muscle in the development of cleft palate-associated middle ear problems David S. P. Heidsieck1 & Bram J. A. Smarius1 & Karin P. Q. Oomen2 & Corstiaan C. Breugem1 Received: 8 July 2015 /Accepted: 17 April 2016 # The Author(s) 2016. This article is published with open access at Springerlink.com Abstract Conclusion More research is warranted to clarify the role of Objective Otitis media with effusion is common in infants the tensor veli palatini muscle in cleft palate-associated with an unrepaired cleft palate. Although its prevalence is Eustachian tube dysfunction and development of middle ear reduced after cleft surgery, many children continue to suffer problems. from middle ear problems during childhood. While the tensor Clinical relevance Optimized surgical management of cleft veli palatini muscle is thought to be involved in middle ear palate could potentially reduce associated middle ear ventilation, evidence about its exact anatomy, function, and problems. role in cleft palate surgery is limited. This study aimed to perform a thorough review of the lit- Keywords Cleft palate . Eustachian tube . Otitis media with erature on (1) the role of the tensor veli palatini muscle in the effusion . Tensor veli palatini muscle Eustachian tube opening and middle ear ventilation, (2) ana- tomical anomalies in cleft palate infants related to middle ear disease, and (3) their implications for surgical techniques used in cleft palate repair. Introduction Materials and methods A literature search on the MEDLINE database was performed using a combination of the keywords Otitis media with effusion is very common in infants with an Btensor veli palatini muscle,^ BEustachian tube,^ Botitis media unrepaired cleft palate under the age of 2 years. -
The Articulatory System Chapter 6 Speech Science/ COMD 6305 UTD/ Callier Center William F. Katz, Ph.D
The articulatory system Chapter 6 Speech Science/ COMD 6305 UTD/ Callier Center William F. Katz, Ph.D. STRUCTURE/FUNCTION VOCAL TRACT CLASSIFICATION OF CONSONANTS AND VOWELS MORE ON RESONANCE ACOUSTIC ANALYSIS/ SPECTROGRAMS SUPRSEGMENTALS, COARTICULATION 1 Midsagittal dissection From Kent, 1997 2 Oral Cavity 3 Oral Structures – continued • Moistened by saliva • Lined by mucosa • Saliva affected by meds 4 Tonsils • PALATINE* (laterally – seen in oral periph • LINGUAL (inf.- root of tongue) • ADENOIDS (sup.) [= pharyngeal] • Palatine, lingual tonsils are larger in children • *removed in tonsillectomy 5 Adenoid Facies • Enlargement from infection may cause problems (adenoid facies) • Can cause problems with nasal sounds or voicing • Adenoidectomy; also tonsillectomy (for palatine tonsils) 6 Adenoid faces (example) 7 Oral structures - frenulum Important component of oral periphery exam Lingual frenomy – for ankyloglossia “tongue-tie” Some doctors will snip for infants, but often will loosen by itself 8 Hard Palate Much variability in palate shape and height Very high vault 9 Teeth 10 Dentition - details Primary (deciduous, milk teeth) Secondary (permanent) n=20: n=32: ◦ 2 incisor ◦ 4 incisor ◦ 1 canine ◦ 2 canine ◦ 2 molar ◦ 4 premolar (bicuspid) Just for “fun” – baby ◦ 6 molar teeth pushing in! NOTE: x 2 for upper and lower 11 Types of malocclusion • Angle’s classification: • I, II, III • Also, individual teeth can be misaligned (e.g. labioversion) Also “Neutrocclusion/ distocclusion/mesiocclusion” 12 Dental Occlusion –continued Other terminology 13 Mandible Action • Primary movements are elevation and depression • Also…. protrusion/retraction • Lateral grinding motion 14 Muscles of Jaw Elevation Like alligators, we are much stronger at jaw elevation (closing to head) than depression 15 Jaw Muscles ELEVATORS DEPRESSORS •Temporalis ✓ •Mylohyoid ✓ •Masseter ✓ •Geniohyoid✓ •Internal (medial) Pterygoid ✓ •Anterior belly of the digastric (- Kent) •Masseter and IP part of “mandibular sling” •External (lateral) pterygoid(?)-- also protrudes and rocks side to side. -
Morfofunctional Structure of the Skull
N.L. Svintsytska V.H. Hryn Morfofunctional structure of the skull Study guide Poltava 2016 Ministry of Public Health of Ukraine Public Institution «Central Methodological Office for Higher Medical Education of MPH of Ukraine» Higher State Educational Establishment of Ukraine «Ukranian Medical Stomatological Academy» N.L. Svintsytska, V.H. Hryn Morfofunctional structure of the skull Study guide Poltava 2016 2 LBC 28.706 UDC 611.714/716 S 24 «Recommended by the Ministry of Health of Ukraine as textbook for English- speaking students of higher educational institutions of the MPH of Ukraine» (minutes of the meeting of the Commission for the organization of training and methodical literature for the persons enrolled in higher medical (pharmaceutical) educational establishments of postgraduate education MPH of Ukraine, from 02.06.2016 №2). Letter of the MPH of Ukraine of 11.07.2016 № 08.01-30/17321 Composed by: N.L. Svintsytska, Associate Professor at the Department of Human Anatomy of Higher State Educational Establishment of Ukraine «Ukrainian Medical Stomatological Academy», PhD in Medicine, Associate Professor V.H. Hryn, Associate Professor at the Department of Human Anatomy of Higher State Educational Establishment of Ukraine «Ukrainian Medical Stomatological Academy», PhD in Medicine, Associate Professor This textbook is intended for undergraduate, postgraduate students and continuing education of health care professionals in a variety of clinical disciplines (medicine, pediatrics, dentistry) as it includes the basic concepts of human anatomy of the skull in adults and newborns. Rewiewed by: O.M. Slobodian, Head of the Department of Anatomy, Topographic Anatomy and Operative Surgery of Higher State Educational Establishment of Ukraine «Bukovinian State Medical University», Doctor of Medical Sciences, Professor M.V. -
Initial Stage of Fetal Development of the Pharyngotympanic Tube Cartilage with Special Reference to Muscle Attachments to the Tube
Original Article http://dx.doi.org/10.5115/acb.2012.45.3.185 pISSN 2093-3665 eISSN 2093-3673 Initial stage of fetal development of the pharyngotympanic tube cartilage with special reference to muscle attachments to the tube Yukio Katori1, Jose Francisco Rodríguez-Vázquez2, Samuel Verdugo-López2, Gen Murakami3, Tetsuaki Kawase4,5, Toshimitsu Kobayashi5 1Division of Otorhinolaryngology, Sendai Municipal Hospital, Sendai, Japan, 2Department of Anatomy and Embryology II, Faculty of Medicine, Complutense University, Madrid, Spain, 3Division of Internal Medicine, Iwamizawa Kojin-kai Hospital, Iwamizawa, 4Laboratory of Rehabilitative Auditory Science, Tohoku University Graduate School of Biomedical Engineering, 5Department of Otolaryngology-Head and Neck Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan Abstract: Fetal development of the cartilage of the pharyngotympanic tube (PTT) is characterized by its late start. We examined semiserial histological sections of 20 human fetuses at 14-18 weeks of gestation. As controls, we also observed sections of 5 large fetuses at around 30 weeks. At and around 14 weeks, the tubal cartilage first appeared in the posterior side of the pharyngeal opening of the PTT. The levator veli palatini muscle used a mucosal fold containing the initial cartilage for its downward path to the palate. Moreover, the cartilage is a limited hard attachment for the muscle. Therefore, the PTT and its cartilage seemed to play a critical role in early development of levator veli muscle. In contrast, the cartilage developed so that it extended laterally, along a fascia-like structure that connected with the tensor tympani muscle. This muscle appeared to exert mechanical stress on the initial cartilage. -
ANATOMY of EAR Basic Ear Anatomy
ANATOMY OF EAR Basic Ear Anatomy • Expected outcomes • To understand the hearing mechanism • To be able to identify the structures of the ear Development of Ear 1. Pinna develops from 1st & 2nd Branchial arch (Hillocks of His). Starts at 6 Weeks & is complete by 20 weeks. 2. E.A.M. develops from dorsal end of 1st branchial arch starting at 6-8 weeks and is complete by 28 weeks. 3. Middle Ear development —Malleus & Incus develop between 6-8 weeks from 1st & 2nd branchial arch. Branchial arches & Development of Ear Dev. contd---- • T.M at 28 weeks from all 3 germinal layers . • Foot plate of stapes develops from otic capsule b/w 6- 8 weeks. • Inner ear develops from otic capsule starting at 5 weeks & is complete by 25 weeks. • Development of external/middle/inner ear is independent of each other. Development of ear External Ear • It consists of - Pinna and External auditory meatus. Pinna • It is made up of fibro elastic cartilage covered by skin and connected to the surrounding parts by ligaments and muscles. • Various landmarks on the pinna are helix, antihelix, lobule, tragus, concha, scaphoid fossa and triangular fossa • Pinna has two surfaces i.e. medial or cranial surface and a lateral surface . • Cymba concha lies between crus helix and crus antihelix. It is an important landmark for mastoid antrum. Anatomy of external ear • Landmarks of pinna Anatomy of external ear • Bat-Ear is the most common congenital anomaly of pinna in which antihelix has not developed and excessive conchal cartilage is present. • Corrections of Pinna defects are done at 6 years of age. -
Sphenoid Bone and Its Sinus — Anatomo-Clinical Review of the Literature Including Application to FESS
FOLIA MEDICA CRACOVIENSIA Vol. LIX, 2, 2019: 45–59 PL ISSN 0015-5616 DOI: 10.24425/fmc.2019.128453 Sphenoid bone and its sinus — anatomo-clinical review of the literature including application to FESS Joanna Jaworek-Troć1, Michał Zarzecki1, Anna Bonczar2, Lourdes N. Kaythampillai1, Bartosz Rutowicz1, Małgorzata Mazur1, Jacenty Urbaniak1, Wojciech Przybycień1, Katarzyna Piątek-Koziej1, Marcin Kuniewicz1, Marcin Lipski1, Wojciech Kowalski3, Janusz Skrzat1, Marios Loukas4, Jerzy Walocha1 1Department of Anatomy, Jagiellonian University Medical College, Kraków, Poland 2K. Gibiński’s University Center of Silesian Medical University, Katowice, Poland 3Medical Offi ces, Kraków, Poland 4Department of Anatomy, St. Georges University, Grenada, West Indies Corresponding author: Jerzy Walocha, MD, PhD Department of Anatomy, Jagiellonian University Medical College ul. Kopernika 12, 31-034 Kraków, Poland Phone: +48 12 422 95 11; E-mail: [email protected] Abstract: Authors paid attention to anatomy and clinical implications which are associated with the variations of the sphenoid sinus. We discuss also anatomical structure of the sphenoid bone implementing clinical application of this bone to diff erent invasive and miniinvasive procedures (i.e. FESS). Key words: sphenoid bone, sphenoid sinus, anatomy, computer tomography, FESS. Introduction Sphenoid sinuses are pneumatic spaces lined with mucosa, located in the body of the sphenoid bone. Th eir morphology is highly variable. Th eir variability concerns: 46 Joanna Jaworek-Troć, Michał Zarzecki, et al. • Size • Shape • Number of septa • Level of pneumatization Th ere is a lack of unequivocal pattern of the sinuses, which could have been supposed as anatomically normal. Sphenoid sinuses neighbor through their walls with important anatomical structures, both nervous and vascular — this neighbourhood and anatomical composition of the sphenoid sinuses are extremely important for the surgery in these regions. -
Functional Anatomy of the Soft Palate Applied to Wind Playing
Review Functional Anatomy of the Soft Palate Applied to Wind Playing Alison Evans, MMus, Bronwen Ackermann, PhD, and Tim Driscoll, PhD Wind players must be able to sustain high intraoral pressures in dition occurs because of a structural deformity, such as with order to play their instruments. Prolonged exposure to these high cleft palate. It is also associated with some other speech dis- pressures may lead to the performance-related disorder velopharyn- orders. VPI occurs when the soft palate fails to completely geal insufficiency (VPI). This disorder occurs when the soft palate fails to completely close the air passage between the oral and nasal close the oronasal cavity while attempting to blow air through cavities in the upper respiratory cavity during blowing tasks, this clo- the mouth, resulting in air escaping from the nose.5 Without sure being necessary for optimum performance on a wind instru- a tight air seal, the air passes into the nasal cavity and can ment. VPI is potentially career threatening. Improving music teach- then escape out the nose. This has a disastrous effect on wind ers’ and students’ knowledge of the mechanism of velopharyngeal playing, as the power behind the wind musicians’ sound closure may assist in avoiding potentially catastrophic performance- related disorders arising from dysfunction of the soft palate. In the relies on enough controlled expired air through the mouth. functional anatomy of the soft palate as applied to wind playing, Understandably, this disorder may potentially end the musi- seven muscles of the soft palate involved in the velopharyngeal clo- cian’s career.6 sure mechanism are reviewed. -
Atlas of the Facial Nerve and Related Structures
Rhoton Yoshioka Atlas of the Facial Nerve Unique Atlas Opens Window and Related Structures Into Facial Nerve Anatomy… Atlas of the Facial Nerve and Related Structures and Related Nerve Facial of the Atlas “His meticulous methods of anatomical dissection and microsurgical techniques helped transform the primitive specialty of neurosurgery into the magnificent surgical discipline that it is today.”— Nobutaka Yoshioka American Association of Neurological Surgeons. Albert L. Rhoton, Jr. Nobutaka Yoshioka, MD, PhD and Albert L. Rhoton, Jr., MD have created an anatomical atlas of astounding precision. An unparalleled teaching tool, this atlas opens a unique window into the anatomical intricacies of complex facial nerves and related structures. An internationally renowned author, educator, brain anatomist, and neurosurgeon, Dr. Rhoton is regarded by colleagues as one of the fathers of modern microscopic neurosurgery. Dr. Yoshioka, an esteemed craniofacial reconstructive surgeon in Japan, mastered this precise dissection technique while undertaking a fellowship at Dr. Rhoton’s microanatomy lab, writing in the preface that within such precision images lies potential for surgical innovation. Special Features • Exquisite color photographs, prepared from carefully dissected latex injected cadavers, reveal anatomy layer by layer with remarkable detail and clarity • An added highlight, 3-D versions of these extraordinary images, are available online in the Thieme MediaCenter • Major sections include intracranial region and skull, upper facial and midfacial region, and lower facial and posterolateral neck region Organized by region, each layered dissection elucidates specific nerves and structures with pinpoint accuracy, providing the clinician with in-depth anatomical insights. Precise clinical explanations accompany each photograph. In tandem, the images and text provide an excellent foundation for understanding the nerves and structures impacted by neurosurgical-related pathologies as well as other conditions and injuries. -
Anatomy and Physiology of the Velopharyngeal Mechanism
Anatomy and Physiology of the Velopharyngeal Mechanism Jamie L. Perry, Ph.D.1 ABSTRACT Understanding the normal anatomy and physiology of the velopharyngeal mechanism is the first step in providing appropriate diagnosis and treatment for children born with cleft lip and palate. The velopharyngeal mechanism consists of a muscular valve that extends from the posterior surface of the hard palate (roof of mouth) to the posterior pharyngeal wall and includes the velum (soft palate), lateral pharyngeal walls (sides of the throat), and the posterior pharyngeal wall (back wall of the throat). The function of the velopharyngeal mechanism is to create a tight seal between the velum and pharyngeal walls to separate the oral and nasal cavities for various purposes, including speech. Velopharyngeal closure is accomplished through the contraction of several velopharyngeal muscles including the levator veli palatini, musculus uvulae, superior pharyngeal con- strictor, palatopharyngeus, palatoglossus, and salpingopharyngeus. The tensor veli palatini is thought to be responsible for eustachian tube function. KEYWORDS: Anatomy, physiology, velopharyngeal muscles, cleft palate anatomy Downloaded by: SASLHA. Copyrighted material. Learning Outcomes: As a result of this activity, the reader will be able to (1) list the major muscles of the velopharyngeal mechanism and discuss their functions; (2) list the sensory and motor innervation patterns for the muscles of the velopharyngeal mechanism; and (3) discuss the variations in velopharyngeal anatomy found in an unrepaired cleft palate. Understanding the normal anatomy and and treatment for children born with cleft lip physiology of the velopharyngeal mechanism is and palate. Most of the diagnostic and therapy the first step in providing appropriate diagnosis approaches are based on a strong foundation of 1Department of Communication Sciences and Disorders, Guest Editor, Ann W. -
Soft Palate and Its Motor Innervation: a Brief Review
Review Article Anatomy Physiol Biochem Int J Volume 5 Issue 4 - April 2019 Copyright © All rights are reserved by Liancai Mu DOI: 10.19080/APBIJ.2019.05.555672 Soft Palate and Its Motor Innervation: A Brief Review Liancai Mu1*, Jingming Chen1, Jing Li1, Stanislaw Sobotka1,2 and Mary Fowkes3 1Department of Biomedical Research, Upper Airway Research Laboratory, Hackensack University Medical Center, USA 2Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, USA 3Department of Pathology, Icahn School of Medicine at Mount Sinai, USA Submission: March 29, 2019; Published: April 18, 2019 *Corresponding author: Liancai Mu, MD, Ph.D, Upper Airway Research Laboratory, Department of Biomedical Research, Hackensack University Medical Center, 40 Prospect Avenue, Hackensack, NJ, 07601, USA Abstract Human soft palate plays an important role in upper airway functions such as speech, swallowing and respiration. However, neural control of the soft palate is poorly understood because innervation of this structure has long been controversial. In this review, the inconsistent and even contradictory observations regarding the motor innervation of the palatal muscles are summarized. We emphasize to use Sihler’s stain for documenting the nerves and their supply patterns within individual palatal muscles as studies have demonstrated that Sihler’s stain permits mapping of entire nerve supply within organs, skeletal muscles, mucosa, skin, and other structures. This wholemount nerve staining has unique advantage over other anatomical methods as all the nerves within the muscles processed with Sihler’s stain can be visualized in their 3-dimensional positions. Advanced knowledge of the neural organization of the soft palate is critical for a better understanding of its functions and for the development of novel neuromodulation therapies to treat soft palate-related upper airway disorders such as obstructive sleep apnea. -
Chapter 11 Axial Musculature
LECTURE OUTLINE CHAPTER 11 Marieb The Muscular System: Axial Musculature Lecture Outline I. Muscles of Head and Neck A. Facial expression 1. mouth a. buccinator - compresses cheeks, sucking muscle b. depressor labii inferioris - depresses lower lip c. levator labii superioris - lifts upper lip d. mentalis - lifts and protrudes lower lip e. orbicularis oris - closes mouth (the “kissing” muscle) f. risorius - pulls corners of mouth laterally g. depressor anguli oris - depresses corners of mouth h. zygomaticus major and minor - elevates corner of mouth 2. eye a. orbicularis oculi - encircles and closes the eye b. corrugator supercilii - wrinkles brow c. levator palpebrae superioris - lifts upper eyelid 3. scalp a. frontalis - tightens scalp b. occipitalis - tightens scalp 4. neck a. platysma - opens mouth, expresses horror 5. nose a. procerus - changes shape of nostrils b. nasalis - depresses tip of nose, elevates corners of nostrils 6. ear a. temporoparietalis - moves pinna of ear B. Muscles of mastication 1. masseter - elevates mandible 2. temporalis - elevates mandible 3. medial pterygoid - elevates and moves mandible side to side 4. lateral pterygoid - protrudes and moves mandible side to side, opens jaws C. Extrinsic eye muscles 1. superior rectus - rotates eye upward 2. inferior rectus - rotates eye downward 3. lateral rectus - rotates eye laterally 4. medial rectus - rotates eye inward 5. superior oblique - rotates eye laterally and downward 6. inferior oblique - rotates eye laterally and upward D. Muscles of the tongue----all have -glossus 1. genioglossus - depresses and protracts tongue 2. hyoglossus - depresses and retracts tongue 3. palatoglossus - elevates tongue, depresses soft palate 4. styloglossus - retracts tongue, elevates sides of tongue E. -
Palate, Tonsil, Pharyngeal Wall & Mouth and Tongue
Mouth and Tongue 口腔 與 舌頭 解剖學科 馮琮涵 副教授 分機 3250 E-mail: [email protected] Outline: • Skeletal framework of oral cavity • The floor (muscles) of oral cavity • The structure and muscles of tongue • The blood vessels and nerves of tongue • Position, openings and nerve innervation of salivary glands • The structure of soft and hard palates Skeletal framework of oral cavity • Maxilla • Palatine bone • Sphenoid bone • Temporal bone • Mandible • Hyoid bone Oral Region Oral cavity – oral vestibule and oral cavity proper The lips – covered by skin, orbicularis muscle & mucous membrane four parts: cutaneous zone, vermilion border, transitional zone and mucosal zone blood supply: sup. & inf. labial arteries – branches of facial artery sensory nerves: infraorbital nerve (CN V2) and mental nerve (CN V3) lymph: submandibular and submental lymph nodes The cheeks – the same structure as the lips buccal fatpad, buccinator muscle, buccal glands parotid duct – opening opposite the crown of the 2nd maxillary molar tooth The gingivae (gums) – fibrous tissue covered with mucous membrane alveolar mucosa (loose gingiva) & gingiva proper (attached gingiva) The floor of oral cavity • Mylohyoid muscle Nerve: nerve to mylohyoid (branch of inferior alveolar nerve) from mandibular nerve (CN V3) • Geniohyoid muscle Nerve: hypoglossal nerve (nerve fiber from cervical nerve; C1) The Tongue (highly mobile muscular organ) Gross features of the tongue Sulcus terminalis – foramen cecum Oral part (anterior 2/3) Pharyngeal part (posterior 1/3) Lingual frenulum, Sublingual caruncle