ANATOMY

Embryology:

Events Following fertilization

0 hour Fertilization
4th day 16 cell stage , morula enters uterine cavity
5 day
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Blastocyst
6th day Interstitial implantation
21-22 day Placenta fully established Fetal circulation established & heart formed
8th weeks Internal gonads formed

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10-12 weeks Swallowing starts
11 weeks Fetal breathing movements

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12 weeks External genitalia formed, urine formation occurs

Reproductive system development:

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Female Embryonic Male
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origin
Ovary Genital ridge Testis
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Clitoris Genital tubercle Glans penis

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Uterus, Mullerian duct Remnants of testis,

vagina(partially),cervix prostate(partially)
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Labia majora Genital swelling Scrotum

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Labia minora Genital fold Penis (ventral aspect)

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Types of Epiphysis:
o Pressure Epiphysis: seen at the End of long bones
o Eg: Head of femur, head of humerus, condyles of tibia
o Traction epiphysis: produced by pull of muscles
o Eg: trochanters of femur, tubercles of humerus, mastoid process
o Atavistic epiphysis: independent bone in lower animals, degenerated in humans
o Eg: Chorocoid process of scapula, Ostrigonum
o Abberant epiphysis: Additional epiphysis
o Eg: head of 1stMetacarpels
Primary Cartilaginous Joints: Synchondroses , ex: hyaline cartilage.

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 Secondary Cartilaginous Joints: Symphysis, ex: hyaline cartilage along with
fibrous tissue or fibrous cartilage.
Colles Fracture: Fracture of the distal radius.
Scaphoid Fractures: Fracture of the scaphoid bone.
CARPAL TUNNEL SYNDROME: Entrapped Median Nerve, Treatment: Cut the
flexor retinaculum and relieve the pressure.
CUBITAL TUNNEL SYNDROME: Compression of the Ulnar Nerve.

Blood Supply of heart:

SA node Right coronary artery (65%) Left coronary artery (35%)
AV node Right coronary artery
Bundle of HIS Right coronary artery

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Right bundle branch Left coronary artery

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Left bundle branch Left coronary artery (main part) Right coronary artery(some part)

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Cranial Nerves:
Olfactory Enter cerebellum directly
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Optic nerve 4cm long forms optic chiasma
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Oculomotor Mc to be affected by aneurysm Origin : upper mid brain
Trochlear Mc to be affected by injury. Origin: lower part of mid brain.
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Has longest intracranial course.

Smallest cranial nerve.
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Most slender cranial nerve.

CN with dorsal exit
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Trigeminal Major sensory nerve of face. Passes through MECKELS CAVE.

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Branches: ophthalmic,maxillary and mandibular.

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Largest cranial nerve.

Abducents Orgin: lower pons. Pases through cavernous sinus.
Longest intracranially intracranial course.
Mc involved in ICT
Facial Origin: lower pons. Has longest interosseous course.
Mc nerve to be paralyzed.
Branches:
Greater superficial petrosal (lacrimal glands)
Nerve to stapedius ( stapedial reflux)
Chorda tympani( ant.2/3rd of tongue)
Post auricular.
Nerve to stylo hyoid and post belly of digastric.

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 Cranio temporal branch.
Vestibulocohlear Vestibular branch equilibrium and balance. Cochlear branch for
hearing.
Glossopharyngeal Origin: lower medulla Supply : palatine tonsils
Vagus Origin: lower medulla Largest cranial nerve
Supply: neck ,thorax &abdomen
Branches: pharyngeal and laryngeal.
Spinal accessory Origin: lower medulla. Supply: all the muscles of larynx except
stylopharyngeus.
Hypoglossal Origin: lower medulla Passes through hypoglossal canal;
Supply: all muscles of tongue except palatoglossus.

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Thickest nerve is SCIATIC nerve

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Thickest cutaneous nerve is GREATER OCCIPITAL nerve

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Brachial plexus nerve lesions: ro
Winging of Scapula: paralysis of serratus anterior in long thoracic nerve palsy
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(c5,6,7)
Claw hand/ Main-en-griffe: Paralysis of lumbricals in ulnar nerve palsy (c 8, T 1)
Ape thumb: paralysis of opponenspollicis in median nerve palsy ( C 5- T1)
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Wrist drop: Radial nerve palsy ( C5- T1)

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Pointing index: Paralysis of flexor digitorum superficialis in median nerve palsy (

C5-T1)
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Contents of anatomical snuff box:

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o Lateral Extensor Pollicus brevis

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o Medial- Extensor pollicus longus

o Floor- scaphoid, styloid of radius
Contains:
o Radial artery
o Radial nerve
o Cephalic vein

FEMORAL TRIANGLE:
o Sartorius: Inferior.
o Inguinal Ligament: Superior.
o Adductor Longus: lateral.

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TRIANGLE OF AUSCULTATION:
o Medial Border: Trapezius muscle.
o Lateral Border: Teres Major.
o Inferior Border : Latissimus Dorsi

SUBMANDIBULAR TRIANGLE
o Posterior belly of Digastric: Lateral border
o Anterior belly of Digastric: Medial border
o Mandible: Superior border
Contents: Facial Artery

CAROTID TRIANGLE:
o Superior Belly of the Omohyoid: Medial Border

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o Posterior Belly of the Digastric: Superior Border

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o Sternocleidomastoid: Lateral Border
Contents: Carotid Sheath, external jugular vein.

Compression Neuropathies:
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o Thoracic outlet o C8, T1 nerve roots are
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syndrome involved
o Carpel tunnel syndrome o Median nerve
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o Piriformis syndrome o Sciatic nerve

(hip)
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o Marelgiaparesthetica o Lat cutaneous nerve of thigh

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o Tarsel tunnel syndrome o Posterior tibial nerve

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DUCHENNE-ERB PARALYSIS: Damage to the Upper Trunk of the Brachial Plexus.

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KLUMPKE'S PARALYSIS: Damage to the lower trunk (C8-T1).

MEDIAN NERVE:
o Supplies all of flexor forearm EXCEPT the Flexor Carpi Ulnaris and the medial
half of the Flexor DigitorumProfundus.
o Can be injured in wrist slashing and carpal tunnel syndrome.

ULNAR NERVE:
o Supplies the Flexor Carpi Ulnaris and the medial half of the Flexor
DigitorumProfundus.
o Claw-Hand: Paralysis of small muscles of hand supplied by Ulnar Nerve.

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RADIAL NERVE:
o Wrist-Drop is the sign of radial nerve injury.
o Most commonly injured nerve, due to fracture shaft of the humerus.

Named nerves
Name Nerve
Jacobson Tympanic branch of 9th CN
Bell Long thoracic nerve
Criminal nerve of grassi Branch of right posterior vagus
Vagabond/wandering nerve Vagus
Arnolds/aldermans nerve Vagus ( auricular rbranch)

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THE PARANASAL SINUSES:

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o The Four Sinuses:
o Frontal Sinus

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o Sphenoid Sinus
o Ethmoid Sinus
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o Maxillary Sinus developmental order- M >E> S> F
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Paranasal Status at 1st radiological Best view Drains into

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sinuses birth evidence

Maxillay Present 4-5 months Waters/occipito- Middle meatus
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mental/nose chin
postion
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Ethmoid Present 1year Caldwell view Middle & superior

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meatus
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Frontal Absent 6years Caldwell view Middle meatus

sphenoid Absent 4years Waters view with Sphenoethmodial
open mouth recess

Muscles of thigh:

ANTERIOR COMPARTMENT OF THE THIGH:

Action - flexion of thigh and extension of leg.

Innervation - Femoral Nerve

POSTERIOR COMPARTMENT OF THE THIGH:

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 o Action - Extension of thigh and flexion of leg.
o Innervation - Sciatic Nerve.

MEDIAL (ADDUCTOR) COMPARTMENT OF THE THIGH:

o Action - Adduction of thigh.
o Innervation - Obturator Nerve

TONGUE:
All tongue muscles are somite-derived.
Anterior 2/3: Formed from lateral lingual swellings of 1st arch.
Posterior 1/3: From hypo-branchial eminence of 3rd arch.
Filiform Papillae: Taste reception on anterior 2/3 of tongue.
Circumvallate Papillae: Taste reception on the posterior 1/3 of tongue.

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Sulcus Terminalis: Divides posterior from anterior parts.

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Foramen Cecum: Depression in the midline of tongue, remnant of primitive
thyroglossal duct.

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BLOOD SUPPLY TO TONGUE: Lingual Artery, Branch of the External
Carotid.
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THYROID GLAND:
Develops from thyro-glossal duct.
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BLOOD SUPPLY TO THYROID GLAND:

External Carotid - Superior Thyroid Arteries.
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Thyrocervical Trunk - Inferior Thyroid Arteries.

VENOUS DRAINAGE OF THYROID GLAND:
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Superior Thyroid Vein branch of Internal Jugular.

Middle Thyroid Vein branch of Internal Jugular.
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Inferior Thyroid Vein

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CLEFT LIP: Failure to join of the Maxillary Process and Globular Process. (UL/BL)
CLEFT PALATE: An opening between the nasal and oral cavities, caused by a
failure of fusion of the maxillary shelves.
Groove on the under surface of cuboid lodges the tendon of Peroneus Iongus
Compression fracture of calcaneus occurs in fall from a height
Navicular tuberosity gives attachment to -tibialis posterior.
Third trochanter of femur - Gluteal Tuberosity
The tendon which winds around the medial malleolus tibialis posterior
The tendon which winds around the Lateral malleolus ' Peroneus brevis
Vein that passes between head of gastrocnemius- small saphenous vein
External iliac vein is continuation of femoral vein

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 Main blood supply of head of femur trochanteric anastomosis
Largest joint of body knee joint
Inversion & eversion movements takes place at subtalar & transverse talar joint
Inflammation of infrapatellar bursa- clergymans knee
Housemaids knee- prepatellar bursitis
Positive Trendelenburgs sign dislocation of hip joint

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