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Anatomy
Studyofthemicroscopicstructureofthehumanorganismcorelatedwiththedevelopment,functionandclinicalsignificance.
ItisderivedfromGreektermanatomemeaningcuttingapart.
EMBRYOLOGY
Itisthestudyoftheformationanddevelopmentoftheembryofromthemomentofitsinceptionupto
thetimewhenitisbornasaninfant.
Gonads:no:ofchromosomesinanorganism=23pairs/46no.
44autosomesXY
44autosomesXX
Karyotyping:Classificationofchromosomesbasedupontheirdifferencesthatenableustoidentifyeachchromosomeindividually.
Spermatogenisis:Theprocessofformationanddevelopmentofspermatazoan.
Formedinthewalloftheseminiferoustubulesoftestes.
Spermiogenesis(spermateleosis):Theprocessoftransformationofacircularspermatidtoaspermatozoan.
Maturespermatozoan:Hasahead,aneckmiddlepieceandaprincipalpieceortail.Headiscoveredwithacapcalledacrosome.
Length5060microns
Golgiapparatusformstheacrosomiccap.
Nucleusformshead.
Mitochondrionformsthesheathofmiddlepiece.
Proximalcentriolecomestolieintheneck.
Distalcentriolebecomesringshapedandformstheannulus.
Axialfilamentgrowsoutfromthecentrioleandispresentinmiddlepieceandtail.
Viabilityofspermatozoa=4days.
Ovulation:Thesheddingofovumfromtheovary.
CorpusluteumItisanimportantstructurederivedaftertheruptureofovarianfollicletoshedtheovum.
Itsecreteshormoneprogesterone.
Viabilityofovum=24hrs
Menstrualcycle:Dividedinto4phases
1.Postmenstrualphase
2.Proliferative
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4.Menstrual
Follicularphasepostmenstrual+proliferatephase~Oestrogen
Lutealphasesecretory+menstrualphase~progesterone
SizeofOocyte120u.
Approximatenumberofoccytesatpubertyaround40,000.
Approximatenumberofovaliberatedduringreproductiveperiodoffemalearound300to400.
Timerequiredforformationofspermatozoafromspermatogonium64days.
Fertilizedovumreachesuterinecavityby4days.
Implantationofovum(fertilized)occursabout7thday.
Primitiveuteroplacentalcirculationbeginsbyendof2ndweek.
Numberofsomitesinembryo42to44.
Timeofsomiteformation21to30thday.
Organogenesisfrom4thto8thweeks.
Formationofprimaryovaryinafemaletakesplaceby8thweek
Differentiationofgenitalorgans
1.PersonswithtwoXchromosomesarefemalethosewithonexandoneyaremale.
2.Ychromosomebearsageneresponsibleforproductionofatestisdeterminingfactor.
3.Interstitialcellsintestisproducetestosterone.Itformsacomplexwithcertainreceptorproteinswhichattachesitself
toDNA.Thiscausesthemesonephricducttodevelopasinmale.
4.Presenceofdihydrotestosterone.
5.Sertolicellsproducemullerianinhibitingsubstance.Thiscausesregressionofparamesonephricducts.
Genitalswellingsinmaledifferentiateintoscrotumwhereasinafemale,theyformlabiamajora.
ThemesonephricductinafemaledevelopsintoGartner'sduct.
TheMullerianductsinmaledevelopintoappendixtesteswhereasinafemale,theydevelopintouterusanduterinetubes.
Infemale,thehomologueofprostaticglandsareparaurethralglands.
FOETALCIRCULATION
Differsfromadultcirculationin
a)Sourceofoxygenatedbloodisnotthelungbuttheplacenta.
b)Oxygenatedbloodfromplacentacomestofoetusthroughumbilicalveinandjoinstheleftbranchofportalvein.
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SmallportionpassesthroughthesubstanceofthelivertoIV,butthegreaterpartpassesdirecttoIVthroughtheductusvenosus.
Changesatbirth:1)umbilicalarterycontracts.
2)Lumenofumbilicalveinsandductusvenosusoccludesandthistakesplaceafewminutesafterbirth.
3)Ductusarteriosusoccludesbyabout10thday.
4)Pulmonaryvesselsincreaseinsize.leftatrialpressurerisesthanthatofrightatriumandleadstoclosureofforamenovale.
Remnantof
Umbilicalarterymedialumbilicalligament
Leftumbilicalveinligamentteresoftheliver
DuctusvenosusLigamentumvenosum
DuctusarteriosusLigamentumarteriosum

OSTEOLOGY
Studyofbones.
Bonesaredividedaccordingtotheir
1)Position
Humanskeletonaxial}bonesofskull,vertebralcolumn,ribs,sternum,hyoid.
appendicular}bonesofpectoral,pelvicgirdle,upperandlowerlimbs
2)Shape
Longbones:eg:Femur,tibia,humerus,ulna,radius,andfibula
Shortlongbones:eg:Metacarpals,metatarsals,phalanges
Shortbones:eg:Carpals,tarsals
Flatbones:eg:Scapula,sternum,ribs,parietalandfrontal.
Pneumaticbones:Maxillary,sphenoid,ethmoid,mastoidpartoftemporalbone.
Irregularbones:eg:Vertebrae,skullbones
Sesamoidbone:eg:patella,pisciform,fabella
2)Structure
Compactbone=consistingofhaversiansystem
Cancellous(spongy)bone=consistingofirregularlyplacedlamellae.
Diploic=consistingofinnerandoutertablesofcompactbonewithinterveningporouslayer.
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Ectochondralbones:whichdevelopinmembrane(membranous)
Endochondralbones:whichdevelopincartilage.(cartilageneous)
Totalnoofbones206
Upperlimbs64
Lowerlimbs62
Vertebrae33
Skull29(14facialbones
14cranialbones,hyoidbone)
Sternum1
Ribs12pairs
Longestbonefemur
Smallestbonestapes
StrongestpartinhumanbodyEnamelofteeth
LargestsesamoidbonePatelladevelopinginquadriceps.
Microscopicunitofabone:Haversiansystem(secondaryosteone)
Ossification
Processofgradualboneformation.
a)Ossificationinmembrane(direct)easyprocess
Eg:clavicle,bonesofface,vaultofskull.
b)Ossificationincartilage(Indirect)gradualprocess.
Eg:bonesoflimbs,trunk.
Secondarycartilagebone:eg:neckofmandible,sternalendofclavicle.
Primarycentresofossificationmaybesingleormultiple,appearbeforebirthbetween6th8thweekoffoetallife
exceptcuneiform,navicularbones.
Secondarycentresofossificationaremultipleandappearafterbirthexceptlowerendoffemur.
Ossificationofacetabulumiscompleteat1617years
Growingendsofbonesofupperlimbupperendofhumerus&Lowerendofradiusandulna
Growingendsofbonesoflowerlimbslowerendoffemur&Upperlimbsoftibiaandfibula
Inlongbones,growingendsfusewithshaftat20yrsandoppositeendsatabout18yrs.
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Inotherbonesitisbetween2025yrs.
Typesofepiphysisare:
a)Pressureepiphyseslocatedatpressurepointslikejoints
b)Tractionepiphyses:subjectedtotractionbypullofmuscleswhenlocatedatthemuscularattachment
c)Atavisticepiphyses:centreappearinginthepartofbonewhichwasorginallyaseparateboneinevolutioneg:Coracoid
processofscapula.
Hyalinecartilagehasatendencytogetcalcifiedinlateryearsoflife.
Skullbones22bones
Facialbones(14)pairednasal,maxillae,zygomatic,palantine,lachrymal,inferiornasalconnchae.
Unpairedmandible,vomer
Cranialbones(14)pairedparietal,temporal,earossicles
Unpairedfrontal,ethmoid,sphenoid,occipital.
Carpalbones8bonesLatTOmedial(Proximal)Scaphoid,lunate,triquetral,pisiform
(Distal)Trapezium,trapezoid,capitate,hamate.
Tarsalbones7bones(proximal)Talus,calcaneus
(distal)medialcuneiform,intermediatecuneiform,lateralcuneiform,cuboid.
LargestandstrongestoftarsalbonesCalcaneus
Paranasalsinuses4pairs:Frontal,sphenoidal,ethmoidal,maxillary.
LargestofallairsinusesMaxillarysinus(AntrumofHighmore)
Foraminaofskull
Anteriorcranialfossa:
1.Foramencaecum:liesbetweenthealaeofcristagalliofethmoidandfrontalcrest.Transmitsanemissaryvein.
Middlecranialfossa:
2.Opticcanal(foramen):Transmitsopticnerve,opthalmicartery.
3.Superiororbitalfissure:Boundedbylesserwingabove,greaterwingbelowandbodyofsphenoidmedially.
Dividedbythreecompartmentsbycommontendinousring.
Transmitssuperiorandinferiordivisionsofoculomotor,nasociliarynerve,abducentnerve,trochlearnerve,frontalnerve,
lacrimalnerve,lachrimalartery,orbitalbranchofmiddlemeningealartery,superiorophthalmicvein,recurrentmeningeal
branchoflachrymalartery,inferiorophthalmicvein.
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5.Foramenovaletransmitsmandibularnerve,accessorymeningealartery,lessersuperficialpetrosalnerve,emissaryvein.
6.Foramenspinosumtransmitsmiddlemeningealartery,nervusspinosus
7.ForamenlacerumtransmitsInternalcarotidartery.
8.Carotidcanaltransmitsinternalcarotidarterywithplexus,emissaryveins,meningeallymphatics.
Posteriorcranialfossa:
9.Jugularforamentransmits9th,,10,11thcranialnerves.
10.Foramenmagnumlargestforameninskull.
Dividedintoanteriorsmallcompartment:Apicalligament
Upperbandofcruciateligament
Condylarpartsonsides.
Posteriorlargecompartment:lowerendofmedullaoblongata,2anteriorandoneposteriorspinalartery,veinsjoining
venousplexus,lowerpartoftonsilofcerebellum,vertebralartery,sympatheticplexus,spinalrootofaccessorynerve.
Ribs:12innumberoneachside.
Trueribs17th
Falseribs812th
Floatingribs1112th
Atypicalribs1,2,and10.11,12th.
Foldsofduramater
Falxcerebrienclosessuperiorsagittalsinus,inferiorsagittalsinus,straightsinus
Tentoriumcerebellienclosestransversesinuses,posteriorpetrosalsinuses.
Falxcerebellienclosesoccipitalsinus
Diaphragmasellaeenclosesanteriorandposteriorintercavernoussinuses.
Importantpointsinskull
1.Bregma:meetingofcoronalandsagittalsutures.siteofanteriorfontanelle,closesat11/2yrsofage.
2.Lambda:meetingofsagittalandlambdoidsutures.siteofposteriorfontanelle,closesat23monthsofage.
3.Nasion:meetingpointofinternasalandfrontonasalsutures.
4.Inion:centreofexternaloccipitalprotruberance.
5.Pterion:areaformedbymeetingoffrontal,squamouspartoftemporal,parietal,greaterwingofsphenoid.deepto
thisliesanteriorbranchofmiddlemeningealartery,middlemeningealvein,stemofthelateralsulcus.
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6.Asterion:pointattheposteroinferiorangleofparietalbones.
Diaphragm
Inferioraperture(outlet)ofthorax.
AorticopeningT12transmitsAorta,thoracicduct,Azygosvein
OesophagealopeningT10transmitsoesophagus,gastricnerves,oesophagealbranchesofleftgasticartery.
VenecavalopeningT8transmitsinferiorvenecava,branchesofrightphrenicnerve.
CEREBROSPINALFLUID(CSF)
Definition
CSFisamodifiedtissuefluidinthecentralnervoussystem.Itiscontainedintheventricularsystemofbrainandthe
subaradspaceofbrainandspinalcord.CSFreplaceslymphintheCNS.Itactsasasensitivemirrorwhichreflects
diseasesofthenasystem.Formation
1.ThebulkoftheCSFisformedbychoroidplexusesofthelateralventricules,andthelesseramountsbythechoroidplexus
thethirdandfourthventricles.'
2.Possiblyitisalsoformedbythecapillariesonthesurfaceofthebrainandspinalcord.
Circulation
CSFpassesfromthelateralventriclestothethirdventriclethroughforaminaofMonro(interventricularforamina).From
ventricleitpassestothefourthventriclethroughcerebralaqueduct.FromfourthventricletheCSFpassestothesubarachnoid
aroundthebrainandspinalcordthroughtheforamenofMagendieandforaminaofLuschka.
Absorption
1.CSFisabsorbedchieflybythearachnoidvilliandgranulations,andisthusdrainedtothecranialvenoussinuses.
2.ItisalsoabsorbedpartlybytheperineurallymphaticsaroundI,II,VIIandVIIIcranialnerves
3.Andalsobytheveinsrelatedtothespinalnerves.
RateofFormation
200cc/hour,5000cc/day.
TotalQuantityAbout150cc.Pressure:60150mmoffluid(orwater).Composition
Proteins2040mgper100cc.
Sugar5075mgper100cc.
Chlorides720750mgper100cc.
Cells05percubicmm
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Itis(a)protective,(b)nutritive,and(c)excretorytotheCNS.
AppliedAnatomy
1.CSFcanbeobtainedby(a)lumbarpuncture,(b)cisternalpuncture,or(e)ventricularpuncture.Lumbarpunctureis1st
methodofallandiscommonlyused.Itisdoneintheinterspacebetweenthirdandfourthlumbarspines.
2.BiochemicalanalysisoftheCSFisofdiagnosticvalue,asthecasesofmeningitisandspinaltumours.
3.DrainageofCSFatregularintervalsisoftherapeuticvalueinmeningitis.Certainintractableheadachesofunknownare
alsoknownhavingbeencausedbyamerelumbarpuncturewithdrainageofCSF.
4.ObstructiontotheflowofCSFintheventricularsystemofbrainleadstohydrocephalusinchildren.Spinalobstruction
leadstoFroinssyndrome.
Lengthofparotidduct:5cm.
Lengthofsubmandibularduct:5cm.
Lengthofauditorytube:36mm.
Bonypart:12mm.
Cartilagenouspart:24mm
Lengthofexternalacousticmeatus(frombottomofchoncha):2.4cm.
Bonypart:16mm.
Cartilagenouspart:8mm.
Transversediameterofmidcavity
Oppositethecentreoftympanicmembrane:2mm.
Totalnumberofconesintheretina:6.3to6.8million.
Lengthofpharynx:12to14cm
Lengthoflarynx
Lengthofvocalcords
LengthofTrachea
Pituitarygland:13x8mm.
HeartMeasures12x9cm(5x3or3.5inches)
Weight300g(males)
250g(females)
Terminationofoesophagus11thThoracicvertebra.
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Constrictionsinoesophagus:
atcommencement15cmfromincisorteeth.
atcrossingoverbyaorticarch22.5cmfromincisorteeth.
atcrossingoverbyleftprincipalbronchus27.5cmfromincisorteeth.
atitspointofpiercingdiaphragm40cmfromincisorteeth.
Stomach:
CardiacorificeBehindleft7thcostalcartilage1"fromitsjunctionwithsternum.
Pyloricorifice1.2cm(0.5")totherightofmidlineontranspyloricplane.
Capacityatbirth30mladults1500ml.
Lengthofsmallintestine:6to7metres
Lengthofduodenum:10or25cm
1stpart:5cm
2ndpart:7.5cm
3rdpart:10cm
4thpart:2.5cm
Lengthoflargegut:1.5metres
Analcanal
HilumofkidneyTranspyloricplane(LI).
Kidney:Length:11cm,Breadth:6cm,Anteroposteriordiameter:3cm
LengthofUreter:25cm
Lengthofmaleurethra:1820cm
Spermaticcord:910cm
Lengthofinguinalcanal:4cm
Testis:Length4.5cm,Breadth2.5cm,Anteroposteriordr3
Ovary:Length3cm,Width1.5cm,Thickness1cm
Uterus:Length7.5cm,Breadth5cm,Anteroposteriordiameter2.5cm
Weight:30to40gms
Uterinetubes:Length10cm
SaphenousopeningHeight1.5to8cmWidth1to3cm
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FemoralcanalLength1.25cm.
TendocalcaneusLength15cm.
Weightofspinalcord30gms.
Lengthofspinalcord45cm.
Filumterminale20cm.
Internum15cm.
Externum5cm.
CommencementofspinalcordCranialborderofC1vertebra(Atlas).
TerminationofspinalcordlowerborderofLIordiscbetweenLI&L2vertebrae.
CervicalenlargementofspinalcordCircumference39mm.ExtendsfromLItoSIspinalsegments.
LumbarenlargementofspinalcordCircumference35mm.ExtendsfromLItoS3spinalsegments.
Vertebrallevelsofspinalsegments
CervicalvertebralspinecorrespondstosucceedingcordsegmentEg:C6spinetoC7segment.
UpperthoracicspinecorrespondstotwospinalsegmentslowerEg:T4spinecorrespondstoT4spinalsegments.
LowerthoracicspinecorrespondstothreespinalsementsbelowEg:T10spinetoLIspinalsegment.T11spineto
L3segment,T12spinetoSIsegment.
NewbornchildlowerlimitofspinalcordisatL3vertebralupperborder.
Lengthofmedullaoblongata3cm.
Shortestsegmentofbrainstemmidbrain2.cm.
ThalamusLength4cm.
Corpuscallosumlength10cm.
SpecificgravityofC.S.F:1007.
PressureofCSF(inrecumbentposition):100to150mmofH2O
TotalvolumeofCSFinman:140mlamountofCSFinVentricles25ml.
CommencementofsubclavianarteryBehindsternoclavicularjoint.
TerminationofSubclavianarteryOuterborderof1strib.
TerminationofBrachialarteryNeckofradius.
ThoracicAorta:
CommencementT4Vertebrallowerborder.
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TerminationT12Vertebralbody.
AbdominalAortacommencementT12Vertebralbody.
CoeliacTrunk:OriginT12,Length1.25cm.SuperiormesentericarteryLI.
InferiormesentericarteryL3.
CommencementofcommoniliacL4vertebralbody.
BifurcationofcommoniliacSacroiliacjoint
ExternaliliacterminationMidinguinalpoint.
VertebralprominenceC7.
SuperiorangleofscapulaT2.
Upperborderofmanubriumsterni(suprasternalnotch)T2,T3vertebraljunction.
SpineofscapulaT3
SternalangleT4&T5(Discbetween).
InferiorangleofscapulaT7.
XiphisternaljointT9.
Tonsilisderivedfrom2ndpouch
CSFtoplasmaglucoseratioisnormally0.6to0.8
Appearanceofpermanentkidney5thweekofIntrauterineperiod.
Invasionofprimordialgermcellsintodevelopinggonad5thweek.
Appearanceofneuralplate(nervoussystem)3rdweek.
Developmentofeyebetween4thand7thweeks.
Appearanceoflimbbudsbeginningof5thweek.
Descentoftestis:
Atdeepinguinalring7thmonthofintrauterinelife.
Ininguinalcanal8thmonthofintrauterinelife.
Atsuperficialinguinalring9thmonthofintrauterinelife.
Haller'scircleisfoundinthePyloricorifice.
MarginalarteryofSudeckliesat2.53.8cmfromcolon.
Portalveinisabout8cmlong.
Themaximumbreadthofmesentryisincentralpartandis8inches
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CommoncarotidarteryisderivedfromIIIaorticarch.
Atfullterm,diameterofplacentais68inches.
Mesentrycontainsabout100200lymphnodes.
Betweenlowestsigmoidandsup.RectalarteryanastomosisisregardedasthecriticalpointofSudeck.
Mesentryisfanshapedfoldofperitoneum.
Totalareaofplacentais14sq.m.
Oesophagusstructureisrelatedtobothleftandrightlung.
Weightofparathyroidglandis50mg.
Lengthofcaecumis6cm.
Sprainofankleismostoftenduetoabduction.
ThesuperficialmusclesofthebackoflegaresuppliedbyS1,2.
Thicknessofsuprarenalis10mm.
Duodenojejunalislargestduodenalrecess.
Cisternachyliis57cmlong.
Ovaryhasminimumthickness.
Vpharyngealarchdisappearsattheearliest.
Weightofprostateglandis8gm.
LongestpartofduodenumisIII.
Leftdomeofdiaphragmcorrespondstothelowestpartof5rib.
Widthofstomachis1012cm.
ClaustrumissituatedbetweenputamenandInsula
ThirdventriclesarederivedfromDiencephalon.
Thicknessofspleenis34cm.
Middleonethirdoftransversecolonisderivedfrommidgut.
Placentalmembraneatitsformationis0.025mmthick.
Syncytiotrophoblastiscalledplasmoditrophoplast.
MidbrainisMesencephalon.
Theleftbrachiocephalicveinisabout7.5cmlong.
Deeppalmararchisabout4cmlong.
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Spineofscapulacorrespondsto3rdthoracicspine.
Pereonealtubercleiffeltasaprominenceabout2.0cmbelowtipoflateralmalleolus.
Hipjointlies1.2cmverticallybelowthemiddlethirdofinguinalligament.
PulmonaryarteriesarederivedfromVIaorticarch.
Ischialtuberosityisfelt5.0cmawayfromthemedianplane.
Nelaton'slinetouchesthecentreofacetabulum,ishcialtubeandAnt.sup.iliacspine.
Filumterminaleisabout20cmlongwhichextendsfromconusmedullaristothebackofthe1stcoccygealvertebralsegment
TheduramaterofspinalcordendsatS2vertebrallevel.
Erb'spointisC4C5.
Ureteris50cmlong.
Distancebetweenupperincisorsandgastroesophagealjunctionis40cm.
Theratioofweightofliverandweightinanadultis1:40.
OesophaguscrossesthediaphragmatlevelofT10.
Developinggonadisidentifiedasmaleorfemalebytheendof7thweek.
Theinfantwithpupillarymembranemusthavebeenproductofpregnancylastinglessthan7months.
Stillbornfoetuswitheyelidsfusedisof37months.
Lengthofamaturehumanspermatozoonis5060microns.
Breastdevelopmentinintrauterinelifestartsat12weeks.
Pointsituated1cmbelowsacralpromontaryrepresentingCGofbodyisWeber'spoint.
Thenumberofossificationcentresinthehyoidboneis6.
Greatsaphenousveinisexposedanteriortomedialmalleolusat2.5cm.
Ossificationcentresforallcarpalbonesisfoundby5thyear.
XiphisternaljunctionisusuallyatthelevelofdiscbetweenT9andT10verterbra.
Lengthofductusdeferensisusually45cms.
Frontaleyefieldmotorareais8.
NervesupplyingsubmandibularglandisVIInerve.
Lengthoffemaleurethrais4cm.
RootvalueofphrenicnerveisC^5.
Sacralcanal'svolumeis2535c.c.
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Atmidaxillaryline,parietalpleuraextenduptolevelof10thrib.
Theweightofthelefthealthylungis570gmandthatofrightis620gm.
TheSAnodeisbyabranchoftherightcoronaryarteryin65%.
TheAVnodeissuppliedbyabranchoftherightcoronaryarteryin80%.
Upto80%ofliverresectioncanbetoleratedbynoncirrhoticindividual.
Liverhasahighpowerofregeneration.Followingresectionoftwothirdportionofliver,itregeneratesinaboutsixmonth
Hepatocytesdrainaboutonelitreofbiledailyintobilecanaliculi.
Commonbileduct(CBD)isabout10cmlong.
NormalsizeofCBDis610mm.
Normalpressureinportalveinis612mm.ofHg.
Averagesizeofspleenisabout5x3x1inch.Averageweightisabout150gm.
Averagesizeofkidneyisbeenshaped,havingweightabout150gm.
BloodflowthrougheachKidneyis12litreperminute.
NormalcapacityofUBisabout250ml.butcanaccommodateupto500mlofUrine.
Prostatesecretes0.52mloffluidperday,whichcontainsAcidPhosphatase,Prostateglandins,FibrinogenandCitricAcid.
Lengthoflargeintestineis'1.5m.
Lengthofanalcanalis3.8cm.
Partofanalcanalabout15mmbelowanalvalvesisthetransitionalzonepectin.
Bileductis7.510cmlong.
GallbladderhasCapacityof45ml(range30to50ml)andlengthof7.5to10cm.\
Ureterlies2cmlateraltocervixandUterinearterycrossesaboveandinfrontofureter.
SizeofovaryisLength3cm,Width1.5cm,Thickness1cm.
Vascularsegmentsofkidneyare5.
Numberoflobulesinfoetalkidneyis12.
Saphenousopeningisagapinfascialataofthigh,situated4cm.belowandlateraltopubictubercle.Itssharpedgeiscalledfalciformmargin.
Saphenousopeningiscoveredbycribriformfascia.
Interalveolarseptum0.2mthick(Arithmeticmeansthicknessofbarrierinhumanis2.2nun).
Manubriosternalanglemaybeossifiedaftertheageof30years.
Cervicalcurveappearsinintrauterinelifeandaccentuaiesby3or4monthswhenthechildholdupthehead.
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Lumbarcurveappearsat12to18monthswhenthechildbeginstowalk.
Subpubicarchismoreangularinmales(50to60),infemalesitiswideusualy80to85.
Greatersciaticnotchiswiderinfemales50.4andinmalesis74.4.
Sacralindexinmales10.5%andinfemales115%.
Inhipjoint,extensionbeyondverticalis10to20.
Extensionofkneebeyondverticalfemorotibialaxisis510andflexionis120withextendedhipjoint.
Passiverotationinkneeisabout60to70butconjuctrotationisonlyabout20.
In"Colles"fracture",thereisafractureofdistalendofradiuswithdisplacementoflowerfragmentbackwardsandupward.Thisoccursdueto
fallofoutstretchedhand.Resultingdeformityisdinnerforkdeformity.
Analcanalis38mmlong(upper15mm,middle15mm,lower8mm)
Inhip,primarycentresofossificationappearintheorderofilium(2ndmonth),ischium(4thmonth),andpubis.
Mainactionofquadratorfemorisislateralrotation.
Foramenlacerumliesinbetweenpetrouspartoftemporalboneandsphenoid.
Parotidductpiercesthebuccinatormuscle.
Functionaltissueoflungsisalveoli.
Carpaltunnelsyndrominvolvesmediannerve
Meckel'sdiverticulumarisesfromtheantimesentericborderofileum.
Auerback'splexusislocatedinoesophagus.
Brachialisissuppliedbymusculocutaneousaswellasradialnerve.
Gluteusmaximusissuppliedbyinferiorglutealnerve.
Trendelenburgsignmaybepositiveinglutealmediusparalysis.
Elbowisacondyloidjoint
Lefttesticularveindrainsintoleftrenalvein.
Flexordigitorumprofundushasadualnervesupply.
Anteriorinterosseusarteryisabranchofulnarartery.
Purkinjecellsincerebellumareinputcells.
ThemostfixedpartoftheGITisduodenum.
TheglandsofBrunnerareseeninduodenum.
Spinalpartofaccessorynervesuppliessternocleidomastoidmuscle.
Tsfreeborderoflesseromentumcontainshepaticartery,portalveinandbileduct.
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Dentatenucleusisapartofcerebellum.
Laminacribrosaismodificationofsclera.
Automaticbladderisseeninlesionsofhighercentreswhereaslesionsatlowercentresleadtoautonomicbladder.
Coronarysulcusisoccupiedbythecoronarysinus.
Sirenorvenacavaisformedbybrachiocephalicveins.
Thebaseofheart,formedbyatria,liesoppositethe5th9ththoracicvertebrae.
Allthetonguemusclesaresuppliedbyhypoglossalnerveexceptpalatoglossusmusclewhichissuppliedbypharyngealplexusofnerves
Tympanicmembraneisderivedfromecto,mesoandentoderm.
Edochondralossificationisseeninscapula.
Melanoblastsarederivedfromneuralcrestcells.
Humanplacentaishaemochorial.
Commonestpartofaortarupturedintraumaisjunctionofthoracicandabdominalaorta.
Theonlypharyngealmuscleinnervatedbytheglossopharyngealnerveisstylopharyngeus.
Radialbursaenclosesthetendonofflexorpollicislongus.
Choroidfissureoftheeyepermitstheentryofhyaloidartery.
Uncinatefasciculusconnectsfrontalandtemporallobes.
Musician'snerveisulnarnerve.
LigamentofCooperisrelatedtobreast.
Jacobson'snerveisabranchofIXnerve.
Fasciacribrosaisrelatedtofemoralcanal.
Boa'spointisatenderspotfeltintheleftofT12inapatientwithgastriculcer.
Buck'sfasciaisrelatedtopenis.
ProstoperitonealfasciaisDenonviller'sfascia.
FascialextensionoflacunarligamentalongiliopectineallineisCooper'sligament.
Alderman'snerveisabranchofXnerve.
Labourer'snerveismediannerve.
VeinscommunicatingthecavernoussinustopterygoidplexuspassthroughfossaofVesalli.
DuctofRivinusisfoundinsublingualgland.
Foramentransversariumtransmitsvertebralartery.
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.Krause'sglandsarelacrimalglands.
HepatorenalpouchisMorrison'spouch.
.Cowper'sglandsarefoundinbulbousurethra.
DuctofSantoriniisaccessorypancreaticduct.
Anteriorinterventriculararteryisbranchofleftcoronaryarterywhereasposterioroneisabranchofrightcoronaryarti
Thinnestportionofmyocardialwallisleftandrightatria.
.Thenerverelatedtomedialepicondyleisulnar.
Depressorofmandibleislateralpterygoid.
EdingerWestphalnucleusisGeneralVisceralEfferent.
Hofbauercellsarepresentinplacenta.
TranspyloricplanepassesthroughL1vertebra.
SmallestcranialnerveisTrochlear.
Charcot'sarteryisabranchofmiddlecerebralartery.
Apelikehandoccursinmediannervepalsyatwrist.
Inferiortibiofibularjointissyndesmosistypeofjoint.
Mandibularcanalcontainsinferioralveolarnerve.
Costocoracoidmembraneofaxillaispiercedbylateralpectoralnerve.
Moststablepositionoftheanklejointisdorsiflexion.
Generalsensationofnulliparousuterusisanteversionandanteflexion.
Highestintercostalspaceusedforliverbiopsyis8th.
Theweakestpartsofinguinalcanalaresuperficialanddeepinguinalrings.
Diaphragmaticherniacommonestontheleftistraumatichernia.
Flexionofthekneejointtakesplaceintheuppercompartment.
Thenerveresponsibleforfinemovementsofthehandisulnar.
Theretractionofshoulderiscausedbyserratusanterior.
AccessorypancreaticductisalsocalledBernard'sduct.
ThoracicductisalsocalledPecquetduct.
SuperficialfattyfasciabetweenumbilicusandpubisisCamperfascia.
ParasympatheticoutflowfromsacralplexusisnerveErigentes.
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Theappendixismostoftenfoundinretrocaecalposition.
Juxtaglomerularcellsaresmoothmuscularcellsofafferentarteriole.
FasciaofGerotaisthoracolumbarfascia.
Isthmusofthethyroidglandisfoundacross35thtrachealrings.
Neuraltubedevelopsfromectoderm.
Themovementofversionofthefoottakesplacemainlyinsubtalarjoint,calcaneonavicularandcalcaneocuboidjoints.
IncisiorforaminainthemouthareforamenofVesalli.
Peronealarteryisabranchofposteriortibialartery.
Unlockingofkneejointtopermitflexioniscausedbypopliteus.
LongestmuscleorTailor'smuscleinbodyissartorius.
Boxer'smuscleisserratusanterior.
Toynbee'smuscleistensortympani.
MuscleusedforgrinningisRisorius.
OStrigonumisatavistictypeofepiphysis.
Umbilicalvesicleattainsfulldevelopmentin4weeksoffoetaldevelopment.
Theprincipalsensorynerveofthelarynxisthesuperiorlaryngealnerve.
Thecentralcanalofspinalcanaliscentralinlumbarregion.
Atriventricular(AV)nodeissuppliedbyrightcoronaryartery.
SinoartrialnodeissituatedatthejunctionofSVCandrightatrium.
Koch'striangleisboundedbyseptalleafletoftricuspidvalue,tendonofTodaroandorificeofcoronarysinus.
Germcellsinovarydevelopfromyolksac.
Baseofheartisformedbybothatria.
Lymphaticsfromtestesorovariesdrainintoparaaorticlymphnodes.
Broca'sareaissituatedininferiorfrontalgyrus.
TailofpancreascontainsmoreisletsofLangerhans.
Saphenousopeningisbelowandlateraltopubictubercle.
ThymusdevelopsfromendodermofIIIpharyngealpouch.
CellbodiesofIIorderneuronforpainaresituatedinspinalcord.
InWolfParkinsonWhiteSyndrome,thereisconnectionbetweenatriaandventricles.
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CcellsinthyroidglandarederivedfromUltimobranchialbody.
LymphaticsfromtonsildrainintoJuguloomohyoidnodes.
Jreceptorsaresituatedinalveolarepithelium.
Swallowingcentreissituatedinmedulla.
Angleofmandibleissuppliedbygreaterauricularnerve.
Nasolacrimalductdrainsintomiddlemeatus.
Injurytoaxillarynervemainlycauseslossofabduction.
Wristdrop(injuryinupperarm)orSaturdaynightpalsyinjuryinradialgrooveiscausedbyradialnerveinjury.
AdultlarynxextendsfromC3toC6.
GreatveinofGalendrainsintostraightsinus.
qDuctofSylviusalsocalledcerebralaqueductconnectsIIIandIVventricle.
Whentesticularveinsareligated,thetestesareqdrainedbycremastericveins.
Horner'sSyndromeconsistsofmiosis,ptosisandqanhidrosis.
UterusdevelopsfromMullerianduct.q
Callot'striangleisboundedbyinferiorborderofqliver,commonhepaticductandcysticduct.
Failureoffusionofostiumprimumandostiumsecundumqleadstopatentforamenovale.
OogoniaaresuppliedfromYolksac.q
CartwheelappearanceofnucleusisseeninSertoliqcells.
Pinnaisfullyformedatbirth.q
LigamentofBigelowispresentinhipqjoint.
Uterinearteryisabranchofanteriorinternaliliacqartery.
Thenarrowestpartofmaleurethraisexternalqmeatus.
Ophthalmicarteryisabranchofcerebralpartofqinternalcartoidartery.
Whartonductdrainssubmandibularqgland.
Clavicleisthefirstbonetoqossify.
Paralysisofgluteusmaximusismostnoticeablyqaffectedthegaitcycleatheelstrike.
Femuristhelongestandstrongestboneoftheqbody.
Theischiofemoralligamentismosttautwhenfemurisqextended.
11thand12thribsarefloatingqribs.
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Thelargestcranialnerveisqtrigeminal.
DeeparteryofPenisisabranchofinternalqiliac.
Ejaculationisafractionofsympatheticnervousqsystemwhereaserectionisofparasympathetics.
Cysticarteryisabranchofrightqhepatic.
Trochlearnervehasthelongestintracranialqcourse.
Vertebralveinsdrainintobrachiocephalicqveins.
OvumwasdiscoveredbyvonBaer.q
Kerckring'scentreforossificationisassociatedwithqoccipitalbones.
Foramenrotundumtransmitsmaxillaryqnerve.
Gartner'sductisaremnantofWolffianqduct.
Primordialgermcellsarefirstseeninwallofyolkqsac.
FatherofModernanatomyisqAndreasVesalius.
WilliamHarveydescribedhumanbloodqcirculation.
VocalcordsareabductedbyPosteriorqcricoarytenoid.
SpinalcordinanadultendsatlevelofqLI
Mitralorificeliesatlevelof4thcostalqcartilage.
Thecentralstructureofaxilla'issaidtobeqaxillaryartery.
Strongestligamentsofsacroiliacjointareqinterosseusligaments.
Theligamentumarteriosumextendsbetweentheqconcavityoftheaorticarchandtheleftpulmonaryartery.Itisremnanltheductusarteriosus,
achannelwhichconducteddeoxygenatedbloodfromthepulmonaryarterytotheaortaduringfetal1
Thetransversefissureisfoundonlyintherightqlung.
Asectionoftheupperlobeconsistingoftwoqbronchopulmonarysegmentsisknownasthelingula.
Thesurfacemarkingsfromthelowerborderoftheqlungsduringquietbreathingarethe6thcostalcartilage,8thribintheaxillaryline,andthe1
Oththoracicspine.
TheThoracicductpassesthroughtheaorticopeninginqthediaphragm.
Thethoracicductdrainslymphfromalloverthebody,qexceptfromtherightsideoftheheartandtherightupperlimb.
Thejointbetweentheheadofatypicalribandtwoqvertebralbodiesissynovial.
Thesternalandcostalpartsofdiaphragmarederivedfromtheseptumtransversumagapbetweenthesetwopartsisknownasforamen
ofMorgagni.
Anabnormalforamna(ofBochdalek)issometimesfoundbetweenthecentraltendonandthelumbarsectionofthediaphragm,itisusuallyleft
sided.
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thefilumterminale.ThespinalcordusuallyendsatthelevelofL,,intheadults.TheaortabifurcatesatthelevelofL4.Mamillaryprocessesare
featuresoflumbarvertebrae.T,isresponsibleforthesupplyoftheintrinsipmusclesofthehand.
Theonlynervescontainedwithinthespermaticcordaresympatheticnervesandthegenitalbranchofgenitofemoralnerve.Adirectinguinal
herniapushesthroughtheposteriorwalloftheinguinalcanal,medialtothedeepring.Anindirectinguinalhernia,ontheotherhand,passes
alongapatentprocessusvaginaliswithinthecord.
Theformationoftheportalveinbytheunionofthesuperiormesentericandsplenicveinstakesplacebehindtheneckofthepancreas.
Thegastroduodenalarteryisanimportantposteriorrelationofthefirstpartoftheduodenum,andisthearterywhichmaybeerodedbya
posteriorduodenalulcer.
TheLigamentumteresisaremnantoftheleftumbilicalvein,whichdrainedintotheleftbranchoftheportalveininthefetalliver.
ThehepaticarteryliesonleftofCBDandtheportalveinbehind.Althoughthisistheusualarrangement,variationsaresometimesfound.
Thearteryliestothemedialsideoftheneckoftheindirectinguinalherniaitlieslateraltoadirectinguinalhernia.Pararenalfat(Zuckerkandl)is
foundbehindtherenalfascia:Perirenalfat(Gerota)liesbetweenthecapsuleoftherenalfascia.
TheMedianumbilicalligamentisaremnantofthevitellineoryolkduct.
Theexternalringisanopeningintheexternalobliqueaponeurosisjustabovethecrestofthepubis.Fertilizationusuallytakesplaceinthe
ampulla.
Thesternalandcostalpartsofdiaphragmarederivedfromtheseptumtransversumagapbetweenthesetwopartsisknownasforamenof
Morgagni.
Anabnormalforamna(ofBochdalek)issometimesfoundbetweenthecentraltendonandthelumbarsectionofthediaphragm,itisusuallyleft
sided.
ThepoolofCSFinthelowerlumbosacralregioniscalledthelumbarcistern.Itcontainstherootsofthelowerspinalnerves(caudaequina)and
thefilumterminale.ThespinalcordusuallyendsatthelevelofL,,intheadults.TheaortabifurcatesatthelevelofL4.Mamillaryprocessesare
featuresoflumbarvertebrae.T,isresponsibleforthesupplyoftheintrinsipmusclesofthehand.
Theonlynervescontainedwithinthespermaticcordaresympatheticnervesandthegenitalbranchofgenitofemoralnerve.Adirectinguinal
herniapushesthroughtheposteriorwalloftheinguinalcanal,medialtothedeepring.Anindirectinguinalhernia,ontheotherhand,passes
alongapatentprocessusvaginaliswithinthecord.
Theformationoftheportalveinbytheunionofthesuperiormesentericandsplenicveinstakesplacebehindtheneckofthepancreas.
Thegastroduodenalarteryisanimportantposteriorrelationofthefirstpartoftheduodenum,andisthearterywhichmaybeerodedbya
posteriorduodenalulcer.
TheLigamentumteresisaremnantoftheleftumbilicalvein,whichdrainedintotheleftbranchoftheportalveininthefetalliver.
ThehepaticarteryliesonleftofCBDandtheportalveinbehind.Althoughthisistheusualarrangement,variationsaresometimesfound.
Thearteryliestothemedialsideoftheneckoftheindirectinguinalherniaitlieslateraltoadirectinguinalhernia.Pararenalfat(Zuckerkandl)is
foundbehindtherenalfascia:Perirenalfat(Gerota)liesbetweenthecapsuleoftherenalfascia.
TheMedianumbilicalligamentisaremnantofthevitellineoryolkduct.
Theexternalringisanopeningintheexternalobliqueaponeurosisjustabovethecrestofthepubis.
Fertilizationusuallytakesplaceintheampulla.
TheTendocalcaneus(Achiliestendon)isthecommontendonofgastrocnemius,soleusandplantaris.
Thegastrocnemiusisapowerfulplantarflexorofthefootbutcanalsoactasaflexoroftheknee.
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Bothcruciateligamentsplayapartinlimitingmedialrotationofthetibia(lateralrotationofthefemur).
Thearticularsurfacesofthesubtalarjointarecoveredwithhyalinecartilage.
Thesubtalarjointliesbetweenthetalusandcalcaneus.
Themovementsofinversionandeversiontakeplaceatthesubtalarandtalonavicularjoints.
Itismedialligamentofanklejointwhichisusuallyreferredtoasthedeltoidligament.
Thetibialcollateralligamentisabroadflatband,thefibularcollateralligamentisaroundedcord.
Thecommonperonealnervetravelstothelateralsideofthepoplitealfossa.Thetibialcollateralligamentiscloselyrelatedtothemedialinterior
genicularvesselsandnerve.
Thestructureswhichpassdeeptotheretinaculumfrommedialtolateralare:tibialisposterior,flexordigitorumlongus,posteriortibialvessels,
tibialnerve,andflexorhallucislongus.
Abranchoftheobturatorarteryenterstheheadofthefemur:othernutrientvesselsentertheneckofthebone.
Tensorfasciaeinsertsintotheiliotibialtract.Muscleswhichinsertintothegreatertrochanterincludegluteusmedius,gluteusminimus,piriformis
andobturatorinternus.Obturatorexternusinsertsintothetrochantericfossa.
Bloodbrainbarrierismadeupof:(1)thevesselwall(ii)thearachnoidlayerofperivascularsheath(iii)theperivascularspace(iv)thepial
layerofperivascularsheath,and(v)theneurogliaandthegroundsubstanceofthebrain.Thebarrier,atthecapillarylevel,isreducedtothe
merecapillaryendotheliumwithneurogliaandgroundsubstance.
Hemiplegiaofanuppermotorneurontypeisusuallyduetoaninternalcapsularlesioncausedbythrombosisofoneofthelenticulostriate
branchesofthemiddlecerebralartery(cerebralthrombosis).
Oneofthelenticulostriatebranchesismostfrequentlyruptured(cerebralhaemorrhage)itisknownasCharchot'sarteryofcerebral
haemorrhage.Thislesionalsoproduceshemiplegiawithdeepcoma,andisultimatelyfatal.
ThrombosisoftheHuebner'srecurrentbranchofanteriorcerebralarterycausescontralateraluppermonoplegia.
Thrombosisofparacentralartery(terminalcorticalbranchofanteriorcerebralartery)causescontralaterallowermonoplegia.
Thrombosisofposteriorinferiorcerebellararterycauseslateralmedullarysyndrome(Wallenberg'ssyndrome).Itischaracterizedby:
a.Severegiddiness,duetoinvolvementofvestibularneclei
b.Dysphagia,duetoinvolvementofthenucleusambiguus.
c.Crossedhemianaesthesia,duetoinvolvementofthelateralspinothalamictract(contralateralbody)andnucleusofthespinaltractof
trigeminalnerve(ipsilateralface).
d.Horner'ssyndromeduetoinvolvementofsympatheticpathwayinthemedulla.
e.Cerebellarsymptomsandsigns.
Pontinehaemorrhageischaracterizedby(i)paralysis(contralateralhemiplegia)(ii)deepctfma(iii)hyperpyrexiaand(iv)pinpointpupil.Itis
invariablyfatal.
Thehungerorfeedingcentreisplacedlaterallythesatietycentre,mediallyinhypothalamus.
Thethirstordrinkingcentreissituatedinthelateralpartofhypothalamus.
FatherofAnatomyHerophilus.
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LargestsesamoidboneofbodyPatella
LargestglandofbodyLiver.
LargestbranchoffemoralarteryProfundafemorisartery.
LargestganglionofneckisSuperiorcervicalganglion.
Largestveinofbodyislongsaphenousvein.
FirstteethtoappearininfantareLowercentralincisor.
FirstpermanentteethtoappearareFirstMolar.
FirstbonetoossifyinbodyClavicle.
SecondbonetoossifyinbodyMandible.
MostcommoncauseofnerverootcompressioninneckCervicalspondylosis.
EmbryonicdiskdevelopsduringThirdweek.
LargestbranchoffemoralNerveSaphenousnerve.
whereparietalbonesmeeteachother.
FirstendocrineglandtoappearinfoetusThyroidgland.
BregmaisthepointWheresagitalandcoronalsuturesmeet.
LambdaisthepointWheresagittalandlambdoidsuturesmeet.
LambdaliesatthelocationofPosteriorfontanelle.
LambdoidsutureliesbetweenParietalandoccipitalbones.
SternocleidomastoidisinnervatedbySpinalaccessoryN.&C2,C3SpinalN.
TrapeziusisinnvervatedbySpinalaccessoryN.&C3,C4SpinalN.
MinimumtimerequiredforirreversiblebraindeathduetoischemiaFourminutes.
ClinicallymostimportantlayerofscalpisLooseareolartissue.
Kyphosisisanexaggeratedthoraciccurvature.
Lordosisisanexaggeratedlumbarcurvature.
Scoliosisisalateralcurvature.
FirstcervicalvertebraliscalledAtlas.
SecondcervicalvertebraiscalledAxis.
AnupwardprojectionpresentinsecondcervicalvertebraiscalledDens.

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