Anatomy - Last moment revisions

Study of the microscopic structure of the human organism co related with the development,
function and clinical significance.
It is derived from Greek term anatome meaning cutting apart.
EMBRYOLOGY
It is the study of the formation and development of the embryo from the moment of its inception
upto
the time when it is born as an infant.
Gonads: no: of chromosomes in an organism=23 pairs/46 no.
-----44 autosomes XY
----44 autosomes - XX
Karyotyping : Classification of chromosomes based upon their differences that enable us to
identify each chromosome individually.
Spermatogenisis : The process of formation and development of spermatazoan .
Formed in the wall of the seminiferous tubules of testes.
Spermiogenesis (spermateleosis) : The process of transformation of a circular spermatid to a
spermatozoan.
Mature spermatozoan: Has a head, a neck middle piece and a principal piece or tail. Head is
covered with a cap called acrosome.
Length -50-60 microns
Golgi apparatus forms the acrosomic cap.
Nucleus forms head.
Mitochondrion forms the sheath of middle piece.
Proximal centriole comes to lie in the neck.
Distal centriole becomes ring shaped and forms the annulus.
Axial filament grows out from the centriole and is present in middle piece and tail.
Viability of spermatozoa =4 days.
Ovulation: The shedding of ovum from the ovary.
Corpus luteum- It is an important structure derived after the rupture of ovarian follicle to shed
the ovum.
It secretes hormone progesterone.
Viability of ovum =24 hrs
Menstrual cycle: Divided into 4 phases
1.Post menstrual phase
2.Proliferative
3.Secretory(premenstrual)
4.Menstrual
Follicular phase ---post menstrual + proliferate phase -~ Oestrogen
Luteal phase secretory +menstrual phase -~ progesterone
Size of Oocyte 120u.
Approximate number of occytes at pubertyaround 40,000.

Approximate number of ova liberated during reproductive period of femalearound 300 to

400.
Time required for formation of spermatozoa from spermatogonium64 days.
Fertilized ovum reaches uterine cavityby 4 days.
Implantation of ovum (fertilized) occursabout 7th day.
Primitive uteroplacental circulation beginsby end of 2nd week.
Number of somites in embryo 42 to 44.
Time of somite formation 21 to 30th day.
Organogenesis from 4th to 8th weeks.
Formation of primary ovary in a female takes place by 8th week
Differentiation of genital organs
1.Persons with two X chromosomes are female; those with one x and one y are male.
2.Y chromosome bears a gene responsible for production of a testis determining factor.
3.Interstitial cells in testis produce testosterone .It forms a complex with certain receptor
proteins which attaches itself
to DNA. This causes the mesonephric duct to develop as in male.
4.Presence of dihydrotestosterone .
5.Sertoli cells produce mullerian inhibiting substance .This causes regression of paramesonephric
ducts.
Genital swellings in male differentiate into scrotum whereas in a female, they form labia majora.
The mesonephric duct in a female develops into Gartner's duct.
The Mullerian ducts in male develop into appendix testes whereas in a female, they develop into
uterus and uterine tubes.
In female, the homologue of prostatic glands are paraurethral glands.
FOETAL CIRCULATION
Differs from adult circulation in
a) Source of oxygenated blood is not the lung but the placenta.
b) Oxygenated blood from placenta comes to foetus through umbilical vein and joins the left
branch of portal vein.
Small portion passes through the substance of the liver to I V, but the greater part passes direct
to I V through the ductus venosus.
Changes at birth: 1) umbilical artery contracts.
2) Lumen of umbilical veins and ductus venosus occludes and this takes place a few minutes
after birth.
3) Ductus arteriosus occludes by about 10 th day.
4) Pulmonary vessels increase in size.left atrial pressure rises than that of right atrium and leads
to closure of foramen ovale.
Remnant of
Umbilical artery - medial umbilical ligament
Left umbilical vein - ligament teres of the liver
Ductus venosus - Ligamentum venosum
Ductus arteriosus - Ligamentum arteriosum

OSTEOLOGY
Study of bones.
Bones are divided according to their
1)Position
Human skeleton -------axial} bones of skull, vertebral column, ribs,
sternum, hyoid.
-------appendicular} bones of pectoral, pelvic girdle ,upper and lower
limbs
2) Shape
Long bones: eg: Femur, tibia, humerus, ulna, radius, and fibula
Short long bones: eg: Metacarpals, metatarsals, phalanges
Short bones: eg: Carpals, tarsals
Flat bones: eg : Scapula , sternum, ribs, parietal and frontal.
Pneumatic bones : Maxillary ,sphenoid , ethmoid, mastoid part of temporal bone.
Irregular bones: eg: Vertebrae, skull bones
Sesamoid bone: eg: patella, pisciform, fabella
2)Structure
Compact bone =consisting of haversian system
Cancellous (spongy) bone = consisting of irregularly placed lamellae.
Diploic =consisting of inner and outer tables of compact bone with intervening porous layer.
3)Development
Ecto chondral bones: which develop in membrane (membranous)
Endochondral bones: which develop in cartilage. (cartilageneous)
Total no of bones ---206
Upper limbs-64
Lower limbs-62
Vertebrae-33
Skull
- 29(14-facial bones
- 14- cranial bones , hyoid bone )
Sternum-1
Ribs- 12 pairs
Longest bone---femur
Smallest bone---stapes
Strongest part in human body- Enamel of teeth
Largest sesamoid bone --- Patella developing in quadriceps.
Microscopic unit of a bone: Haversian system (secondary osteone)

Ossification
Process of gradual bone formation.
a)Ossification in membrane (direct)easy process
Eg: clavicle, bones of face,vault of skull.

b)Ossification in cartilage (Indirect) ---gradual process.

Eg: bones of limbs, trunk.
Secondary cartilage bone: eg: neck of mandible, sternal end of clavicle.
Primary centres of ossification may be single or multiple ,appear before birth between 6th 8th
week of foetal life
except cuneiform ,navicular bones .
Secondary centres of ossification are multiple and appear after birth except lower end of femur.
Ossification of acetabulum is complete at 16-17 years
Growing ends of bones of upper limbupper end of humerus & Lower end of radius and
ulna
Growing ends of bones of lower limbs ---- lower end of femur & Upper limbs of tibia and fibula
In long bones, growing ends fuse with shaft at 20 yrs and opposite ends at about 18 yrs.
In other bones it is between 20-25 yrs.
Types of epiphysis are :
a) Pressure epiphyses - located at pressure points like joints
b) Traction epiphyses: subjected to traction by pull of muscles when located at the muscular
attachment
c) Atavistic epiphyses: centre appearing in the part of bone which was orginally a separate bone
in evolution eg : Coracoid
process of scapula.
Hyaline cartilage has a tendency to get calcified in later years of life.
Skull bones22 bones
Facial bones (14)-paired-nasal, maxillae, zygomatic, palantine, lachrymal, inferior nasal
connchae.
Unpaired-mandible, vomer
Cranial bones (14)-paired- parietal, temporal, ear ossicles
Unpaired- frontal, ethmoid, sphenoid, occipital.
Carpal bones- 8 bones Lat TO medial (Proximal) Scaphoid, lunate, triquetral, pisiform
(Distal)Trapezium, trapezoid, capitate, hamate.
Tarsal bones-7 bones (proximal) Talus, calcaneus
(distal) medial cuneiform, intermediate cuneiform, lateral cuneiform, cuboid.
Largest and strongest of tarsal bonesCalcaneus
Paranasal sinuses 4 pairs : Frontal, sphenoidal, ethmoidal, maxillary.
Largest of all air sinuses ---Maxillary sinus (Antrum of Highmore)
Foramina of skull
Anterior cranial fossa :
1.Foramen caecum: lies between the alae of crista galli of ethmoid and frontal crest. Transmits
an emissary vein.
Middle cranial fossa:
2.Optic canal (foramen): Transmits optic nerve, opthalmic artery.

3.Superior orbital fissure: Bounded by lesser wing above, greater wing below and body of
sphenoid medially.
Divided by three compartments by common tendinous ring.
Transmits superior and inferior divisions of oculomotor, nasociliary nerve, abducent nerve,
trochlear nerve, frontal nerve,
lacrimal nerve, lachrimal artery, orbital branch of middle meningeal artery, superior ophthalmic
vein,recurrent meningeal
branch of lachrymal artery, inferior ophthalmic vein.
4.Foramen rotundum---transmits maxillary nerve.
5. Foramen ovale --- transmits mandibular nerve,accessory meningeal artery ,lesser superficial
petrosal nerve, emissary vein.
6. Foramen spinosum--- transmits middle meningeal artery, nervus spinosus
7. Foramen lacerum--- transmits Internal carotid artery.
8. Carotid canal---- transmits internal carotid artery with plexus,
emissary veins, meningeal
lymphatics.
Posterior cranial fossa:
9. Jugular foramen --- transmits 9th,, 10, 11th cranial nerves.
10. Foramen magnum---largest foramen in skull.
Divided into anterior small compartment: Apical ligament
Upper band of cruciate ligament
Condylar parts on sides.
Posterior large compartment: lower end of medulla oblongata, 2 anterior and one posterior
spinal artery, veins joining
venous plexus, lower part of tonsil of cerebellum, vertebral artery, sympathetic plexus, spinal
root of accessory nerve.
Ribs: 12 in number on each side.
True ribs1-7th
False ribs--- 8-12th
Floating ribs --- 11-12th
Atypical ribs1, 2, and 10.11, 12th.
Folds of duramater
Falx cerebri encloses superior sagittal sinus, inferior sagittal sinus,
straight sinus
Tentorium cerebelli- encloses transverse sinuses, posterior petrosal
sinuses.
Falx cerebelliencloses occipital sinus
Diaphragma sellaeencloses anterior and posterior intercavernous sinuses.
Important points in skull
1.Bregma: meeting of coronal and sagittal sutures.site of anterior fontanelle, closes at 11/2 yrs
of age.

2 .Lambda: meeting of sagittal and lambdoid sutures .site of posterior fontanelle ,closes at 2-3
months of age.
3. Nasion : meeting point of internasal and fronto nasal sutures.
4. Inion : centre of external occipital protruberance.
5. Pterion : area formed by meeting of frontal, squamous part of temporal ,parietal, greater wing
of sphenoid.deep to
this lies anterior branch of middle meningeal artery, middle meningeal vein ,stem of the lateral
sulcus.
6. Asterion : point at the postero inferior angle of parietal bones.
Diaphragm
Inferior aperture (outlet )of thorax.
Aortic openingT12- transmits Aorta, thoracic duct, Azygos vein
Oesophageal openingT10-transmits oesophagus, gastric nerves, oesophageal branches of left
gastic artery.
Venecaval opening --- T8 transmits inferior venecava, branches of right phrenic nerve.
CEREBROSPINAL FLUID (CSF)
Definition
CSF is a modified tissue fluid in the central nervous system. It is contained in the ventricular
system of brain and the
subarad space of brain and spinal cord. CSF replaces lymph in the CNS. It acts as a sensitive
mirror which reflects
diseases of the na system. Formation
1.The bulk of the CSF is formed by choroid plexuses of the lateral ventricules, and the lesser
amounts by the choroid plexus
the third and fourth ventricles. '
2.Possibly it is also formed by the capillaries on the surface of the brain and spinal cord.
Circulation
CSF passes from the lateral ventricles to the third ventricle through foramina of Monro
(interventricular foramina). From
ventricle it passes to the fourth ventricle through cerebral aqueduct. From fourth ventricle the
CSF passes to the subarachnoid
around the brain and spinal cord through the foramen of Magendie and foramina of Luschka.
Absorption
1.CSF is absorbed chiefly by the arachnoid villi and granulations, and is thus drained to the
cranial venous sinuses.
2.It is also absorbed partly by the perineural lymphatics around I, II, VII and VIII cranial nerves
3.And also by the veins related to the spinal nerves.
Rate of Formation
200 cc/hour, 5000 cc/day.
Total Quantity
About 150 cc. Pressure:60-150 mm of fluid (or water). Composition
Proteins
20-40 mg per 100 cc.
Sugar
50-75 mg per 100 cc.

Chlorides
Cells

720-750 mg per 100 cc.

0-5 per cubic mm

Functions
It is (a) protective, (b) nutritive, and (c) excretory to the CNS.
Applied Anatomy
1.CSF can be obtained by (a) lumbar puncture, (b) cisternal puncture, or (e) ventricular
puncture. Lumbar puncture is 1st
method of all and is commonly used. It is done in the interspace between third and fourth
lumbar spines.
2.Biochemical analysis of the CSF is of diagnostic value, as the cases of meningitis and spinal
tumours.
3.Drainage of CSF at regular intervals is of therapeutic value in meningitis. Certain intractable
headaches of unknown are
also known having been caused by a mere lumbar puncture with drainage of CSF.
4.Obstruction to the flow of CSF in the ventricular system of brain leads to hydrocephalus in
children .Spinal obstruction
leads to Froins syndrome.
Length of parotid duct: 5 cm.
Length of submandibular duct: 5 cm.
Length of auditory tube: 36 mm.
Bony part: 12 mm.
Cartilagenous part: 24 mm
Length of external acoustic meatus(from bottom of choncha):
Bony part:16 mm.
Cartilagenous part:8 mm.
Transverse diameter of mid cavity
Opposite the centre of tympanic membrane:
2 mm.

2.4 cm.

Total number of cones in the retina: 6.3 to 6.8 million.

Length of pharynx: 12 to 14 cm
Length of larynx
Length of vocal cords
Length of Trachea Pituitary gland:
13 x 8 mm.
Heart
Measures 12 x 9 cm (5x3 or 3.5 inches)
Weight 300 g (males)
250 g (females)
Termination of oesophagus 11th Thoracic vertebra.
Constrictions in oesophagus :

at commencement 15 cm from incisor teeth.

at crossing over by aortic arch 22.5 cm from incisor teeth.

at crossing over by left principal bronchus 27.5 cm from incisor teeth.

at its point of piercing diaphragm 40 cm from incisor teeth.

Stomach :

Cardiac orifice Behind left 7th costal cartilage 1" from its junction with sternum.

Pyloric orifice 1.2 cm (0.5") to the right of midline on transpyloric plane.

Capacity at birth 30 ml; adults 1500 ml.

Length of small intestine: 6 to7 metres
Length of duodenum: 10 or 25 cm
1 st part: 5 cm
2nd part: 7.5 cm
3rd part: 10 cm
4th part: 2.5 cm
Length of large gut: 1.5 metres
Anal canal
Hilum of kidney Transpyloric plane (LI).
Kidney:Length: 11 cm, Breadth : 6 cm, Antero-posterior diameter: 3 cm
Length of Ureter : 25 cm
Length of male urethra: 18-20 cm
Spermatic cord : 9-10 cm
Length of inguinal canal: 4 cm
Testis: Length-4.5 cm, Breadth-2.5cm, Anteroposterior dr-3
Ovary: Length
-3 cm, Width-1.5 cm,Thickness-1 cm
Uterus: Length-7.5 cm, Breadth-5 cm,Antero-posterior diameter-2.5 cm
Weight :30 to 40 gms
Uterine tubes: Length-10 cm
Saphenous opening Height 1.5 to 8 cm; Width 1 to 3 cm
Femoral sheath Length 3 to 4 cm.
Femoral canal Length 1.25 cm.
Tendo calcaneus Length 15 cm.
Weight of spinal cord 30 gms.
Length of spinal cord 45 cm.
Filum terminale 20 cm.
Internum 15 cm.
Externum 5 cm.
Commencement of spinal cord Cranial border of C1 vertebra (Atlas).
Termination of spinal cord - lower border of LI or disc between LI & L2 vertebrae.
Cervical enlargement of spinal cord Circumference 39 mm. Extends from LI to SI spinal
segments.
Lumbar enlargement of spinal cord Circumference 35 mm. Extends from LI to S3 spinal
segments.
Vertebral levels of spinal segments
Cervical vertebral spine corresponds to succeeding cord segment Eg : C6 spine to C7 segment.
Upper thoracic spine corresponds to two spinal segments lower Eg : T4 spine corresponds to T4
spinal segments.

Lower thoracic spine corresponds to three spinal sements below Eg : T10 spine to LI spinal
segment. T11 spine to
L3segment, T12 spine to SI segment.
New born child lower limit of spinal cord is at L3 vertebral upper border.
Length of medulla oblongata 3 cm.
Shortest segment of brain stem mid brain 2.cm.
Thalamus-Length - 4 cm.
Corpus callosum length 10 cm.
Specific gravity of C.S.F: 1007.
Pressure of CSF (in recumbent position):100 to 150 mm of H2O
Total volume of CSF in man: 140 ml; amount of CSF in Ventricles 25 ml.
Commencement of subclavian artery Behind sternoclavicular joint.
Termination of Subclavian artery Outer border of 1st rib.
Termination of Brachial artery Neck of radius.
Thoracic Aorta :
Commencement T4 Vertebral lower border.
Termination T12 Vertebral body.
Abdominal Aorta commencement T12 Vertebral body.
Coeliac Trunk:Origin T12, Length 1.25 cm.Superior mesenteric artery LI.
Inferior mesenteric artery L3.
Commencement of common iliac L4 vertebral body.
Bifurcation of common iliacSacroiliac joint
External iliac termination Mid-inguinal point.
Vertebral prominence C7.
Superior angle of scapula T2.
Upper border of manubrium sterni (suprasternal notch)T2, T3 vertebral junction.
Spine of scapula T3
Sternal angle T4 & T5 (Disc between).
Inferior angle of scapula T7.
Xiphisternal joint T9.
Tonsil is derived from 2nd pouch
CSF to plasma glucose ratio is normally 0.6 to 0.8
Appearance of permanent kidney 5th week of Intrauterine period.
Invasion of primordial germ cells into developing gonad 5th week.
Appearance of neural plate (nervous system) 3rd week.
Development of eye between 4th and 7th weeks.
Appearance of limb buds beginning of 5th week.
Descent of testis:
At deep inguinal ring 7th month of intra uterine life.
In inguinal canal 8th month of intrauterine life.
At superficial inguinal ring 9th month of intrauterine life.
Haller's circle is found in the Pyloric orifice.

Marginal artery of Sudeck lies at 2.5-3.8 cm from colon.

Portal vein is about 8 cm long.
The maximum breadth of mesentry is in central part and is 8 inches
The lesser omentum is a fold of peritoneum extending from lesser curvature of stomach and first
2 cm of duodenum to the liver.
Common carotid artery is derived from III aortic arch.
At full term, diameter of placenta is 6-8 inches.
Mesentry contains about 100-200 lymph nodes.
Between lowest sigmoid and sup. Rectal artery anastomosis is regarded as the critical point of
Sudeck.
Mesentry is fan shaped fold of peritoneum.
Total area of placenta is 14 sq. m.
Oesophagus structure is related to both left and right lung.
Weight of parathyroid gland is 50 mg.
Length of caecum is 6 cm.
Sprain of ankle is most often due to abduction.
The superficial muscles of the back of leg are supplied by S1,2.
Thickness of suprarenal is 10 mm.
Duodenojejunal is largest duodenal recess.
Cisterna chyli is 5-7 cm long.
Ovary has minimum thickness.
V pharyngeal arch disappears at the earliest.
Weight of prostate gland is 8 gm.
Longest part of duodenum is III.
Left dome of diaphragm corresponds to the lowest part of 5 rib.
Width of stomach is 10-12 cm.
Claustrum is situated between putamen and Insula

Third ventricles are derived from Diencephalon.

Thickness of spleen is 3-4 cm.
Middle one third of transverse colon is derived from midgut.
Placental membrane at its formation is 0.025 mm thick.
Syncytiotrophoblast is called plasmoditrophoplast.
Midbrain is Mesencephalon.
The left brachiocephalic vein is about 7.5 cm long.
Deep palmar arch is about 4 cm long.
Spine of scapula corresponds to 3rd thoracic spine.
Pereoneal tubercle if felt as a prominence about 2.0 cm below tip of lateral malleolus.
Hip joint lies 1.2 cm vertically below the middle third of inguinal ligament.
Pulmonary arteries are derived from VI aortic arch.
Ischial tuberosity is felt 5.0 cm away from the median plane.
Nelaton's line touches the centre of acetabulum, ishcial tube and Ant. sup. iliac spine.
Filum terminale is about 20 cm long which extends from conus medullaris to the back of the 1st
coccygeal vertebral segment

10

The duramater of spinal cord ends at S2 vertebral level.

Erb's point is C4 C5.
Ureter is 50 cm long.
Distance between upper incisors and gastroesophageal junction is 40 cm.
The ratio of weight of liver and weight in an adult is 1: 40.
Oesophagus crosses the diaphragm at level of T10.
Developing gonad is identified as male or female by the end of 7th week.
The infant with pupillary membrane must have been product of pregnancy lasting less than 7
months.
Stillborn foetus with eyelids fused is of 3-7 months.
Length of a mature human spermatozoon is 50-60 microns.
Breast development in intrauterine life starts at 12 weeks.
Point situated 1 cm below sacral promontary representing CG of body is Weber's point.
The number of ossification centres in the hyoid bone is 6.
Great saphenous vein is exposed anterior to medial malleolus at 2.5 cm.
Ossification centres for all carpal bones is found by 5th year.
Xiphisternal junction is usually at the level of disc between T9 and T10 verterbra.
Length of ductus deferens is usually 45 cms.
Frontal eye field motor area is 8.
Nerve supplying submandibular gland is VII nerve.
Length of female urethra is 4 cm.
Root value of phrenic nerve is C^5.
Sacral canal's volume is 25-35 c.c.
Detrusor is supplied by Sj_4.
At midaxillary line, parietal pleura extend up to level of 10th rib.
The weight of the left healthy lung is 570 gm and that of right is 620 gm.
The SA node is by a branch of the right coronary artery in 65%.
The AV node is supplied by a branch of the right coronary artery in 80%.
Upto 80% of liver resection can be tolerated by noncirrhotic individual.
Liver has a high power of regeneration. Following resection of two third portion of liver, it
regenerates in about six month
Hepatocytes drain about one litre of bile daily into bile canaliculi.
Common bile duct (CBD) is about 10 cm long.
Normal size of CBD is 6-10 mm.
Normal pressure in portal vein is 6-12 mm. of Hg.
Average size of spleen is about 5x3x1 inch. Average weight is about 150 gm.
Average size of kidney is been shaped, having weight about 150 gm.
Blood flow through each Kidney is 1-2 litre per minute.
Normal capacity of UB is about 250 ml. but can accommodate upto 500 ml of Urine.
Prostate secretes 0.5-2 ml of fluid per day, which contains Acid Phosphatase, Prostate
glandins, Fibrinogen and Citric Acid.
Length of large intestine is'1.5 m.
Length of anal canal is 3.8 cm.
Part of anal canal about 15 mm below anal valves is the transitional zone pectin.

11

Bile duct is 7.5-10 cm long.

Gall bladder has Capacity of 45 ml (range 30 to 50 ml) and length of 7.5 to 10 cm. \
Ureter lies 2 cm lateral to cervix and Uterine artery crosses above and infront of ureter.
Size of ovary is Length 3 cm, Width 1.5 cm, Thickness 1 cm.
Vascular segments of kidney are 5.
Number of lobules in foetal kidney is 12.
Saphenous opening is a gap in fascia lata of thigh, situated 4 cm. below and lateral to pubic
tubercle. Its sharp edge is called falciform margin.
Saphenous opening is covered by cribriform fascia.
Inter alveolar septum0.2 m thick (Arithmetic means thickness of barrier in human is 2.2
nun).
Manubriosternal angle may be ossified after the age of 30 years.
Cervical curve appears in intrauterine life and accentuaies by 3 or 4 months when the child
hold up the head.
Lumbar curve appears at 12 to 18 months when the child begins to walk.
Subpubic arch is more angular in males (50 to 60), in females it is wide usualy 80 to
85.
Greater sciatic notch is wider in females 50.4 and in males is 74.4.
Sacral index in males 10.5% and in females 115%.
In hip joint, extension beyond vertical is 10 to 20.
Extension of knee beyond vertical femoro-tibial axis is 5 -10 and flexion is 120 with
extended hip joint.
Passive rotation in knee is about 60 to 70 but conjuct rotation is only about 20.
In "Colles "fracture", there is a fracture of distal end of radius with displacement of lower
fragment backwards and upward. This occurs due to fall of outstretched hand. Resulting
deformity is dinner fork deformity.
Anal canal is 38 mm long (upper - 15 mm, middle - 15 mm, lower - 8 mm)
In hip, primary centres of ossification appear in the order of ilium (2nd month), ischium (4th
month), and pubis .
Main action of quadrator femoris is lateral rotation.
Foramen lacerum lies in between petrous part of temporal bone and sphenoid.
Parotid duct pierces the buccinator muscle.
Functional tissue of lungs is alveoli.
Carpal tunnel syndrom involves median nerve
Meckel's diverticulum arises from the antimesenteric border of ileum.
Auerback's plexus is located in oesophagus.
Brachialis is supplied by musculocutaneous as well as radial nerve.
Gluteus maximus is supplied by inferior gluteal nerve.
Trendelenburg sign may be positive in gluteal medius paralysis.
Elbow is a condyloid joint
Left testicular vein drains into left renal vein.
Flexor digitorum profundus has a dual nerve supply.
Anterior interosseus artery is a branch of ulnar artery.
Purkinje cells in cerebellum are input cells.

12

The most fixed part of the GIT is duodenum.

The glands of Brunner are seen in duodenum.
Spinal part of accessory nerve supplies sternocleidomastoid muscle.
T-s free border of lesser omentum contains hepatic artery, portal vein and bile duct.
Lateral rectus is supplied by VI cranial nerve.
Dentate nucleus is a part of cerebellum.
Lamina cribrosa is modification of sclera.
Automatic bladder is seen in lesions of higher centres whereas lesions at lower centres lead to
autonomic bladder.
Coronary sulcus is occupied by the coronary sinus.
Siren or vena cava is formed by brachiocephalic veins.
The base of heart, formed by atria, lies opposite the 5th-9th thoracic vertebrae.
All the tongue muscles are supplied by hypoglossal nerve except palatoglossus muscle which is
supplied by pharyngeal plexus of nerves
Tympanic membrane is derived from ecto, meso and entoderm.
Edochondral ossification is seen in scapula.
Melanoblasts are derived from neural crest cells.
Human placenta is haemochorial.
Commonest part of aorta ruptured in trauma is junction of thoracic and abdominal aorta.
The only pharyngeal muscle innervated by the glossopharyngeal nerve is stylopharyngeus.
Radial bursa encloses the tendon of flexor pollicis longus.
Choroid fissure of the eye permits the entry of hyaloid artery.
Uncinate fasciculus connects frontal and temporal lobes.
Musician's nerve is ulnar nerve.
Ligament of Cooper is related to breast.
Jacobson's nerve is a branch of IX nerve.
Fascia cribrosa is related to femoral canal.
Boa's point is a tender spot felt in the left of T12 in a patient with gastric ulcer.
Buck's fascia is related to penis.
Prostoperitoneal fascia is Denonviller's fascia.
Fascial extension of lacunar ligament along iliopectineal line is Cooper's ligament.
Alderman's nerve is a branch of X nerve.
Labourer's nerve is median nerve.
Veins communicating the cavernous sinus to pterygoid plexus pass through fossa of Vesalli.
Duct of Rivinus is found in sublingual gland.
Foramen transversarium transmits vertebral artery.
.Krause's glands are lacrimal glands.
Hepatorenal pouch is Morrison's pouch.
.Cowper's glands are found in bulbous urethra.
Duct of Santorini is accessory pancreatic duct.
Anterior interventricular artery is branch of left coronary artery whereas posterior one is a
branch of right coronary arti
Thinnest portion of myocardial wall is left and right atria.
.The nerve related to medial epicondyle is ulnar.

13

Depressor of mandible is lateral pterygoid.

Edinger Westphal nucleus is General Visceral Efferent.
Hofbauer cells are present in placenta.
Transpyloric plane passes through L1 vertebra.
Smallest cranial nerve is Trochlear.
Charcot's artery is a branch of middle cerebral artery.
Apelike hand occurs in median nerve palsy at wrist.
Inferior tibiofibular joint is syndesmosis type of joint.
Mandibular canal contains inferior alveolar nerve.
Costocoracoid membrane of axilla is pierced by lateral pectoral nerve.
Most stable position of the ankle joint is dorsiflexion.
General sensation of nulliparous uterus is anteversion and anteflexion.
Highest intercostal space used for liver biopsy is 8th.
The weakest parts of inguinal canal are superficial and deep inguinal rings.
Diaphragmatic hernia commonest on the left is traumatic hernia.
Flexion of the knee joint takes place in the upper compartment.
The nerve responsible for fine movements of the hand is ulnar.
The retraction of shoulder is caused by serratus anterior.
Accessory pancreatic duct is also called Bernard's duct.
Thoracic duct is also called Pecquet duct.
Superficial fatty fascia between umbilicus and pubis is Camper fascia.
Parasympathetic outflow from sacral plexus is nerve Erigentes.
CSF is partly absorbed by lymphatics around I, II, VII and VIII cranial nerves.
The appendix is most often found in retrocaecal position.
Juxta glomerular cells are smooth muscular cells of afferent arteriole.
Fascia of Gerota is thoracolumbar fascia.
Isthmus of the thyroid gland is found across 3-5 th tracheal rings.
Neural tube develops from ectoderm.
The movement of version of the foot takes place mainly in subtalar joint, calcaneonavicular and
calcaneocuboid joints.
Incisior foramina in the mouth are foramen of Vesalli.
Peroneal artery is a branch of posterior tibial artery.
Unlocking of knee joint to permit flexion is caused by popliteus.
Longest muscle or Tailor's muscle in body is sartorius.
Boxer's muscle is serratus anterior.
Toynbee's muscle is tensor tympani.
Muscle used for grinning is Risorius.
OS trigonum is atavistic type of epiphysis.
Umbilical vesicle attains full development in 4 weeks of foetal development.
The principal sensory nerve of the larynx is the superior laryngeal nerve.
The central canal of spinal canal is central in lumbar region.
Atriventricular (A-V) node is supplied by right coronary artery.
Sinoartrial node is situated at the junction of SVC and right atrium.

14

Koch's triangle is bounded by septal leaflet of tricuspid value, tendon of Todaro and orifice of
coronary sinus.
Germ cells in ovary develop from yolk sac.
Base of heart is formed by both atria.
Lymphatics from testes or ovaries drain into para aortic lymph nodes.
Broca's area is situated in inferior frontal gyrus.
Tail of pancreas contains more islets of Langerhans.
Saphenous opening is below and lateral to pubic tubercle.
Thymus develops from endoderm of III pharyngeal pouch.
Cell bodies of II order neuron for pain are situated in spinal cord.
In Wolf Parkinson White Syndrome, there is connection between atria and ventricles.
C-cells in thyroid gland are derived from Ultimobranchial body.
Lymphatics from tonsil drain into Juguloomohyoid nodes.
J receptors are situated in alveolar epithelium.
Swallowing centre is situated in medulla.
Angle of mandible is supplied by greater auricular nerve.
Nasolacrimal duct drains into middle meatus.
Injury to axillary nerve mainly causes loss of abduction.
Wrist drop (injury in upper arm) or Saturday night palsy injury in radial groove is caused by
radial nerve injury.
Adult larynx extends from C3 to C6.
Great vein of Galen drains into straight sinus.
Duct of Sylvius also called cerebral aqueduct connects III and IV ventricle.
When testicular veins are ligated, the testes are drained by cremasteric veins.
Horner's Syndrome consists of miosis, ptosis and anhidrosis.
Uterus develops from Mullerian duct.
Callot's triangle is bounded by inferior border of liver, common hepatic duct and cystic duct.
Failure of fusion of ostium primum and ostium secundum leads to patent foramen ovale.
Oogonia are supplied from Yolk sac.
Cartwheel appearance of nucleus is seen in Sertoli cells.
Pinna is fully formed at birth.
Ligament of Bigelow is present in hip joint.
Uterine artery is a branch of anterior internal iliac artery.
The narrowest part of male urethra is external meatus.
Ophthalmic artery is a branch of cerebral part of internal cartoid artery.
Wharton duct drains submandibular gland.
Clavicle is the first bone to ossify.
Paralysis of gluteus maximus is most noticeably affected the gait cycle at heel strike.
Femur is the longest and strongest bone of the body.
The ischiofemoral ligament is most taut when femur is extended.
11th and 12th ribs are floating ribs.
Cremasteric artery is a branch of inferior epigastric.
The largest cranial nerve is trigeminal.
Deep artery of Penis is a branch of internal iliac.

15

Ejaculation

is

fraction of sympathetic nervous system whereas erection is of

parasympathetics.
Cystic artery is a branch of right hepatic.
Trochlear nerve has the longest intracranial course.
Vertebral veins drain into brachiocephalic veins.
Ovum was discovered by von Baer.
Kerckring's centre for ossification is associated with occipital bones.
Foramen rotundum transmits maxillary nerve.
Gartner's duct is a remnant of Wolffian duct.
Primordial germ cells are first seen in wall of yolk sac.
Father of Modern anatomy is Andreas Vesalius.
William Harvey described human blood circulation.
Vocal cords are abducted by Posterior cricoarytenoid.
Spinal cord in an adult ends at level of LI
Mitral orifice lies at level of 4th costal cartilage.
The central structure of axilla' is said to be axillary artery.
Strongest ligaments of sacroiliac joint are interosseus ligaments.
The ligamentum arteriosum extends between the concavity of the aortic arch and the left
pulmonary artery. It is remnanl the ductus arteriosus, a channel which conducted deoxygenated
blood from the pulmonary artery to the aorta during fetal 1
The transverse fissure is found only in the right lung.
A section of the upper lobe consisting of two bronchopulmonary segments is known as the
lingula.
The surface markings from the lower border of the lungs during quiet breathing are the 6th
costal cartilage, 8th rib in the axillary line, and the 1 Oth thoracic spine.
The Thoracic duct passes through the aortic opening in the diaphragm.
The thoracic duct drains lymph from all over the body, except from the right side of the heart
and the right upper limb.
The joint between the head of a typical rib and two vertebral bodies is synovial.
The sternal and costal parts of diaphragm are derived from the septum transversum; a gap
between these two parts is known as foramen of Morgagni.
An abnormal foramna (of Bochdalek) is sometimes found between the central tendon and the
lumbar section of the diaphragm, it is usually left-sided.
The pool of CSF in the lower lumbosacral region is called the lumbar cistern. It contains the roots
of the lower spinal nerves (cauda equina) and the filum terminale. The spinal cord usually ends
at the level of L,, in the adults. The aorta bifurcates at the level of L4. Mamillary processes are
features of lumbar vertebrae. T, is responsible for the supply of the intrinsip muscles of the
hand.
The only nerves contained within the spermatic cord are sympathetic nerves and the genital
branch of genitofemoral nerve. A direct inguinal hernia pushes through the posterior wall of the
inguinal canal, medial to the deep ring. An indirect inguinal hernia, on the other hand, passes
along a patent processus vaginalis within the cord.
The formation of the portal vein by the union of the superior mesenteric and splenic veins takes
place behind the neck of the pancreas.

16

The gastroduodenal artery is an important posterior relation of the first part of the duodenum,
and is the artery which may be eroded by a posterior duodenal ulcer.
The Ligamentum teres is a remnant of the left umbilical vein, which drained into the left branch
of the portal vein in the fetal liver.
The hepatic artery lies on left of CBD and the portal vein behind. Although this is the usual
arrangement, variations are sometimes found.
The artery lies to the medial side of the neck of the indirect inguinal hernia; it lies lateral to a
direct inguinal hernia. Pararenal fat (Zuckerkandl) is found behind the renal fascia: Perirenal fat
(Gerota) lies between the capsule of the renal fascia.
The Median umbilical ligament is a remnant of the vitelline or yolk duct.
The external ring is an opening in the external oblique aponeurosis just above the crest of the
pubis. Fertilization usually takes place in the ampulla.
The sternal and costal parts of diaphragm are derived from the septum transversum; a gap
between these two parts is known as foramen of Morgagni.
An abnormal foramna (of Bochdalek) is sometimes found between the central tendon and the
lumbar section of the diaphragm, it is usually left-sided.
The pool of CSF in the lower lumbosacral region is called the lumbar cistern. It contains the roots
of the lower spinal nerves (cauda equina) and the filum terminale. The spinal cord usually ends
at the level of L,, in the adults. The aorta bifurcates at the level of L4. Mamillary processes are
features of lumbar vertebrae. T, is responsible for the supply of the intrinsip muscles of the
hand.
The only nerves contained within the spermatic cord are sympathetic nerves and the genital
branch of genitofemoral nerve. A direct inguinal hernia pushes through the posterior wall of the
inguinal canal, medial to the deep ring. An indirect inguinal hernia, on the other hand, passes
along a patent processus vaginalis within the cord.
The formation of the portal vein by the union of the superior mesenteric and splenic veins takes
place behind the neck of the pancreas.
The gastroduodenal artery is an important posterior relation of the first part of the duodenum,
and is the artery which may be eroded by a posterior duodenal ulcer.
The Ligamentum teres is a remnant of the left umbilical vein, which drained into the left branch
of the portal vein in the fetal liver.
The hepatic artery lies on left of CBD and the portal vein behind. Although this is the usual
arrangement, variations are sometimes found.
The artery lies to the medial side of the neck of the indirect inguinal hernia; it lies lateral to a
direct inguinal hernia. Pararenal fat (Zuckerkandl) is found behind the renal fascia: Perirenal fat
(Gerota) lies between the capsule of the renal fascia.
The Median umbilical ligament is a remnant of the vitelline or yolk duct.
The external ring is an opening in the external oblique aponeurosis just above the crest of the
pubis.
Fertilization usually takes place in the ampulla.
The Tendo calcaneus (Achilies tendon) is the common tendon of gastrocnemius, soleus and
plantaris.

17

The gastrocnemius is a powerful plantarflexor of the foot but can also act as a flexor of the knee.
Both cruciate ligaments play a part in limiting medial rotation of the tibia (lateral rotation of the
femur).
The articular surfaces of the subtalar joint are covered with hyaline cartilage.
The subtalar joint lies between the talus and calcaneus.
The movements of inversion and eversion take place at the subtalar and talonavicular joints.
It is medial ligament of ankle joint which is usually referred to as the deltoid ligament.
The tibial collateral ligament is a broad flat band, the fibular collateral ligament is a rounded
cord.
The common peroneal nerve travels to the lateral side of the popliteal fossa. The tibial collateral
ligament is closely related to the medial interior genicular vessels and nerve.
The structures which pass deep to the retinaculum from medial to lateral are : tibialis
posterior, flexor digitorum longus,posterior tibial vessels, tibial nerve, and flexor hallucis longus.
A branch of the obturator artery enters the head of the femur: other nutrient vessels enter the
neck of the bone.
Tensor fasciae inserts into the iliotibial tract. Muscles which insert into the greater trochanter
include gluteus medius,gluteus minimus, piriformis and obturator internus. Obturator externus
inserts into the trochanteric fossa.
Blood brain barrier is made up of : (1) the vessel wall; (ii) the arachnoid layer of perivascular
sheath; (iii) the perivascular space; (iv) the pial layer of perivascular sheath, and (v) the
neuroglia and the ground substance of the brain. The barrier, at the capillary level, is reduced to
the mere capillary endothelium with neuroglia and ground substance.
Hemiplegia of an upper motor neuron type is usually due to an internal capsular lesion caused by
thrombosis of one of the lenticulostriate branches of the middle cerebral artery (cerebral
thrombosis).
One of the lenticulostriate branches is most frequently ruptured (cerebral haemorrhage); it is
known as Charchot's artery ofcerebral haemorrhage. This lesion also produces hemiplegia with
deep coma, and is ultimately fatal.
Thrombosis of the Huebner's recurrent branch of anterior cerebral artery causes contralateral
upper monoplegia.
Thrombosis of paracentral artery (terminal cortical branch of anterior cerebral artery) causes
contralateral lower monoplegia.
Thrombosis of posterior inferior cerebellar artery causes lateral medullary syndrome
(Wallenberg's syndrome). It is characterized by :
a.Severe giddiness, due to involvement of vestibular neclei
b.Dysphagia, due to involvement of the nucleus ambiguus.
c.Crossed hemianaesthesia, due to involvement of the lateral spinothalamic tract
(contralateral body) and nucleus of the spinal tract of trigeminal nerve (ipsilateral face).
d. Horner's syndrome due to involvement of sympathetic pathway in the medulla.
e.Cerebellar symptoms and signs.

18

Pontine haemorrhage is characterized by (i) paralysis (contralateral hemiplegia); (ii) deep

ctfma; (iii) hyperpyrexia; and (iv)pin-point pupil. It is invariably fatal.
The hunger or feeding centre is placed laterally; the satiety centre, medially in hypothalamus.
The thirst or drinking centre is situated in the lateral part of hypothalamus.
Father of Anatomy Herophilus.
Largest organ of body Skin.
Largest sesamoid bone of bodyPatella
Largest gland of body Liver.
Largest branch of femoral artery Profunda femoris artery.
Largest ganglion of neck is Superior cervical ganglion.
Largest vein of body is long saphenous vein.
First teeth to appear in infant are Lower central incisor.
First permanent teeth to appear are First Molar.
First bone to ossify in bodyClavicle.
Second bone to ossify in body Mandible.
Most common cause of nerve root compression in neck Cervical spondylosis.
Embryonic disk develops during Third week.
Largest branch of femoral Nerve Saphenous nerve.
where parietal bones meet each other.
First endocrine gland to appear in foetusThyroid gland.
Bregma is the pointWhere sagital and coronal sutures meet.
Lambda is the pointWhere sagittal and lambdoid sutures meet.
Lambda lies at the location of Posterior fontanelle.
Lambdoid suture lies between Parietal and occipital bones.
Sternocleidomastoid is innervated by Spinal accessory N. & C2, C3 Spinal N.
Trapezius is innvervated by Spinal accessory N. &C3, C4 Spinal N.
Minimum time required for irreversible brain death due to ischemiaFour minutes.
Clinically most important layer of scalp is Loose areolar tissue.
Kyphosis is an exaggerated thoracic curvature.
Lordosis is an exaggerated lumbar curvature.
Scoliosis is a lateral curvature.
First cervical vertebral is called Atlas.
Second cervical vertebra is called Axis.
An upward projection present in second cervical vertebra is called Dens.
Transverse foramen is characteristic of Cervical vertebrae.
Transverse formen transmits Vertebral artery.
Structure transmitted in intervertebral canal is Spinal nerve.
Nucleus pulposus, is the remnant of Notochord.
Digastric triangle and submandibular fossa of mandible.
Sphenoethmoidal recess is a depression lying above and behind the superior choncha. It
receives the opening of
sphenoidal air sinus.
Superior meatus receives the opening of posterior ethmoidal air sinuses.

19

Middle meatus receives the opening of middle ethmoidal air sinuses on or above the bulla
ethmoidalis and maxillary sinus opening in the floor of hiatus semilunaris.
Anterior meatus receives the opening of naso lacrimal duct. Opening is guarded by a fold of
mucous membrane which forms a valve.
Uvula is a conical (projection) process hanging from middle of posterior border of soft palate.
Dorsal surface of tongue is divided into posterior 1/3 and anterior 2/3 by a 'V shaped sulcus
terminalis. Papillae of the tongue are filiform, fungiform and circumvallate papillae
Foreign body removal from pyri form fossa may damage the internal laryngeal nerve resulting in
anaesthesia of laryngeal mucous membrane upto vocal cords.
Erb's point' is the meeting point of two roots C3, C6, two divisions of upper trunk (anterior and
posterior); and two nerves viz. supra scapular and nerve to subclavius. Stretch of this point
leads to Erb's paralysis.
External Jugular vein pierces the deep cervical fascia before it drains into the subclavian vein.
The walls of the vein are adherent to the deep fascia and this factor prevents the retraction of
vein when cut. Hence the opening should immediately be closed by applying pressure otherwise
air may be sucked in during inspiration.
True capsule of thyroid gland has to be removed during thyroidectomy along with the gland as
the major vessel trunks pass through the space between true and false capsules and there is a
rich plexus of vessels immediately beneath the true capsule. Rupture of veins draining from
upper part of nasal septum (Joining the inferior cerebral veins in cranium) may be the source of
severe nasal bleeding in elderly hypertensive patients.
Sibson's fascia is Suprasternal space.
Suprasternal space of 'Burns' is space above upper margin of manubrium sterni with in the
general investing layer of deep cervical fascia.
Typical intercostal space is the space present between two typical ribs (i.e 3rd, 4th, 5th and 6th
spaces) and transversed by vessels and nerves confined to thoracic wall. Angle of Louis is
sternal angle.
Typical intercostal nerves are 3rd, 4th, 5th, 6th, intercostal nerves; these run in typical
intercostal space and supply the structures of that intercostal space only.
Anteriorly 2nd to 4th tracheal rings are related to isthmus of thyroid gland.
Trachea divides into right and left principal bronchi, Right principal bronchus is 2.5 cm long and
in
line
with
trachea
and
left
runs
transversely.
Right principal bronchus divides into 3 lobar bronchi and left principal bronchus divides into 2
lobar
bronchi.
There
are
10
bronchopulmonary
segments
in
each
lung.
In its course thoracic duct is behind and to the right of oesophagus in the lower part, crosses the
midline at 5th thoracic vertebral level behind oesophagus then lies to the left of oesophagus in
the
rest
of
its
course.
Thoracic duct passes from abdomen to thorax through aortic opening of diaphragm.
Suprapleural membrane is a membrane which expands over cervical pleura and is attached
infront to the 1st rib and behind to the transverse process of 7th cervical vertebra. This is also
called
Sibson's
fascia.

20

Innervation by intercostal nerves makes the parietal pleura sensitive to pain.

Arrangement of structures in each intercostal space is vein, artery and nerve (VAN) from above
downwards except in upper spaces. Here the nerve is at first above the posterior intercostal
artery.
'
Symphathetic
nerves
cause
bronchodilatation.
1
Suprapleural
membrane
is
regarded
as
the
tendon
of
scalenus
minimus.
Fibers from thoracic part of sympathetic trunk pass in greater splanchnic (branches of 5th to 9th
ganglia);
lesser
spanchnl
(branch
of
12th
thoracic
ganglion)
nerves.
Weakest point of the rib is the region infront of the neck. This is the usual site for fracture.
Mediastinal and central diaphragmatic pleura are innervated by phrenic nerve; hence irritation
causes referred pain to should tip or lower neck i.e. the area of skin supply by same spinal
segments
(C3,
C4).
Diagnostic radiological finding in pleural effusion is obliteration of costo diaphragmatic recess.
Achalasia (cardio-spasm) is due to congenital absence of nerve cells of oesophagus resulting in
neuromuscular
incoordination
Telencephalon
is
End
brain
(cerebral
hemispheres).
Diencephalon is Thalamus, epithalamus, hypothalamus, subthalamus.
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.
Medualla oblongata continues as spinal cord at the upper border of atlas.
Filum terminale is a connective tissue filament extending from conus medullaris to the 1st
coccygeal segment, Initial 15 cm of
this is filum terminale internum and extends upto 2nd sacral vertebral where dura and arachnoid
meninges stop.
Last 5 cm is filum terminale externum, contains only pial extension and terminates at 1 st
coccygeal segment.

21

Cervical enlargment of spinal cord corresponds to C3 to T2 spinal segments; lumbar enlargment

corresponds to L1 to S3 spinal segments.
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.
Grey matter is traversed by Central canal and white matter has ascending and descending
tracts.
Posterior funiculus has fasciculus gracillis and cuneatus.
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.
Cervical 8, Thoracic 12, Lumbar 5, Sacral 5, coccygeal 1.
Basal ganglia include caudate nucleus and lentiform nculeus.
Corpus striatum includes caudate nucleus and lentiform nucleus.
Putamen and globus pallidus are subdivisions of lentiform nucleus.
Paleo striatum is globus pallidus.
Corpus callosum is a great cerebral commissure.
Ventricles are cavities lined with ependyma and contain CSF.
Illrd ventricle and IVth ventricle communicate with each othr through cerebral aqueduct.
IVth ventricle has a floor (Rhomboid fossa) and a roof.
Sacral outflow is from SI, S2, S3 spinal segments.
Retrolentiform and sublentiform, parts of internal capsule have optic and auditory radiations
respectively.
Basal vein is formed by union of deep middle cerebral vein, anterior cerebral vein, and striate
veins. It opens into great cerebral vein.
Choroidal vein and thalamostriate vein unite and form internal cerebral veins.
Great cerebral vein is formed by the union of two internal cerebral veins
Sciatic nerve is a branch of sacral plexus - its tibial component is L4, L5,, S1, S2 and common
peroneal component is L4, S1.S2.
Main role of menisci of knee joint is in Rotation.
Main dorsiflexor of foot is Tibialis anterior.
Highest point of medial longitudinal arch of foot is at Head of talus.
Most important ligament in maintainance of medial longitudinal arch is Spring ligament.
Abductor compartment of thigh is represented in upper limb by Nervus hesitans.
Nerve involved in Meralgia paraesthetica is Lateral cutaneous nerve of thigh (L2,3).
Blood supply to S.A. node of heart is derived from Right coronary artery.
Cusps of Semilunar valve of Aorta are One anterior and two posterior.
Cusps of semilunar valve of Pulmonary trunk are one posterior and two anterior.
Cusps of tricuspid valve are Septal, Anterior, Posterior.
Papillary muscles of right ventricle are Septal, Anterior, Posterior.
Circumflex branch of left coronary artery supplies mainly Left atrium.
Apex of heart is situated at Left fifth intercostal space.
Chief muscle of inspiration is Diaphragm.
Motor nerve of diaphragm is from Phrenic nerve (C3,4,5)

22

Bronchopulmonary segment is not a bronchovascular segment because It has not got its
own vein lies in intersegmei plane.
Thinnest wall of all the four -chamber of heart is of Right atrium.
Bundles of Kent are (cause of W.P.W. syndrome)Abnormal muscle bridges between atria and
ventricle.
Duration of cardiac cycle is 0.8 second.
Early functional closure of foramen ovale is mainly due to Pressure difference.
Initial closure of ductus arteriorus is mainly due to Muscular contraction (Mediated by
bradykinin).
Anterior vagal trunk at oesophageal hiatus is formed by Left vagus.
Posterior vagal trunk at oesophageal hiatus is formed by Right vagus.
Tricuspid orifice of heart is located at Right fifth Interocostal space.
Action of vagus nerve on heart is Inhibitory.
Action of vagus on gut is Facilitatory.
Angle of Louis (Sternal angle) is located at Articulation of second rib.
Ligamentum arteriosus is present in between Left pulmonary artery and arch of aorta.
Inferior venacava enters right atrium at the level of Sixth chondro-sternal joint.
Trachea bifurcates at the level of Lower border of Fourth thoracic vertebra (in cadaver).
Level of beginning of arch of aorta is T4-Vertebra.
Level of thoracic aorta piercing diaphragm is T12 - Vetebra.
Level of of Oesophagus passing through diaphragm is T10.
Azygous vein crosses to opposite side at the level of T4
Level of inferior venacava piercing diaphragms is T8.
Level of transpyloric plane is at LI.
Coeliac artery arises from abdominal aorta at the level of T12.
Superior venacava develops from Right common cardinal vein, Right anterior cardinal vein.
Coronary sinus develops from Left horn of sinus venosus, Left common cardinal vein.
Left umblical vein ends into Left branch of portal vein.
Muscles of back get motor innervation from Dorsal primary rami.
Contents of lieno-renal ligament are Splenic artery and tail of pancreas.
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
paralysisHorner'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.

23

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 ofMaxillary 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 isSigmoid 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 ofCervix and vagina (90 degree).
Anteversion on' of uterus is the angle between long axis ofCervix 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.

24

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

25

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 of Berry aneurysm.
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.
Artery of first branchial arch is Maxillary artery.
Cartilage of first arch is called Meckel's cartilage.
Nerve of second branchial arch is Facial N.
Artery of Second arch is Stapedial artery.
Nerve of third branchial arch is glossopharyngeal N.
Muscle derived from third arch is stylopharyngeus muscle.
Cartilage of third arch forms greater cornu of hyoid and inferior part of body of hyoid bone.
Nerve of fourth arch is superior laryngeal nerve and nerve of sixth arch is recurrent laryngeal
nerve.
Mdian (Pterigoid) canal transmits Vidian N. (Formed by Greater superficial petrosal nerve and
deep petrosal nerve).
Optic canal transmits optic nerve, ophthalmic artery and central vein of retina.
Superior orbital fissure transmits Illrd, IVth, ophthalmic division of Vth and Vlth cranial N. and
ophthalmic vein.
Inferior orbital fissure transmits Infraorbital branch of maxillary division of trigeminal nerve.
Internal auditory meatus transmits Vlth and VHIth cranial N.
Right common carotid artery arises from Branchiocephalic artery.
Tenon's capsule is a connective tissue socket in which eyeball is suspended.
Cornea is the main refractor of eye.

26

Sphincter pupillae consists of myoepithelial cells arranged in a circle around pupil. It is under
parasympathetic control.
Dilator pupillae consists of myoepithelial cells arranged in a radial. It is under sympathetic
control.
Aqueous humor is secreted by ciliary process into posterior chamber.
Aqueous humor is formed by ultrafiltration (25%) and active ciliary secretory process (75%)
Aqueous humor passes through pupil into anterior chamber and then through Schlemm's canal
drains into venous system.
Retina is derived from optic vesicle, an evagination of brain.
Circulus Iridis major is situated in root of iris.
Retinal arteries are the only arteries, which can be directly examined for systemic diseases,
Anterior chamber of eyeball is situated between cornea and iris.
Posterior chamber is situated between iris and lens.
External auditory meatus has 2 parts. Outer one third is cartilaginous and inner two third is
bony.
Axilla is a pyramidal space containing cords & branches of brachial plexus, axillary vessels,
lymph nodes & fat.
Apex of axilla is bounded by 1 st rib, clavicle and scapula.
Anterior axillary fold is formed by pectoralis major.
Posterior axillary fold is formed by teres major and latissimus dorsi.
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.
Structures passing through Quadrangular space are axillary nerve and posterior circumflex
humeral vessels.
Nerve of flexor compatment is musculo cutaneous nerve (C5,C6,C7) and extensor compartment
is radial nerve (C5,C6,C7,C8,T1).
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).
Axillary nerve passes through quadrangular space curving around the surgical neck of humerus.
Radial nerve in the spiral groove is covered posteriorly by lateral head of triceps brachii muscle.
Radial bursa is the synovial sheath covering flexor pollicis longus and extends upto its insertion.
Myelin of peripheral nerves is produced by "Schwann cells" and of central nervous system is
by oligodendrocytes.
Spinal nucleus of trigeminal nerve is in continuation below with substantia gelatinosa of Rolando.
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.
Temporal lobe is closely associated with memory (short term memory).
Cerebellum is connected to medulla by inferior; to pons by middle; and to mid brain by suprior
cerebellar peduncles.
The trigeminal is the only nerve having primary sensory neurons within the brainstem(Mesencephalic nucleus of trigeminal nerve in mid brain).
Eye of the handmedian nerve as it is sensory to the most part of the palm of hand.

27

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.
Cerebello medullary cistern is selected for cisternal puncture.
Usually cerebral haemorrhage is due to rupture of Charcot's artery (one of lateral striate branch
of middle cerebral artery).
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".
Rupture of middle meningeal artery leads to extradural haematoma.
Rupture of cerebral veins leads to subdural haemotoma.
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.
Lateral geniculate body is concerned with Light reflex.
Medial geniculate body is concerned with auditory pathway.
Arch of aorta develops from Left sided fourth arch artery.
Pulmonary artery develops from sixth arch artery.
Artery of first branchial arch is Stapedial artery.
The nerve piercing supinator muscle is Posterior interosseus nerve.
Space of Kanavel is Mid palmar space.
Ligament of Struther represents Third head of coracobrinchialis.
Basilic vein pierces deep fascia at the level of Insertion of Coracobrachialis.
'Holden's line is The line along which the membranous layer of superficial fascia is attached
to deep fascia of thigh.
Nerve winding around the neck of fibula is Common peroneal N.
Main extensor of thigh is Gluteus maximus.
Most powerful ligament of hip joint is L3 - L4.
Narrowest part of oesophagus is at cricopharynx.
Sphincter at lower end of oesophagus is physiological.
Main blood supply of oesophagus:
Upper thirdfrom inferior thyroid artery
Middle thirdAorta.
lower thirdLeft gastric artery.
Pyloric sphincterIt 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.
Bare area of stomach is a small area at its posterior surface near cardia.
Anastomoses between gastric and duodenal arteries are scanty, giving rise to a 'white line' at
pyloroduodenal junction.
Ligament of Treitz is a surgical landmark of duodenojejunal flexure. It extends from
duodenojejunal flexure to right cms of diaphragm.
Radiographically, jejunum is characterised by its valvulae conniventes, which are spaced
regularly, giving rise to a concertina effect.

28

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.
Appendicular artery arises from ileocolic artery, whereas the accessary appendicular artery (if
present) arises from posterior caecal artery.
Most common position on appendix is retrocaecal (65-70% cases).
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

29

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 arteryArises from abdominal aorta.
Inferior suprarenal arteryArises 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 fasciaOuter 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.

30

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 per Treves
classification). 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 liverRight 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 longwidest and most dilatable part.

31

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 3C 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.

32

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 involvementphrenic 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.

33

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.
Popliteus muscle pierces capsular ligament of knee posteriorly to become an intracapsular
structure.
Main role of menisci of knee joint is rotational movement.
Nerve roots involved in knee jerk reflex is L2,3,4.
Extensor of knee is Quadriceps muscles.
Flexor of knee is Hamstring muscles.
Main joint of lateral longitudinal arch is calcaneocuboid.
Posterior transverse arch is an incomplete arch and formed by major parts of tarsus and
metatarsus.
Main invertor of foot is Tibialis Anterior.
Wharton's jelly is Mesenchyme of umbilical cord.
Mullerian tubercle is elevated region in relation to urogenital sinus at the point of contact of
uterovaginal canal.
Copula of His is Hypobranchial eminence.
Gartner's duct is persistant mesonephric duct in female.
Para urethral glands of Skene are Urethral glands arising from urogenital sinus in female.
Duct of Cuvier is common cardinal vein.
Blood islands of Pander is mesenchymal congregations on the wall of yolk sac giving raise to
blood cells and blood vessels.
Liver is the largest gland of the body
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.
Fold of Douglas or linea semicircularis or arcuate line is related to internal oblique muscle in
abdomen.
Corpora amylaceae are Prostatic concretions.
Zona pellucida is amorphous material surrounding ovum.
Cords of Bilroth are Pulp cords of spleen.
Malpighian bodies are Nodules of white pulp of spleen.
Hassel's corpuscles rounded bodies in medulla due to degenerative thymic epithelial cells.
Serous demilunes of Heidenhein are Serous alveoli capping the mucous alveoli in mixed gland.
Cells of Paneth are cells present at the bottom of crypt of small intestine.
Henle's loop is Part of nephron.
Leydig cells are interstitial cells present in stroma between semiinferous tubules of testis
Sertoli cells are supporting cells in semiinferous tubule.
Herring bodies are Neurosecretory material seen in pars nervosa of pituitary.
Canal of Schlemm is Canal present at the sclero corneal angle in scleral furrow.

34

Betz cells are large pyramidal cells located in inner pyramidal layer of cerebral cortex.
Outer and Inner bands of Ballarger are Horizontally running fibres located in 4th and 5th lamina
of cerebral cortex.
Node of Ranvier is Region on the nerve fibres between two internodes.
Nissl granules are Chromatic bodies (granules) in the cytoplasm of neurones.
Region at the junction of 3 hepatic lobules presents portal triad, which includes a portal venous
radicle, branch of hepatic artery and biliary canaliculus.
Lung : Lining epithelium of alveoli shows the following cells :
Type I alveolor cells Squamous cells.
Type II alveolar cells Irregular cuboidal cells (Surfactant cells)
Clara cells Cuboidal non ciliated
Remnants
Remnant of ductus arteriosum is Ligamentum arteriosum.
Ductus venosum Ligamentum venosum.
Urachus Median umbilical ligament.
Left umbilical vein Ligamentum teres of liver.
Right umbilical vein Disappears.
Vitello-intestinal duct Meckel's diverticulum.
Distal part of umbilical artery Medial umbilical ligament.
Proximal part of umbilical artery Superior vesical artery.
Wolfian duct Gartner duct (Gives rise to vaginal cyst).
Wolfian tubule Paraoophoron, Eoophron.
Left anterior cardinal vein Oblique vein of Marshall.
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.

35

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.

36

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 auscultationa 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.

37

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.

38

"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.
Superior and 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 medusaedue 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

39

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 of Italy is 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

40

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)

41

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
3. To the left: gastroduodental artery

2. Posteriorly : inferior vena cava

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.

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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
Locationfrom 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. Vagusright and left
2. Left recurrent laryngeal
3. Phrenicright and left
4. Cardiac plexus (superficial)
g. Lymphatics
1. Brachiocephalic and tracheobronchial nodes
2. Thoracic duct
Inferior mediastinumhas three subdivisions that extend downward from lower border of
superior mediastinum to diaphragm
1. Anterior mediastinum
a. Locationposterior to body of sternum and attached costal cartilages, anterior to heart and
pericardium
b. Contents
1. Fat

43

2. Remnants of thymus gland

3. Anterior mediastinal lymph nodes
2. Middle mediastinum
a. Locationbetween 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. Locationposterior 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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Autonomic nervous system

Sympathetic system(thoracolumbar
Parasympathetic
outflow)
system(craniosacral outflow)
C3, T11,L4
More active during wakeful hours
Adrenergic

3,7,9,10 cranial nerves.S2,3,4.

Active during sleep
cholenergic

Pupillary dilatation
Cardiac acceleration
Spleenic contraction
Vaso constriction in skin & viscera
Coronary vasodilatation
Inhibition of intestinal motility

Pupillary constriction
Slowing of heart rate

Broncho dilatation
Ejaculation of semen
Contraction of sphincter
Hepato gluconeogenesis
Glycogenolysis

Bronchial constriction
Penile erection
Contraction of urinary bladder
Increased secretion of insulin
Edinger westphal nucleus,
lacrimatory nucleus, superior
salivatory nucleus, inferior
salivatory nucleus, dorsal nucleus of
the vagus.

Vaso dilatation of skin & viscera

Increasing peristalsis

Ciliary ganglion, pterygopalatine

ganglion,oticganglion, submandibular
ganglion.

45