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Clinical Anatomy (A Problem Solving Approach)
Neeta V Kulkarni
SECTION 1: INTRODUCTION
1:
ANATOMY—PAST, PRESENT AND FUTURE
ANATOMY IN BRIEF
Greek Era
Roman Era
Dark Ages
Fourteenth Century
Renaissance (15th and 16th Centuries)
Seventeenth Century
Eighteenth Century
Nineteenth Century
Twentieth Century
Twenty First Century
2:
BASIC TISSUES OF THE BODY
STRUCTURAL ORGANIZATION OF HUMAN BODY
TYPES OF BASIC TISSUES
EPITHELIAL TISSUE
Characteristic Features of Epithelium
Polarity
Cell Junctions
Structural Specializations for Absorptive Functions
Structural Specialization for Protection
Basement Membrane
Functions of Basement Membrane
Nourishment
Cell Turn Over
Classification of Epithelium
Simple Epithelium
Stratified Epithelium
Glandular Epithelium
Classification of Exocrine Glands
Subtypes of Multicellular Exocrine Glands
CONNECTIVE TISSUE
Basic Components
Resident Cells
Migrant Cells
Ground Substance
Connective Tissue Fibers
Collagen Fibers
Elastic Fibers
Reticular Fibers
Classification of Connective Tissue Proper
Loose Connective Tissue
Dense Connective Tissue
Yellow Elastic Tissue
Reticular Tissue
Adipose Tissue
Myxomatous (mucoid) Connective Tissue
MUSCULAR TISSUE
Types of Muscle Tissue
Skeletal Muscle
Cardiac Muscle
Smooth Muscle (Plain or visceral muscle)
Additional Features of Skeletal Muscles
NEURAL TISSUE
Subdivisions of Nervous System
Classification of Neurons
According to the Number of Processes
According to the Function of Neurons
According to the Location of Neuronal Cell Body
Microscopic Structure of Multipolar Neuron
Neuroglia
Neuroglia cells in CNS
Neuroglia Cells in PNS
Myelination in CNS and PNS
3:
CARTILAGE, BONES AND JOINTS
CARTILAGE
General Features
Histological Types of Cartilage
Hyaline Cartilage
Elastic Cartilage
Fibrocartilage
BONE OR OSSEOUS TISSUE
Components of Osseous Tissue
Bone Cells
Bone Matrix
Microscopic Structure of Bone
Structure of Spongy Bone
Structure of Compact Bone
Development and Ossification of Bone
Growth in Diameter of a Bone
Types of Bones
Parts of Developing Long Bone
Types of Epiphyses
Blood Supply of Long Bone
JOINTS
Types of Synarthroses
Subtypes of Fibrous Joints
Subtypes of Cartilaginous Joints
Types of Synovial Joints
Basic Structure of Synovial Joint
Movements of Synovial Joints (Fig.3.2)
4:
VASCULAR TISSUE AND LYMPHATIC TISSUE
VASCULAR TISSUE
General Layout of Arteries
Brief Review of Histology of Arteries and Veins
LYMPHATIC TISSUE
Functions of Lymphatic Tissue
Types of Lymphocytes
Primary Lymphoid Organs
Secondary Lymphoid Organs
Lymphatic Tissue within Other Organs
Thymus
Lymph Node
Spleen
Palatine Tonsil
5:
SKIN, HYPODERMIS AND DEEP FASCIA
SKIN
Functions of Skin
Layers of Skin
Layers of the Epidermis in Thick Skin (From Deep to Superficial)
Surface Epidermal Ridges
Dermal-Epidermal Junction
Dermis
Glands of Skin
HYPODERMIS OR SUPERFICIAL FASCIA
DEEP FASCIA
Modifications of Deep Fascia
6:
DESCRIPTIVE ANATOMICAL TERMS
ANATOMICAL POSITION (FIG. 6.1)
Definition
VARIOUS ANATOMICAL TERMS
Additional Descriptive Terms for Position of Body
DIRECTIONAL PLANES OF HUMAN BODY (FIG. 6.1)
7:
GENERAL EMBRYOLOGY AND GENETICS
GAMETOGENESIS
Oogenesis (Fig.7.1)
Spermatogenesis (Fig.7.3)
Spermiogenesis
FERTILIZATION
Cleavage of Zygote and Formation of Morula (Fig. 7.5)
Blastocyst Formation
Implantation of Blastocyst
Decidua
Subdivisions of Decidua
Normal Site of Implantation (Fig. 7.7)
Formation of Bilaminar Embryonic Disc (Figs 7.9A and B)
Endoderm
Ectoderm
Amniotic Cavity
Primary and Secondary Yolk Sac
Chorion
Prochordal Plate
Primitive Streak and Gastrulation (Fig.7.10)
Fate of Primitive Streak
Formation of Notochord
Remnants of Notochord
Formation of Neural Tube (Neurulation)
Neural Crest
Derivatives of Neural Crest
Subdivisions of Intraembryonic Mesoderm (Fig. 7.14)
Paraxial Mesoderm
Intermediate Mesoderm
Lateral Plate Mesoderm
Folding of Embryonic Disc
Fetal Membranes (Fig.7.15)
Yolk Sac
Allantois
Amnion
Chorion
Gross Appearance of Placenta
Umbilical Cord
GENETIC FACTORS AND CONGENITAL ANOMALIES
Genetic Diseases due to Gene Mutation
Modes of Inheritance of Monogenic Diseases
Polygenic Diseases
Mitochondrial Inheritance
CHROMOSOMES
Parts of a Chromosome (Fig.7.17)
Morphological Types of Chromosomes
Karyotyping
Common Techniques for Studying Chromosomes
Karyotyping using Giemsa Banding
Denver Classification of Chromosomes
Sex Chromosomes (Fig. 7.19)
Role of Y chromosome in Sex Differentiation
Significance of Barr Bodies
Structural Anomalies of Chromosomes
Deletion
Translocation
Isochromosome
Philadelphia Chromosome (Ph1 chromosome)
Numerical Anomalies of Chromosomes
Cell Cycle in Somatic Cells (Fig.7.23)
Nondisjunction during Gametogenesis (Fig. 7.26)
Types of Numerical Anomalies
8:
CLINICOANATOMICAL PROBLEMS AND SOLUTIONS
CASE 1
Questions and Solutions
CASE 2
Questions and Solutions
CASE 3
Questions and Solutions
CASE 4
Questions and Solutions
SECTION 2: UPPER EXTREMITY
9:
BONES OF UPPER EXTREMITY
CLAVICLE
Parts
Shaft
Junctional Point of Shaft
Articulations
Unique Features of Clavicle
Posterior Relations of Medial Two-third
Ligaments Attached to Clavicle
Growing End
Blood Supply
Special Features
SCAPULA
General Features
Palpable Parts
Vertebral Levels
Triangle of Auscultation
Neurovascular Relations (Fig. 9.8)
HUMERUS
General Features
Upper End
Shaft
Lower End
Growing End
RADIUS
Articulations of Radius
General Features
Upper End
Shaft of Radius
Lower End
Growing End
ULNA
Articulations of Ulna
General Features
Upper End
Shaft
Lower End
Growing End
BONES OF HAND
Carpal Bones
Proximal Row
Distal Row
Features
Carpal Tunnel
Ossification
Time of Appearance of Ossification Centers
METACARPAL BONES
Unique Features of First Metacarpal
Bennett's Fracture
10:
PECTORAL REGION AND BREAST
PECTORAL REGION
Surface Landmarks (Fig. 10.1)
Superficial Fascia
Cutaneous Nerves (Fig. 10.3)
Line of Discontinuous Dermatomes
Deep Fascia
Deltopectoral Triangle (Fig. 10.1)
Pectoralis Major (Fig. 10.3)
Origin
Insertion
Nerve Supply
Actions
Testing Function of Pectoralis Major
Poland Anomaly
Pectoralis Minor (Fig. 10.4)
Origin
Insertion
Relations
Nerve Supply
Actions
Subclavius
Nerve Supply
Action
Clavipectoral Fascia (Figs 10.5A and B)
Vertical Extent
Horizontal Extent
Costocoracoid Ligament
Structures Piercing Clavipectoral Fascia
Pectoral Nerves
BREAST OR MAMMARY GLANDS
Female Breast
Parts of Breast
Base of Breast (Fig. 10.8)
Nipple and Areola
Structure (Fig. 10.8)
Modes of Secretion
Arterial Supply
Venous Drainage
Lymphatic Drainage
11:
AXILLA AND AXILLARY LYMPH NODES
AXILLA
Contents of Axilla (Fig. 11.1)
Walls of Axilla (Fig. 11.2)
Serratus Anterior Muscle (Fig. 11.4)
Nerve Supply
Actions
Testing Muscle Function
Long Thoracic Nerve (Fig. 11.4)
Cervical Course
Axillary Course
AXILLARY LYMPH NODES
12:
BRACHIAL PLEXUS AND AXILLARY VESSELS
BRACHIAL PLEXUS
Location and Parts (Fig.12.1)
Formation (Fig.12.2)
Root Stage
Branches from Root Stage
Trunk Stage
Branches of Upper Trunk
Division Stage
Cord Stage
Relations of Cords to Axillary Artery
Connections with Sympathetic Chain
AXILLARY ARTERY AND VEIN
Surface Marking (Fig. 12.7)
Course
Parts of Axillary Artery (Fig. 12.8)
Relations of First Part (Fig.12.9)
Relations of Second Part
Relations of Third Part
Branches (Fig. 12.8)
Scapular Anastomosis (Fig.12.10)
Axillary Vein
Formation
Course
Tributaries
13:
SUPERFICIAL MUSCLES OF BACK AND SCAPULAR REGION
SUPERFICIAL MUSCLES
Trapezius (Fig. 13.1)
Origin
Insertion
Actions
Nerve Supply
Testing Function of Trapezius
Latissimus Dorsi (Fig. 13.1)
Origin
Insertion
Nerve Supply
Actions
Testing Function of Latissimus Dorsi
Triangles Related to Latissimus Dorsi
Muscles Taking Origin from Medial Border of Scapula (Fig. 13.1)
Nerve Supply
Actions
Dorsal Scapular Nerve (Nerve to rhomboid)
Deltoid Muscle (Fig. 13.3)
Origin
Insertion
Nerve Supply
Actions
Testing Function of Deltoid
Teres Minor
Nerve Supply
Actions
Teres Major
Nerve Supply
Actions
Supraspinatus
Infraspinatus
Actions
Nerve Supply
Testing Function of Supraspinatus
Testing Function of Infraspinatus
Features of Supraspinatus
Subscapularis
Nerve Supply
Actions
Intermuscular Spaces (Fig.13.4)
Boundaries of Quadrangular Space (from anterior side)
Boundaries of Quadrangular Space (from posterior side)
Contents of Quadrangular Space
Boundaries of Upper Triangular Space
Contents
Boundaries of Lower Triangular Space
Contents
Axillary Nerve
Relations in Axilla
Relations in Quadrangular Space
Distribution (Fig. 13.5)
Suprascapular Nerve
Cervical Course
Course in Scapular Region (Fig. 9.8)
Distribution
14:
PECTORAL GIRDLE AND SHOULDER JOINT
PECTORAL GIRDLE
Special Features
Girdle Joints (Fig. 14.1)
Sternoclavicular Joint
Articulating Ends
Ligaments
Posterior Relations
Acromioclavicular Joint
Articulating Ends
Ligaments
Movements of Scapula (Fig. 14.2)
Elevation and Depression
Protraction and Retraction
Rotation of Scapula
SHOULDER JOINT
Articular Surfaces (Fig. 14.3)
Fibrous Capsule (Fig. 14.4)
Glenohumeral Ligaments
Other Small Ligaments
Synovial Membrane
Bursae (Fig. 14.5)
Relations (Fig. 14.5)
Stability
Blood Supply
Nerve Supply
Movements
Stages in Movement of Abduction (Fig. 14.6)
15:
UPPER LIMB (Cutaneous Nerves, Dermatomes, Venous Drainage and Lymph Vessels)
UPPER LIMB
Cutaneous Nerves
Cutaneous Nerves of Arm
Cutaneous Nerves of Forearm
Cutaneous Nerves of Hand
Dermatomes
Dermatomes of Upper Limb (Fig. 15.1)
Veins of Upper Limb
Superficial Veins (Fig. 15.2)
Dorsal Venous Network (Fig.15.3)
Formation of Cephalic Vein
Formation of Basilic Vein
Median Vein of Forearm
Lymphatic Drainage of Upper Limb
Superficial Lymph Vessels (Fig. 15.7)
Deep Lymph Vessels
16:
COMPARTMENTS OF ARM
COMPARTMENTS OF ARM
Contents of Anterior Compartment
Coracobrachialis (Fig. 16.2)
Biceps Brachii
Brachialis
Brachial Artery (Fig. 16.3)
Branches of Brachial Artery (Fig. 16.8)
Musculocutaneous Nerve
Median Nerve in Arm
Ulnar Nerve in Arm
Contents of Posterior Compartment
Triceps Brachii Muscle
Spiral or Radial Groove (Fig. 16.10)
Profunda Brachii Artery (Fig.16.8)
Radial Nerve (Fig. 16.10)
17:
CUBITAL FOSSA AND ELBOW JOINT
CUBITAL FOSSA
Boundaries (Fig. 17.1)
Contents (Fig. 17.3)
Exit of Neurovascular Contents
Anastomosis around Elbow (Fig. 16.3)
Anterior Anastomosis Medially
Posterior Anastomosis Medially
Anterior Anastomosis Laterally
Posterior Anastomosis Laterally
Functional Importance
ELBOW JOINT
Articulating Bones (Figs 17.4 and 17.5)
Articular Surfaces
Fibrous Capsule (Figs 17.4A and B)
Upper Attachment
Lower Attachment
Intra-articular Fossae
Synovial Membrane
Collateral Ligaments (Figs 17.6A and B)
Relations of Joint
Arterial Supply
Nerve Supply
Movements
18:
COMPARTMENTS OF FOREARM
FOREARM
Anterior Compartment (Fig. 18.1) of Forearm
Superficial Group
Intermediate Group
Deep Group
Superficial Branch of Radial Nerve
Ulnar Nerve
Median Nerve
Radial Artery
Ulnar Artery
Posterior Compartment of Forearm
Superficial Muscles
Deep Muscles (Figs 18.9A and B)
Posterior Interosseous Nerve
Posterior Interosseous Artery
19:
RADIOULNAR JOINTS AND WRIST JOINT
RADIOULNAR JOINTS
Superior Radioulnar Joint
Ligaments
Inferior Radioulnar Joint
Middle Radioulnar Joint
Relations of Anterior Surface
Relations of Posterior Surface
Functions
Supination and Pronation (Fig. 19.3)
Muscles of Pronation (Fig. 19.4)
Pronator Teres
Testing Function of Pronator Teres
Pronator Quadratus
Muscles of Supination (Fig. 19.4)
Biceps Brachii
Supinator
WRIST JOINT (FIG. 19.7)
Ligaments
Fibrous Capsule
Radiocarpal Ligaments
Carpal Collateral Ligaments
Relations
Nerve Supply
Arterial Supply
Arteries Forming Palmar Carpal Arch
Arteries Forming Dorsal Carpal Arch
Movements at Wrist Joint
Muscles Responsible for Movements
Anatomical Snuffbox (Fig. 19.8)
Boundaries
Content
Retinacula at the Wrist
Flexor Retinaculum (Fig. 19.9)
Special Note
Extensor Retinaculum (Fig. 19.10)
20:
HAND
FEATURES OF HAND
Dorsum of Hand
Spaces on Dorsum
Structures on Dorsum
The Palm
External Appearance of Palm
Superficial Fascia of Palm
Palmaris Brevis (Fig. 20.3)
Palmar Aponeurosis (Fig. 20.3)
Fibrous Flexor Sheath (Fig. 20.3)
Fascial Compartments of Palm (Fig. 20.4)
Palmar Spaces (Fig. 20.4)
Arteries of Hand
Superficial Palmar Arch (Fig. 20.7)
Deep Palmar Arch (Fig. 20.8)
Nerves of Palm
Intrinsic Muscles of Hand
Hypothenar Muscles
Thenar Muscles
Lumbrical Muscles (Fig. 20.13)
Interossei Muscles (Fig. 20.15)
Movements of Thumb and Fingers
First Carpometacarpal Joint
Muscles Acting on Thumb
Metacarpophalangeal (MCP) Joints
Interphalangeal (IP) Joints
21:
LONG NERVES OF UPPER LIMB
MEDIAN NERVE
Union of Roots
Course and Relations (Fig. 21.1)
Branches
ULNAR NERVE
Course and Relations (Fig. 21.4)
Branches in Forearm
Distribution in Palm
RADIAL NERVE
Course and Relations
Branches of Radial Nerve in Axilla
Branches of Radial Nerve in Spiral Groove
Terminal Branches of Radial Nerve
Superficial Branch of Radial Nerve
Surface Marking of Superficial Branch
22:
CLINICOANATOMICAL PROBLEMS AND SOLUTIONS
CASE 1
Questions and Solutions
CASE 2
Questions and Solutions
CASE 3
Questions and Solutions
CASE 4
Questions and Solutions
CASE 5
Questions and Solutions
CASE 6
Questions and Solutions
CASE 7
Questions and Solutions
CASE 8
Questions and Solutions
CASE 9
Questions and Solutions
CASE 10
Questions and Solutions
CASE 11
Questions and Solutions
CASE 12
CASE 13
CASE 14
Questions and Solutions
SECTION 3: THORAX
23:
BONES OF THORACIC CAGE
THORACIC CAGE
Sternum
Parts of Sternum
Vertebral Levels
Joints of Sternum
Posterior Relations (Fig. 23.2B)
Ribs or Costae
Length of Ribs
Classifications of Ribs
Articulations of Typical Rib
Movements of Ribs
Typical Rib (Fig. 23.3)
First Rib (Fig. 23.4)
Second Rib
Tenth Rib
Eleventh and Twelfth Ribs
Costal Cartilages
Abnormal Ribs
Thoracic Vertebrae
Typical Thoracic Vertebra (Figs 23.5A and B)
Atypical Thoracic Vertebrae
24:
THORACIC INLET AND THORACIC WALL
THORACIC INLET
Boundaries of Thoracic Inlet (Fig. 24.1)
Scalene Triangle
THORACIC WALL
Surface Landmarks
Orientation Lines (Figs 24.3A and B)
Intercostal Spaces
Contents of Intercostal Space (Fig. 24.4)
25:
MEDIASTINUM AND RESPIRATORY ORGANS
MEDIASTINUM
Boundaries of Mediastinum
Extent
Subdivisions (Fig. 25.2)
Boundaries of Superior Mediastinum
Contents (Fig. 25.3)
Boundaries of Anterior Mediastinum
Contents
Boundaries of Middle Mediastinum
Contents
Boundaries of Posterior Mediastinum
Contents
TRACHEA
Length
Location
Extent
Mobility
Tracheal Patency
Comparative Features of Adult and Infant Trachea
Anterior Relations of Cervical Part of Trachea (Figs 25.9 and 25.10A)
Posterior Relations
Lateral Relations
Anterior Relations of Thoracic Part of Trachea
Posterior Relation
Left Lateral Relations
Right Lateral Relations
Surface Marking
Blood Supply (Fig. 25.12)
Lymph Drainage
Nerve Supply
THE PLEURA AND PLEURAL CAVITIES
Visceral Pleura (Figs 25.14 and 25.15)
Parietal Pleura
Subdivisions of Parietal Pleura
Lines of Pleural Reflections
Surface Marking
Costomediastinal Line
Costodiaphragmatic Line
Costovertebral Line
Cervical Pleura
Pleural Recesses
Nerve Supply of Pleura
Arterial Supply of Pleura
Functional Importance of Pleural Cavity
LUNGS
Gross Features
Surfaces
Borders (Margins)
Fissures
External Features of Right and Left Lungs
Surface Markings of Fissures (Fig. 25.22)
Surface Marking of Lung
Relations of Apex
Medial Surface
Impressions on Mediastinal Surface of Right Lung (Fig. 25.24)
Vertebral Surface of Right Lung
Impressions on Mediastinal Surface of Left Lung (Fig. 25.25)
Vertebral Surface of Left Lung
Root of Lung (Fig. 25.26)
Vertebral Level
Contents
Pulmonary Ligament
Bronchial Tree (Fig. 25.27)
Right Main Bronchus
Left Main Bronchus
Intrapulmonary Airways
Bronchopulmonary Segments
Characteristic Features (Fig. 25.29)
Blood Supply of Lungs
Bronchial Arteries (Fig. 32.10)
Bronchial Veins
Lymphatic Drainage (Fig. 25.30)
Nerve Supply
Radiological Anatomy
26:
DIAPHRAGM AND PHRENIC NERVES
DIAPHRAGM
Parts and Relations
Surface Marking
Attachments
Origin
Insertion
Apertures in Diaphragm (Fig. 26.2)
Major Apertures
Minor Apertures
Motor Nerve Supply
Sensory Nerve Supply
Arterial Supply
Lymphatic Drainage
Actions
PHRENIC NERVES
Origin
Course and Relations
Cervical Course of Phrenic Nerves
Thoracic Course of Phrenic Nerves
Course of Right Phrenic Nerve
Course of Left Phrenic Nerve
Distribution
27:
DEVELOPMENT OF HEART
EVENTS IN DEVELOPMENT OF HEART
Fate of Components of Cardiac Tube and Pericardial Coelom
Subdivisions of Cardiac Tube
Further Development of Cardiac Tube
Fate of Sinus Venosus (Figs 27.3A to C)
Septation of Embryonic Heart
Development of Pulmonary Veins (Figs 27.5A to C)
Developmental Sources of Atria
Atrioventricular Valves
Septation in Truncus Arteriosus, Bulbus Cordis and Common Ventricle (Fig. 27.7)
Development of Ascending Aorta and Pulmonary Trunk
Development of Semilunar Valves
Pulmonary Cushions
Aortic Cushions
Development of Outflow Tracts of Ventricles
Interventricular Septum (Fig. 27.8)
Developmental Sources of Ventricles
Development of Conducting Tissue
28:
PHARYNGEAL ARCH ARTERIES AND FETAL CIRCULATION
PHARYNGEAL ARCH ARTERIES
Transformation of Arch Arteries (Fig. 28.1)
Derivatives of Arch Arteries
Relation to Recurrent Laryngeal Nerves
FETAL CIRCULATION (FIG. 28.7)
Unique Features of Fetal Circulation
Blood Circulation
First Shunt in Liver
Second Shunt in Heart
Third Shunt to Bypass Lung
Postnatal Changes in Fetal Circulation
Time of Anatomical Closure
Fate of Fetal Shunts and Umbilical Blood Vessels
29:
PERICARDIUM AND HEART
PERICARDIUM
Subdivisions
Pericardial Cavity
Fibrous Pericardium (Fig. 26.9)
Serous Pericardium
HEART
Orientation of Heart in Thorax
External Features
Atrioventricular Sulcus
Interventricular Sulci
Interatrial Sulcus
Crux of Heart
Borders (Margins) and Surfaces
Apex of Heart
Margins of Heart
Surfaces of Heart
Sternocostal Surface (Figs 29.7 and 29.8)
Diaphragmatic Surface (Fig. 29.9)
Posterior Surface (Base)
Surface Marking (Fig. 29.16)
Chambers of Heart
Right Atrium
Right Ventricle
Left Atrium
Left Ventricle
Interventricular Septum (Fig. 29.14)
Parts of Interventricular Septum
Conducting Tissue in Interventricular Septum
Arterial Supply of Interventricular Septum (Fig. 29.15)
Surface Markings of Cardiac Valves (Fig. 29.16)
Surface Markings of Cardiac Auscultation Areas (Fig. 29.16)
Radiological Anatomy of Heart (Fig. 29.17)
30:
BLOOD SUPPLY OF HEART
BLOOD SUPPLY
Unique Features of Coronary Arteries
Origin of Right Coronary Artery (Fig. 30.1)
Course (Figs 30.2A and B)
Termination
Branches of Right Coronary Artery
Area of Supply
Origin of Left Coronary Artery (Fig. 30.1)
Course
Branches of Left Coronary Artery
Area of Supply
Coronary Dominance
Coronary Anastomosis
Veins of Heart (Fig. 30.9)
Coronary Sinus
Origin and Termination
Tributaries
31:
FIBROUS SKELETON, CONDUCTING TISSUE AND NERVE SUPPLY OF HEART
FIBROUS SKELETON OF HEART
Component Parts
CONDUCTING TISSUE OF HEART
Components
Arterial Supply of Conducting Tissue (Fig. 31.3)
NERVE SUPPLY OF HEART
Efferent Nerve Supply
Afferent Nerve Supply
32:
MAJOR BLOOD VESSELS OF THORAX
MAJOR BLOOD VESSELS
Pulmonary Vessels
Pulmonary Trunk
Pulmonary Veins (Fig. 32.3)
Ascending Aorta (Fig. 32.4)
Surface Marking
Sinuses of Valsalva
Bulb of Ascending Aorta
Relations
Branches
Arch of Aorta (Fig. 32.5)
Course
Surface Marking (Fig. 32.6)
Relations (Fig. 32.7)
Branches
Arterial Supply
Radiological Appearance
Descending Thoracic Aorta (Fig. 32.10)
Location
Extent
Surface Marking
Relations
Branches of Descending Aorta
Major Veins of Thorax
Superior Vena Cava
Brachiocephalic Veins
Azygos Vein (Fig. 24.10)
Hemiazygos Vein (Inferior Hemiazygos Vein)
Accessory Hemiazygos Vein (Superior Azygos Vein)
Posterior Intercostal Veins (Fig. 24.10)
Venous Communications
33:
LYMPHATIC ORGANS AND AUTONOMIC NERVES OF THORAX
LYMPHATIC ORGANS
Thymus
Location (Fig. 33.1)
Shape
Age Changes
Relations in Superior Mediastinum
Relations in Anterior Mediastinum
Blood Supply
Lymphatic Drainage
Functions
Unique Features of Thymus
Lymph Nodes of Thorax
Superficial Lymph Nodes
Deeper Lymph Nodes
Thoracic Duct
Extent
Appearance
Area of Drainage
Course and Relations (Fig. 33.2)
Termination
Tributaries
Right Lymphovenous Portal
AUTONOMIC NERVES OF THORAX
Vagus Nerve (Parasympathetic Supply)
Course in Thorax
Branches in Thorax
Visceral Afferent Fibers
Sympathetic Chains (Fig. 33.4)
Thoracic Branches of Sympathetic Chain
Branches of Sympathetic Chain (Fig. 33.4)
Visceral Afferent Fibers
Autonomic Plexuses in Thorax
Superficial Cardiac Plexus
Deep Cardiac Plexus
Coronary Plexuses
Pulmonary Plexuses
Esophageal Plexus
34:
ESOPHAGUS
ESOPHAGUS
Course (Fig. 34.1)
Constrictions (Fig. 34.1)
Relations of Cervical Esophagus
Relations of Thoracic Esophagus (Figs 34.2A and D)
Relations to Vagus Nerves
Relations at Esophageal Aperture in Diaphragm
Abdominal Part of Esophagus
Lower Esophageal Sphincter
Arterial Supply
Venous Drainage
Lymphatic Drainage
Nerve Supply
35:
CLINICOANATOMICAL PROBLEMS AND SOLUTIONS
CASE 1
Questions
CASE 2
Questions
CASE 3
Questions
CASE 4
Questions
CASE 5
Questions
CASE 6
Questions
CASE 7
Questions
CASE 8
CASE 9
CASE 10
SECTION 4: HEAD AND NECK
36:
BONES OF HEAD AND NECK
SKULL
Bones of Calvaria
Bones of Facial Skeleton
External Features of Skull
Norma Verticalis
Norma Frontalis (Fig. 36.1)
Norma Occipitalis
Norma Lateralis (Fig. 36.2)
Norma Basalis (Fig. 36.3)
Jugular Foramen
Jugular Fossa
Interior of Cranium (Fig. 36.4)
Features of Anterior Cranial Fossa
Features of Middle Cranial Fossa (Fig. 36.4)
Features of Posterior Cranial Fossa
Internal Acoustic Meatus
Fetal Skull (Fig. 36.5)
Functions of Fontanelles
Fontanelles (Fig. 36.6)
Characteristic Features of Fetal Skull
Individual Cranial Bones
Parietal Bone
Occipital Bone
Frontal Bone
Ethmoidal Bone
Sphenoid Bone
Temporal Bone
Temporal Bone in Newborn
Maxilla
Mandible
Relation to Salivary Glands (Fig. 36.8)
Nerves Closely Related to Mandible
Relation to Facial Artery
Ligaments Attached to Mandible
Age Changes in Mandible
Zygomatic Bone
Nasal Bones
Hyoid Bone (Figs 36.10A and B)
Attachments of Hyoid Bone
Medicolegal Importance
Cervical Vertebrae
Atlas (Fig. 36.12)
Axis (Fig. 36.13A)
Seventh Cervical Vertebra
37:
SCALP
ANATOMY OF SCALP
Extent
Subdivisions
Layers of Scalp (Fig. 37.1)
Galea Aponeurotica
Muscular Part
Nerves of Anterior Quadrant (Fig. 37.3)
Nerves of Posterior Quadrant (Fig. 37.3)
Arterial Supply (Fig. 37.3)
Venous Drainage
Lymphatic Drainage
38:
FACE
DEVELOPMENT OF FACE
Facial Processes
Frontonasal Process (Fig. 38.1A)
Maxillary Processes
Size of Oral Orifice
Anomalies of Oral Orifice
Nerve Supply
Sensory Nerves of Face (Fig. 38.4)
Branches of Ophthalmic Nerve
Branches of Maxillary Nerve
Branches of Mandibular Nerve
Blood Supply
Facial Artery (Figs 38.6 and 38.7)
Superficial Temporal Artery (Fig. 59.2)
Venous Drainage
Facial Vein (Figs 38.8)
Muscles of Facial Expression
Classification (Fig. 38.9)
Compound Sphincter of the Mouth
Modiolus
Orbicularis Oris
Testing Function of Facial Muscles
Extracranial Course of Facial Nerve (Fig. 38.10A)
Relation to Styloid Process
Intraparotid Course
Branches in the Face
Eyelids
External Features of Eyelids
Structure of Eyelids (Fig. 38.11)
Blood Supply
Nerve Supply
Lacrimal Apparatus
Components of Lacrimal Apparatus(Fig. 38.12)
39:
PAROTID GLAND
ANATOMY OF PAROTID GLAND
General Features
Location (Fig. 39.1)
Parts, Surfaces and Borders
Processes
Surface Marking (Fig. 39.2)
Fascial Capsule
Relations (Fig. 39.3)
Contents (Fig. 39.3)
Exit of Structures from the Gland (Fig. 39.4)
Parotid Duct or Stensen's Duct
Surface Marking of Parotid Duct
Parotid Sialography
Secretomotor Innervation of Parotid Gland
Lymphatic Drainage
40:
CERVICAL FASCIA AND TRIANGLES OF NECK
CERVICAL FASCIA
Superficial Fascia
Platysma
Deep Fascia of Neck
Attachments of Investing Layer
Attachments of Pretracheal Layer
Attachments of Prevertebral Fascia
Carotid Sheath
Sternomastoid Muscle
TRIANGLES OF NECK
Posterior Triangle of Neck
Boundaries (Fig. 40.6)
Subdivisions
Muscular Floor
Fascial Roof
Superficial Contents (Fig. 40.7)
Deeper Contents (Fig. 40.8)
External Jugular Vein (Fig. 40.9)
Median Region of Front of Neck
Suprahyoid Region
Infrahyoid Region
Carotid Triangle (Fig. 40.14)
Boundaries of Carotid Triangle (Fig. 40.14)
Contents (Fig. 40.15)
Carotid Pulse
Branches of External Carotid Artery
Deep Cervical Lymph Nodes
41:
SUBMANDIBULAR REGION AND SUBMANDIBULAR GLAND
DIGASTRIC TRIANGLE
Boundaries (Fig. 41.1)
Subdivisions
Contents of Anterior Part
Contents of Posterior Part
Digastric Muscle
Attachments
Development and Nerve Supply
Actions
Relations of Posterior Belly
Stylohyoid Muscle
Nerve Supply
Action
Hyoglossus Muscle (Fig. 41.2)
Attachments
Relations
Nerve Supply
Actions
Mylohyoid Muscle (Fig. 41.3)
Surfaces and Borders
Attachments
Oral Diaphragm
Relations to Submandibular Salivary Gland
Relations of Inferior Surface
Relations of Superior Surface (Fig. 41.4)
Nerve Supply
Actions
Geniohyoid Muscle (Fig. 41.4)
SUBMANDIBULAR SALIVARY GLAND
Parts (Fig. 41.5)
Fascial Capsule (Fig. 41.6)
Bidigital Palpation
Surface Marking
Surfaces of Superficial Part of Gland
Relations
Relation to Facial Artery (Fig. 41.8)
Relations of Deep Part of the Gland (Fig. 41.9)
Submandibular or Wharton's Duct
Secretomotor Nerve Supply (Fig. 41.11)
SUBLINGUAL SALIVARY GLAND
Relations
Secretomotor Supply
42:
PHARYNGEAL (BRANCHIAL) APPARATUS
PHARYNGEAL (BRANCHIAL) ARCHES
Components of Each Arch (Fig. 42.1)
Nerves of Arches
Derivatives of First Arch (Fig. 42.3)
Derivatives of Second Arch (Fig. 42.3)
Derivatives of Third Arch (Fig. 42.3)
Derivatives of Fourth and Sixth Arches
Derivatives of Endodermal Pouches (Fig. 42.4)
43:
THYROID GLAND AND PARATHYROID GLANDS
THYROID GLAND
General Features (Fig. 43.1)
Capsules of Thyroid Gland (Fig. 43.4)
Relations of Lobes (Fig. 43.5)
Relations of Surfaces
Relations of Isthmus
Arterial Supply (Figs 43.6 and 43.7)
Venous Drainage (Fig. 43.8)
Lymphatic Drainage (Fig. 43.9)
Nuclear Scan of Thyroid Gland
PARATHYROID GLANDS (FIG. 43.11)
Location
Blood Supply
44:
BLOOD VESSELS, NERVES AND LYMPH NODES OF NECK
BLOOD VESSELS
Common Carotid Arteries
Surface Marking
Cervical Course of Common Carotid Artery
Internal Carotid Artery
Anterior Relation (Fig. 44.1)
Posterior Relation
Lateral Relation
External Carotid Artery
Relations in Carotid Triangle
Relations in Posterior Part of Digastric Triangle
Branches in Carotid Triangle (Fig. 40.15)
Branches Outside Carotid Triangle
Subclavian Artery (Fig. 44.2)
Origin and Termination
Surface Marking
Parts of Subclavian Artery
Branches of First Part (Fig. 44.2)
Branches of Second Part
Branches of Third Part
VEINS OF NECK
Internal Jugular Vein (Fig. 44.3)
Surface Marking
Tributaries
Subclavian Vein
CERVICAL PLEXUS
Formation (Fig. 44.4)
Deep or Muscular Branches
Superficial Branches (Fig. 40.7)
Communicating Branches
Ansa Cervicalis (Fig. 40.13)
Phrenic Nerve
Cervical Sympathetic Chain
Sympathetic Ganglia
CERVICAL LYMPH NODES
Superficial Lymph Nodes (Fig. 44.7)
Deep Lymph Nodes (Fig. 44.8)
Paravertebral Muscles of Neck
Scalenus Anterior (Fig. 24.1)
Scalenus Medius
Scalenus Posterior
Scalenus Minimus
Prevertebral Muscles of Neck
Longus Colli
Longus Capitis
Rectus Capitis Anterior
Rectus Capitis Lateralis
45:
INFRATEMPORAL FOSSA AND PTERYGOPALATINE FOSSA
INFRATEMPORAL FOSSA
Bony Boundaries (Fig. 45.1)
Contents
Mandibular Nerve
Otic Ganglion
PTERYGOPALATINE FOSSA
Communications
Maxillary Nerve (Fig. 45.4)
Pterygopalatine (Sphenopalatine) Ganglion
Maxillary Artery
Temporomandibular Joint
Special Features
Type of joint
Articular Bones (Fig. 45.7)
Fibrous Capsule
Ligaments
Synovial Membrane
Relations
Nerve Supply
Movements (Fig. 45.8)
Muscles of Mastication
Testing the Function of Muscles of Mastication
46:
ORBIT AND EYEBALL
ORBIT
Bony Boundaries (Fig. 46.1)
Periorbita
Communications
Contents
Extraocular Muscles
Voluntary Muscles
Involuntary Muscles
Ophthalmic Nerve (Fig. 46.6A)
Lacrimal Nerve
Frontal Nerve
Nasociliary Nerve
Ciliary Ganglion
Connections
Branches
Ophthalmic Artery (Fig. 46.7)
Branches
Ophthalmic Veins (Fig. 46.8)
Fascia Bulbi (Tenon's Capsule)
EYEBALL
Coats of Eyeball (Fig. 46.10)
Fibrous layer
Uveal Tract
Retina
Parts of Retina (Fig. 46.13)
Layers of Retina (Fig. 46.14)
Arterial Supply of Retina
Venous Drainage of Retina
Refractive Media
47:
ORAL CAVITY, TONGUE AND PALATE
ORAL CAVITY
Teeth or Dentition
Floor of the Mouth (Fig. 47.2)
TONGUE
Parts of the Tongue
Gross Appearance of Dorsum (Fig. 47.3)
Anterior Two-third
Posterior One-third
Muscles of Tongue
Extrinsic Muscles (Fig. 47.4)
Intrinsic Muscles
Nerve Supply
Motor Nerve Supply
Sensory Nerve Supply
Arterial Supply (Fig.47.7)
Venous Drainage (Fig. 47.8)
Lymphatic Drainage (Fig. 47.8)
Gustatory or Taste Pathways
PALATE
Components of Hard Palate (Fig. 47.10)
Foramina in Hard Palate
Soft Palate
Layers of Soft Palate
Muscles of Soft Palate (Fig. 47.11)
Motor Nerve Supply
Sensory Nerve Supply
Blood Supply
48:
NASAL CAVITY AND PARANASAL AIR SINUSES
NASAL CAVITY
Subdivisions
Nasal Vestibule
Nasal Cavity Proper
Functions of Nasal Cavity
Communications of Nasal Cavity
Boundaries of Nasal Cavity Proper (Fig. 48.1)
Floor
Formation of Roof
Lateral Wall
Main Features of Middle Meatus (Fig. 48.2)
Nasal Septum
Arterial Supply of Nasal Cavity (Fig. 48.4)
Arterial Supply of Nasal Septum
Arterial Supply of Lateral wall
Venous Drainage of Nasal Cavity
Nerve Supply of Nasal Cavity (Fig. 48.5)
From Nasal Septum
From Lateral Wall
PARANASAL AIR SINUSES
General Characteristics
Frontal Sinus (Figs 48.1 and 48.2)
Ethmoidal Sinuses (Fig. 48.6)
Sphenoidal Sinus (Fig. 48.2)
Maxillary Sinus (Fig. 48.6)
Relations of Walls of Sinus
Nerves Related to Maxillary Sinus
Radiology of PNS
49:
PHARYNX
ANATOMY OF PHARYNX
Shape
Length
Width
Extent
Deficiencies in Anterior Wall
Subdivisions (Fig. 49.1)
Layers of Pharyngeal Wall
Mucous Membrane
Submucosa
Pharyngeal Aponeurosis (Pharyngobasilar Fascia)
Pharyngeal Muscles
Nasopharynx (Fig. 49.1)
Communications
Functions
Walls of Nasopharynx
Sensory Supply of Mucosa of Nasopharynx
Oropharynx (Fig. 49.3)
Inspection of Oropharynx (Fig. 49.3)
Walls of Oropharynx
Palatine Tonsil (Faucial Tonsil)
Waldeyer's Ring (Fig. 49.6)
Components of Waldeyer's Ring
Laryngopharynx
Walls of Laryngopharynx
Nerve Supply
Inspection of Laryngopharynx
Radiological Appearance
50:
LARYNX
ANATOMY OF FACIAL NERVE
Location
Differences in Male and Female
Differences in Adult and Infant
Laryngeal Cartilages (Fig. 50.1)
Membranes and Ligaments of Larynx
Subdivisions of Laryngeal Cavity (Fig. 50.3)
Sinus or Ventricle of Larynx
Rima Glottis (Fig. 50.4)
Mucosa of Laryngeal Cavity
Sensory Nerve Supply and Blood Supply
Lymphatic Drainage
Laryngoscopic Examination
Laryngeal Muscles (Fig. 50.6)
Intrinsic Muscles of Larynx
51:
EAR (EXTERNAL AND MIDDLE), EUSTACHIAN TUBE, MASTOID ANTRUM AND INTERNAL EAR
EAR
External Ear
Gross Features of Auricle (Pinna)
External Acoustic Meatus
Middle Ear or Tympanic Cavity
Subdivisions
Shape and Measurements
Walls of Middle Ear (Fig. 51.4)
Contents of Middle Ear
Intratympanic Muscles
AUDITORY TUBE OR EUSTACHIAN TUBE
Length
Direction
Parts (Fig. 51.7)
Diameter
Location of Pharyngeal Opening
Muscles Attachment (Fig. 51.7)
Actions
Nerve Supply
Blood Supply
Lymphatic Drainage
MASTOID OR TYMPANIC ANTRUM
Boundaries of Mastoid Antrum
Boundaries of Suprameatal Triangle
Surface Marking of Suprameatal Triangle
Mastoid Air Cells
Extra-Mastoidal Sites of Air Cells
Internal Ear
Major Subdivisions
52:
CLINICOANATOMICAL PROBLEMS AND SOLUTIONS
CASE 1
Questions and Solutions
CASE 2
Questions and Solutions
CASE 3
Questions and Solutions
CASE 4
Questions and Solutions
CASE 5
Questions and Solutions
CASE 6
Questions and Solutions
CASE 7
Questions and Solutions
CASE 8
CASE 9
Questions and Solutions
Subdivisions
CASE 10
Questions and Answers
Contents
CASE 11
Questions and Solutions
CASE 12
Questions and Solutions
CASE 13
Questions and Solutions
CASE 14
Questions and Solutions
CASE 15
Questions and Solutions
SECTION 5: VERTEBRAL COLUMN AND SPINAL CORD, CRANIAL CAVITY AND BRAIN
53:
DEEP MUSCLES OF BACK
DEEP MUSCLES OR INTRINSIC MUSCLES
Nerve Supply
Classification of Postvertebral Muscles
Splenius Muscles
Erector Spinae or Sacrospinalis
Transversospinalis
Semispinalis Capitis
Suboccipital Triangle
Boundaries (Fig. 53.1)
Contents
Suboccipital Muscles
Vertebral Artery (Fig. 53.2)
Vertebral Vein
Vertebral Angiography (Fig. 53.3)
54:
VERTEBRAL COLUMN
ANATOMY OF VERTEBRAL COLUMN
Length of Vertebral Column
Number of Vertebrae
Parts of Vertebra
Intervertebral Joints
Boundaries of Intervertebral Foramina
Contents of Intervertebral Foramen
Vertebral Canal
Extent
Shape
Contents
Curvatures of Vertebral Column (Fig. 54.5)
Ligaments of Vertebral Column (Fig. 54.6)
Intervertebral Discs
Parts of Disc (Figs 54.7A and B)
Diurnal Variation
Age Changes
Craniovertebral Joints
Ligaments Connecting Axis and Occipital Bone
Lumbosacral Joint
Sacrococcygeal Joint
Movements of Vertebral Column
Movements of Cervical Spine
Movements of Thoracic Spine
Movements of Lumbar Spine
Arterial Supply
Venous Drainage
55:
SPINAL CORD
ANATOMY OF SPINAL CORD
Development of Spinal Cord
Extent
Length
Spinal Meninges (Fig. 55.2)
Spinal Dura Mater
Arachnoid mater
Pia Mater
Enlargements of Spinal Cord
Surface Features of Spinal Cord (Fig. 55.8)
Spinal Nerves (Fig. 55.4)
Sympathetic Connections of Spinal Nerves
Spinal Segments (Fig. 55.5)
Exit of Spinal Nerves
Cauda Equina (Figs 55.7A and B)
Internal Structure (Fig. 55.8)
Central Canal of Spinal Cord
Gray Matter (Fig. 55.9)
White Matter (Fig. 55.10)
White Commissure
Major Ascending Tracts
Spinothalamic Tracts
Posterior Column Tracts (Fig. 55.12)
Spinocerebellar Tracts
Cuneocerebellar Tract
Lissauer's Tract
Major Descending Tracts
Corticospinal Tract (Fig. 55.14)
Descending Autonomic Pathways
Fasciculus Proprius (intersegmental tract)
Arterial Supply of Spinal Cord
Anterior Spinal Artery
Posterior Spinal Arteries
Radicular Arteries (Fig. 55.15B)
Arteria Radicularis Magna
Intrinsic Blood Supply (Fig. 55.15B)
Venous Drainage (Fig. 55.16)
Radiology of Spinal Cord
UMN Vs LMN
Differences in UMN and LMN Lesions
56:
CRANIAL MENINGES, MIDDLE MENINGEAL ARTERY AND PITUITARY GLAND
CRANIAL MENINGES
Cranial Dura Mater
Dural Folds (Fig. 56.2.)
Nerve Supply of Dura mater
Blood Supply
Dural Venous Sinuses
Arachnoid Mater
Subarachnoid Space
Subarachnoid Cisterns
Pia Mater
MIDDLE MENINGEAL ARTERY
Origin
Course and Termination
Branches
Surface Marking (Fig. 56.8)
Middle Meningeal Vein or Sinus
PITUITARY GLAND
Lobes
Location
Subdivisions of Pituitary (Fig. 56.11)
Infundibulum
Relations of Pituitary (Figs 56.6 and 56.12)
Connections with Hypothalamus (Fig. 56.13)
Blood Supply (Fig. 56.15)
Structure of Adenohypophysis
Structure of Neurohypophysis
57:
DEVELOPMENT OF CENTRAL NERVOUS SYSTEM
CENTRAL NERVOUS SYSTEM
Main Parts of Brain
Gray Matter and White Matter
DEVELOPMENT
Neural Tube
Development of Spinal Cord (Fig. 57.2)
Positional Changes in Spinal Cord
Development of Brain
Primary Brain Vesicles
Secondary Brain Vesicles
Effect of Pontine Flexure
Functional Classification of Neurons in Developing Brain (Fig. 57.5)
Columns Derived from Alar Lamina
Derivatives of Myelencephalon
Derivatives of Metencephalon
Derivatives of Mesencephalon
Derivatives of Diencephalon
Derivatives of Telencephalon
58:
BASE OF BRAIN AND BRAINSTEM
BASE OF BRAIN (Fig. 58.1A)
Features Visible at Base of Brain
Anterior Perforated Structure
Interpeduncular Fossa
Boundaries (Fig. 58.1B)
Structures in the Fossa
BRAINSTEM (FIGS 58.2A AND B)
Medulla Oblongata
Location
Relations
Subdivisions
Surface Features
Internal Structure
Arterial Supply of Medulla Oblongata
Pons
External Features
Cerebellopontine Angle
Internal Structure of Pons
Basilar Part of Pons (Fig. 58.6)
Tegmentum of Pons (Fig. 58.6)
Arterial Supply of Pons
Midbrain
Parts of Midbrain
Internal Structure of Midbrain
Tegmentum at the Level of Inferior Colliculi (Fig. 58.8)
Tegmentum at the Level of Superior Colliculi (Fig. 58.9)
Medial Longitudinal Fasciculus
Tectum
Arterial Supply of Midbrain
59:
CEREBELLUM AND FOURTH VENTRICLE
CEREBELLUM
Cerebellar Cortex
Intracerebellar Nuclei
Parts of Cerebellum
Anatomical Lobes of Cerebellum (Fig. 59.2)
Functional Lobes of Cerebellum
Archicerebellum
Paleocerebellum
Neocerebellum
Cerebellar Peduncles
Histology of Cerebellar Cortex
Neurons of Cerebellar Cortex
Cerebellar Nuclei
Arterial Supply
Summary of Functions of Cerebellum
FOURTH VENTRICLE (FIG. 59.6)
Features
Lateral Recesses
Roof (Fig. 59.7)
Choroid Plexuses of Fourth Ventricle (Fig. 59.7)
Lateral Walls
Floor (Rhomboid Fossa)
Features of Pontine Part
Features of Medullary Part
60:
DIENCEPHALON
DIENCEPHALON
Subdivisions
Thalamus
Epithalamus (Fig. 60.5)
Hypothalamus (Fig. 60.4)
Subthalamus
Metathalamus
Third Ventricle
Boundaries (Fig. 60.5)
Recesses (Fig. 60.5)
61:
CEREBRUM
ANATOMY OF CEREBRUM
Cerebral Hemisphere
External Features (Figs 61.1 and 61.2)
Lobes of Cerebrum
Cerebral Sulci and Gyri (Fig. 61.3A)
Lateral Sulcus or Sylvian Fissure
Central Sulcus or Fissure of Rolando
Parieto-occipital Sulcus
Sulci and Gyri on Superolateral Surface (Fig. 61.3A)
Insula (Island of Reil)
Medial Surface of Cerebral Hemisphere
Sulci and Gyri on Medial Surface (Fig. 61.4)
Sulci and Gyri on Inferior Surface (Fig. 61.2)
Functional Areas of Cerebral Cortex
Motor Areas (Figs 61.5 and 61.6)
Sensory Areas (Figs 61.5 and 61.6)
Cortical Speech Areas
62:
BLOOD SUPPLY OF BRAIN
BLOOD SUPPLY OF BRAIN
Intracranial Course of Internal Carotid Artery
Intrapetrous Part
Intracavernous Part
Supraclinoid Part
Carotid Siphon
Branches
Vertebrobasilar Arteries (Fig. 62.1)
Circle of Willis (circulus arteriosus)
Formation (Fig. 62.1)
Functional Importance
Carotid Angiogram
Branches of Circle of Willis (Fig. 62.1)
Blood Supply of Cerebral Cortex
Anterior Cerebral Artery
Middle Cerebral Artery
Posterior Cerebral Artery
Cerebral Angiography (Fig. 62.2)
Venous Drainage of Cerebrum
63:
WHITE MATTER OF CEREBRUM
WHITE MATTER OF CEREBRUM
Association Fibers (Fig. 63.1)
Examples of Long Association Fibers
Commissural Fibers
Examples of Commissural Fibers
Corpus Callosum (Fig. 58.2B)
Projection Fibers
Examples of Projection Fibers
Internal Capsule (Figs 63.4A and B)
Parts
Relations
Fiber Composition
Arterial Supply (Fig. 63.5)
Pyramidal Tract (Fig. 55.14)
Origin
Course of Corticospinal Fibers (Fig. 55.14)
Comparative Features of UMN and LMN Lesions See Table 63.1
64:
LATERAL VENTRICLE, BASAL GANGLIA, LIMBIC SYSTEM AND CSF CIRCULATION
LATERAL VENTRICLE
Subdivisions (Fig. 64.2)
Central Part
Anterior Horn
Inferior Horn (Fig. 64.3A)
Posterior Horn (Fig. 64.3B)
Choroid Fissure
Choroid Plexus
Radiological Visualization
BASAL GANGLIA
Component Nuclei (Fig. 64.4)
Corpus Striatum
Striatum
Pallidum
Caudate Nucleus (Fig. 64.2)
Lentiform Nucleus
Claustrum
Amygdaloid Nucleus
LIMBIC SYSTEM
Constituents of Limbic System
Cortical Gray Matter
Subcortical Gray Matter
Interconnecting Fiber Tracts
Amygdaloid Nucleus (Fig. 64.4)
Subcortical Connections of Amygdala
Cortical Connections of Amygdala
Hippocampal Formation
Papez Circuit (Fig. 64.6)
Functional Importance of Hippocampus
Limbic Lobe
CEREBROSPINAL FLUID
Site of Production
Characteristic Features of CSF
Circulation of CSF (Fig. 64.7)
Blood Brain Barrier
65:
OVERVIEW OF AUTONOMIC NERVOUS SYSTEM
AUTONOMIC NERVOUS SYSTEM
Subdivisions of Efferent Component
Neurotransmitters at Sympathetic Synapses
Neurotransmitter at Parasympathetic Synapses
Thoracolumbar Outflow (Fig. 65.1)
Craniosacral Outflow (Fig. 65.2)
Visceral Afferent Fibers
66:
CLINICOANATOMICAL PROBLEMS AND SOLUTIONS
CASE 1
Questions and Solutions
CASE 2
Questions and Solutions
CASE 3
Questions and Solutions
CASE 4
Questions
CASE 5
Questions and Solutions
CASE 6
Questions and Solutions
CASE 7
Questions and Solutions
CASE 8
Questions and Solutions
CASE 9
Questions and Solutions
CASE 10
Questions and Solutions
SECTION 6: CRANIAL NERVES
67:
OLFACTORY NERVE AND PATHWAY
OLFACTORY NERVE AND PATHWAY
Olfactory Bulb (Fig. 67.1)
Olfactory Tract
Olfactory Cortex
68:
OPTIC NERVE AND VISUAL PATHWAY
OPTIC NERVE AND VISUAL PATHWAY
Optic Nerve (Fig. 68.1B)
Coverings
Parts
Arterial Supply
Arrangement of Nerve Fibers
Relation of Field of Vision to Retinal Quadrants (Fig. 68.2)
Optic Chiasma (Fig. 68.2)
Relations of Optic Chiasma (Fig. 56.6)
Arterial Supply
Optic Tract (Fig. 68.2)
Arterial Supply
Lateral Geniculate Body
Arterial Supply
Optic Radiation (Fig. 68.2)
Arterial Supply
Visual Cortex (Fig. 61.6)
Arterial Supply
Pupillary Light Reflexes (Fig. 68.4)
Accomodation Reflex
69:
OCULOMOTOR NERVE, TROCHLEAR NERVE AND ABDUCENT NERVE
CRANIAL NERVES
Functional Classification (Fig. 69.1)
Motor Fibers
Sensory Fibers
OCULOMOTOR NERVE
Nuclei of Origin (Fig. 69.2)
Functional Components
Connections
Intraneural Course (Fig. 69.2)
Point of Emergence (Figs 58.1A and B)
Location of Fibers in Oculomotor Nerve
Intracranial Course
Exit from Cranium (Fig. 46.2)
Intraorbital Course and Branches (Fig. 69.3)
Ciliary Ganglion (Fig. 69.3)
TROCHLEAR NERVE
Unique Features
Nucleus of Origin (Fig. 69.5)
Functional Component
Intraneural Course (Fig. 69.5)
Point of Emergence (Fig. 69.5)
Intracranial Course
Exit from Cranium (Fig. 46.2)
Intraorbital Course
ABDUCENT NERVE
Nucleus of Origin (Fig. 58.6)
Functional Component
Intrapontine Course
Point of Emergence (Figs 58.1A and 58.2A)
Intracranial Course
Exit from Cranium (Fig. 46.2)
Intraorbital Course
70:
TRIGEMINAL NERVE AND RELATED SENSORY PATHWAY
TRIGEMINAL NERVE
Motor and Sensory Nuclei
Functional Importance of Sensory Nuclei
Functional Components
Point of Emergence (Figs 58.1A and 58.2A)
Trigeminal (Gasserian) Ganglion
Location
Dural Relations
Intracranial Course of Ophthalmic Nerve
Intracranial Course of Maxillary Nerve
Intracranial Course of Mandibular Nerve
Summary of Sensory Distribution
Testing Sensory Areas of Trigeminal Subdivisions
Corneal Reflex (Fig. 70.4)
TRIGEMINAL SENSORY PATHWAYS
Role of Mesencephalic Nucleus
Jaw Jerk (Reflex)
71:
FACIAL NERVE
ANATOMY OF FACIAL NERVE
Nuclei of Origin (Fig. 71.1)
Functional Components (Fig.71.1)
Intrapontine Course (Fig. 58.6)
Attachment to Brainstem (Fig. 58.1)
Course through Posterior Cranial Fossa
Intrapetrous Course (Fig. 71.3)
Geniculate Ganglion
Branches of Facial Nerve in Facial Canal
Exit from Cranium
Extracranial Course (Fig. 38.10A)
Chorda Tympani Nerve (Fig. 71.4)
Origin
Course
72:
VESTIBULOCOCHLEAR NERVE
VESTIBULOCOCHLEAR NERVE
Functional Components
Vestibular Nerve (Fig. 72.2)
Origin and Intrapetrous Course
Course through Posterior Cranial Fossa
Nuclei of Termination
Efferent Connections of Vestibular Nuclei
Cochlear Nerve
Origin and Intrapetrous Course (Fig. 72.3)
Course in Posterior Cranial Fossa
Auditory Pathway (Fig. 72.3)
Lateral Lemniscus
Inferior Colliculus
Medial Geniculate Body
Auditory Radiation
Auditory Cortex
73:
GLOSSOPHARYNGEAL NERVE
GLOSSOPHARYNGEAL NERVE
Nuclei of Origin (Fig. 73.1)
Functional Components
Point of Emergence (Figs 58.1A and 58.2A)
Course in Posterior Cranial Fossa
Exit from Cranium
Relations in Jugular Foramen
Extracranial Course (Fig. 73.2)
Branches
74:
VAGUS NERVE
ANATOMY OF VAGUS NERVE
Nuclei of Origin (Fig. 74.1)
Functional Components
Point of Emergence (Figs 58.1A and 58.2A)
Intracranial Course
Exit from Cranium
Sensory Ganglia
Branches in Jugular Foramen
Extracranial Course (Fig. 74.2)
Cervical Course
Entry into Thorax
Abdominal Course
75:
ACCESSORY NERVE
ACCESSORY NERVE
Formation of Accessory Nerve (Fig. 75.1)
Splitting of Accessory Nerve
Extracranial Course of Spinal Part
76:
HYPOGLOSSAL NERVE
ANATOMY OF HYPOGLOSSAL NERVE
Nucleus of Origin
Functional Component
Intramedullary Course (Fig. 76.1)
Point of Emergence (Figs 58.1A and 58.2A)
Intracranial Course
Exit from Cranium
Extracranial Course (Fig. 76.1)
Branches of Communication
Branches (carrying C1 fibers)
Branches of Hypoglossal Nerve
Testing Nerve Function
77:
CLINICOANATOMICAL PROBLEMS AND SOLUTIONS
CASE 1
Questions and Solutions
CASE 2
Questions and Solutions
CASE 3
Questions and Solutions
CASE 4
Questions and Solutions
CASE 5
Questions and Solutions
CASE 6
Questions and Solutions
SECTION 7: ABDOMEN, PELVIS AND PERINEUM
78:
BONES OF ABDOMEN AND PELVIS
LUMBAR VERTEBRAE
Typical Lumbar Vertebra (Fig. 78.1)
Fifth Lumbar Vertebra (Fig. 78.2)
Muscle Attachments
Attachments of Thoracolumbar Fascia
SACRUM (FIG. 78.3)
Ala of Sacrum
Relations of Pelvic Surface
Dorsal Surface
Lateral Surface
Contents of Sacral Canal
Sacral Hiatus
Sex Differences
COCCYX
BONY PELVIS (FIGS 78.4 AND 78.5)
Joints of Pelvis
Subdivisions of Pelvis
Pelvic Inlet
Pelvic Cavity
Pelvic Outlet
Sex Differences in Pelvis
Types of Female Pelvis
79:
ANTERIOR ABDOMINAL WALL AND INGUINAL CANAL
ABDOMEN
Boundaries of Abdomen Proper
ANTERIOR ABDOMINAL WALL (FIG. 79.2)
Surface Features
Layers of Anterior Abdominal Wall
Skin
Anterolateral Muscles of Anterior Abdominal Wall
External Oblique Abdominis (Fig. 79.6)
Internal Oblique Muscle (Fig. 79.8)
Transversus Abdominis (Fig. 79.9)
Rectus Sheath (Figs 79.10A to C)
Above the Level of Costal Margin
From the Costal Margin to Midway between Umbilicus and Pubic Symphysis
Below the Level of the Point Midway between Umbilicus and Pubic Symphysis
Contents of Rectus Sheath
Fascia Transversalis
Nerves of Anterior Abdominal Wall
Arteries of Anterior Abdominal Wall
UMBILICUS
INGUINAL CANAL
Extent
Surface Marking (Fig. 79.16)
Contents of Inguinal Canal in Male
Contents of Inguinal Canal in Female
Walls of Inguinal Canal
Deep (internal) Inguinal Ring
Superficial (external) Inguinal Ring
Protection of Inguinal Canal
80:
DISPOSITION OF VISCERA AND PERITONEUM IN ABDOMINOPELVIC CAVITY
ABDOMINOPELVIC CAVITY
Contents
General Disposition of Viscera
Abdominopelvic Cavity in Newborn
FORMATION OF EMBRYONIC MESENTERIES
Derivatives of Abdominal Part of Foregut
Derivatives of Ventral Mesogastrium
Derivatives of Dorsal Mesogastrium
Derivatives of Midgut
Formation of Midgut Loop (Fig. 80.2A)
Derivatives of Hindgut
Derivatives of Preallantoic Hindgut
Postallantoic Hindgut (Endodermal cloaca)
Fate of Mesenteries of Midgut and Hindgut
Peritoneum
Functions of Peritoneum
Subdivisions of Peritoneal Cavity (Fig. 80.5A)
Vertical Disposition of Peritoneum
Falciform Ligament
Coronary and Triangular Ligaments
Lesser Omentum (Fig. 81.3)
Greater Omentum (Fig. 81.3)
Transverse Mesocolon
The Mesentery
Pelvic Mesocolon
Transverse Disposition of Peritoneum
Cross-sectional Anatomy of Abdomen
Subphrenic Spaces (Fig. 80.10)
Classification
Spaces of Infracolic Compartment
Nerve Supply
Blood Supply
81:
STOMACH, DUODENUM, SMALL INTESTINE AND LARGE INTESTINE
STOMACH
Functions
Parts (Fig. 81.1A)
Gastric Orifices
Curvatures
Fundus
Traube's Space (Fig. 81.1B)
Boundaries
Relations of Gastric Surfaces
Pyloric Part
Peritoneal Relations (Fig. 81.3)
Lesser Omentum
Greater Omentum
Gastrosplenic Ligament
Gastrophrenic Ligament
Radiological Appearance
Interior of Stomach (Fig. 81.5)
Arterial Supply (Fig. 81.7)
Venous Drainage
Lymphatic Drainage (Fig. 81.8)
Nerve Supply (Figs 81.9A to C)
SMALL INTESTINE
Duodenum
General Features
Parts (Fig. 81.13)
Surface Marking
Relations of First Part (Figs 81.14A and B)
Relations of Second Part
Relations of Third Part
Relations of Fourth Part
Duodenojejunal Flexure
Arterial Supply (Fig. 81.20)
Venous Drainage
Lymphatic Drainage
Nerve Supply
Peritoneal Recesses in Relation to Duodenum (Fig. 81.21)
Contrast X-ray of Duodenum
Jejunum and Ileum
Extent
Mesentery
Distinguishing Features (Fig. 81.23)
Small Intestine (Small Bowel)
Arterial Supply
Arterial Arcades
LARGE INTESTINE
Functions
Distinguishing Features
Cecum (Fig. 81.27)
Surface Marking (Fig. 81.25)
Relations
Peritoneal Recesses (Fig. 81.28)
Orifices in the Interior of Cecum
Blood Supply (Fig. 81.30)
Lymphatic Drainage
Vermiform Appendix
Parts
Peritoneal Relation
Surface Marking
Positions of the Tip of Appendix (Fig. 81.32)
Blood Supply
Nerve Supply
Ascending Colon
External Features
Relations
Transverse Colon
External Features
Relations
Transverse Mesocolon
Comparison of Hepatic and Splenic Flexures
Descending Colon
Relations
Blood Supply of Colon
Lymphatic Drainage
Nerve Supply
Parasympathetic Supply
Afferent Nerve Supply
82:
PANCREAS, LIVER, EXTRAHEPATIC BILIARY APPARATUS AND SPLEEN
PANCREAS
Functions
General Features
Surface Marking
Relations of Head (Fig. 82.3)
Relations of Neck
Relations of Body
Relations of Borders
Relations of Surfaces
Tail of Pancreas
Pancreatic Ducts (Fig. 82.4)
Radiological Examination of Ducts
Microscopic Structure
Arterial Supply (Figs 81.13 and 81.20)
Venous Drainage
Lymphatic Drainage
Nerve Supply
LIVER
Development
Surfaces
Surface Marking (from anterior aspect)
Details of Posterior Surface (Fig. 82.7)
Inferior or Visceral Surface (Fig. 82.7)
Peritoneal Ligaments
Subphrenic Spaces (Fig. 80.10)
Blood Supply
Anatomical Lobes
Functional Lobes (Figs 82.8A and B)
Couinaud's Segments (Fig. 82.9)
Left Hemiliver
Right Hemiliver
Lymphatic Drainage
Microscopic Structure
Functions
Liver Biopsy
BILIARY APPARATUS
Intrahepatic Part
Extrahepatic Parts (Fig. 82.12)
Right and Left Hepatic Ducts
Common Hepatic Duct
Gallbladder
Cystic Duct
Common Bile Duct
Arterial Supply of Extrahepatic Biliary Apparatus (Fig. 82.14)
Venous Drainage
Lymphatic Drainage
Nerve Supply
Radiology of Biliary Apparatus
SPLEEN
Location
Size and Measurements
Surfaces, Borders and Poles
Surface Marking
Peritoneal Relations (Fig. 82.21)
Blood Supply
Lymphatic Drainage
83:
BLOOD SUPPLY OF DIGESTIVE TRACT
BLOOD SUPPLY OF DIGESTIVE TRACT
Celiac Trunk (Fig. 83.1)
Celiac Arteriography
Left Gastric Artery
Common Hepatic Artery
Hepatic Artery Proper
Splenic Artery
Superior Mesenteric Artery (Fig. 83.2)
Course
Surface Marking
Branches (Fig. 83.2)
Intestinal Angina
Superior Mesenteric Arteriography
Inferior Mesenteric Artery
Surface Marking
Branches (Fig. 83.3)
Inferior Mesenteric Arteriography
Marginal Artery of Drummond (Fig. 83.4)
Venous Drainage
Portal Vein
Formation (Fig. 83.5)
Parts
Termination
Extrahepatic Course
Intrahepatic Course
Blood Flow in Portal Vein (Fig. 83.5)
Tributaries (Fig. 83.7)
Paraumbilical, Cystic and Prepyloric Veins
Radiological Examination
84:
LUMBAR FASCIA AND POSTERIOR ABDOMINAL WALL (RETROPERITONEUM)
LUMBAR FASCIA
Posterior Layer
Middle Layer
Anterior Layer
Muscles Attached to Lumbar Fascia
Special Relations of Anterior Layer
MUSCLES OF POSTERIOR ABDOMINAL WALL
Quadratus Lumborum (Fig. 84.2)
Nerve Supply
Relations
Actions
Psoas Major (Fig. 84.3)
Origin
Insertion
Relations of Psoas Major in Abdomen
Relations in Femoral Triangle
Nerve Supply
Actions
Testing Function of Psoas Major
Iliacus Muscle (Fig. 84.3)
Nerve Supply
Actions
Lumbar Plexus
Formation
Iliohypogastric and Ilioinguinal Nerves
Genitofemoral Nerve
Lateral Cutaneous Nerve of Thigh
Obturator Nerve
Femoral Nerve
ABDOMINAL AORTA
Surface Marking
Aortic Pulsations
Histological Peculiarity
Radiological Visualization
Relations of Abdominal Aorta
Branches of Abdominal Aorta with Vertebral Level of Origin
Common Iliac Arteries
Branches
Angiography of Common Iliac Arteries
External Iliac Artery
Surface Marking
Branches
Internal Iliac Artery
INFERIOR VENA CAVA (IVC)
LYMPH NODES OF ABDOMEN AND PELVIS
Cisterna Chyli (Fig. 33.2)
Abdominopelvic Part of Autonomic Nervous System
Sympathetic Part
Parasympathetic Part
Sympathetic Chains in Abdomen and Pelvis
Branches of Lumbar Part of Sympathetic Chain
Branches of Sacral Part of Sympathetic Chain
Intra-abdominal Branches of Vagus Nerves
Intrapelvic Branches of Sacral Parasympathetic Outflow
Celiac Plexus (Solar Plexus)
Constituents
Secondary Plexuses from Celiac Plexus
Superior Hypogastric Plexus
Inferior Hypogastric Plexus
Constituents of Inferior Hypogastric Plexus
Secondary Plexuses from Inferior Hypogastric Plexus
85:
SUPRARENAL GLANDS, KIDNEYS AND URETERS
SUPRARENAL GLANDS
Parts
Weight and Shape
Relations of Right Suprarenal Gland (Fig. 85.1)
Relations of Left Suprarenal Gland (Fig. 85.1)
Hormones of Suprarenal Cortex
Hormones of Suprarenal Medulla
Arterial Supply (Fig. 85.2)
Venous Drainage (Fig. 85.1)
Nerve Supply
Radiology of Suprarenal Gland
KIDNEY
Gross Anatomy of Kidneys
Measurements
Position
Surfaces and Borders (Fig. 85.6)
Hilum of Kidney
Surface Marking
Surface Marking on the Back of Trunk (Fig. 85.6)
Renal Angle
Coverings of Kidney (Fig. 85.7)
True Capsule
Fatty Capsule
Fascial Capsule
Paranephric Fat
Supports of Kidney
Relations of Kidney
Anterior Relations of Right Kidney (Fig. 85.8)
Anterior Relations of Left Kidney (Fig. 85.8)
Posterior Relations (Fig. 85.9)
Gross Appearance of Kidney in Coronal Section (Fig. 85.10)
Functional Correlation to Histology
Juxtaglomerular Complex (Fig. 85.11)
Function of JG Complex
Arterial Supply of Kidney
Intrarenal Course of Segmental Arteries
Renal Artery Angiography
Venous Drainage
Vascular Segments (Fig. 85.14)
Lymphatic Drainage
Nerve Supply
Palpation of Kidneys
Radiology of Urinary Organs
URETERS
Location
Length and Diameter
Extent
Parts
Sites of Constrictions (Fig. 85.17)
Surface Marking on Anterior Surface
Surface Marking on Posterior Surface
Abdominal Part of Right Ureter
Medial Relation
Posterior Relations
Abdominal Part of Left Ureter
Posterior Relations
Pelvic Part of Ureter in Male
Pelvic Part of Ureter in Female
Intravesical (Intramural) Part of Ureter
Blood Supply
Nerve Supply
Ureteric Peristalsis
Skeletal Relations of Ureter (Fig. 85.18)
86:
EXTRAPERITONEAL STRUCTURES IN TRUE PELVIS
TRUE PELVIS
Obturator Internus (Fig. 86.1)
Nerve Supply
Actions
Obturator Fascia
Arcus Tendinalis
Parts of Obturator Internus and their Relations
Pelvic Diaphragm or Pelvic Floor (Fig. 86.2)
Levator Ani
Broad Subdivisions of Levator Ani
Coccygeus (Ischiococcygeus)
Nerve Supply
Fascia of Pelvic Diaphragm
Relations of Pelvic Diaphragm
Actions
Piriformis (Figs 86.3 and 87.2)
Sacral Plexus
Formation
Branches of Communications
Branches from Dorsal Divisions
Branches from Ventral Divisions
Branches from Both Divisions
Coccygeal Plexus
Blood Vessels of Pelvis
Internal Iliac Artery (Fig. 86.4)
Veins of Pelvis
Internal Iliac Vein
Pelvic Venous Plexuses
87:
SIGMOID COLON, RECTUM AND URINARY BLADDER
SIGMOID COLON
Pelvic Mesocolon
Relations of Sigmoid Colon
Rectosigmoid Junction
RECTUM
Curvatures
Interior (Fig. 87.3)
Peritoneal Relations
Anterior Relations (Below the Level of Peritoneal Reflection)
Anterior Relations (Above the Level of Peritoneal Reflection)
Posterior Relations (Figs 87.4A and B)
Lateral Relations
Fascial Relations
Rectal Support
Arterial Supply of Rectum (Fig. 87.5)
Venous Drainage of Rectum
Lymphatic Drainage (Fig. 87.6)
Nerve Supply
URINARY BLADDER
Position
Shape and Capacity
Surfaces, Borders and Angles (Fig. 87.7)
Relations in Male (Fig. 87.8)
Relations in Female (Fig. 87.10)
Neck of the Bladder
Ligaments
True Ligaments
False Ligaments
Interior of Bladder
Internal Trigone (Fig. 87.11)
Blood Supply
Lymphatic Drainage
Nerve Supply (Fig. 87.12)
Visualization of Urinary Bladder
88:
REPRODUCTIVE ORGANS IN MALE AND FEMALE
DEVELOPMENT OF REPRODUCTIVE ORGANS
Male Reproductive Organs
Duct System of Testis Derived from Mesonephric Tubules and Genital Ducts (Fig. 88.4)
Descent of Testis (Fig. 88.5)
Chronology of Descent (Fig. 88.6)
Female Reproductive Organs (Fig. 88.8)
Descent of Ovary (Fig. 88.5)
GROSS ANATOMY OF TESTIS, EPIDIDYMIS, VAS DEFERENS
Location and Parts of Testis
Epididymis
Tunica Vaginalis Testis
Coverings of Testis
Testis and Epididymis on Section (Fig. 88.13)
Microscopic Structure of Seminiferous Tubule
Arterial Supply (Fig. 88.14)
Venous Drainage
Lymphatic Drainage
Nerve Supply
Testicular Thermoregulation
Ductus Deferens or Vas Deferens
Course (Fig. 88.1)
Spermatic Cord
Prostate
Shape and Size
Location (Fig. 88.17)
Embryological Remnants inside Prostate
Capsules (Fig. 87.11)
Relations (Fig. 87.8)
Internal Features
Surgical Lobes (Figs 88.17 and 88.18)
Prostatic Urethra
Structure
Arterial Supply
Venous Drainage
Lymphatic Drainage
Nerve Supply
Age Changes in Prostate
Seminal Vesicle and Ejaculatory Duct
Arterial Supply
Nerve Supply
GROSS ANATOMY OF OVARIES, FALLOPIAN TUBES AND UTERUS
Ovaries
Position of Ovaries
Shape and Appearance
Examination of Ovary
Functional Importance
Parts of Ovary
Peritoneal Relation
Ligaments of Ovary
Arterial Supply
Venous Drainage
Lymphatic Drainage
Nerve Supply
Uterine Tube or Fallopian Tube
Length and Shape
Functions
Parts (Fig. 88.24)
Peritoneal Relations
Relation to Ovary
Blood Supply
Lymphatic Drainage
Nerve Supply
Radiological Examination
Uterus
Shape and Size
Parts (Fig. 88.25).
Uterine Cavity
Normal Position of Uterus (Fig. 88.26)
Peritoneal Relations (Fig. 80.5A)
Cervix (Cervix Uteri)
Blood Supply of Uterus (Fig. 88.25)
Lymphatic Drainage (Figs 88.29A and B)
Nerve Supply
Ligaments of Uterus
Supports of Uterus
Radiological Examination
Gravid Uterus
89:
PERINEUM IN MALE AND FEMALE
PERINEUM
Bony Boundaries (Fig. 89.1)
Subdivisions
Superficial Fascia
Fascial Boundaries of Urogenital Triangle
Perineal Pouches
Ischiorectal Fossa
Boundaries (Fig. 89.2)
Fascial Relations
Contents (Fig. 89.2)
Pudendal or Alcock's Canal
Anal Canal
Relations
Internal Appearance (Fig. 89.3)
Upper Fifteen millimeter
Pecten (Middle Fifteen Millimeter)
Lowest Eight to Ten Millimeter
Anal Musculature (Fig. 89.4)
Arterial Supply (Fig. 89.5)
Venous Drainage (Fig. 89.6)
Nerve Supply of Anal Mucosa (Fig. 89.7)
Lymphatic Drainage (Fig. 89.8)
Urogenital Triangle
Superficial Perineal Pouch in Male
Deep Perineal Pouch in Male
Perineal Membrane in Male (Fig. 89.16)
Perineal Body in Male
Superficial Perineal Pouch in Female
Deep Perineal Pouch in Female
Perineal Membrane in Female (Fig. 89.16)
Perineal Body in Female
Vagina
Functions
Location (Fig. 89.15)
Length
Vaginal Fornices (Fig. 88.27)
Relations
Blood Supply
Nerve Supply
Lymphatic Drainage (Fig. 88.30)
Supports of Vagina
Per Vaginum Examination
Female External Genitalia (Fig. 89.18)
Gross Anatomy of Female Urethra
Extent
Length
Relations
Mucosal Lining
Composition of Urethral Wall
Sphincters of Female Urethra
Gross Anatomy of Male Urethra
Extent
Length
Parts (Fig. 89.23)
Mucosa of Male Urethra
Urethral Sphincters
Arterial Supply
Venous Drainage
Lymph Drainage
Male External Genitalia
Penis
Root (Figs 89.12 and 89.24A)
Body (Fig. 89.24A)
Skin and Fasciae Covering Penis (Fig. 89.24B)
Arterial Supply
Venous Drainage
Lymphatic Drainage
Nerve Supply
Scrotum
Layers of Scrotal Wall (Fig. 79.3)
Characteristics of Scrotal Skin
Blood Supply
Lymphatic Drainage
Nerve Supply
Pudendal Nerve
Course (Fig. 89.27)
Branches
Internal Pudendal Artery
Origin
Course
Branches
Internal Pudendal Vein
90:
CLINICOANATOMICAL PROBLEMS AND SOLUTIONS
CASE 1
Questions and Solutions
CASE 2
Questions and Solutions
CASE 3
Questions and Solutions
CASE 4
Questions and Solutions
CASE 5
CASE 6
Questions and Solutions
CASE 7
Questions and Solutions
CASE 8
Questions and Solutions
CASE 9
Questions and Solutions
CASE 10
Questions and Solutions
CASE 11
Questions and Solutions
CASE 12
Questions and Solutions
CASE 13
Questions and Solutions
CASE 14
Questions and Solutions
CASE 15
Questions and Solutions
Case 16
Questions and Solutions
CASE 17
Questions and Solutions
CASE 18
Questions and Solutions
CASE 19
Questions and Solutions
CASE 20
Questions and Solutions
SECTION 8: LOWER LIMB
91:
BONES OF LOWER LIMB
LOWER LIMB
Hip Bone or Innominate Bone
Articulations of Hip Bone
Anatomical Position
Acetabulum
Obturator Foramen
Ilium
Attachments to Ventral Segment (Fig. 91.2A)
Ischium
Pubis
Superior Ramus
Inferior Ramus
Femur (Fig. 91.3A)
Articulations of Femur
Parts
Attachments of Capsule of Hip Joint
Attachments of Capsule of Knee Joint
Growing End
Patella (Knee-cap)
Parts of Patella
Attachments
Ossification
Tibia (Shin Bone)
Parts
Articulations of Tibia
Upper End
Shaft of Tibia
Medial Surface
Lower End
Growing End
Fibula
Articulations of Fibula
Features
Skeleton of Foot
Tarsal Bones
Metatarsal Bones
92:
SURFACE FEATURES, CUTANEOUS NERVES, VENOUS AND LYMPHATIC DRAINAGE OF LOWER LIMB
SURFACE LANDMARKS
CUTANEOUS NERVE SUPPLY (FIGS 92.1A AND B)
Gluteal Region (Fig. 94.2)
Thigh
Popliteal Fossa
Back of Leg
Front of Leg
Dorsum of Foot
Dorsum of Toes
Sole of Foot
DERMATOMES (FIGS 92.2A AND B)
VENOUS DRAINAGE
Superficial Veins
Dorsal Venous Arch
Great Saphenous Vein (Fig. 92.3)
Small Saphenous Vein
Deep Veins
Major Deep Veins
Factors Facilitating Venous Return
LYMPHATIC DRAINAGE
Superficial Group (Fig. 92.10)
Areas of Drainage
Deep Group (Fig. 92.11)
93:
ANTERIOR COMPARTMENT OF THIGH
OSTEOFASCIAL COMPARTMENTS (FIG. 93.1)
Superficial Fascia of Thigh
Deep Fascia of Thigh (Fascia Lata)
Superior Attachment
Inferior Attachment
Salient Features of Fascia Lata
Saphenous Opening
Iliotibial Tract or Band (Fig. 93.3)
Attachments
Functional Importance
ANTERIOR COMPARTMENT OF THIGH
Femoral Sheath
Formation
Compartments (Fig. 93.4)
Femoral Triangle
Boundaries (Fig. 93.7)
Contents
Exit of Contents from Femoral Triangle (Fig. 93.8)
Relations at Apex of Femoral Triangle
Subsartorial Canal
Extent
Boundaries (Fig. 93.9)
Main Contents
Exit of Contents
Subsartorial Plexus of Nerves
Femoral Nerve
Course (Fig. 93.10)
Branches in Femoral Triangle
Saphenous Nerve
Course
Branches
Saphenous Nerve Graft
Femoral Artery
Extent (Fig. 93.11)
Surface Marking
Femoral Pulse (Fig. 93.12)
Relations in Femoral Triangle
Relations in Subsartorial Canal
Branches in Femoral Triangle (Fig. 93.13)
Branches in Subsartorial Canal (Fig. 93.13)
Femoral Vein
Relations
Valves in Femoral Vein
Tributaries
Muscles of Anterior Compartment
Tensor Fasciae Latae
Sartorius (Fig. 91.5)
Quadriceps Femoris
94:
GLUTEAL REGION, POSTERIOR COMPARTMENT OF THIGH AND SCIATIC NERVE
GLUTEAL REGION
Boundaries (Fig. 94.1)
Communications
Superficial Fascia
Deep Fascia
Gluteus Maximus
Origin
Insertion
Nerve Supply
Actions
Testing Function
Structures Under Cover (Fig. 94.3)
Gluteus Medius and Minimus
Nerve Supply
Actions
Testing Function
Short Lateral Rotators of Thigh
Piriformis (Fig. 86.3)
Origin
Course and Relations
Insertion
Nerve Supply
Actions
Obturator Internus (Fig. 86.1)
Origin
Course and Relations
Insertion
Nerve Supply
Actions
Gemelli
Origin
Insertion
Nerve Supply
Action
Quadratus Femoris
Origin
Insertion
Nerve Supply
Action
Obturator Externus
Nerves in Gluteal Region
Vessels of Gluteal Region (Fig. 94.5)
POSTERIOR COMPARTMENT OF THIGH
Characteristics of Hamstring Muscles
Contents of Posterior Compartment
Biceps Femoris
Semitendinosus
Semimembranosus
Adductor Magnus
SCIATIC NERVE
High Division
Root Value
Components
Exit from Pelvis
Course and Relations in Gluteal Region
Anterior Relations (Fig. 94.10) (from above downwards)
Posterior Relation
Course and Relations in Posterior Compartment of Thigh
Surface Marking (Fig. 94.11)
Arterial Supply (Fig. 94.3)
Branches in the Gluteal Region
Branches in the Thigh
95:
ADDUCTOR COMPARTMENT OF THIGH AND HIP JOINT
ADDUCTOR COMPARTMENT OF THIGH
Arrangement of Muscles
Pectineus
Adductor Longus
Gracilis
Obturator Externus
Adductor Brevis (Figs 91.2A and 91.3C)
Adductor Magnus (Fig. 95.1)
Obturator Nerve (Fig. 95.2)
Course inside Pelvis
Course and Distribution of Anterior Division
Course and Distribution of Posterior Division
Blood Vessels in Adductor Compartment
Obturator Artery
Profunda Femoris Artery (Deep Femoral Artery)
Medial Circumflex Femoral Artery (MCFA)
Lateral Circumflex Femoral Artery
Perforating Arteries (Fig. 95.4)
HIP JOINT OR COXAL JOINT
Articular Surfaces
Acetabulum
Head of Femur
Fibrous Capsule
Major Parts of Capsule
Ligaments (Fig. 95.6)
Synovial Membrane (Fig. 95.7)
Relations of Joint (Fig. 95.8)
Arterial Supply (Fig. 95.9)
Nerve Supply
Movements
Flexion and Extension
Adduction and Abduction
Medial and Lateral Rotation
Muscles Responsible for Movements (Table 95.1)
96:
POPLITEAL FOSSA AND KNEE JOINT
POPLITEAL FOSSA
Boundaries (Fig. 96.1)
Contents
Popliteal Artery (Fig. 96.3)
Relation to Popliteal Lymph Nodes
Popliteal Vein
Tibial Nerve in Popliteal Fossa
Common Peroneal Nerve (Fig. 96.6)
Popliteal Lymph Nodes
KNEE JOINT
Articular Surfaces
Proximal or Femoral Articular Surface
Distal or Tibial Articular Surfaces
Patellar Articular Surface
Fibrous Capsule
Upper Attachment (Figs 96.7A and B)
Lower Attachment (Figs 96.7A and B)
Ligaments
Coronary Ligaments
Ligamentum Patellae
Oblique Popliteal Ligament
Arcuate Popliteal Ligament
Tibial Collateral Ligament (TCL)
Fibular Collateral Ligament (FCL)
Intra-articular Structures (Figs 96.9 and 96.10)
Cruciate Ligaments
Menisci or Semilunar Cartilages (Fig. 96.13A)
Synovial Membrane (Fig. 96.16)
Bursae in Relation to Knee Joint
Anterior Group
Lateral Group
Medial Group
Relations of Knee Joint (Fig. 96.18)
Nerve Supply
Movements
Extension
Flexion
Rotation in Semiflexed Knee
Radiological Anatomy
97:
COMPARTMENTS OF LEG AND RETINACULA AROUND ANKLE
COMPARTMENTS OF LEG
Deep Fascia of Leg
Boundaries Anterior Compartment (Fig. 97.1)
Contents (Fig. 97.2)
Tibialis Anterior
Extensor Hallucis Longus
Extensor Digitorum Longus
Peroneal Compartment
Boundaries
Contents
Posterior Compartment of Leg
Boundaries (Fig.97.1)
Subdivisions
Synovial Sheaths of Flexor Tendons
RETINACULA AROUND ANKLE
Extensor Retinacula (Fig. 97.8)
Superior Extensor Retinaculum
Inferior Extensor Retinaculum
Peroneal Retinacula (Fig.97.9)
Flexor Retinaculum (Fig.97.10)
98:
TIBIOFIBULAR JOINTS AND ANKLE JOINT
TIBIOFIBULAR JOINTS
Proximal Tibiofibular Joint
Interosseous Membrane of Leg
Distal Tibiofibular Joint
ANKLE OR TALOCRURAL JOINT
Articulating Bones
Articular Surfaces
Fibrous Capsule
Ligaments
Parts
Synovial Membrane
Relations (Fig. 98.5)
Arterial Supply
Nerve supply
Movements
Muscles producing Dorsiflexion
Muscles producing Plantarflexion
99:
FOOT
ANATOMY OF FOOT
Dorsum of Foot
Sensory Nerve Supply (Fig. 99.1)
Dorsal Venous Arch
Tendons on Dorsum (Fig. 97.8)
Extensor Digitorum Brevis (Fig.99.2)
Dorsalis Pedis Artery
Sole of Foot
Sensory Nerve Supply (Fig. 99.4)
Arterial Supply of Heel
Deep Fascia of Sole
Muscles of Sole
Arteries of Sole (Fig. 99.10)
Veins of Sole
Nerves of Sole
Joints of Foot
Intertarsal Joints
Subtalar Joint
Talocalcaneonavicular Joint
Calcaneocuboid Joint
Movements of foot
Arches of Foot
Types of Arches (Figs 99.14A and B)
Functions of Arches
100:
CLINICOANATOMICAL PROBLEMS AND SOLUTIONS
CASE 1
Questions and Solutions
CASE 2
Questions and Solutions
CASE 3
Questions and Solutions
CASE 4
Questions and Solutions
CASE 5
Questions and Solutions
CASE 6
Questions and Solutions
CASE 7
Questions and Solutions
CASE 8
Questions and Solutions
CASE 9
CASE 10
Questions and Solutions
INDEX
TOC
Index
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