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Date posted: October 23, 2011

Mesencephalon is Mid brain. Rhombencephalon is Hind brain.
Metencephalon is Pons.
Myelencephalon is Medulla oblongata.
Brainstem mean Mid brain, pons, medulla.
Sulcus mean surface depression.
Gyrus means surface elevation.
Cortex Grey matter cover surface of cerebral and cerebellar hemispheres.
Rhomboid fossa is floor of 4th ventricle.
Calamus scriptorius is caudal end of rhomboid fossa (resembles nib of a pen).
Locus ceruleus is bluish grey area in floor of 4th ventricle.
Restiform body is large lateral component of inferior cerebellar peduncle.
Juxtarestiform body is small medial component of Inferior cerebellar peduncle.
Brain and spinal cord are enclosed in meninges dura, arachnoid and pia.

  • Cranial dura has two layers, an outer endosteal and an inner meningeal layers.
  • Spinal dura is continuation of meningeal layer.
  • CSF is formed either by secretion or ultrafiltration from choroid plexus.
  • Blood vessels of brain run in subarachnoid space.
  1. Medualla oblongata continues as spinal cord at the upper border of atlas.
  2. Filum terminale is a connective tissue filament extending from conus medullaris to the 1st coccygeal segment, Initial 15 cm of
  3. this is filum terminale internum and extends upto 2nd sacral vertebral where dura and arachnoid meninges stop.
  4. Last 5 cm is filum terminale externum, contains only pial extension and terminates at 1 st coccygeal segment.
  5. Cervical enlargment of spinal cord corresponds to C3 to T2 spinal segments; lumbar enlargment corresponds to L1 to S3 spinal segments.
  6. In spinal cord, grey matter is inside and presents anterior and posterior horns; white matter is outside and is divided into posterior, lateral and anterior funiculi by emerging dorsal and ventral roQts of spinal nerves.
  7. Grey matter is traversed by Central canal and white matter has ascending and descending tracts.
  8. Posterior funiculus has fasciculus gracillis and cuneatus.
  9. Anterior 2/3 of cross sectional area of Spinal cord is supplied by branches of anterior spinal arterior and the rest by posterior spinal artery and pial plexus.
  10. Cervical 8, Thoracic 12, Lumbar 5, Sacral 5, coccygeal 1.
  11. Basal ganglia include caudate nucleus and lentiform nculeus.
  12. Corpus striatum includes caudate nucleus and lentiform nucleus.
  13. Putamen and globus pallidus are subdivisions of lentiform nucleus.
  14. Paleo striatum is globus pallidus.
  15. Corpus callosum is a great cerebral commissure.
  16. Ventricles are cavities lined with ependyma and contain CSF.
  17. Illrd ventricle and IVth ventricle communicate with each othr through cerebral aqueduct.
  18. IVth ventricle has a floor (Rhomboid fossa) and a roof.
  19. Sacral outflow is from SI, S2, S3 spinal segments.
  20. Retrolentiform and sublentiform, parts of internal capsule have optic and auditory radiations respectively.
  21. Basal vein is formed by union of deep middle cerebral vein, anterior cerebral vein, and striate veins. It opens into great cerebral vein.
  22. Choroidal vein and thalamostriate vein unite and form internal cerebral veins.
  23. Great cerebral vein is formed by the union of two internal cerebral veins
  24. Sciatic nerve is a branch of sacral plexus – its tibial component is L4, L5,, S1, S2 and common peroneal component is L4, S1.S2.
  25. Main role of menisci of knee joint is in — Rotation.
  26. Main dorsiflexor of foot is — Tibialis anterior.
  27. Highest point of medial longitudinal arch of foot is at — Head of talus.
  28. Most important ligament in maintainance of medial longitudinal arch is — Spring ligament.
  29. Abductor compartment of thigh is represented in upper limb by —Nervus hesitans.
  30. Nerve involved in Meralgia paraesthetica is —Lateral cutaneous nerve of thigh (L2,3).
  31. Blood supply toS.A.node of heart is derived from —Right coronary artery.
  32. Cusps of Semilunar valve of Aorta are —One anterior and two posterior.
  33. Cusps of semilunar valve of Pulmonary trunk are — one posterior and two anterior.
  34. Cusps of tricuspid valve are —Septal, Anterior, Posterior.
  35. Papillary muscles of right ventricle are —Septal, Anterior, Posterior.
  36. Circumflex branch of left coronary artery supplies mainly —Left atrium.
  37. Apex of heart is situated at —Left fifth intercostal space.
  38. Chief muscle of inspiration is —Diaphragm.
  39. Motor nerve of diaphragm is from —Phrenic nerve (C3,4,5)
  40. Bronchopulmonary segment is not a bronchovascular segment because —It has not got its own vein lies in intersegmei plane.
  41. Thinnest wall of all the four -chamber of heart is of —Right atrium.
  42. Bundles ofKentare (cause of W.P.W. syndrome)—Abnormal muscle bridges between atria and ventricle.
  43. Duration of cardiac cycle — is 0.8 second.
  44. Early functional closure of foramen ovale is mainly due to — Pressure difference.
  45. Initial closure of ductus arteriorus is mainly due to — Muscular contraction (Mediated by bradykinin).
  46. Anterior vagal trunk at oesophageal hiatus is formed by — Left vagus.
  47. Posterior vagal trunk at oesophageal hiatus is formed by — Right vagus.
  48. Tricuspid orifice of heart is located at — Right fifth Interocostal space.
  49. Action of vagus nerve on heart is — Inhibitory.
  50. Action of vagus on gut is — Facilitatory.
  51. Angle of Louis (Sternal angle) is located at — Articulation of second rib.
  52. Ligamentum arteriosus is present in between — Left pulmonary artery and arch of aorta.
  53. Inferior venacava enters right atrium at the level of — Sixth chondro-sternal joint.
  54. Trachea bifurcates at the level of —Lower border of Fourth thoracic vertebra (in cadaver).
  55. Level of beginning of arch of aorta is —T4-Vertebra.
  56. Level of thoracic aorta piercing diaphragm is —T12 – Vetebra.
  57. Level of of Oesophagus passing through diaphragm is —T10.
  58. Azygous vein crosses to opposite side at the level of —T4
  59. Level of inferior venacava piercing diaphragms is —T8.
  60. Level of transpyloric plane is at —LI.
  61. Coeliac artery arises from abdominal aorta at the level of —T12.
  62. Superior venacava develops from — Right common cardinal vein, Right anterior cardinal vein.
  63. Coronary sinus develops from — Left horn of sinus venosus, Left common cardinal vein.
  64. Left umblical vein ends into —Left branch of portal vein.
  65. Muscles of back get motor innervation from —Dorsal primary rami.
  66. Contents of lieno-renal ligament are —Splenic artery and tail of pancreas.
  67. Space of Disse is — a space between hepatocytes and hepatic sinusoids

Erb’s Paralysis …Forcible widening of the angle between the head and the shoulder, upper trunk at Erb’s point sustains injury resulting in Erb’s paralysis. This leads to Porter tip deformity.

Klumpke’s paralysis….Hyperabduction of arm results in damage to C8 Tl and sometimes Cl roots. Paralysis affects intrinsic muscles of hand and flexors of wrist and fingers.

Injury to roots…. (Tearing away of 1st thoracic root) associated with cervical sympathetic paralysis—Horner’s syndrome. This is characterized by constriction of pupil, ptosis, apparent enophthalmos, anhidrosis on affected side of face and netk.

Crutch paralysis….Radial nerve is damaged due to pressure of crutch on radial nerve.

Sleep paralysis….Median and radial nerves suffer due to pressure effet while the patient is asleep under the influence < alcohol.

Winging of scapula ….Due to paralysis of long thoracic nerve common in people carrying heavy weights on shoulder for the nerve is exposed to injury in posterior triangle, (porter’s paralysis).

Ape hand is due to median nerve injury proximal to origin of its muscular and anterior interosseous branches.

Pointing index finger …lesion produced due to injury of median nerve just above the middle of forearm. There is on| weakness in flexion of index finger as the nerve to that part of flexor digitorum superficialis is given at about the middle forearm.

Carpal tunnel syndrome is due to pressure on median nerve in carpal tunnel.

Ulnar claw hand is due to injury to ulnar nerve….Mild degree of clawing observed which leads to extension of 1 st phalanges of 4th & 5th fingers and flexion of 2nd and 3rd phalanges.     .

True claw hand… a combined ulnar and median nerve lesions at elbow causes ‘true claw hand’.

  • Clitoris develops from —Genital tubercle.
  • Portal vein develops from —Vitelline veins.
  • Falciform ligament is derived from —Ventral mesogastrium.
  • Macula Densa is related to —Distal tubule of kidney.
  • Safety muscle of Tongue— Genioglossus.
  • The structure lodged in Meckel’s cave is —Trigeminal ganglion.
  • Thyroid gland is attached to cartilages of larynx by —Pretracheal fascia.
  • Middle meningeal artery is a branch of—Maxillary artery.
  • Adam Kiewicz artery supplies — Spinal cord.
  • Enteric reflexes causing segmental and pendular movement of gut may be explained by — Bayliss-Starling law of gut.
  • Most common site of diverticulosis coli is—Sigmoid colon.
  • Left colic artery is a branch of —-Inferior mesenteric artery.
  • Uvula vesicae is produced by —Median lobe of prostate.
  • Floor of retropubic space is formed by —Puboprostatic ligament.
  • Fascia of Denon viller is present between —Rectum and Prostate.
  • Number of rectal valve is —Three.
  • Hilton’s line is — Ano-cutaenous junction.
  • Tngone of urinary bladder develops from —Mesonephric duct.
  • Artery to vas deferens is a branch of —Inferior vesical artery.
  • Anteversion’ of uterus is the angle between long axis of—Cervix and vagina (90 degree).
  • Anteversion on’ of uterus is the angle between long axis of—Cervix and body of uterus (120 degree).
  • Anti ‘Rape’ muscle is —Gracillis.
  • Falx cerebelli separates the two lobes of cerebellum.
  • Tentorium cerebelli separates occipital lobes and cerebellum.
  • Central sulcus (Fissure of Rolando) extends in a coronal plane and divides frontal lobe from parietal lobe.
  • Calcarine fissure is present only in medial aspect and bisects occipital lobe in a transverse plane.
  • Left cerebral hemisphere in most persons is concerned with verbal, calculating and analytic thinking as well as interpretation speech, stereognosis and motor function of right hand.
  • Right cerebral hemisphere in most persons is concerned with Nonverbal, spatial, temporal and synthetic function, appreciation, art and music and motor function of left hand.
  • Frontal  lobe is mainly concerned with Motor, speech,cognition,Highest levels of affective behaviour.
  • Parietal lobe is mainly concerned with somatosensory processing, so damage to specific locations correlates with paraesthesia at opposite side of body.
  • Occipital loije is mainly concerned with visual sensation, so lesions to occipital cortex leads to contralateral homonymous anopia. Lesion to visual association areas leads to alexia or visual agnosia.

Temporal lobe is mainly concerned with memory, audition,

Limbic lobe is concerned with olfaction, emotions, behavioral activity.

Thalamus  serves as a major synaptic relay station.

  • Damage to subthalamic nuclei leads to Ballismus.
  • Damage to substantia nigra leads to Parkinsonism (Paralysis agitans), due to reduced dopamine production.
  • Trigeminal nerve emerges from pons laterally and abducens nerve emerges anteriorly at pontomedullary junction.
  • About 20 olfactory nerves pass from nasal mucosa to olfactory bulbs via cribriform plate, so they are a important source)
    • Meningitis.
    • Mitral cells is the second order neuron of first Cr. Nerve.
    • Optic nerve is actually a tract of brain, carrying meningeal sheaths complete with durameter, arachnoidmater, subarachno
    • space and piamater. So intracranial pressure of C.S.F. is directly reflected in subarachnoid space of optic nerve. High intracranial pressure causes papilloedema (Oedema at optic disc).
    • True equivalent of optic nerves are represented in retina by Bipolar cells.
    • Edinger-Westphal nucleus gives rise to parasympathetic component of oculomotor nerve.
    • This nucleus supplies ciliary muscles and sphincter of pupil via ciliary ganglia.
    • Largest of cranial nerves is trigeminal
    • Mesencephalic Nucleus of trigeminal receives fibers carrying proprioception i.e. Jaw Jerk reflex.
    • Most striking disorder of Trigeminal nerve fucntion is Tic douloureux.
    • Nervus intermedius of Wrisberg is small sensory component of facial N.
    • Represents nerve of the 4th and 6th branchial arches.
    • Torticollis is the spasm of sternomastoid and trapezius due to irritation of the Xlth Cr. nerve.
    • Blood supply of brain occurs by two vertebral arteries and two internal carotid arteries.

Branches of Internal carotid artery are :

  • Ophthalmic artery
  • Posterior communicating artery
  • Anterior cerebral artery
  • Middle cerebral artery.

Branches of Vertebral Arteries are :

  • Posterior inferior cerebellar artery
  • Anterior spinal artery
  • Basilar artery

Branches of Basilar Artery are :

  • Anterior – inferior cerebellar arteries.
  • Pontine arteries
  • Superior cerebellar arteries
  • Posterior cerebellar arteries.
  • Oculomotor Nerve emerges between posterior cerebral and superior cerebellar artery.
  • Circle of Willis which is formed by branches of Internal carotid and Basilar artery. It is complete in 90 % individuals and I
  • circle is an important site ofBerryaneurysm.
  • Anterior spinal artery is one in number, whereas posterior spinal arteries are two in number
  • Anterior spinal artery arises from Vertebral artery.
  • Posterior spinal arteries arise from Posterior inferior cerebellar artery.
  • The Dorsal root of spinal nerve contains only sensory fibres
  • The ventral root of spinal nerve contains only motor fibres.
  • The cervical roots (Except C6) exit from neural foramina above their respective vertebral bodies, while thoracic and lumbar oots exit below each body.
  • Waldeyer’s ring is a ring of lymphoid tissue around pharynx. This ring is formed by pharyngeal, tubal, palatine and lir
  • tonsils.
  • First arch is called Mandibular arch.
  • Second arch is called Hyoid arch.
  1. Artery of first branchial arch is Maxillary artery.
  2. Cartilage of first arch is called Meckel’s cartilage.
  3. Nerve of second branchial arch is Facial N.
  4. Artery of Second arch is Stapedial artery.
  5. Nerve of third branchial arch is glossopharyngeal N.
  6. Muscle derived from third arch is stylopharyngeus muscle.
  7. Cartilage of third arch forms greater cornu of hyoid and inferior part of body of hyoid bone.
  8. Nerve of fourth arch is superior laryngeal nerve and nerve of sixth arch is recurrent laryngeal nerve.
  9. Mdian (Pterigoid) canal transmits Vidian N. (Formed by Greater superficial petrosal nerve and deep petrosal nerve).
  10. Optic canal transmits optic nerve, ophthalmic artery and central vein of retina.
  11. Superior orbital fissure transmits Illrd, IVth, ophthalmic division of Vth and Vlth cranial N.   and ophthalmic vein.
  12. Inferior orbital fissure transmits Infraorbital branch of maxillary division of trigeminal nerve.
  13. Internal auditory meatus transmits Vlth and VHIth cranial N.
  14. Right common carotid artery arises from Branchiocephalic artery.
  15. Tenon’s capsule is a connective tissue socket in which eyeball is suspended.
  16. Cornea is the main refractor of eye.
  17. Sphincter pupillae consists of myoepithelial cells arranged in a circle around pupil. It is under parasympathetic control.
  18. Dilator pupillae consists of myoepithelial cells arranged in a radial. It is under sympathetic control.
  19. Aqueous humor is secreted by ciliary process into posterior chamber.
  20. Aqueous humor is formed by ultrafiltration (25%) and active ciliary secretory process (75%)
  21. Aqueous humor passes through pupil into anterior chamber and then through Schlemm’s canal drains into venous system.
  22. Retina is derived from optic vesicle, an evagination of brain.
  23. Circulus Iridis major is situated in root of iris.
  24. Retinal arteries are the only arteries, which can be directly examined for systemic diseases,
  25. Anterior chamber of eyeball is situated between cornea and iris.
  26. Posterior chamber is situated between iris and lens.
  27. External auditory meatus has 2 parts. Outer one third is cartilaginous and inner two third is bony.
  28. Axilla is a pyramidal space containing cords & branches of brachial plexus, axillary vessels, lymph nodes & fat.
  29. Apex of axilla is bounded by 1 st rib, clavicle and scapula.
  30. Anterior axillary fold is formed by pectoralis major.
  31. Posterior axillary fold is formed by teres major and latissimus dorsi.
  32. Mammary gland is located in superficial fascia. It extends from 2nd to 6th ribs; from parasternal region to midaxillary line at  4 th costal cartilage level.
  33. Structures passing through Quadrangular space are axillary nerve and posterior circumflex humeral vessels.
  34. Nerve of flexor compatment is musculo cutaneous nerve (C5,C6,C7) and extensor compartment is radial nerve (C5,C6,C7,C8,T1).
  35. Anatomical snuff box is the space present on lateral aspect ofwrist and is bounded by abductor pollicis longus and extensor pollicis brevis laterally (anteriorly) and extensor pollicis longus medially (Posteriorly).
  36. Axillary nerve passes through quadrangular space curving around the surgical neck of humerus.
  37. Radial nerve in the spiral groove is covered posteriorly by lateral head of triceps brachii muscle.
  38. Radial bursa is the synovial sheath covering flexor pollicis longus and extends upto its insertion.
  39. Myelin of peripheral nerves is produced by “Schwann cells” and of central nervous system is by oligodendrocytes.
  40. Spinal nucleus of trigeminal nerve is in continuation below with substantia gelatinosa of Rolando.
  41. Facial colliculus is an elevation in the floor of IVth ventricle produced by the fibres of facial nerve as they are turning round the nucleus of abducent nerve.
  42. Temporal lobe is closely associated with memory (short term memory).
  43. Cerebellum is connected to medulla by inferior; to pons by middle; and to mid brain by suprior cerebellar peduncles.
  44. The trigeminal is the only nerve having primary sensory neurons within the brainstem-(Mesencephalic nucleus of trigeminal nerve in mid brain).
  45. Eye of the hand—median nerve as it is sensory to the most part of the palm of hand.
  46. Lumbar puncture can be done to obtain CSF by passing a needle between laminae or spines of L3 & L4 vertebrae as the spinal cord ends at the lower border of LI or upper border of L2 vertebra.
  47. Cerebello medullary cistern is selected for cisternal puncture.
  48. Usually cerebral haemorrhage is due to rupture of Charcot’s artery (one of lateral striate branch of middle cerebral artery).
  49. Macular area in occupital lobe is supplied by both middle and posterior cerebral arteries. In states of blockage of middle cerebral artery, posterior cerebral artery takes over the supply thus “Sparing the macular area”.
  50. Rupture of middle meningeal artery leads to extradural haematoma.
  51. Rupture of cerebral veins leads to subdural haemotoma.
  52. Subarachnoid space is continuous along the optic nerve as far as lamina cribrosa. Increased intracranial tension due to excess of fluid in the space produces papilloedema.
  53. Lateral geniculate body is concerned with —Light reflex.
  54. Medial geniculate body is concerned with —auditory pathway.
  55. Arch of aorta develops from —Left sided fourth arch artery.
  56. Pulmonary artery develops from — sixth arch artery.
  57. Artery of first branchial arch is —Stapedial artery.
  58. The nerve piercing supinator muscle is — Posterior interosseus nerve.
  59. Space of Kanavel is — Mid palmar space.
  60. Ligament of Struther represents — Third head of coracobrinchialis.
  61. Basilic vein pierces deep fascia at the level of — Insertion of Coracobrachialis.
  62. ‘Holden’s line is — The line along which the membranous layer of superficial fascia is attached to deep fascia of thigh.
  63. Nerve winding around the neck of fibula is — Common peroneal N.
  64. Main extensor of thigh is — Gluteus maximus.
  65. Most powerful ligament of hip joint is —L3 – L4.
  66. Narrowest part of oesophagus is at cricopharynx.
  67. Sphincter at lower end of oesophagus is physiological.
  68. Main blood supply of oesophagus:
  69. Upper third—from inferior thyroid artery
  70. Middle third—Aorta.
  71. lower third—Left gastric artery.
  72. Pyloric sphincter—It continues in duodenum at pyloroduodenal junction, which is demarcated externally by ‘Bloodless white line’. This line is the distal extend of congenital hypertrophic pyloric stenosis.
  73. Bare area of stomach is a small area at its posterior surface near cardia.
  74. Anastomoses between gastric and duodenal arteries are scanty, giving rise to a ‘white line’ at pyloroduodenal junction.
  75. Ligament of Treitz is a surgical landmark of duodenojejunal flexure. It extends from duodenojejunal flexure to right cms of diaphragm.
  76. Radiographically, jejunum is characterised by its valvulae conniventes, which are spaced regularly, giving rise to a concertina effect.
  77. Radiographically, ileum is recognised as characterless part, lying mainly in hypogastrium. An individual can lead a normal life even after resection of upto one third of small gut. An individual can survive even with one and half feet of small gut. Main function of colon is conservation of fluid, shortest part of colon is ascending colon.
  78. Appendicular artery arises from ileocolic artery, whereas the accessary appendicular artery (if present) arises from posterior caecal artery.
  79. Most common position on appendix is retrocaecal (65-70% cases).
  80. Because the appendix develops from midgut; which is innervated by lesser splanchnic nerve (T10-T11), initial colicky pain visceral pain) is referred to periumbilical region (T10-T11)

Most common age group for appendicitis is teenagers and young adults, because at this age the lumen of appendix is very narrow.

Ampulla is the widest portion of rectum, lying just above the pelvic floor. It is usually empty because faeces are stored in sigmoid colon.

The cardinal features of large gut (i.e taeniae, appendices epiploicae and sacculations) are absent in rectum.Houston’s valves are semicircular rectal folds present at inner wall of rectum. They are three in number. because of mesenteric attachment, liver moves with diaphragm during respiration.

Anatomically right and left lobe are separated by a line passing along falciform ligament. The  line of division of surgical lobes passes from gall bladder fossa to inferior venacava. Liver has been divided into eight segments, which has got importance in segementectomy of liver, jixamural portion in the narrowest portion of CBD.

Mucosal fold in cystic duct is called ‘Valves of Heister’, which maintains the patency of cystic duct. G3 can undergo distension upto 50 times.

Posteromedial wall of neck of Gall bladder is dilated, and is known as Hartmann’s pouch.

Calot’s triangle is formed by common hepatic duct on the left, liver above and cystic duct on the right side. In 90% cases, 3 sac artery lies in Calot’s triangle. Failure of complete rotation of ventral bud leads to annular pancreas.

Portal vein is formed by union of superior mesenteric vein and splenic vein behind the neck of pancreas at the level of L2 vertebra.

  • Portal venous system is valveless.
  • Horeshoe Kidney is produced due to fusion of Lower Poles of Kidney (Usually). Ureters pass Anterior to the isthmus (
  • Kidney.
  • Left Kidney is ectopic more commonly than right.
  • The epithelium of bladder is thus endodermal in origin, except that of trigone, which is mesodermal.
  • Pain sensation of bladder is carried mainly by parasympathetic nerves.
  • Numerous prostatic ducts open on posterior wall of prostatic Urethra on either side of Urethral crest (Crista Urethralis).
  • Verumontanum is the widest portion of Urethral crest.
  • Microscopically, adrenal cortex has three parts (G.F.R)
  • Zona Glomerulosa — Outer zone, secretes Aldosterone
  • Zona fasciculata — Middle zone
  • Zona Reticularis — Inner zone, secretes Sex hormones.
  • Adrenal medulla is composed of chromaffin cells, which secrete noradrenaline and adrenaline.
  • Arterial supply of adrenals is from three arteries :
  • Superior suprarenal artery —Arises from inferior phrenic artery.
  • Middle suprarenal artery—Arises from abdominal aorta.
  • Inferior suprarenal artery—Arises from renal artery.
  • Right suprarenal vein drains into inferior venacava.
  • Left suprarenal vein drains into left renal vein
  • Ectopic adrenal tissue consists of both medulla and cortex.
  • Main structure is anal triangle is anal canal and anus.
  • Buck’s fascia is the deep fascia of penis which surrounds all three corpus, but does not extend into glans.
  • Prostate gland has two parts. Outer zone is called Prostatic Gland Proper which is the site of Carcinoma. Inner
  • occupied by Submucosal Glands and this zone is called Adenomatous zone (site for benign enlargement).
  • An enlarged Prostate is covered by three capsule :
  • Prostatic sheath of pelvic fascia—Outer most.
  • True capsule : Also called surgical capsule. It is the Compressed outer Zone of prostate gland itself.
  • Ovarian Ligament is attached between the medial pole of ovary and Uterine cornu.
  • Corpus albicantes is the scar of regressed corpus luteum.
  • Right ovarian vein drains into inferior venacava, whereas left ovarian vein drains into left renal vein. •
  • Urinary bladder is an important support of anteverted and anteflexed uterus.
  • Important ligamentous supports of uterus are Cardinal Ligament, Pubocervical ligament and Uterosacral ligament.
  • Mackenrodt’s ligament (Cardinal ligament or Transverse cervical ligament) are the principal support in retroverted ut
  • Fertilized ovum is usually implanted in posterior wall of fundus.
  • Vaginal fluid is acidic (four in taste), due to fermentation of glycogen by Doderlein’s bacilli in vaginal cells.
  • Lower Third of vagina is pain sensitive, whereas upper two third is pain insensitive.
  • In Uterus Duplex, there are two uteri but single vagina.
  • In Didelphis, there are two uteri and two vagina.
  • In Bicornuate Uterus, Uterus has a partition in its upper part.

Umbilicus corresponds to T10 spinal segment. Deep fascia is absent over  anterior abdominal wall.

Space between the external oblique aponeurosis and membranous layer of superficial fascia near inguinal region is called “superficial inguinal pouch”.

Inguinal ligament is the folded lower border of external oblique aponeurosis.

Reflected part of inguinal ligament and pectinate ligament are other extensions of inguinal ligament.

Superficial inguinal ring is an opening in the external oblique aponeurosis located just above and lateral to crest of pubis.

Deep inguinal ring is a gap in transversalis fascia present about 1.25 cm above mid inguinal point.

Space between hip bone and inguinal ligament is pelvifemoral space. Through this vessels, nerves and two muscles pass from abdomen to thigh.

Inguinal canal is a musculo aponeurotic tunnel extending from deep inguinal ring to superficial inguinal ring. It is about 4 cm long.

Rectus sheath : An aponeurotic sheath which envelopes the rectus abdominis muscle. It prevents bow stringing of the muscle.

Nerve supply of anterior abdominal wall :

From xiphisternum to umbilicus   —       T7, T8, T9

Umbilicus           —        T|{)

From Umbilicus to symphysis       —       T,,, T,2&L,

  • Vas deferens has a length of 45 cm: It is continuation of duct of epididymis.
  • Lesser sac communicates with greater sac through epiploic foramen.
  • Stomach is a muscular organ with cardiac and pyloric orifices and greater and lesser curvatures.
  • Duodenum: has 1st (ascending) 2nd (descending) 3rd (horizontal) and 4th parts, describing a ‘C shaped curve.
  • Vasa recta of jenunum are long and of ileum are short.
  • Payer’s patches are present in ileum along the anti-mesentric border.
  • Meckel’s diverticulum is an embryological remnant of vitellointestinal duct present in 2% of individuals 2′ proximal toileocaecal junction and 2″ in length.
  • Speculations are present in large intestine as the longitudinal muscle coat is in 3 longitudinal bands, called taeniae coli (1.2 mtlong).
  • Appendix has  :Length — 9 cm. Position — common position is retrocaecal retrocolic.
  • Pre or post ileal positions of appendix (come under splenic or 2 ‘O clock position as perTrevesclassification). Base of appendix is located at Mc Burney’s point. Enlargement of these veins give rise to internal haemorrhoids.
  • Anal valves are the mucous folds present at lower ends of anal columns. They join the lower ends of columns.
  • White line of Hilton is a wavy line situated where transitional zone ends below. It is at the level of interval between the subcutaenous part of external sphincter and lower border of internal sphincter
  • Bare area of liver is triangular area bounded by superior and inferior layer of coronary ligament base by groove for inferior venacava. It is a site of portocaval anastomosis.
  • Anatomical lobes of liver—Right and left lobes; right lobe includes quadrate and caudate lobes. Division is by attachment of falciform fold, fissure for ligamentum teres and fissure for ligamentum venosum. Pancreas is retroperitoneal organ. Male Urethra has total length 18 to 20 cm.
  • Prostatic part of male urethra 3 cm long—widest and most dilatable part.
  • Prostate is a fibromusculo glandular organ and it has 5 lobes viz anterior, posterior, two lateral and median lobes.
  • Ovarian fossa is founded anteriorly by obliterated umbilical artery, posteriorly ureer and intenal iliac artery. Superficial vessels, nerves and lymphatics of anterior abdominal wall lie in between the two layers of superficial fascia. Sensory component for cremasterjc reflex .
  • Ilioinguinal nerve (LI) and motor component genito femoral (LI,2) which supplies cremasteric muscle
  • Gastric canal is a radiological entity extending from cardiac orifice to angular incisure.
  • Nerve of Laterjet is the continuation of anterior vagus nerve ia the lesser omentum 10 to 15 mm away from lesser curvature
  • This is responsible for acid secretion.
  • In foetus, cervix is larger than body of uterus.
  • Pancreas is retroperitoneal organ.
  • Greater, lesser and least splanchnic nerves are branches of thoracic part of sympathetic chain.
  • Urachus is remnant of allantois.
  • Defective arterio-venous anastomosis in the gastro duodenal mucosa may lead to mucosal ischemia and ulceration.
  • Sphincter vesicae is supplied by S2, S3 and S4 (Parasympathetic) nerves.
  • Interval between external oblique aponeurosis and deep layer of superficial fascia is “superficial inguinal pouch”. It is often occupied by testis in children (in retracted state).
  • Superficial perineal pouch is open and deep perineal pouch is closed.
  • Transverse perineal ligament is thickened ventral part of perineal membrane.
  • Temperature of scrotal sac is 3°C lower than the temperature of abdominal cavity. This is probably stabilized by counter current heat exchange mechanism between testicular artery and pampiniform plexus of veins.
  • Peritoneal fluid is instantly absorbed into subperitoneal lymphatic capillaries near the diaphragm.
  • Fascia covering under surface of diaphragm extends through its oesophageal opening and penetrates into submucosa of oesophgus as “phreno oesophageal ligament”.
  • Factor holding the duodenojejunal flexure is “ligament of Treitz”.
  • Tonic contraction of physiological gastro-oesophageal sphincter prevents the regurgitation of stomach contents into the oesophgus.
  • Duodenojejunal flexure is separated from stomach by greater omentum and transverse mesocolon.
  • “Payer’s patches” of ileum lie along its antimesenteic border.
  • Muscle coat in some parts of wall of appendix may be absent. In these areas mucous membrane of appendix and peritoneinj are in contact with each other. In such case infection when present in mucous coat may spread to the peritoneum.
  • Suprarenals and kidneys are enclosed in renal fascia. However suprarenals lie in a separate compartment.
  • Lowest region of urinary bladder is its neck.
  • Round ligament of uterus and ligament of ovary are derivatives of gubernaculum ovary.
  • Ovarian or testicular arteries (gonadal arteries) are branches directly from aorta but right gonadal vein drains to inferior venacava and left gonadal vein drains to left renal vein.
  • One of the sites of portocaval anastomosis is in anorectal wall it is between superio rectal vein, (portal system) and inferior,middle rectal veins (systemic veins).
  • Neck of henial sac is medial to inferior epigastric artery in direct inguinal hernia and it is lateral to artery in indirect (oblique inguinal hernia.)
  • Iliopubic tract (thickened lower part of fascia transversalis) when well developed can be used for hernial repair.
  • Tenderness in renal angle indicates kidney pathology.
  • Diaphagmatic irritation causes referred pain in shoulder tip. This is due to same spinal segmental involvement—phrenic  and  supra clavicular nerves have the same root value C3,4.
  • In sliding hiatal hernia, there is upward slide of gastro-oesophagial junction through the lax oesophageal hiatus. The clampii action of the crura of the diaphragm is lost, hence there is acid regurgitation.
  • In para-oesophageal hiatal hernia gastro-oesophagial junction is normal and only part of fundus of stomach enters through the oesophageal hiatus and there is no acid regurgitation.
  • Gastroduodenal artery is an end artery.
  • Lesion of vagal trunks at the cardiac end of stomach might affect the motility of stomach, small intestine, and large intestine as far as the distal third of transverse colon.

Carcinoma head of pancreas speedily involves the bile duct and may cause jaundice or may press on portal vein and cause ascites or obstruct pylorus.

Blood less zone of Brodel is not blood less in kidney – Hence radial or intersegmental incisions are preferred during surgery on kidney.

Safe position to divide the ureter is 2 cm below the bifurcation of common iliac artery as the inferior vesical artery supplies the lower part.

Pubococcygeus supports vagina, urethra and anus, Injury to pubococcygeus and pelvic fascia results in cystocele.

Prostatic tumors may spread to vertebrae as the prostatic venous plexus drains to inferior venacava through sacral veins and vertebral venous plexus.

Removal of metastatic lymph nodes from the lateral pelvic wall may cause damage to obturator nerve (as it runs in the extra peritoneal tissue of lateral pelvic wall) resulting in weakness of adduction of thigh on the affected side.

Abscess in the rectouterine pouch can be drained through posterior vaginal wall at posterior fornix.

Herniation to ischiorectal fossa is through “hiatus of Schwalbe”.

In mediolateral episiotomy levator ani muscle is usually spared as that muscle supports pelvic floor.

All muscles of anterior group of thigh are innervated by femoral Nerve (L2,3,4)

Pubofemoral ligament resists excess abduction. .

Hip joint is Least Stable in flexed posture.

Knee joint is Largest and most complex joint of body.

Its highest stability is achieved in full extension.

Medial meniscus injury is more common that lateral meniscus injury.

Medial meniscus is semilunar in shape whereas lateral meniscus is nearly circular.

Phylongenetically Medical collateral ligament is the degenerated tendon of adductor magnur

Phylogenetically, lateral collateral ligament is the degenerated tendon of Peroneus longus.

Oblique popliteal ligament is a lateral extension of semimembranous tendon.

Cruciate ligamens give anteroposterior stability to the knee joint.

Collateral ligaments give side to side stability.

Locking of knee occurs by Medial Rotation of lower and of femur on tibia during terminal stages of extension, when feet are  supporting the body weight.

  1. Popliteus muscle pierces capsular ligament of knee posteriorly to become an intracapsular structure.
  2. Main role of menisci of knee joint is rotational movement.
  3. Nerve roots involved in knee jerk reflex is L2,3,4.
  4. Extensor of knee is Quadriceps muscles.
  5. Flexor of knee is Hamstring muscles.
  6. Main joint of lateral longitudinal arch is calcaneocuboid.
  7. Posterior transverse arch is an incomplete arch and formed by major parts of tarsus and metatarsus.
  8. Main invertor of foot is Tibialis Anterior.
  9. Wharton’s jelly is Mesenchyme of umbilical cord.
  10. Mullerian tubercle is elevated region in relation to urogenital sinus at the point of contact of uterovaginal canal.
  11. Copula of His is Hypobranchial eminence.
  12. Gartner’s duct is persistant mesonephric duct in female.
  13. Paraurethral glands of Skene are Urethral glands arising from urogenital sinus in female.
  14. Duct of Cuvier is common cardinal vein.
  15. Blood islands of Pander is mesenchymal congregations on the wall of yolk sac giving raise to blood cells and blood vessels.
  16. Liver is the largest gland of the body
  17. Blood How through kidney 1700 L/day out of whic 170L of glomerular filtrate is formed and only about 1.5 L wine is formed.
  18. Fold ofDouglasor linea semicircularis or arcuate line is related to internal oblique muscle in abdomen.
  19. Corpora amylaceae are Prostatic concretions.
  20. Zona pellucida is amorphous material surrounding ovum.
  21. Cords of Bilroth are Pulp cords of spleen.
  22. Malpighian bodies are Nodules of white pulp of spleen.
  23. Hassel’s corpuscles   rounded bodies in medulla due to degenerative thymic epithelial cells.
  24. Serous demilunes of Heidenhein are Serous alveoli capping the mucous alveoli in mixed gland.
  25. Cells of Paneth are cells present at the bottom of crypt of small intestine.
  26. Henle’s loop is Part of nephron.
  27. Leydig cells are interstitial cells present in stroma between semiinferous tubules of testis
  28. Sertoli cells are supporting cells in semiinferous tubule.
  29. Herring bodies are Neurosecretory material seen in pars nervosa of pituitary.
  30. CanalofSchlemmis Canal present at the sclero corneal angle in scleral furrow.
  31. Betz cells are large pyramidal cells located in inner pyramidal layer of cerebral cortex.
  32. Outer and Inner bands of Ballarger are Horizontally running fibres located in 4th and 5th lamina of cerebral cortex.
  33. Node of Ranvier is Region on the nerve fibres between two internodes.
  34. Nissl granules are Chromatic bodies (granules) in the cytoplasm of neurones.
  35. Region at the junction of 3 hepatic lobules presents portal triad, which includes a portal venous radicle, branch of hepatic artery and biliary canaliculus.
  36. Lung : Lining epithelium of alveoli shows the following cells :
  37. Type I alveolor cells — Squamous cells.
  38. Type II alveolar cells — Irregular cuboidal cells (Surfactant cells)
  39. Clara cells — Cuboidal non ciliated 

Remnants

  1. Remnant of ductus arteriosum is — Ligamentum arteriosum.
  2. Ductus venosum — Ligamentum venosum.
  3. Urachus — Median umbilical ligament.
  4. Left umbilical vein — Ligamentum teres of liver.
  5. Right umbilical vein — Disappears.
  6. Vitello-intestinal duct — Meckel’s diverticulum.
  7. Distal part of umbilical artery — Medial umbilical ligament.
  8. Proximal part of umbilical artery —Superiorvesical artery.
  9. Wolfian duct — Gartner duct (Gives rise to vaginal cyst).
  10. Wolfian tubule — Paraoophoron, Eoophron.
  11. Left anterior cardinal vein — Oblique vein ofMarshall.
  • Kerking’s centre is ossification centre appearing in posterior margin of foramen magnum in occipital bones.
  • Haversian canal is longitudinal channel containing blood vessel located in compact bone.
  • Volkmann’s canal is transverse channels running from periosteum to endosteum of bone, inter connect Haversian canals and contain blood vessles.
  • Whitnall’s tubercle is tubercle on orbital surface of zygomatic bone.
  • Bones located add leverage to tendons and differ from regular bones in not having a periosteum.
  • Bones located within the tendons are seasamoid bones.
  • Sesamoid bones add leverage to tendons and differ from regular bones in not having a periosteum.
  • Bones ossified in a mesenchymatous membrane are membrane bones.

Pancreatic islets are more abundant in the tail of the pancreas and contain a cells which secrete glucogen; P cells which secrete insulin; y cells secrete somatostatin which inhibits secretory activity of beta or more a alpha cells.

GEP (Gastro Entero Pancreatic) endocrine system belongs to APUD cell series and has scattered solitary hormone producing cells in gastrointestinal mucosa and pancreas.

Lamina propria of the intestine is the chief site for production of the secretory immunoglobulin (IgA). Secreted IgA coats the mucosal surface and prevents the attachment of the antigen to the intestinal cells. IgA is important for local immunological process through out the body.

Villi are absent over the Payer’s patches.

Epithelium covering the Payer’s patches has “M” cells which help in immune responses.

Lining of terminal bronchioles is simple columnar or cuboidal epthelium with or without cilia but without mucous glands or goblet cells in the wall.

Interalveolar septum in between the alveoli is composed of lining cells of adjacent alveoli and structures interposed between them (capillaries).

Inverted retina is characteristic of all vertebrates.

Ora serrata is the scalloped anterior margin of neural retina.

Midler’s cells are retinal neuroglial cells.

Unicellular mucous gland is goblet cell.

Striated ducts of the salivary glands modify the composition of alveolar secretions.

3 cells of the islets comprise 60-90% of all the islets cells. They are in the central part, a cells are located in peripheral part.

Terminal bronchioles are the finer divisions of conducting part of respiratory system which are 0.5 mm or less in diameter.

Sertoli cells of the testis produce steroids, secrete fluids including androgen binding protein, inhibin in adult and Mullerian inhibiting hormone in the fetus and estrogens.

Sternal angle is also called angle of Louis (5 cm below suprasternal notch.

Foramen of Morgagni (in duaphragm) is also called Larry’s space.

One type of entero endocrine cell may become numerous and produce carcinoid tumour, characterised by excessive secretion of serotonin.

Premature infants suffer with respiratory distress syndrome due to lack of type II pneumocytes in lungs.

Talus is the key stone of the arch. It receives body weight and transmits it to the arches below.

Body to the axis (C2) bears a strong process getting vertically upwards from its superior surface. This process is “odontoid process” which is the detached centrum of atlas.

Bodies of 5th to 8th thoracic vertebrae on left side show flattening due to pressure of thoracic aorta.

Coccyx usually has 4 rudimentary vertebrae fused to single piece.

Failure of fusion of two arch centres posteriorly results in “spina bifida” occurs commonly in lumbar region. If the deformity is not associated with neurological abnormality it is “spina bifida occulta”.

When the defect involves one or several arches, spinal cord with meninges may prolapse (meningomyelocele).

Fractures of spine most commonly involve T12 LI and L2 — cause is usually flexion compression type of injury.

Disc prolapse or prolapsed intervertebral disc is protrusion of nucleus pulposus posteriorly into vertebral canal through posterior part of annulus fibrosus either due to trauma or degenerative changes in the annulus. Most common sites are L4L5 or L5/ SI.

Prolapse of L5/S1 disc produces pressure on 1st sacral nerve.

Plane of greatest pelvic dimensions is at the level of pelvis where the cavity is most spacious. It’s antero posterior diameters taken from a point between 2nd & 3rd sacral vertebrae and middle of symphysis. Children under 9 years and males have anthropoid type of pelvis (dolichopelvic).

  • Abrupt pronation during tennis play causes sprain or partial tear of radial collateral ligament. This is manifested as pain tenderness over lateral epicondyle.
  • Tennis elbow is a condition which has either sprain of lateral ligament of elbow joint or tear of some fibers of extensor radialis brevis or an inflammation of its bursa.
  • Lumbar triangle of Petit is triangular area bounded by Latissimus dorsi, iliac crest and external oblique.
  • arcuate ligament is a poorly defined arch in front of aorta connecting the medial tendinous Median margins of crura of diaphragm.
  • Medial arcuate ligament is the tendinous arch in fascia covering the psoas major muscle.
  • Lateral arcuate ligament is the tendinous arch in anterior layer of thoraco-lumbar fascia covering Quadratus lumborum muscle.
  • Biceps brachii is a flexor of elbow and a powerful supinator of forearm when the arm is semiflexed.
  • Brachioradialis is flexor of elbow when the forearm is in mid prone position.
  • Lumbrical muscle tendon in hand turns round the lateral sides of fingers, but in foot they turn round the medial sides of to reach the dorsal digital expansions.
  • Motor supply to skeletal muscles is through spinal or cranial nerves, but to cardiac and smooth muscles it is through autonomic nerves.
  • All the muscles of mastication are supplied by mandibular division of trigeminal nerve (V Cranial).
  • All anterior crural muscles are supplied by deep peroneal nerve..
  • Posterior crural muscles are all supplied by tibial nerve.
  • A muscle which initiates and maintains a movement is a prime mover.
  • A muscle which can initiate and maintain an opposite movement of the prime mover is antogonist.
  • A muscle which can eliminate the additional unwanted movements produced by a prime move at a joint other than the desired joint is called a synergic muscle.
  • Muscles of head can be grouped into muscles of facial expression and muscles of mastication.
  • Trumpeter’s muscle is buccinator.
  • In quiet inspiration, the thoraco-abdominal diaphragm is the sole muscle concerned with movements.
  • Triangle of auscultation—a space bounded by trapezius, latissimus dorsi and medial border of scapula. Deep to this triangle, cardiac orifice of stomach lies (on left side). (1) In oesophageal obstruction s splash of swallowed liquied can be ausculated in the region of left side. (2) Apex of lower lobe of both lungs is located beneath this area of corresponding sides.
  • Torticollis is deformity due to contracture of sternocleidomastoid muscle.
  • Paralysis of gluteus medius and minimus produces lurching gait.
  • Triangle of Koch is area on where AV node is located in right atrium.
  • Annulus of Vieussen’s is Arterial circle formed by right and left conus arteries at the commencement of pulmonary trunk.
  • Recurrent artery is central branch arising from anterior cerebral artery.
  • Rateson’s plexus is internal vertebral venous plexus.
  • “Moderator band” runs in septomarginal trabecul to anterior papillary muscle.
  • On the left aspect of Interatrial septum “Lunate impression” is the representative of osteum secundum.
  • Superior thyroid artery is related to external laryngeal nerve. Nerve lies frequently on a more posterior plane.
  • Superior laryngeal artery which is in close relation with internal laryngeal nerve is a branch of superior thyroid artery.
  • Axillary artery is the continuation of subclavian artery at the outer border of 1st rib.
  • Arteria princeps pollicis is a branch of radial artery. It turns medially into palm and supplied nutrient artery to 1 st metacarpal bone.
  • Arteria radialis indicis frequently arises from arteria princeps pollicis.
  • “Thoracic Aorta commenses at lower border of T4 and terminates at lower border of T12 (aortic opening of diaphragm) and continues beyond that level as abdominal aorta upto L4 vertebra. Here it divides into two common iliac arteries.
  • Supraduodenal artery is a branch either from gastroduodenal or hepatic vessels.
  • Gastroduodenal artery is a brach of hepatic and divides into superior pancreatico duodenal (supplies pancreas &
  • duodenum) & right gastroepiploic arteries.
  • Gastro epiploic vessles run in greater omentum along the greater curvature of stomach.
  • Coeiiac artery supplies lower part of oesophagus, stomach, 1 st and upper half of 2nd part of duodenum.
  • Profunda femoris artery gives lateral and medial circumflex femoral and four perforating arteries.
  • Femoral artery runs in adductor canal (subsartorial canal) and becomes popliteal artery at the level of adductor opening.
  • Coronary sinus opens into right atrium and guarded by a valve; tributatries are great cardiac vein, small cardiac vein,middle cardiac vein, posterior vein of left ventricle and oblique vein of left atrium.
  • Superior vena cava drains upper limbs, head, neck and thorax into posterior part of right atrium.
  • Veins draining the face:Angular, Facial maxillary, Middle temporal
  • Tributaries of Internal Jugular vein are :Veins of tongue, Veins of pharynx, Veins of thyroid, Veins of face (through facial vein), Inferior petrosal sinus
  • Right coronary artery supplies conducing system of heart as far as proximal parts of the right and left bundle branch.
  • SA node is supplied by right coronary artery (artery to SA node or nodal artery).
  • AV node is supplied by right coronary artery (branch of large posterior septal artery, a branch of posterior interventricular branch of right coronary artery).
  • Posterior interventricular artery is a branch of right coronary given at the crux of heart.
  • Anterior interventricular artery is a branch of left coronary artery.
  • Circle of willis” is formed by posterior cerebral, middle cerebral, anterior cerebral, posterior communicating arteries and  is located in inter peduncular fossa of base of brain.
  • Tonsillar artery is a branch of facial artery.
  • Middle meningeal artery is a branch of maxillary.
  • “Anastomosis around the elbow” is between superior and inferior ulnar collateral, descending branches of profunc
  • brachi, ulnar recurrent, radial recurrent, and interosseous recurrent arteries.
  • Arteries taking part in “anastomoses around the knee joint” are medial & lateral genicular arteries, descending genicular artery, descending branch of lateral circumflex femoral, circumflex; fibular, anterior and posterior tibial recurrent artery.
  • “Cruciate anastomoses” is formed by 1st perforating branch of profunda femoris, branch of inferior gluteal, branch medial and lateral circumflex femoral vessels.
  • Trochanteric anastomosis is formed by branches of superior gluteal artery, ascending branch of lateral circumflex and deep circumflex iliac artery.
  • Emissary veins connect the intercranial venous sinuses with extracranial veins.
  • Cavernous sinus contains internal carotid artery, III, IV, VI and maxillary division of V cranial nerves in its walls wide communication with veins outside the skull.
  • Sigmoid sinus is in close relation to mastoid antrum.
  • Great cerebral vein opens into straight sinus.
  • Basivertebral veins drain the bodies of vertebrae.
  • In fetus, internal iliac artery is twice as large as external iliac artery.
  • 1st part of superior vesical artery is the proximal patent section of umbilical artery.
  • Superiorand middle thyroid veins open into internal jugular vein and Inferior thyroid veins into brachiocephalic of corresponding sides.
  • Shadow of left profile of aortic arch in X-ray photographs is called “aortic knuckle”.
  • In wounds of Palmar arches, ligature of vessels proximal to wrist may be inefffective as there is anastomoses between radial and ulnar arteries through their palmar and dorsal carpal branches and other branches.
  • There is constant anastomosis between branches of last sigmoidal and superior rectal arteries “Critical point of Sudack” is non anastomatic area on sigmoid colon when the above anastomosis is absent.
  • Facial vein has communications with cavernous venous sinus, hence infective thrombosis of facial vein may extend to the intracranial venous sinuses.
  • In thrombosis of superior bulb of internal jugular vein IX, X, & XI nerves are involved.
  • Cannulation of basilic vein is more liable to be successful than cephalic as the basilic vein continues as axillary vein without angulation.
  • Axillary vein thrombosis in prolonged abduction (Eg. Painting a ceiling) may be due to the groove produced by subclavius muscle on the 1st part of vein where there is a valve in the wall.
  • Obstruction of portal vein may produce opening of sites of portocaval anastomoses which are at:
  • Lower end of oesophagus — leads to oesophageal varices. (Communication between left gastric & azygos system of  veins).
  • Umbilicus-caput medusae—due to opening up of para umbilical veins
  • Lower end of rectum & anal canal — communication between
  • The Schwann cells form the neruolemma and myelin sheath of nerve fibres in the peripheral nervous system whereas oligodendrocytes form myelin around nerve fibres in the CNS

Peculiarities of clavicle are :-

  • This is the only long bone that lies horizontally in the body
  • It is the first time to ossify in the body
  • It is the only long bone which ossifies from two primary centres
  • It has no medullary cavity
  • Occasionally, it is pierced by middle supraclavicular nerve

The largest cerebellar efferent bundle is the superior cerebellar peduncle. This is formed by fibres from the globose, emboliform and dentate nuclei.

Mundinus or Mondino d’ Luzzi is called the Restorer of Anatomy

Leonardo da vinci ofItalyis called the ‘Originator of.cross sectional anatomy

Vesalius is called the ‘reformer’ of anatomy

William Harvey discovered circulation of blood

William Hunter introduced present day embalming

Raphe is defined as a fibrous band made up of interdigiting fibres of tendons or aponeuroses.

According to Wolff’s law, the bone formation is directly proportional to stress and strain

Motor point is the site where the motor nerve enters the muscle

Glioblasts are stem cells that differentiate into microglial cells

The mucous membrane of jejunum contains tongue shaped villi

Blood brain barrier is constituted by capillary endothelium (with fenestrations), basement membrane of endothelium end feet of astrocytes covering the capillary walls.

Carpal Tunnel and its contents

It is osseofibrous tunnel between concave palmar suface of carpal bones and deep surface of flexor retinaculum of wrist Contents

1.Four Tendons of Flexor Digitorum Superficialis

2.Four Tendons of Flexor Digtorum Profundus These 8 tendons are enclosed in a common synovial sheath (Ulnar Bursa)

3.Median Nerve

4.Tendon of Flexor Pollicis Longus enclosed in a synovial sheath (Radial Bursa)

Tendon of Flexor Carpi Radialis with its synovial Sheath

Cribriform Fascia is pierced by the following structures.

1.Great Saphenous Vein

2.Superficial branches of Femoral Artery

(a)Superficial External Pudendal Artery

(b)Superficial Epigastric Artery

(c)Superficial Circumflexiliac artery

3.Lymph Vessels connecting superficial and deep inguinal lymph nodes

  • Neck pulsation felt inferiorly at medial border of sternocleidomastoid is Subclavian
  • Mandibular nerve lesions at orign involves following Tensor Palati, Messeter and Tensor Tympani
  • Pyramidal fibers are projection fibers
  • Trigeminal nerve extends lower down up to the level of C2
  • Safety muscle of tongus is Genioglossus
  • The choroid plexus of the fourth ventricle is supplied by the posterior inferior cerebellar artery
  • Unpaired artery in the brain is basilar artery
  • Arch of aorta begins opposite 2nd costal cartilage
  • The largest group of axillary lymph nodes is apical.
  • The most important component of the development of diaphragm is septum transverum
  • Triangle of Koch is bounded by tricuspid leaflet, orifice of coronary sinus & tendon of todaro
  • Diaphragm is at lowest level in prone position
  • Structure affected first when accessory cervical rib is stretched is medial cord of brachial plexus
  • Phrenic nerve lies in middle and superior mediastinum
  • Transverse arch of foot is maintained by abductor hallucis brevis.
  • A fontanelle occasionally occurring in the sagittal suture is Casser’s fontanelle.
  • Wrisberg’s nerve is Nervus intermedius.
  • Dawbarn’s sign : In subacromial bursitis pressure over the deltoid below the acromion (with the arm by the side) causes pain.
  • However when the arm is abducted pressure over the same point causes no pain, because bursa disappears under acromion is called Dawbarn’s sign.

End Arteries

Artereis which do not anastomose with their adjacent one are called end arteries. e.g.

(i)   The best example being central artery of retina.

(ii)   Central branches of central arteries.

(iii)  Vasa recta of mesenteric arteries.

(iv)  Arteries of spleen, kidney, and metaphysis of long bones.

Left coronary artery

Branches

—Ant.interventricular branch.

— Circumflex branch.

Distribution

— Rt. auricle in 40% of cases.

— SA node in 40% of cases.

— AV node and Bundle of His in 10% of cases.

— Large part of left ventricle.

— Upper margin of the ant. surface of right ventricle.

— Post, surface & the auricular appendage of the left atrium.

Note :    Branches of both Rt. & Lt. coronary arteries supply interatrial and interventricular septa.

Tributaries of the coronary sinus

Great cardiac vein          ‘— Oblique vein of the Lt. atrium.

Small cardial vein.          — Post, vein of the Lt. ventricle.

Middle cardiac vein. 

ABDOMEN

IMPORTANT RELATIONS

Relations of bile duct

A.Supraduodenal part (in the free margin of lesser omentum)

1. Anteriorly : liver    2. Posteriorly : portal vein and epiploic foramen.

3. To the left: hepatic artery.

B.Retroduodenal part

1. Anteriorly : first part of duodenum    2. Posteriorly : inferior vena cava

3. To the left: gastroduodental artery

C. Infraduodenal part

1. Anteriorly :    a groove in the upper and lateral parts of the posterior surface of the head of the pancreas.

2. Posteriorly : inferior vena cava.   3. Relations of the Kidneys

A.  Relations Common to the Two Kidneys

1.The upper pole of each kidney is related to the corresponding suprarenal gland. The lower poles lie about one inch  to the iliac crests.

2.The medial border of each kidney is related to (i) the suprarenal gland, above the hilus; and (ii) to the ureter below hilus.

3.   Posterior relations .

The posterior surfaeces of both kidneys are related to : (1) the diaphragm; (2) the medial and lateral arcuate ligaments; (3) the psoas major; (4) the quadratus lumborum; (5) the transversus abdominis; (6) the subcostal vessels; and (7) the subcostal, iliohypogastric and ilioinguinal nerves. In addition, the right kidney is related to 12th rib, and the left kidney to 1 lth and 12th ribs.

B.Other Relations of the Right Kidney

1.Anterior relations:

1.Right suparental gland; (2) liver; (3) second part of duodenum; (4) hepatic flexure of colon and (5) small intestine. Out of these the hepatic and intestinal surfaces are covered by peritoneum.

2.The lateral border of the right kidney is related to the right lobe of the liver and to the hepatic flexure of the colon.

C.Other Relations of the Left Kidney

1.Anterior relations :

1.left suprarenal gland; (2) spleen; (3) stomach; (4) pancreas; (5) splenic vessels; (6) splenic flexure and descending colon; and (7) jejunum. Out of these the gastric, splenic and jejunal surfaces are covered by perotoneum.

2.The lateral border of the left kidney is related in the spleen and to the descending colon.

Relations of Right Suprarenal Gland

A.The base is related to the upper pole of the right kidney.

B.The anterior surface is devoid of peritoneum, except for a small part inferiorly. It is related to : (1) the inferior vena cava medially; (2) the liver, laterally; and (3) occasionally to the duodenum, inferiorly.

C.The posterior surface is related to the right crus of the diaphragm.

D.Anterior border. A little below the apex it presents the hilum where the suprarenal vein emerges.

E.Medial border. It is related to : (1) the right coeliac ganglion; and (2) the right inferior phrenic artery.

Relations of Left Suprarenal Gland A.Anterior surface. From above downwards it is related to : (1) the cardiac end of the stomach; (2) the splenic artery; and (3) the pancreas. The upper end may be related to the posterior extremity of the spleen. Near the lower end there is the hilum through which the left suprarenal vein emerges. Only the gastric impression is covered by peritoneum (of the lesser sac):

B.Posterior surface. It is related to : (1) the kidney, laterally; and (2) the left crus of the diaphragm, medially.

C.Medial border. It is related to : (1) the left coeliac ganglion; (2) the left inferior phrenic artery; and (3) the left gastric artery.

THORAX

MEDIASTINUM AND ITS CONTENTS
Subdivisions of Mediastinum
Superior mediastinum
Location—from   inlet  of thorax to plane extending from level of sternal angle anteriorly to lower   border of T4 vertebra posteriorly

Contents
a. Muscles attached to sternum (sternothyroid and sternohyoid)
b. Remnants of thymus gland
c. Vessels

1. Arch of aorta
2. Origin of brachiocephalic, left common carotid, and left subclavian arteries
3. Left and right branchiocephalic veins
4. Superior vena cava

d. Trachea
e. Esophagus
f. Nerves and plexuses
1. Vagus—right and left
2. Left recurrent laryngeal
3. Phrenic—right and left
4. Cardiac plexus (superficial)
g. Lymphatics
1. Brachiocephalic and tracheobronchial nodes

2. Thoracic duct
Inferior mediastinum—has three subdivisions that extend downward from lower border of superior mediastinum to diaphragm
1. Anterior mediastinum
a. Location—posterior to body of sternum and attached costal cartilages, anterior to heart and pericardium

b. Contents
1. Fat
2. Remnants of thymus gland
3. Anterior mediastinal lymph nodes
2. Middle mediastinum
a. Location—between anterior mediastinum and posterior mediastinum

b. Contents
1. Heart and pericardium
2. Beginning or termination of great vessels
3. Pulmonary arteries and veins
4. Phrenic nerves
5. Bifurcation of trachea
6. Tracheobronchial lymph nodes
7. Cardiac plexus (deep)

Posterior mediastinum
a. Location—posterior to heart and pericardium, anterior to vertebrae T5-T12
b. Contents
1. Esophagus
2. Descending aorta and origins of posterior intercostal arteries
3. Azygos system of veins and termination of posterior intercostal veins
4. Nerves
a. Vagus nerves
b. Splanchnic nerves
5. Lymphatics
a. Thoracic duct
b. Posterior mediastinal nodes
c. Tracheobronchial nodes
d. Bronchomediastinal trunk

  • Boxer’s muscle–Serratus anterior.
  • Locking muscles—Popliteus.
  • Casser’s perforated muscle—Coracobrachialis
  • Coiter’s muscle–Corrugator supercilli.
  • Cowl muscle—Trapezius.
  • Rider’s muscle—Adductor muscles of thigh
  • .Laughing/Smiling muscle—-Zygomaticus major.
  • Sommering’s muscles—Levator glandulae thyroideae.
  • Theile’s muscle—Superficial transverse perinei muscle.
  • Toynbee’s muscle—-Tensor tympani.
  • Wilson’s muscle—Sphincter urethrae.—-Few fibres of Levator ani.
  • Wrinkler muscles of eyebrow—Corrugator supercilii.
  • Sibson’s muscle—Scaleneus minimus.
  • Gavard’s muscle—Oblique fibres in the muscular coat of the stomach.
  • Oehl’s muscle——Strands of muscle fibres in the chordae tendineae of the left A-V valve.

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