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Title: Medteck
Description: Easy way to get knowledge on anatomy with simple points
Description: Easy way to get knowledge on anatomy with simple points
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ANATOMY
INFERIOR EXTREMITY
1
...
2
...
3
...
4
...
5
...
6
...
Angle of femoral torsion or angle of
anteversion : 15°
...
Muscular attachment to greater trochanter : Piriformis, gluteus minimus and
medius, obturator internus and externus
...
Muscular attachment to lesser trochanter : Psoas major, illiacus, adductor
magnus
...
Femur ossifies from one primary centre (For shaft) and 4 secondary centres
...
10
...
Lower end of the femur is the growing end
...
Patella, the largest sesamoid bone develops in the tendon of quadriceps
femoris
...
Tibia has one primary and two secondary centres for ossification
...
(like femur)
13
...
14
...
15
...
Fibula
is an exception to this rule
...
Fibula : upper and lower ends are subcutaneous
...
This is an ideal spare bone for grafting
...
Talus : It has one centre of ossification
...
Neck
body angle is 150° in adults and 130° - 140° in infants
...
Sesamoid bones : patella (largest) in tendon of quadriceps femoris, other :in tendons of tibialis anterior and posterior, lateral head of gastroc nemius,
gluteus maximus, flexor hallucis brevis
...
Root value : ilio – inguinal nerve → L1 genitofemoral nerve → L1, L2
...
Iliohypogastric → L1
...
Lumbar plexus (L1 – L5)
...
a) Housemaid’s knee : Enlarged prepatellar bursa
...
c) Clergyman’s knee : Enlarged infrapatellar bursa
...
Illiotibial tract : Thickened lateral part of fascia 5 cm wide
...
23
...
4 cm below and 4 cm cateral to the
pubic tubercle
...
5 cm X2 cm
...
24
...
It is continuous below with the adductor
canal
...
25
...
26
...
5 X 1
...
Upper part/ base is called femoral ring
...
27
...
But, abnormally, it may
arise from inferior epigastric artery
...
Muscles in the anterior compartment of thigh are supplied by femoral
nerve (L2, L3, L4)
...
Both illiacus and psoas major have common insertion in the lesser
trochanter
...
30
...
Bounded anteriorly by vastus medialis, posteriorly by
adductor longus (above) and magnus (below)
...
Contents : femoral artery and vein, saphenous nerve, nerve to vastus medialis,
two divisions of obturator nerve
...
Last branch of femoral artery : descending branch of genicular artery
...
Quadriceps is an extensor to the knee joint
...
Adductor magnus is supplied by two different motor nerves – obturator
and sciatic nerve
...
Pictineus has two origins also
...
Principal nerve supply of adductor compartment : obturator nerve
...
Root value : L2, L3, L4
...
Accessory obturator nerve is present in 30% cases
...
Root value : L3 , L4
...
Gluteus maximus is supplied by inferior gluteal nerve whereas gluteus
medius and minimus are supplied by superior gluteal nerve
...
Gamellus superior is supplied by nerve to obturator internus (L5, S1, S2) and
gamellus inferior is supplied by nerve to Quadratus femoris (L4, L5, S1)
...
Tensor fascia lata is supplied by superior gluteal nerve (L4, L5, S1)
...
Root value of a) Sciatic nerve - L4, L5, S1 – S3
...
C) Inferior gluteal nerve – L5, S1, S2
...
40
...
Very prone to
aneurysm
...
P
...
Common site of
atherosclerosis
...
Root value of a) Tibial nerve - L4, L5, S1 – S3
...
42
...
Thickest nerve in the body (2
cm)
...
Divides into tibial and common peroneal nerves
...
Common peroneal part supplies → short head of biceps
femoris
...
‘Sleeping foot’ – is due to the compression of sciatic nerve
...
Principal nerve of the lateral compartment : Superficial peroneal nerve
...
Guy ropes : Three muscles – Sartorius, gracillis and semitendinosus are
unitedly called guy ropes
...
Nerve of illium, ischium and pubis :
nerve of ilium → femoral nerve → supplies sartorius nerve of ischium → sciaƟc
nerve →supplies semitendinosus nerve of pubis → obturator nerve → supplies
gracillis
...
47
...
The bursa has several diverticula
...
Peripheral hearts : Soleus muscles in the calf
...
Sural nerve : Branch of tibial nerve
...
L5, S1, S2
...
50
...
B) medial
cutaneous nerve of thigh →L2, L3
...
D) saphenous nerve → L3, L4
...
Muscles of posterior compartment of leg are supplied by tibial nerve
...
Gastrocnemius and soleus are plantar flexors of foot
...
The sesamoid bone fabella is in tendon of lateral head of gastrocnemius
...
Brodie’s bursa lies deep to : medial head of gastrocnemius and
semimembranosus
...
55
...
15 cm long
...
56
...
57
...
58
...
59
...
60
...
61
...
Varicose veins become
distended if the perforators are blocked
...
Superficial inguinal lymph nodes drain the skin and fascia of lower limb,
perineum, trunk below the umbilicus
...
Gland of cloquet / Rossenmutller –lies in femoral canal
...
Deep inguinal lymph nodes receive afferents from a) superficial inguinal
nodes b) popliteal nodes c) glans penis /clitoris d) deep lymphatics of lower
limb
...
Sympathetic innervations of lower limb : T10-L2
...
66
...
d) Triceps – radial
...
Tibia & radius are pre-axial bones and fibula and ulna are post axial bones
...
Illiofemoral ligament = ligament of Bigelow (Y shaped) is the strongest
ligament of the body
...
Hip joint : Ball and socket variety of synovial joint
...
Chief extensor → gluteus maximus and hamstrings
...
70
...
71
...
Hyperdense/sclerotic
...
Important lines : a) Shenton’s line : between upper border of obturator
foramen and lower border of neck of femour
...
Passes through the highest part of greater trochanter
...
73
...
74
...
a) <5 years-congenital dislocation of hip, T-B
...
c) 10-20 years – coxa vara
...
Knee joint is a compound saddle joint
...
Ligamentum patellae : Central portion of common tendon of insertion of
quadriceps femoris
...
5 cm long, 2
...
Attached to : apex of patella and
tibial tuberosity
...
a) oblique popliteal ligament is an expansion from tendon of
semimembranosus
...
c) Tibial (medial) collateral ligament is degenerated tendon of adductor
magnus
...
e) Cruciate ligaments are collateral ligaments of femorotibial joints
...
Principal flexors of knee : biceps femoris, semitendinosus,
semimembranosus
...
79
...
Lateral meniscus is protected by poplitius
...
Anterior cruciate ligament starts in the intercondylar region of tibia and
attached to medial surface of lateral condyle of femur
...
81
...
Less commonly injured
...
Menisci, cruciate ligaments, tendons, cartilage- all are hypointense (black)
on MRI
...
Medial meniscus is semicircular
...
84
...
Attached to femur via meniscofemoral
ligaments
...
Sinovial membrane of knee lines all aspects except posteriorly where it is
reflected by the cruciate ligaments forming a common covering for ACL and
PCL
...
Bursae around knee : Total 13
...
87
...
88
...
Both superficial and deep parts have
common attachment to medial malleolus
...
89
...
b) Principal plantar flexors of foot : Gastrocnemius, soleus (plus accessory :
Tibialis posterior and flexors)
...
d) Principal inverters of foot : Tibialis anterior and posterior
...
Subtalar joint is talocalcaneal joint
...
Separated from
talocalcaneo navicular joint by sinus tarsi
...
Spring ligament = plantar calcaneonavicular ligament
...
Abnormalities of arch of foot :
a) Pes planus – absence/ collapse of arch
...
c) Talips equinus – walks on toes
...
e) Talipes varus – walks on outer border of foot (foot is inverted and
adducted)
...
g) Talipes equinovarus (club foot) : Foot is inverted, adducted + planter flexed
(± associated with spina bifida)
...
Femoral nerve : Root value → L2, L3, L4
...
Test : patellar jerk
...
Obturator nerve : A branch of lumbar plexus
...
Branches : adductors, pectineus, gracillis, obturator externus
...
Femoral artery, hip, knee joints – are supplied by both femoral and
obturator nerves
...
Accessory obturator nerve : present in 30% cases
...
Supplies – pectineus (deep part), hip joint
...
Tibial nerve : Larger terminal branch of sciatic nerve
...
Supplies : gastro – soleus, popiteus, plantaris, tibialis posterior (3P) flexors of
back of leg oyher branches – sural, medial and middle jeniculars, ankle joint
...
98
...
Root
value : L4, L5, S1, S2
...
The nerve can
be rolled against tibular neck
...
99
...
100
...
101
...
102
...
Calcaneo cuboid joint is a
saddle joint
...
Tarsals : a) Talus – no muscular attachment
b) Cuboid – groove for peroneus longus tendon
...
Movement of hip joint : extension – gluteus maximus, abduction by
gluteus medius, flexion by illiacus, lateral rotation by obturator internus
...
Medial aspect of leg (skin) is supplied by saphenous nerve
...
ANATOMY MCQS
INFERIOR EXTREMITY
1
...
2
...
3
...
4
...
5
...
6
...
7
...
8
...
9
...
10
...
11
...
12
...
13
...
All of the following are attached to greater trochanter except –
a) piriformis b) obturator internus c) obturator externus d) gluteus maximus
...
Accessory obturator nerve is seen in
a) 30% b) 40% c) 10% d) 20%
...
Aneurysm is commonest in
a) femoral artery b) popliteal artery c) anterior tibial artery d) posterior tibial
artery
...
Adductor magnus is supplied by which nerve?
a) obturator b) sciatic c) femoral d) a + b
...
Common perneal nerve supplies
a) short head of biceps femoris b) long head of biceps femoris
c) semitendinosus d) semimembranosus
...
Which of the following is not a member of ‘Guy ropes’
a) Sartorius b) gracillis c) semitendinosus d) long head of biceps
...
Gamellus superior is supplied by
a) nerve to quadrates femoris b) nerve to obturator internus c) both
d) accessory obturator nerve
...
Inferior gluteal nerve supplies
a) gluteus maximus b) gluteus medius c) gluteus minimus d) all
...
Gluteus medius and minimus are supplied by
a) inferior gluteal nerve b) superior gluteal nerve c) obturator nerve
d) accessory obturator nerve
23
...
Tibial nerve supplies all except
a) short head of biceps b) long head of biceps c) semitendinosus
d) semimembranosus
...
Sural nerve is
a) lateral to lateral head of gastrocnemius b) medial to medial head of
gastrocnemius c) between the two heads of gastrocnemius d) posterior to
soleus
...
Peripheral hearts are located in
a) soleus b) medial head of gastrocnemius c) medial head of gastrocnemius
d) all
...
Bursa deep to medial head of gastrocnemius
a) anserine bursa b) Brodie’s bursa c) infrapatellar bursa d) none
...
Muscles of posterior compartment of leg are supplied by
a) femoral nerve b) obturator nerve c) common peroneal nerve d) tibial nerve
...
Number of dorsal interrossei in leg
a) 2 b) 3 c) 4 d) 5
...
Medial plantar nerve is a branch of
a) superficial peroneal b) common peroneal c) deep peroneal d) tibial
...
Adductor group of muscles are supplied by – nerve
a) sciatic b) femoral c) obturator d) accessory obturator
...
Strongest ligament in the body is
a) Illio lumbar b) anterior cruciate c) posterior cruciate d) sacro – tuberous
...
Imaginary line joining anterior superior iliac spine and tip of greater
trochanter is
a) Nelaton’s line b) Schoemaker’s line c) shenton’s line d) none
...
Perthe’s disease is commonest in the age group
a) < 5 years b) 5 – 10 years c) 10 – 20 years d) > 20 years
...
line passing between upper border of obturator foramen and lower border
of femoral neck is
a) Shenton’s line b) Schoemaker’s line c) Nelaton’s line d) M
...
Gregor’s line
...
Oblique popliteal ligament is an expansion of
a) tendon of semimembranosu b) short lateral ligament c) tendon of adductor
magnus d) tendon of peroneus longus
...
In the knee joint, sinovium lines all aspects except
a) anteriorly b) posteriorly c) medially d) laterally
...
What is not true about meniscus?
a) Lateral meniscus is nearly circular b) medial meniscus is semicircular c)
lateral meniscus is attached to femur via meniscofemoral ligament d) medial
meniscus is resistant to injury
...
What is not true about deltoid ligament
a) triangular in shape b) attached to lateral meniscus c) crossed by tendons of
tibialis posterior and flexor digitorum longus d) none
...
Which of the following is not an everter of foot?
a) peroneus longus b) peronus brevis c) tibialis anterior d) all
...
Patients with talipes equinus walks on
a) toes b) heel c) lateral border d) medial border
...
All of the following are components of talipes equinovarus except
a) inversion b) adduction c) plantar flexion d) walks on inner border of foot
...
Unlocking of knee is due to
a) popliteus b) hamstrings c) quadriceps d) gastrocnemius
...
All of the following muscles have dual nerve supply except
a) pectineus b) adductor magnus c) adductor longus d) biceps femoris
...
All of the following muscles act on both hip and knee joints except :
a) rectus femoris b) sartorius c) short head of biceps d) long head of biceps
...
Cuboid bone has groove for tendon of
a) peroneus longus b) peroneus brevis c) flexor hallucis longus d) flexor hallucis
brevis
...
Abduction of hip joint is accomplished by
a) gluteus medius b) gluteus maximus c) gluteus minimus d) illiacus
...
Cutaneous supply of lateral aspect of leg is by
a) saphenous nerve b) superficial peroneal c) common peroneal d) sural nerve
...
Bone having no muscle attachment
a) talus b) navicular c) cuboid d) medial cuneiform
...
Which of the following is a wrong match?
a) knee joint – saddle joint b) hip joint – sinoval joint c) ankle joint –
syndesmosis d) calcaneo – cuboid joint – saddle joint
...
36) a, 37) b, 38)
d, 39) b, 40) c, 41) a, 42) d, 43) a, 44) c, 45) c, 46) a, 47) b, 47) a, 48) d, 49) a,
50) c
...
Important points about clavicle : a) subcutaneous b) first bone to ossify c)
only long bone showing membranous ossification d) only long bone with 2
primary centres of ossification e) may be pierced by middle supraclavicular
nerve f) In females, lateral end lies at lower level than medial end
...
2
...
3
...
Primary centre appearsat 8th week of intrauterine life
...
Winging of scapula : paralysis of serratus anterior- due to palsy of long
thoracic nerve of Bell
...
Arm can
not be abduced beyond 90˚
...
Scaphoid scapula : concave medial border of scapula
...
Nerves liable to injury : median nerve in supracondylar fracture humerus,
axillary nerve at surgical neck of humerus, radial nerve at radial groove, ulnar
nerve behind medial epicondyle
...
Congenitally absent radius : thrombocytopenia with absent radius (TAR),
Holt-oram syndrome
...
Fracture of scaphoid commonly occurs at waist
...
9
...
10
...
11
...
Supplied by nerve to serratus anterior (C5, C6, C7) (= nerve of bell) = long
thoracic nerve which is a branch of brachial plexus root
...
12
...
Spinal nerve with
contribution from C4 is more and in a post fixed plexus, contribution from T1 is
more, T2 present and C4 absent
...
13
...
14
...
Medial cord → ventral division of lower trunk
...
15
...
B) suprascapular nerve and nerve to subclavius
arise from upper trunk
...
D) medial root of median nerve (C8, T1) arises from
medial cord and lateral root of median nerve (C5 –C7) from lateral cord
...
F)
axillary, radial nerves arise from posterior cord
...
16
...
Muscles paralysed : biceps, brachialis, brachioradialis and deltoid
...
17
...
Claw hand and Horner’s syndrome
...
Dislocation of humerus causes injury to lateral cord and subcoracoid
dislocation causes injury to medial cord
...
Injury to either ulnar nerve or median nerve (both arise from medial cord)
→claw hand
...
Axillary artery : continuation of subclavian artery and continues as brachial
artery
...
Branches : superior thoracic, thoracoacromial, lateral thoracic, subscapular,
anterior and posterior circumflex humeral arteries ± alar thoracic
...
Axillary vein → conƟnuaƟon of basilic vein
...
Axillary sheath comes from : Prevertebral layer of deep cervical fascia
...
Commonest artery affected by lacerated injury : Popliteal artery in lower
limb
...
Over all, popliteal is the commonest in the
body
...
Trapezeus is supplied by spinal accessory (spinal part), C3, C4
...
25
...
26
...
Corresponding lateral half hand and digits → radial
nerve
...
Digits-palmar aspect + dorsal aspect of middle and distal phalanges : lateral
3 ½ : supplied by median nerve medial 1 ½ : supplied by ulnar nerve
...
Cutaneous of innervations of upper limb : C5 – T1
...
Vertebral spinal level is always lower than corresponding spinal segment
...
Cephalic vein is pre-axial
...
These are joined by
median cubital vein in 70% of cases
...
Caphalic vein is longer than basilic vein
...
Superficial veins in upper limb are absent in : palm, ulnar border of
forearm, back of arm, trapezeus region
...
Cephalic vein begins in the lateral end of dorsal venous arch and basilar
vein begins in medial end
...
In the elbow, BP is recorded from brachial artery and blood is drained/I
...
injection is given in medial cubital vein
...
Cephalic vein frequently communicates with external jugular vein
...
Supraspinatus, infraspinatus are supplied by suprascapular nerve,
subscapularis, teres major by subscapular nerve and teres minor by axillary
nerve
...
Rotator cuff : Supraspinatus, infraspinatus, subscapularis, teres minor
...
Largest bursa in the body : subacromial bursa
...
It is situated below coracoacromial arch and
deltoid muscle
...
38
...
39
...
Rounded contour of shoulder is lost
...
Ulnar nerve can be palpated behind medial epicondyle of humerus
...
41
...
42
...
Brachialis is supplied by both musculocutaneous (motor) and radial
nerve
(proprioception)
...
43
...
It is pierced and supplied by musculocutaneous nerve
...
Radial nerve : Root value C5-T1
...
Arises
from posterior cord
...
Paralysis causes wrist drop
...
Median nerve : Labourer’s nerve (coarse movements)
...
Root value C5-T1
...
1st
and 2nd lumbricals others : flexor carpi radialis, flexor digitorum superficialis,
Palmaris longus, anterior interosseous, flexor digitorum profundus, flexor
policis longus and brevis, pronator quadrates
...
46
...
Root value C8, T1
...
Branches to : hypothener muscles, medial two
lumbricals, all interossei
...
47
...
48
...
Anterior and
posterior interosseous artery are branches of ulnar artery
...
Ape thumb deformity due to paralysis of thener muscles (injury to median
nerve)
...
Injury to median nerve at the wrist : ape thumb deformity, loss of
opposition of thumb, paralysis of 1 st and 2nd lumbricals
...
Carpal tunnel syndrome : compression of median nerve in the carpal
tunnel
...
Absence of sweating
...
52
...
Ring finger is most commonly affected
...
53
...
Supplied by median nerve
...
Hypothener eminence : abductor, flexor and opponens digitiminimi
...
Supplied by ulnar
nerve
...
Adductor of thumb : adductor policis-supplied by ulnar nerve
...
There are 4 lumbricals, 4 palmar interossei and 4 dorsal interossei
...
57
...
a) Lumbricals : flex the MCP joints and extend the I
...
joints of digits
...
c) Dorsal interossei : abduct the digit away from middle finger
...
a) Opponens policis is tested by : trying to touch the finger-tips with the tip
of thumb
...
c) Palmar interossei and adductor policis are tested by : trying to hold firmly a
piece of paper between fingers
...
Ulnar nerve is tested by : Froment’s sign or book test which test the
adductor policis muscle
...
Claw hand- True or complete : due to paralysis of both median and ulnar
nerve
...
P
...
61
...
62
...
It lies in
front of pronator quadrates deep to the long flexor tendons
...
63
...
Flexor digitorum superficialis
and profundus tendons are enclosed
...
64
...
Infection generally spreads from thumb
...
Posterior interosseous nerve supplies : extensor carpi radialis brevis,
extensor carpi ulnaris, supinator, abductor policis longus, extensor policis
longus and brevis, extensor indicis
...
Shoulder joint is a synovial joint of ball and socket variety
...
67
...
68
...
69
...
70
...
71
...
Supination is more powerful than pronation
...
Supination and pronation take place at : Superior and
inferior radio-ulnar joints
...
Sympathetic nerves for skin of upper limb are : Vasomotor, sudomotor and
pilomotor
...
Carpal tunnel contains : median nerve, tendon of flexor policis longus and
flexor digitorum superficialis
...
Structures in cubital fossa (medial to lateral) : median nerve, brachial
artery, tendon of biceps brachii, radial nerve (superficial branch)
...
Injury to median nerve in arm causes : Impaired-pronation of forearm,
flexion of thumb and wrist
...
Effect of Erb’s Palsy : a) Loss of biceps and supinator jerks b) Loss of
abduction and lateral rotation of arm
...
Segmental innervations of tendon reflexes : a) biceps-C5, C6
...
ANATOMY MCQS
SUPERIOR EXTREMITY
1
...
2
...
3
...
4
...
5
...
6
...
7
...
8
...
9
...
10
...
11
...
12
...
13
...
14
...
15
...
16
...
17
...
18
...
19
...
20
...
21
...
22
...
23
...
24
...
25
...
26
...
27
...
28
...
29
...
30
...
P
...
P
...
31
...
32
...
33
...
34
...
35
...
Ans :- 1) b, 2) b, 3) c, 4) c, 5) a, 6) b, 7) d, 8) b, 9) d, 10) a, 11) c, 12) a, 13) d,
14) b, 15) a, 16) b, 17) d, 18) b, 19) a, 20) c, 21) a, 22) b, 23) a, 24) b, 25) c,
26) b, 27) d, 28) a, 29) b, 30) c, 31) b, 32) a, 33) a, 34) c, 35) c
...
Incidence of cervical rib: 0
...
Cervical rib causes pressure over lower trunk of brachial plexus and wasting
of small muscles of hand
...
Rib notching in coarctation of aorta is due enlargement of posterior
intercostal arteries
...
Diaphragm at the thoracic inlet = Sibson’s fascia = suprapleural membrane
...
5
...
6
...
With neuro - vascular symptoms
...
Major openings of diaphragm : a) Aortic – D12 level
...
Transmits :
oesophagus, gastric (branch of vagus) nerve and left gastric arterial branches
c) vena caval : D8 level
...
8
...
5 cm
below suprasternal notch
...
Importance: Ribs are counted from this level
...
Ascending aorta
ends, aorch of aorta begins and ends, descending aorta begins at this level
...
Thoracic duct crosses from right to left
...
9
...
C) floating ribs : 11,12th d)
typical ribs – 3rd to 9th
...
10
...
Maximum length of ribs – 7th
...
Costal groove contains: Intercostal nerve, posterior intercostals vessels
...
12
...
13
...
14
...
15
...
Medial end of 1st to 7th costal
cartileges attach directly to sternum
...
Rectus abdominis muscle attaches to 5th – 7the costal cartileges
...
Transversus abdominis attaches to 7th to 10th
...
17
...
18
...
19
...
20
...
V
...
Peripheral collagenous fibres blend with longitudinal ligaments (anterior and
posterior)
...
Posterior longitudinal ligament is continuous with membrana tectoria
...
Supra spinous ligaments connect tips of vertebral spines from c7 to sacrum
...
23
...
Hence dyspnoic
patients feel better in sitting position due to be tter ventilation
...
Typical intercostal nerves : 3rd to 6th
...
Subcostal nerve : anterior primary ramus of 12th thoraci nerve
...
26
...
Supplies axillary skin, upper medial arm
...
Posterior intercostals arteries: 1st and 2nd arise from superior intercostal
artery of costocervical trunk and 3rd to 11th from descending thoracic aorta
...
Internal thoracic (mammary) artery : Takes origin from first part of sub
clavian artery opposite thyrocervical trunk 2 cm above clavicle
...
29
...
Passes through aortic opening of diaphragm
...
30
...
All these are medial branches and are
preganglionic
...
Intrapleural pressure is negative
...
32
...
33
...
34
...
35
...
Visceral pleura is not sensitive to
pain
...
Visceral pleura is supplied by bronchial arteries while parietal pleura is
supplied by internal thoracic, intercostals and musculophrenic arteries
...
Oblique fissure of lung cut across hilum
...
Horizontal fissure runs at the level of the 4th costal
cartilegs
...
There is no medial basal segment of left left lower lobe
...
Lungs and bronchial tissues are supplied by bronchial arteries
...
On the
right side it arises from 3rd posterior intercostal artery or left upper bronchial
artery
...
40
...
41
...
42
...
43
...
44
...
It consists of
alveolar duct, atria, air saccule and pulmonary alveoli
...
In the right lung, middle lobe has lateral and medial segments while, in the
left lung, lingula (middle lobe equivalent) of upper lobe has superior and
inferior segments
...
Bronchopulmonary segments do not have their own vein
...
Abscess/aspiration pneumonia are common in posterior segment of right
upper lobe and apical segment of right lower lobe
...
5cm
...
Hence right lung is affected more commonly
...
Trachea and extrapulmonary bronchi are lined by pseudostradtified
columner cpithelium which are endodermal in origin
...
Superior and inferior mediastinum are demarcated by an imaginary line
joining Louis angle (sterna angle) in front and lower border of T4 behind
...
Important contents of a) anterior mediastinum : thymus, branches of
internal thoracic artery
...
Lymph nodes are present in
all the 3 compartments
...
Veins are on right side and arteries on left side of mediastinum
...
52
...
Serous and parietal
pericardium are continuous at the root of great vessels
...
Transverse sinus is a horizontal gap between arterial and venous ends of
heart tube
...
Arterial supply of pericardium : Internal thoraccic, musculophrenic and
descending thoracic aorta
...
Atria and ventricles of heart are separated by coronary sulcus (A
...
groove)
...
It is in left 5th intercostal
space 9 cm
...
56
...
Ventricular
fibres are arranged in three layers – super ficial, middle and deep
...
57
...
S
...
node is is situated at the upper part of sulcus
...
A
...
node is at the lower part of the septum
...
Veins draining into right atrium : SVC, IVC, Coronary sinus, anterior cardiac
veins, thebasian veins ( venae cordis minimi)
...
Fossa ovalis, limbus fossa ovalis (or annulus ovalis) are in interatrial
septum
...
Sinus venorum is smooth posterior part and pectinate part is rough
anterior part of right atrium
...
61
...
Right ventricle has 3 papillary muscles : anterior, posterior and
septal
...
Lt ventricle has 2 papillary muscles –
anterior and posterior
...
62
...
63
...
Lower
part is thick and muscular
...
Fossa lunata is in IVS
...
Left atrium receives 4 pulmonary veins + few thebasian veins
...
Active contraction of ventricular papillary muscles keep the A
...
valves
competent
...
Coronary arteries arise from : anterior and left posterior aortic sinuses
...
Cariac valve with largest diameter : Tricuspid (4 cm
...
1st heart sound (S1) is due to closure of A
...
valves
...
69
...
70
...
Highest rate of conduction
(4m/sec
...
71
...
Right coronary artery supplies : Rt atrium,
maximum of right ventricle, minimum of left ventricle, posterior part of IVS
and maximum of conducting system
...
72
...
73
...
A node is supplied by right coronary artery in 60% of cases and left
coronary artery in 40% of cases
...
Posterior interventricular artery arises from right coronary artery in 90% of
cases (right dominance) and from left coronary artery in 10% case
...
Largest cardiac vein : coronary sinus
...
76
...
Posterior
vein of left ventricle, oblique vein of left atrium (vein of Marshallo), right
marginal vein
...
Diastolic pressure in ventricles : Zero
...
Branches of arch of aorta : Regular : brachiocephalic trunk, left common
carotid, left subclavian
...
79
...
80
...
Left
recurrent laryngeal nerve hooks around the ligamentum arteriosus (post natal
remnant of ductus)
...
Trachea is 10 -15 cm long
...
internal diameter in adults : 12mm
...
82
...
‘C’ shaped – deficient posteriorly
...
Trachea is supplied by inferior thyroid arteries
...
Oesophagus starts at the level of cricoid cartilage
...
84
...
Next : Pharyngo –
esophageal junction
...
4 constrictions of esophagus : at beginning, where it is crossed by aortic
arch, where it is crossed by left bronchus, where it pierces the diaphragm
(distance from incisor teeth – 6”, 9”, 11” and 15” respectively)
86
...
87
...
88
...
Receives lymph from both halves of
body below the diaphragm and left half of body above diaphragm
...
ANATOMY MCQS
THORAX
1
...
2
...
3
...
5% b) 1% c) 1
...
4
...
5
...
6
...
7
...
8
...
9
...
10
...
11
...
12
...
V
...
13
...
14
...
15
...
16
...
17
...
18
...
19
...
20
...
21
...
22
...
23
...
24
...
25
...
26
...
27
...
28
...
29
...
30
...
31
...
32
...
Ans : 1) a, 2) d, 3) a, 4) b, 5) d, 6) a, 7) c, 8) c, 9) c, 10) c, 11) a, 12) b, 13) b, 14)
a, 15) c, 16) c, 17) a, 18) c, 19) d, 20) a, 21) a, 22) b, 23) d, 24) a, 25) c, 26) c, 27)
a, 28) b, 29) c, 30) b, 31) b, 32) c
...
Lumbar vertebrae has 3 primary and 7 secondary centres of ossification
...
Sacrum gives attachment to : Pyriformis, erector spinae and multifidus
...
Average sacral index in males 105
...
4
...
4%)
...
Subpubic angle : Females → 80 - 85°, males → 50 - 60°
...
Greater sciatic notch : Females → 74°, males → 50°
...
Puboischial index : Females → 100°,males → 83°
...
Thichness of I
...
discs : Cervical and lumber → thicker in front
...
9
...
10
...
11
...
12
...
13
...
14
...
15
...
(b) Patent vitello – intestinal duct : fecal fistula in
umbilicus
...
(d) Failure of infraumbillical part of
anterior abdominal wall to develop : Ectopia vesicae
...
Infraumbillical anterior abdominal wall has 2 layers of the fascia : Outer/
superficial = camper’s fascia composed of fat and inner/ deep = scarpa’s fascia
is membranous
...
M
embranous layer is continuous in the perineum with colles fascia
...
17
...
18
...
19
...
Upper 4 slips inter
digitate with serratus anterior and lower 4 with latissimus dorsi
...
Superficial inguinal ring is seen
in the aponeurosis of this muscle
...
20
...
Cremastric muacle is formed of fibres of this muscle
...
Supplied by lower 6 thoracic plus L1 nerve
...
Transversus abdominis : Arises from lateral 1/3rd of inguinal ligament, iliac
crest and thoraco – lumbar fascia
...
Supplied by : Lower 6
thoracic plus L1 nerve
...
Aponerosis of external obliqus, internal oblique and transverses abdominis
participate in the formation of rectus sheath
...
23
...
24
...
25
...
Lies deep to external
spermatic fascia
...
It
suspends and elevates the testis
...
26
...
27
...
28
...
Posterior wall is deficient and incomplete and
is free from rectus muscle
...
29
...
30
...
Deep
inguinal ring is located within this fascia 1
...
Internal spermatic fascia and anterior wall of femoral sheath are prolongations
of this fascia
...
Structures passing through inguinal canal : Spermatic cord in male or round
ligament in female → enters through deep ring and exits through superficial
ring
...
32
...
33
...
It covers the spermatic cord below the superficial ring
...
It covers the whole of
spermatic cord
...
Direct inguinal hernia passes medial to the inferior epigastric artery
(posterior to deep ring) while, indirect inguinal hernia passes lateral to inferior
epigastric artery (through the deep ring)
...
Transpyloric plane passes anteriorly through tips of 9th costal cartileges and
posteriorly through L1 vertebra
...
Posteriorly : L3
...
Visceral peritoneum develops from splanchopleuric layer of lateral plate
mesoderm
...
Not sensitive to painful stimuli but
sensitive to ischaemia, stretch or distension → pain
...
Parietal peritoneum develops from somatopleuric layer of lateral plate
mesoderm
...
Pain sensitive
...
Abdominal police guard : Greater omentum
...
Mesothelial cells of peritoneum can transform into fibroblast and aid in
healing responses
...
(a) Structures developing from foregut : From esophagus to 2nd part of
duodenum (upto the level of opening of CBD), liver, GB, pancreas
...
(c) Structures developing from hindgut :
From left 1/3rd of transverse colon to proximal part of rectum
...
Structures developing from ventral mesogastrium : Lesser omentum,
triangular, coronary and falciform ligaments
...
Structures developing from dorsal mesogastrium : Greater omentum,
gastrosplenic, gastrophrenic and lienorenal ligaments
...
Greater omentum develops from dorsal mesogastrium
...
It hangs from greater curvature of
stomach
...
Right and left gastro epiploic vessels and fat are its contents
...
44
...
It is a fold of
peritoneum extending from lesser curvature of stomach to first 2 cm of
duodenum
...
Along
the right free margin there are : Hepatic artery, bile duct, portal vein plus
nerves and lymph nodes
...
45
...
It
extends from duodeno – jejunal flexure to upper part of sacro – iliac joint
...
46
...
47
...
When supine, it is the most dependent part of peritoneal
cavity
...
48
...
49
...
25 cm long
...
5 cm to the left of midline
...
Oesophageal carcinoma most commonly occurs at the lower
end
...
Epithelial lining of oesophagus : Stratified squamous nonkeratinising
...
Capacity of newborn stomach : 30 ml
...
Cardiac orifice of stomach : T11 level
...
53
...
54
...
55
...
Pyloric antrum is 7
...
5 cm
...
Secretory cells of stomach : Mucus cells, chief cells or peptic cells ( secrete
digestive enzymes) and parietal / oxyntic cells (secrete HCL)
...
Blood supply of stomach : Left gastric from celiac trunk, right gastric from
common hepatic, left gastroepiploic from splenic, right gastroepiploic from
gastroduodenal and short gastric ( 5 to 7 in number) from splenic artery
...
Sympathetic supply of stomach : T6 – T10
...
59
...
Lower end of esophagus and Meckel’s diverticulum may also be
affected
...
Carcinoma of stomach commonly affects greater curvature
...
61
...
Duodenum is fixed and rest is mobile
...
They start at second part of duodenum
...
Intestinal villi are finger like projection – more in
duodenum and jejunum and less in ileum
...
Peyer’s Patches are aggregated lymphatic follicles – are
seen in maximum number and in large size in ileum and small, few in number
in distal jejunum
...
62
...
Sympathetic nerve supply of small intestine → T9 – T11 and parasympathetic →
vagus
...
Shortest and widest part of small intestine is duodenum
...
25 cm long – 3rd part is longest (10 cm) and 4th part is shortest (2
...
3rd part courses between superior mesenteric artery and aorta and is
compressed in superior mesenteric artery syndrome causing obstructive
features
...
64
...
Ampulla of vater
opens at its summit
...
(b) Minor duodenal papilla :
6-8 cm distal to pylorus
...
65
...
I
...
66
...
Arterial arcades 1 or 2
...
Peyer’s patches are present
...
Shorter but numerous vasa recta
...
67
...
Calibre is nearly equal to ileum
...
68
...
1
...
Except for appendix,
transverse and sigmoid colon – large bowel is fixed
...
Appendices epiplicae are fat filled
pouches of peritoneum seen in large intestinal surface except appendix,
caecum, rectum
...
Small intestine vs large intestine : small intestine → Peyer’s Patches are
present (ileum), villi are present while, appendices epiploicae, taeniae coli,
sacculations are absent
...
Transverse mucosal folds are permanent in small intestine but may be
obliterated in large intestine
...
Pain impulses upto descending colon are carried by sympathetic nerves and
from sigmoid colon to rectum by pelvic splanchnic nerves
...
Caecum is a blind-sac more wide than its length (7
...
Ampullary type is the commonest (78%)
...
Caecum and appendix develop from post arterial segment of midgut
loop ( caecal bud)
...
Vemiform appendix : Arises from posteromedial wall of caecum, 2 cm
below the ileo – caecal orifice
...
Average length 9 cm (2-20 cm)
...
12 o’clock or
retrocaecal position is commonest (65%)
...
Appendicular artery is a branch of ileo – colic artery
...
Longest part of large bowel : Transverse colon (50 cm)
...
Physiological hernia of midnight returns at 10th week of gestation with 270o
anti-clockwise rotation
...
Origin of (a) celiac trunk : D12/ L1 , disc level (b) Superior mesenteric artery :
L1 ( 1 cm below celiac trunk) (c) Inferior mesenteric artery : L3 (behind third part
of duodenum (d)Portal vein : L2 (behind neck of pancreas)
...
Coeliac trunk is 1
...
Branches – left gastric, hepatic, splenic
arteries
...
Branches of common hepatic artery : gastroduodenal, right gastroepiploic,
superior pancreatoico duodenal, right gastric artery
...
78
...
Arteria pancreatica magna
is a branch of splenic artery
...
Jejunal and ileal branches of superior mesenteric artery are 12 – 15 in
number arising from left side
...
Branches of inferior mesenteric artery : superior left colic ( first branch),
inferior left colic (sigmoid), superior rectal ( continuation of IMA)
...
Median sacral artery is the terminal continuation of primitive abdominal
aorta
...
Marginal artery is an arterial arcade / anastomosis formed by : ileocolic,
right colic, middle colic, left colic, sigmoid arteries
...
83
...
Rt branch receives cystic vein before
entering right lobe and Lt branch receives ligamentum teres, ligamentum
venosum and paraumbillical veins before entering Lt lobe
...
84
...
Portal
hypertension : >40 mm Hg
...
85
...
86
...
Hepatic ducts
...
Accessory hepatic duct : Present in 15% of population
...
86
...
89
...
Spiral valves of Heister are
mucous folds – not true valves (5-12 in number)
...
Bile duct : After the cystic duct joins the common hepatic duct, it becomes
CBD
...
5 to 8 cm long, 6 mm wide
...
CBD &
MPD may open separately in the papilla also
...
Sphincter choledochus is located at the lower end of CBD before
termination
...
Sphincter pancreaticus is seen at the MPD before it opens in ampulla of vater
...
Sphicter surrounding the ampulla of vater sphincter of
oddi
...
Principal arterial supply of biliary apparatus : cystic artery
...
93
...
94
...
95
...
96
...
1 inch thick, 3
inches wide, 5 inches long, 7 ounces in weight and lies on 9th to 11th ribs
...
Long axis of spleen corresponds to long axis of 10th rib
...
Impressions on spleen : gastric, renal, pancreatic and colic
...
99
...
100
...
Smaller branches’ are end arteries
...
Malpighian’s corpuscle is in white pulp of spleen
...
Intrasplenic pressure is an indirect measurement of portal pressure
...
Most significant injury during splenectomy : Pancreatic tail
...
Spleen is palpable when it is enlarged twice its size
...
ANATOMY MCQS
1
...
Transpyloric plane goes through
a) T11 b) T12 c) L1 d) L2
3
...
4
...
Raspbery red tumour is due to
a) failure of physiological umbilical hernia to return
...
6
...
7
...
8
...
9
...
10
...
11
...
12
...
13
...
14
...
15
...
16
...
17
...
18
...
19
...
20
...
21
...
22
...
23
...
24
...
25
...
26
...
5 cm b) 3 – 3
...
5 – 5 cm d) 7
...
27
...
28
...
29
...
b) crypts of Liberkuhn are more
numberous in duodenum c) Payer’s patches are more numerous and large in
ileum
...
30
...
31
...
32
...
Which part of duodenum is horizontal?
a) D1 b) D2 c) D3 d) D4
34
...
35
...
36
...
37
...
38
...
39
...
40
...
Regarding branches of aorta which is wrong?
a) cystic artery is a branch of rt hepatic artery b) right gastric artery is a branch
of coeliac trunk c) splenic artery is the largest branch of coeliac trunk
...
42
...
43
...
44
...
45
...
b) CBD is approx 7
...
46
...
47
...
48
...
49
...
Which of the following is not a common site of porto-systemic
communication?
a) umbillicus b) bare of liver c) lower end of esophagus d) recto-sigmoid
junction
...
ANATOMY
ABDOMEN PART II
105
...
106
...
107
...
108
...
Superior (related to 1st part of duodenum), right
lateral (related to second part of duodenum) and inferior (related to 3rd part of
duodenum)
...
109
...
Of pancreas lies on : Lieno-renal ligament
...
Main pancreatic duct = Duct of wirsung runs close to the posterior surface
of pancreas
...
Opens in 2nd part of duodenum at ampulla
of vater, which in turn, opens at the summit of major duodenal papilla
...
Accessory pancreatic duct = duct of santorini crosses the main duct and
opens in minor duodenal papilla
...
Like duodenum, pancreas also has dual source of development and dual
arterial supply – coeliac trunk and superior mesenteric artery
...
113
...
Β cells
constitute approx 80%
...
114
...
Rest of the pancreas develops from dorsal bud
...
Accessory pancreatic tissue may be present in : duodenum, jejunum,
ileum, Meckel’s diverticulum
...
Largest gland in the body : Liver
...
Liver has 5 surfaces
...
118
...
119
...
120
...
121
...
Located in inferior surface of right lobe of
liver
...
Provides
attachment to lesser omentum
...
Parts of liver with no peritoneal coverings : bare area on the posterior
surface of right lobe, fossa for gall bladder, groove for IVC, coronary ligament,
lesser omentum
...
Contribution of hepatic supply by portal vein : hepatic artery → 4 : 1
...
No
anastomosis between adjacent hepatic arterial territories
...
Hepatic segments are divided by coinaud
...
Capsule of liver : Glisson’s capsule
...
Rectum : appendices epiploicae, taeniae coli and sacculations (features of
large bowel) are absent
...
There are 2
anteroposterior curves and 3 lateral curves
...
Rather, these become more
prominent
...
;
127
...
Others are middle rectal and median
sacral
...
Anal Canal : 3
...
Upper part is mucous part, middle part is the transitional zone
and lower part is cutaneous
...
Skin covering with sebaceous and sweat glands are seen in
lower part
...
Internal anal canal is involuntary
...
External and sphincter is voluntary and surrounds
the lower 8 mm of anal canal (below Hilton’s line)
...
130
...
It is formed by
puborectalis, deep external and internal sphincters
...
131
...
132
...
133
...
134
...
These are
painful but do not bleed on straining
...
Rectum and upper 15 mm of anal canal are endodermal in origin (above
pectinate line)
...
136
...
137
...
138
...
Medial margin of
two crura form a tendinous are anterior to aorta
...
139
...
140
...
141
...
(b) vena caval : IVC, branches of right phrenic nerve (c) aortic
: aorta, thoracic duct, azygos vein
...
Foramen o9f morgagni = space of Larry : space between xiphoid process
and 17th costal cartilage origin of diaphragm
...
143
...
5 cm
...
144
...
145
...
146
...
The stomach can ‘roll’ upwards into
posterior mediastinum (rolling hernia)
...
147
...
Cardial end of stomach
‘shide’ up through the opening (sliding hernia)
...
Commonest
internal hernia
...
Diaphragmatic eventration :
congenital weakness/defect of
diaphragmatic musculature
...
149
...
Posterolateral, more common on left side
...
150
...
Generally
asymptomatic
...
In the renal hilum, the structures from anterior to posterior are renal vein,
renal artery and pelvis
...
Vertebral level of kidneys – D12 to L3
...
Upper poles are more medial than lower poles
...
Renal fascia or fascia of Gerota has anterior layer called fascia of Toldt and
posterior layer called fascia of Zuckerkandl
...
154
...
155
...
Interlobular arteries do not anastomose with each
other – they are end arteries
...
Arterial supply of medulla : efferent arterioles of the Juxtaglomerular
glomeruli
...
157
...
158
...
159
...
160
...
161
...
It is crossed by uterine artery
...
Kidney develops from : metanephros
...
Congenital polycystic kidney results from failure of union of collecting and
secretary parts of kidney
...
Suprarenal glands are located at 11th intercostal space and 12th rib level
...
Right suprarenal gland is triangular or pyramidal and left one is semilunar
in shape
...
Right suprarenal gland has apex, base, 2 surfaces and 3 borders whereas
left gland has upper and lower ends, two borders and 2 surfaces
...
167
...
Superior
suprarenal artery is a branch of inferior phrenic artery and inferior suprarenal
artery is a branch of renal artery
...
Location of accessory suprarenal gland : around the main gland, in
spermatic cord, epididymis, broad ligament of uterus
...
Suprarenal cortical cells have numerous vacuoles in the cytoplasm
...
Suprarenal cortex is developed from mesoderm and medulla is developed
from neuroectoderm
...
Para – aortic bodies are located on each side of origin of inferior
mesenteric artery connected with each other in a ‘H’ or horse – shoe pattern
...
Secrete nor – adrenaline
...
Glomus coccygeum = coccygeal body is located in front of coccyx
connected to median sacral artery and ganglion impar
...
Abdominal aorta starts at aortic opening at D12 level and ends at the
bifurcation at lower border of L4
...
174
...
175
...
176
...
177
...
Renal artery arises below it
...
Ovarian artery enters broad ligament
...
179
...
180
...
It pierces the central tendon of diaphragm at T8 level
...
5 cm in
diameter (wider than aorta)
...
Left renal vein receives – left testicular / ovarian vein and left suprarenal
vein
...
Azygos vein is formed by union of ascending lumbar vein and subcostal
vein
...
183
...
It continues above as thoracic duct
...
External iliac nodes (8-10 in number) receive afferent from inguinal lymph
nodes, infraumbillical abdominal wall, medial (adductor) aspect of thigh, glans
penis/clitoris, urinary bladder (fundus), prostate, membranous urethra, cervix,
upper part of vagina
...
185
...
Superior part of Psoas major is in posterior
mediastinum
...
Nerve supply of Psoas major : L2, L3 ± L4, illiacus : L2, L3
...
187
...
(4th lumbar number gives contribution to :
lumbo sacral trunk)
...
188
...
189
...
It runs deep to medial
arcuate ligament and along the medial margin of Psoas major
...
Coeliac ganglia is the largest ganglia in the body, situated on either side of
celiac trunk
...
191
...
It is located behind
the lower part of pubic symphysis
...
Sphincter urethrae is located in deep perineal space
...
Empty of bladder is tetrahedral, full blader is ovoid
...
Apex of of bladder is connected to umbilicus via median umbilical
ligament
...
In males, superior surface of bladder is wholly covered by peritoneum
...
When the blader fills, the lower part of
anterior surface in both sex becomes devoid of peritoneum – comes in direct
contract with anterior abdominal wall
...
Trigone of bladder : located in lower part of base of bladder
...
Mucosa is smooth (does not show folding)
...
197
...
5 cm when empty, 5cm when
distended
...
Blood supply of bladder : superior and inferior vesical arteries in male,
superior vesical artery, uterine and vaginal arteries in females –
...
199
...
Symphathetic –
T11 to L2
...
Pain originating from bladder is conveyed via lateral spinothalamic tract
but sense of distension is conveyed via posterior column
...
201
...
202
...
18-20
cm in length
...
It is the part vulnerable to rupture in pelvic injury
...
External urethral meatus is the
narrowest part
...
Structures opening in prostatic urethra : prostatic utricle (opens in
colliculus seminalis), ejaculatory ducts, prostatic glands (open in prostatic
sinuses)
...
Prostatic utricle is a 6mm blind sac in prostate analogous to uterus or
vagina in females
...
Structures opening in penile urethra : ducts of bulbourethral glands,
urethral glands (of littre), lacuna of morgagni
...
206
...
207
...
Paraurethral glands of
skene are seen around it
...
208
...
Epispadius is common
associated finding
...
Pelvic diaphragm – which forms the pelvic floor – consists of levator ani
and coccygeus
...
Pelivic inlet is heart shaped in male and oval shaped in female
...
Sacrotuberous and sacrospinous
ligaments traverse from hip bone to sacrum
...
ANATOMY MCQS
1
...
2
...
3
...
4
...
5
...
6
...
7
...
8
...
9
...
10
...
11
...
12
...
13
...
14
...
15
...
16
...
17
...
18
...
19
...
20
...
21
...
22
...
Ans :- 1) d, 2) a, 3) b, 4) c, 5) c, 6) b, 7) d, 8) b, 9) b, 10) b, 11) c, 12) d, 13) a,
14) b, 15) a, 16) b, 17) a, 18) d, 19) b, 20) c, 21) d, 22) b
...
There are 3 muscles in body of penis – two corpora cavernosa and one
corpus spongiosa
...
Tunica albuginea covers the corpora cavernosa
...
3
...
Urethra is within spongiosa
...
Buck’s fascia or deep fascia of penis
...
5
...
Superficial external pudendal artery – a branch of femoral artery
supplies skin and fascia of penis
...
Deep artery of penis supplies – corpora cavernosa
...
Both are branches of internal
pudendal artery
...
Scrotum is supplied by widely separatewd dermatomes (L1, S3)
...
8
...
9
...
10
...
11
...
12
...
b) Right testicular vein drains into IVC, left testicular vein into left renal vein
...
13
...
U
...
iliac fossa – 3rd month, deep
inguinal ring → 4-6th month, inguinal canal – 7th month, superficial inguinal ring
at 8th month, scrotum – 9th month
...
Male genital structures are predominantly developed from mesonephric /
wolfian duct
...
Structures developed are : trigone of
bladder, epididymis, ejaculatory duct, seminal vesicles, ductus deferens
...
Appendix of testis and vestigeal component are developed from paramesonephric duct
...
16
...
17
...
18
...
19
...
This opens into prostatic urethra
...
Prodstatic venous plexus communicates with vertebral venous plexus of
Batson which is valveless
...
21
...
Maturation
of sperm occurs in epididymis (tail) and capacitation in female genital tract
...
Ductus deferens is 45 cm long when uncurled
...
In pelvis, it hooks round inferior
epigastric artery, crosses the obliterated umbillical artery, obturator and
vesical vessels and ureter
...
23
...
Forms the main secretory fluid of semen
...
Alkaline fluid contributes fructose and vesiculase to semen
...
Prostate is separated from rectum by fascia of denonvillers
...
Anterior lobe of prostate does not contain glandular tissue and hence does
not form adenoma
...
Median or middle lobe is a common site for carcinoma
...
75% of glandular tissue is in peripheral zone of prostate where carcinoma
starts 25% of glandular tissue is in central zone which undergoes benign
hypertrophy
...
True capsule of prostate is actually condensation of peripheral part of
prostate gland itself
...
False capsule is derived
from pelvic fascia
...
28
...
29
...
Lymphatic drainage is to internal iliac and sacral nodes and partly to
external iliac nodes
...
Vertebral venous plexus of Batson : Valveless
...
3 intercommunicating parts-epidural plexus,
within vertebral bodies and infront as well as behind the vertebral bodies
...
Spreads tumours and infection from prostate
...
In females, skenes glands (paraurethral) are equivalent to prostate
...
Primary sites for vertebral secondaries : breast (female), prostate (male),
kidney (both sex)
...
Ovarian fossa is bounded anteriorly by obliterated umbilical artery and
posteriorly by ureter and internal iliac artery
...
Ovary is covered by peritoneum except along anterior border or
mesovarium
...
It transmits vessels and nerves to / from ovary
...
Ovarian artery arises from aorta below the origin of renal artery
...
Uterine artery also
supplies part of ovary
...
4
...
The largest fimbria is called
ovarian fimbria (does not arise from ovary)
...
Interstitial part is narrowest and shortest
...
5
...
Normal anteflexion = 25°
...
6
...
7
...
8
...
Its upper border is free and contains fallopian tube
...
9
...
10
...
11
...
Round ligament, transverse
cervical ligament and uterosacral ligament are fibromuscular ligaments
...
The muscular / active supports include : pelvic
diaphragm, urogenital diaphragm and perineal body
...
Pelvic diaphragm resists rise of intra – abdominal pressure
...
Urogenital diaphragm is formed by 2 deep transversus perinii and one
sphincter urethrae muscle
...
14
...
It anchors the pelvic diaphragm
and maintains the integrity of pelvic floor
...
Mackenrodt’s ligament or cardinal ligament of uterus is transverse cervical
ligament – is a fan shaped condensation of pelvic fascia on either side of cervix
above levator ani
...
16
...
It maintains angle of anteversion
along with uterosacral ligament
...
17
...
Uterus, fallopian tubes are in turn, partly supplied by
ovarian artery
...
Lymphatic drainage of uterus and cervix : fundus and upper body → aortic
nodes + partly superficial inguinal nodes
...
Cervix → external iliac, internal iliac, sacral
...
Vagina : anterior wall 7
...
Lined by
nonkeratinising stratified squamous epithelium
...
Supplied by vaginal, middle rectal and
internal pudendal arteries
...
Lymphatic drainage of vagina : upper third – external iliac, middle third
internal iliac, lower third – superficial – inguinal
...
Upper 2/3rd of vagina is pain insensitive, supplied by autonomic nerves,
Lower 1/3rd is pain sensitive, supplied by pudendal nerve
...
Vagina has no gland of its own
...
23
...
24
...
25
...
26
...
Ends near the margin of
hymen
...
27
...
PERINEUM
1
...
2
...
3
...
Pudendal nerve
supplies – skin, muscles, mucus membrane of both urogenital and anal
triangles
...
Colles’ fascia is deep membranous layer of superficial perineal fascia
...
5
...
The
gap between transverse perineal ligament and arcuate pubic ligament
transmits deep dorsal vein of penis
...
Structures piercing the perineal membrane :
a) Male : urethra and urethral artery, deep and dorsal artery of penis, artery
and nerve to bulb, duct of bulbourethral glands, branches of perineal nerve
...
7
...
8
...
Superficial muscles : Ischiocavernosus, bulbospongiosus and superficial
transversus perneii
...
Gynaecological perineum : space between posterior commissure and anus
...
5 cm in length
...
Corpus cavernosa (2) are present in clitoris (like penis) but corpus
spongiosa is absent (unlike penis)
...
Contents of superficial perineal space : root of penis / body of clitoris,
superficial perineal muscles (see point no – 8), branches of perineal nerve and
artery, branches of artery of penis, ducts of bulbourethral glands in males /
greater vestibular glands and ducts in females
...
Contents of deep perineal space : part of urethra (+vagina in females), deep
perineal muscles (see point no – 8), dorsal nerve and artery of penis / clitoris,
muscular branches of perineal nerve, bulbourethral gland in males
...
Pudendal nerve is the principal nerve of perineum and external genitalia
...
Branches are inferior rectal, perineal,
dorsal nerve of penis / clitoris
...
Internal pudendal artery : principal artery of perineum and external
genitalia
...
Passes in front of piriformis and through the lesser sciatic foramen
...
15
...
PELVIC WALLS
1
...
2
...
Female : no inferior vesical artery
...
3
...
4
...
Efferents pass to common illiac nodes
...
Internal illiac nodes receive lymphatics from deep perineum, pelvic viscera,
muscles of buttock and back of thigh
...
6
...
Efferents to lateral aortic nodes
...
Sacral plexus is formed by lumbosacral trunk, S1 –S3 (ventral rami) and part
of S4
...
Important nerve supply : Pyriformis → S1, S2
...
Levator ani, coccygeus → S4
...
There are 4 sympathetic ganglia on each side in the pelvic sympathetic
system and one in front of coccyx (ganglion impar)
...
Levator ani has 2 parts : illiococcygeus, pubococcygeus
...
11
...
12
...
ANATOMY MCQS
1
...
2
...
3
...
4
...
U
...
b) seen in deep ring at 4 – 6th month c) seen in
inguinal canal in 7th month d) reaches scrotum at 9th month
...
Appendix of testis develops from
a) mullerian duct b) wolfian duct c) mesonephric tubules d) paramesonephric
tubules
...
Ejaculatory duct
a) opens into prostatic urethra b) develops from paramesonephric duct c) both
are true d) both are false
...
Sperms are fully mature in
a) head of epididymis b) fail of epididymis c) vas deferens d) female genital
tract
...
Fructose of semen comes from
a) seminal vesicle b) vas deferens c) prostate d) epididymis
...
Regarding prostate not true is
a) carcinoma is common in peripheral zone b) 25% of glandular tissue is in
peripheral zone c) prostatic urethra and ejaculatory ducts are within the gland
d) supplied by inferior rectal and vesical arteries
...
Anterior boundary of ovary is formed by
a) obliterated umbilical artery b) internal illiac artery c) ureter d) none
...
Part of ovary not covered by peritoneum
a) anterior border b) posterior border c) medial border d) lateral border
...
Ovarian artery supplies all except – a) ovary b) uterus c) ureter d) none
...
Widest part of fallopian tube
a) intramural b) isthmus c) ampulla d) infundibulum
...
Regarding uterine angles not true is
a) normal anteversion - 90° b) normal anteflexion 125° c) anteversion is
maintained by broad ligament d) uterosacral and round ligaments participate
in maintaining anteversion
...
Fallopian tube is contained within
a) upper margin of broad ligament b) lower margin of broad ligament
c) infundibulopelvic ligament d) round ligament
...
Broad ligament contains all except
a) round ligament b) fallopian tube c) mesovarium d) ovarian vessels
...
Which of the following provides weakest support to uterus?
a) broad ligament b) mackenrodt ligament c) round ligament d) uterosacral
ligament
...
Urogenital diaphragm is formed by
a) 2 deep transversus perinii b) sphincter urethrae c) a + b d) a+b+ 1 superficial
transversus perinii
...
Lymphatics from lower 1/3rd of vagina drains into
a) superficial inguinal b) deep inguinal c) external illiac d) internal illiac nodes
...
Gartner’s duct develops from
a) mesonephric duct b) paramesonephric duct c) epoophoron d) paraphooron
...
urethral fold gives rise to – a) labia majora b) labia minora c) clitoris d)
none
...
Pelvic diaphragm is formed by
a) pubococcygeus and ischiococcygeus b) levator ani and pubococcygeus
c) levator ani and ischiococcygeus d) all
...
Which of the following is not a deep perineal muscle?
a) sphincter urethrae b) deep transversus perinii c) ischiocavernosus d) none
...
Deep perineal space contains all except
a) urethra b) deep perineal muscles c) dorsal artery of penis / clitoris d) duct of
bulbourethral gland in male and greater vestibular gland in female
...
All are branches of pudendal nerve except
a) inferior vesical b) inferior rectal c) dorsal nerve of penis / clitoris d) perineal
...
In females, all are branches of anterior division of internal illiac artery
except
a) superior vesical b) inferior vesical c) inferior gluteal d) internal pudendal
...
All are branches of posterior division of internal illiac artery except
a) superior gluteal b) inferior gluteal c) iliolumbar d) lateral sacral
...
Predominant lymphatic drainage of cervix is to
a) external illiac nodes b) internal illiac nodes c) common illiac nodes d) pre and
paraaortic nodes
...
Pyriformis is supplied from – a) L5, S1 b) S1, S2 c) S2,3,4, d) L5 – S2
...
Strongest ligament of body is
a) ilio – lumbar b) anterior cruciate ligament c) ligamentum patellac d) sacro –
tuberous ligament
...
ANATOMY
HEAD, NECK, BRAIN
1
...
b) Foramen rotundum : maxillary nerve c) foramen
spinosum – middle meningeal artery d) foramen lacerum (upper part) : internal
carotid artery, venous and sympathetic plexus, greater petrosal nerve, (joins
deep petrosal nerve to form nerve of pterygoid canal) e) carotid canal : internal
carotid artery, venous and sympathetic plexus
...
2
...
Superolateral angles of dorsum sellae forms posterior clinoid process
...
a) Cilliary ganglion has sensory root from nasocilliary nerve and motor
ganglion at Edinger – westphal nucleus
...
4
...
5
...
c) III rd
...
d) IV th & VI th arch
...
= mandibular nv
...
External and recurrent
laryngial nv
...
Derivatives of pharyngeal pouches
Pouch
● Dorsal part of I & II (tubo tympanic
recess)
● Ventral part of II
...
● palaƟne tonsil
...
● V (ulƟmobranchial body)
● Parafollicular ‘c’ cells of
thyroid
...
Structures passing through foramen transversarium : vertebral artery, vein,
branch from inferior cervical ganglion
...
Dangerous area of scalp : loose areolar tissue layer
...
Muscle of a) Smiling – zygomaticus major b) sadness : levator labi superioris,
angularis
...
10
...
11
...
b) In infranuclear lesion (Bell’s palsy) the whole of the face of
same side is paralysed
...
Anaesthetist’s artery : facial artery
...
a) Lacrimal gland : located in the antero lateral part of roof of bony orbit
...
Indented by levator paepebrae superioris
...
b) Nasolacrymal duct : 18 mm
...
Open into inferior meat us
...
Contents of carotid sheath : common carotid artery, internal carotid artery,
internal jugular vein, vagus nerve
...
Common malignancy to spread to left supraclavicular lymph node
(virchow’s / scalene nodes) : CA stomach, testis
...
Vertebral artery is a branch of 1st part of subclavian artery
...
Two vertebral arteries join to form basilar
artery that runs in prepontine cistern
...
Froin’s syndrome : obstruction in sub arachnoid space by spinal tumour
causes yellow discolouration of fluid below the level of obstruction
...
Queckenstedi’s
test : No sudden rise fall of CSF pressure by coughing or jugular comnpression
...
Meckel’s cave (= trigeminal cave) : A recess of dura matter in relation to
attached margin of tentorium
...
Cavernous sinus : paired on either side of body of sphenoid bone
...
Roof, lateral and medial wall-formed by
meningeal dura matter
...
6th nerve and internal
carotid artery with its venous and sympathetic plexus run through the centre
of the sinus
...
Right and left
intercommunicate
...
In carotid cavernous fistula, superior opthalmic vein is
enlarged
...
a) Superior sagittal sinus : starts by union of tiny meningeal veins and ends
by being continuous with right transeverse sinus
...
b) Inferior sagittal sinus joins great vein of Galen to form straight sinus
...
Each
transverse sinus becomes continuous with sigmoid sinus
...
Confluence of venous sinuses is
called ‘torcula’
...
There are paired and unpaired dural venous sinuses
...
Transeverse sinus, sigmoid sinus,
cavernous sinus, super and inferior petrosal sinuses are paired
...
Cavenous sinus drains into transverse sinus via superior petrosal sinus and
into internal jugular vein via inferior petrosal sinus
...
Middle meningeal artery : A branch of maxillary artery (1st part)
...
It is the artery of extradural
haemorrhage – frontal (anterior) branch is commonly involved which is larger
than pariental branch
...
Cervical part of ICA has no branch
...
Cerebral part gives rise to :- anterior and middle
cerebral, posterior communicating, ophthalmic, anterior choroidal arteries
...
Extra ocular muscles include : a) Voluntary : all recti (4), obliques (2),
levator palpebrae superioris (b) involuntary : superior tarsal (deeper portion of
levator palpebrae superioris), inferior tarsal and orbitalis
...
Nerve supply : SO – 4th (trochlear), LR 6th and all
others – 3rd
...
Optic nerve : Formed by axons of ganglion cell layer of retina 4 cm long
...
27
...
Innervates both extra
ocular and intraocular muscles
...
Nucleus located in midbrain at
the level of superior colliculus
...
Effects of 3rd nerve palsy : ptosis, mydriasis, mild
proptosis, lateral squint, diplopia, loss of accommodation
...
28
...
29
...
Lies near the apex of orbit between optic nerve and lateral rectus
tendon
...
30
...
Compressed most
commonly by pathologies (tumour, infection etc
...
Lacrimal nerve is the smallest and frontal nerve is the largest branch of
ophthalmic nerve
...
Terminal branches of external carotid artery : superficial temporal,
maxillary
...
Infra hyoid muscles of neck : sternohyoid, sternothyroid, thyrohyoid,
omohyoid
...
34
...
Geniohyoid is supplied by C1 through 12th nerve
...
35
...
36
...
Carotid body is located behind the
bifurcation of CCA
...
37
...
Supplies the infrahyoid muscles except thyrohyod
...
Inferior root comes from C2, C3 nerves (descending cervical nerves)
...
Parotid duct : 5 cm long
...
Runs on
masseter
...
39
...
Relay in otic ganglion
...
7th nerve : Parasympathetic, secretomotor fibers from 7th nerve supplies
sub mandibular, sub lingual and lacrimal gland but not parotid
...
Chorda tympani, greater petrosal, nerve to stapedeus, posterior auricular
...
3 important ganglia in relation to 7th nerve – geniculate, pterygo
palatine and sub mandibular
...
Important branches of maxillary artery : middle meningeal, accessory
meningeal, inferior alveolar, anterior tympanic, deep auricular, greater
palatine
...
42
...
Nerve of 1st arch
...
Important branches –
auriculotemporal lingual, inferior alveolar
...
43
...
Related to mandibular nerve, but functionally a part of
glossopharyngial (9th) nerve
...
44
...
Arises from anterior end of deep part
...
Opens on floor of moluth at the side of frenulum at
the summit of sublingual papilla
...
Blood supply of thyroid : inferior thyroid artery from thyrocervical trunk
(branch of subclavian artery), superior thyroid artery from external carotid and
lowest thyroid or arteria thyroidea ima (present in 3 %) from brachiocephalic
trunk or arch of aorta directly
...
Branches of subclavian artery : vertebral, internal thoracic (mammary),
thyrocervical trunk, costocervical trunk, dorsal scapular
...
Costocervical trunk arises
from 2nd part
...
Internal jugular vein begins as a continuation of sigmoid sinus at the jugular
foramen, and ends by joining with subclavian vein to become brachiocephalic
vein posterior to sternal end of clavicle
...
48
...
Motor to stylopharyngius,
secretomotor to parotid, gustatory to posterior third of tongue (anterior 2/3rd
by chorda tympani of 7th nerve) and sensory to pharynx, tonsil, posterior third
of tongue, carotid body and carotid sinus
...
49
...
N
...
ambiguous,
dorsal nucleus of vagus, N
...
50
...
51
...
Supplies all intrinsic muscles of larynx except
cricothyroid
...
52
...
53
...
54
...
Superior is formed by fusion of upper
4, middle by 5th & 6th and inferior by 7th and 8th
...
55
...
Occurs due to injury / compression to cervical sympathetic trunk
...
Cervical plexus is formed by ventral rami of upper 4 cervical nerves
...
Phrenic nerve : mixed nerve conveys motor fibers to diaphragm and
receives sensory fibers from diaphragm
...
Formed
at the level of thyroid cartilege
...
Prevertebral space contains : vertebral artery, 4 muscles, joints
...
4th part enters the cranial cavity through
foramen magnum
...
59
...
60
...
61
...
They support
atlantooccipital as well as atlanto-axial joints
...
62
...
Tentorium cerebelli encloses transverse sinuses, superior
petrosal sinus
...
Substantia gelationosa : Found at the tip of posterior horn
...
Lamina II of cord
...
Its axons give rise to lateral spinothalamic tract
...
Rubrospinal tract : Efferent pathway for cerebellum and corupus striatum
...
Crossed fibers, spinal segment C1 –C5
...
65
...
Of these, 3rd nerve is at the
level of superior colliculus, 4th nerve at the level of inferior colliculus, 8th nerve
at the junction of pons and medulla
...
Location of specific nuclei : a) Medulla → dorsal nucleus of vagus, tractus
solitarius, gracillis, cuneatus, ambiguous, arcuate, inferior olivary, b) Pons →
superior and inferior salivatory, vestibular, cochlear
...
67
...
68
...
69
...
Formed by the fibres arising in the cochlear nuclei of both sides
...
70
...
Midbrain anterior to cerebral aqueduct is called cerebral
peduncle
...
Medial and lateral geniculate bodies constitute metathalamus
...
Superior colliculus is connected to LGB and inferior
colliculus to MGB
...
72
...
[Note : both afferent from and efferent to subthalamic nucleus]
inhibits muscle tone
...
a) Central sulcus of Rolando divides frontal lobe from parietal lobe
...
74
...
75
...
76
...
Located in the lateral wall of 3rd
ventricle the main relay station(except olfactory)
...
Pineal body : projects between two superior colliculi
...
78
...
Located
on floor and lateral wall of 3rd ventricle (below thalamus)
...
79
...
Caudate N +
putamen = striatum
...
Corpus callosum : largest commissure of brain
...
From anterior to posterior genu, body, splenium and
rostrum lies posteroinferior to genu
...
Rostrum and forceps
minor (genu) connect to frontal lobes
...
Lateral ventricles become wide apart and parallel in callosal
agenesis
...
Internal capsule : V shaped
...
Contains fibers from and to the cerebral cortex
...
Important pathways : a) cortico spinal = pyramidal tract : motor cortex →
internal capsule → brainstem → decussaƟon at medulla → spinal cord →
effector region
...
c) Auditory : cochlear nuclei → ± crossing at
trapezoid body → superior olivary nuclei → inferior colliculus → MGB →
auditory radiation → auditory cortex (temporal)
...
Important areas in cerebral cortex
...
paracentral lobule
...
b) Frontal eye field in
Frontal
6, 8
middle frontal gyrus
...
f) Visual association
Occipital
18, 19
visuo – psychic
g) Auditory : superior
Temporal
41, 42
temporal and anterior
transverse temporal
gyrus
h) Wernicke’s
Temporal
22
ANATOMY MCQS
1
...
2
...
3
...
b) greater petrosal nerve c) accessory meningeal artery
d) emissary vein
...
Greater petrosal nerve passe through
a) foramen lacerum b) foramen rotundum c) foramen ovale d) foramen
spinosum
...
Otic ganglion receives sensory branch from
a) greater auricular nerve b) auriculo temporal nerve c) marginal mandibular
nerve d) facial nerve
...
All of the following pass through superior orbital fissure except
a) 3rd nerve b) lacrimal nerve c) nasocilliary nerve d) superior ophthalmic
artery
...
Nerve of 1st arch is
a) V2 segment of 5th nerve b) maxillary nerve c) mandibular nerve d) facial
nerve
...
Greater cornu of hyoid bone arises from
a) 1st arch b) 2nd arch c) 4th arch d) none
...
7th nerve is a derivative of – a) 1 arch b) 2nd arch c) 3rd arch d) 4th arch
...
Pharyngial pouch giving rise to palatine tonsil
a) 1st b) dorsal part of 2nd c) ventral part of 2nd d) 3rd
...
Which of the following statements is wrong?
a) superior parathyroid develops from 4th pharyngeal pouch b) inferior
parathyroid develops from 3rd pouch c) parafollicular ‘c’ cells of thyroid
develops from 5th pouch d) palatine tonsil develops from 3rd pouch
...
Foramen transversarium of C7 vertebrae give passage to all except
a) vertebral artery b) vertebral vein c) accessory branch of subclavian artery
d) branch of inferior cervical ganglion
...
Which of the following is not a muscle of mastication
a) buccinator b) masseter c) both pterygoids d) temporalis
...
Which of the following is anaesthetist’s artery?
a) lingual b) facial c) mandibular d) external carotid
...
Which of the following is a content of carotid sheath?
a) 7th nerve b) 8th nerve c) 9th nerve d) 10th nerve
...
Vertebral artery is a branch of
a) sub clavian A b) brachiocephalic trunk c) left common carotid A d) aortic
arch
...
First branch of subclavian artery
a) thyrocervical trunk b) costocervical trunk c) internal mammary A
d) subclavian A
...
Albumino – cytological dissociation is a feature of
a) Froin’s syndrome b) Horner’s syndrome c) Wilson’s disease d) obstructive
hydrocephalus
...
Structures passing through cavernous sinus are all except
a) 3rd nerve b) 4th nerve c) 6th nerve d) 7th nerve
...
Structure enlarged in carotico – cavernous fistula
a) superior ophthalmic vein b) inferior ophthalmic vein c) superior orbital vein
d) central retinal vein
21
...
22
...
23
...
24
...
25
...
26
...
27
...
28
...
29
...
30
...
31
...
32
...
33
...
34
...
35
...
36
...
37
...
38
...
39
...
40
...
41
...
42
...
43
...
44
...
45
...
46
...
47
...
48
...
49
...
50
...
51
...
52
...
53
...
54
...
55
...
56
...
57
...
58
...
59
...
60
...
61
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Ans : -1) b, 2) c, 3) b, 4) a, 5) b, 6) d, 7) c, 8) d, 9) b, 10) c, 11) d, 12) c, 13) a, 14)
b, 15) d, 16) a, 17) d, 18) a, 19) d, 20) a, 21) b, 22) a, 23) a, 24) c, 25) b, 26) a,
27) c, 28) b, 29) d, 30) a, 31) d, 32) a, 33) c, 34) a, 35) b, 36) c, 37) c, 38) a, 39) c,
40) d, 41) b, 42) a, 43) c, 44) c, 45) a, 46) b, 47) d, 48) a, 49) a, 50) d, 51) c, 52)
c, 53) a, 54) d, 55) a, 56) c, 57) d, 58) c, 59) a, 60) a, 61) c
Title: Medteck
Description: Easy way to get knowledge on anatomy with simple points
Description: Easy way to get knowledge on anatomy with simple points