DEEP CERVICAL FASCIA

ST SH OH Enclosed in Infrahyoid fascia

SCM
RLN
Sym chain
Pretracheal layer
X Nv Carotid sheath
Phrenic nerve SA
Investing layer
SM
Spinal nerve
Prevertebral layer

• Axillary sheath
• Nerve deep to it
 Phrenic nv
TZ  Long thoracic nv
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DEEP CERVICAL FASCIA

Buccopharyngeal fascia
Alar fascia*
Prevertebral fascia (ant layer of prevertebral fascia)
(T1-T3)
Retropharyngeal space

Investing layer

DANGER SPACE
Pretracheal layer
Fibrous pericardium

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FB- ANATOMY-DR ASHWANI KUMAR Alar fascia*  merges with buccopharyngeal fascia between C6- T4
DURAL FOLDS & SINUSES

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DURAL FOLDS & SINUSES

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DURAL FOLDS & SINUSES

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ECA BRANCHES

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MAXILLARY ARTERY

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TMJ- SUPPORTS

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MASTICATION MUSCLES

1. MASSETER
2. TEMPORALIS
3. MEDIAL PTERYGOID
4. LATERAL PTERYGOID

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CONSTRICTOR MUSCLES

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INLET OF LARYNX-
CORONAL SECTION

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LARYNGEAL MUSCLES

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LARYNGEAL MUSCLES

Closes Inlet Opens Inlet

Aryepiglottic Thyroepiglottic muscle
muscle

Thyroarytenoid muscle

A. Posterior cricoarytenoid Only Abductor

B. Cricothyroid Tensor of VC

C. Lateral cricoarytenoid
Adductor
D. Transverse arytenoid
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LARYNGEAL MUSCLES

Relaxes VC
Thyroarytenoid

Vocalis
Relaxes post 2/3rd
Tenses ant 1/3rd

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 TRIANGLES OF NECK

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 CRANIAL CAVITY
Optic canal optic nerve, ophthalmic art

Internal acoustic
F. Ovale V3, Accessory
meatus VII, VIII,
meningeal art, Lesser
Labyrinthine art
petrosal nv, Emissary vein

F. Spinosum  middle
meningeal vessels &
Jugular foramen nervous spinosus
 Inf petrosal
& sigmoidal
sinus, IX, X, XI
nerves F. Lacerum  ICA, carotid plexus &
greater petrosal nv, pharyngeal
branches of ascending pharyngeal
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artery
 ATLAS (C1) Atlas (sup. view)

Anterior tubercle • Anterior longitudinal ligament

• Longus colli
Anterior arch

Transverse foramen Trans lig

2nd part of vertebral artery
3rd part of vertebral artery
C1
Posterior arch

Posterior tubercle
Ligamentum nuchae
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 AXIS (C2)
Remnant of notocord
Apical ligament

Alar ligament
Odontoid process Upper band of cruciate lig
(represent centrum of atlas) Transverse band of cruciate lig

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 SPHENOID BONE Lesser wing Greater lesser wing
(ANTERIOR VIEW)

Foramen rotundum
• Maxillary nerve

Lateral pterygoid (lat surface) Pterygoid canal

Medial pterygoid (med surface) • Greater petrosal nerve
• Deep petrosal nerve
Pterygoid Hamulus • Artery to pterygoid canal
• Superior constrictor
• Pterygomandibular raphe
• TVP tendon glides around it
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ORBIT WALLS Orbital plate of frontal bone
ROOF
Lesser wing of sphenoid MEDIAL WALL
1. Frontal pr of maxilla
2. Lacrimal bone
3. Orbital plate of ethmoid
4. Body of sphenoid

1 2 3 4
Greater wing of sphenoid LATERAL
Frontal pr of zygomatic bone WALL

Orbital surface of maxilla Orbital surface of palatine bone FLOOR

Orbital surface of zygomatic
RELATIONS OF SCALENUS ANTERIOR IJV CCA Vagus nerve
ANT
Phrenic nerve POST

SCALENUS ANTERIOR
Sym chain
Scalenus medius

RLN
Brachial plexus
Thyrocervical trunk
• Trans cervical art
• Suprascapular art
Subclavian art • Infeior thyroid art

Subclavian vein

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FB- ANATOMY-DR ASHWANI KUMAR Sibson’s fascia
REALTIONS OF HYOGLOSSUS
Styloglossus muscle
Lingual n.
SH lig
Submandibular ganglion
Stylopharyngeus muscle

Glossopharyngeal n.

HYOGLOSSUS MUSCLE
Hypoglossal n. Lingual a.
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 BRAINSTEM- Ant perf substance
VENTRAL VIEW
Optic chiasma
A
Optic tract
B
C III Crus cerebri
IV
A Infundibulum
B Mammillary body
V VI C Post perf substance
III Oculomotor nerve
VII
VIII
IX
XII X Ventrolateral sulcus
Ventromedial sulcus XI
VI- Pontopyramidal junction
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VII- Pontolivary junction
 FLOOR OF IV VENTRICLE Pineal gland
SC

IC
IV Nerve
Striae medularis
Arcuate nucleus  ICP
Facial colliculus
VI Nucleus
Vestibular area
Lateral recess VIII Nucleus
XII trigone
XII Nucleus
Cuneate tubercle X trigone
Gracile tubercle X Nucleus
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T.S CEREBRUM Forceps minor
Caudate nucleus

Insula G

Lentiform nu
Internal capsule
Thalamus

S
Auditory radiations Forceps major
(ITR)
Optic radiations
(PTR)
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 T.S CEREBRUM

External capsule

Extreme capsule

Claustrum
Insula

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SAGITTAL SECTION (III VENTRICLE)
Choroid plexus
Body of fornix Vein of Galen

Anterior Habenular commissure

commissure Pineal gland (epithalamus)
Lamina terminalis Posterior commissure

Optic chiasma

Infundibulum

MB

Post perforating substance

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CORONAL SECTION- BOUNDARIES OF LATERAL VENTRICLE

Septum pellucidum

Corona radiata

Caudate nucleus
Insula Thamostriate vein
Lentiform
nucleus Choroid plexus

Internal Fornix
capsule Thlamus

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 ANT. & POST. Recurrent art of Heubner 
CIRCULATION AL & Genu of Internal capsule

Choroid plx of
inferior horn of LV ACA
Deep
Ant choroidal art ICA cerebellar
MCA nuclei
• LGB & MGB PCoA
• Calcarine br PCA Sup cerebellar artery
visual cortex
Basilar artery

Ant inf cerebellar art

PICA

• Deep cerebellar nuclei Vertebral artery

• Choroid plx of IV Vent.
DIVISION OF INTRAEMBRYONIC MESODERM
PRIMITIVE BLOOD VESSELS OF EMBRYO
PHARYNGEAL ARCH ARTERIES
PHARYNGEAL ARCHES
 DOUBLE
AORTIC ARCH

Vascular ring

• Dysphagia
• Dyspnoea

Persistence of right dorsal

aorta below 7th cervical Double aortic Arch
intersegmental artery
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NEURAL TUBE- BRAIN VESICLES
DIAPHRAGM DEVELOPMENT
 DIAPHRAGM DEVELOPMENT
A- Body Wall mesoderm Muscular part

B- Dorsal mesentery of Oesophagus Crura

C- Septum transversum Central Tendon

D- Pleuroperitoneal membrane Incorporated by muscles

Persistence of Pleuroperitoneal canal Failure of muscle tissue to

develop inside
Bochdalek foramen
Evertration of Diaphragm
Congenital Diaphragmatic Hernia • Similar to CDH
• Common on left side • Not a True Hernia
• Complication left lung Hypoplasia REVISION SLIDES- DR ASHWANI KUMAR
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PHARYNGEAL ARCHES
PHARYNGEAL ARCHES
FACE & PALATE
FACE DEVELOPMENT

Non fusion of…..

• MNP to MNP  Midline cleft upper lip
• MNP to MxP  U/L cleft upper lip
• LNP to Mxp  Oblique facial cleft

Note: skin of upper lip is not by medial nasal process

A: Medial nasal process (MNP)

B: Lateral nasal process (LNP)
C: Maxillary process (MxP)
D: Mandibular process (MdP)
TONGUE DEVELOPMENT
GENITAL SYSTEM
SI to right side
LI to left side

NON ROTATION
 INCOMPLETE ROTATION
(MALROTATION)

SUBPYLORIC
CAECUM/APPENDIX
Ladd band

• Mesentery is very small chances of volvulus

• Presence of Ladd band  duodenal obstruction
• Bilious vomiting
• Double bubble sign
2nd & 3rd rotation are CLOCKWISE

Transverse Colon overlapped by

duodenum and SMA

REVERSE ROTATION
 NCC fails to migrate in myenteric plexus

Parasym ganglia are absent

No peristalsis

Dilatation proximal to the anomalous area

Congenital megacolon
(Hirschprung’s disease)

Early sign: New-born fail to pass meconium in first 24-48hrs after birth
INTERCOSTAL SPACES
STRUCTURAL ARRANGEMENT
DIAPHRAGM
INTERCOSTAL NERVE
PLEURAL RECESSES
MEDIASTINAL SURFACE OF RIGHT LUNG
MEDIASTINAL SURFACE OF LEFT LUNG
PERICARDIAL SINUSES
INTERIOR OF RIGHT ATRIUM
INTERIOR OF RIGHT VENTRICLE
TRIBUTARIES OF CORONARY SINUS & CORRESPONDING ARTERIES
RECTUS SHEATH

T.S ABOVE ARCUATE LINE

T.S BELOW ARCUATE LINE

SAGITTAL SECTION- PERITONEUM
TRANSVERSE SECTION- PERITONEUM
PERITONEAL FOLDS & ROOTS ON POSTERIOR ABDOMINAL WALL
ROOT OF MESENTERY
ROOT OF SIGMOID MESOCOLON
SUBPHRENIC SPACES
LIVER- ANTERIOR VIEW
LIVER- POTEROINFERIOR VIEW
HEPATIC SEGMENTS
BLOOD VESSELS OF GUT
SMA & IMA
NERVES/VESSELS/MUSCLES OF POTERIOR ABDOMINAL WALL
GLUTEAL REGION- MUSCLES
GLUTEAL REGION- NERVES/VESSELS
FEMORAL TRIANGLE- BOUNDARIES & CONTENTS
INTRA ARTICULAR STRUCTURES- KNEE JOINT
POPLITEAL FOSSA- BOUNDARIES
CONTENTS
LIGAMENTS OF FOOT AND ANKLE- MEDIAL SIDE
SOLE OF FOOT
SOLE OF FOOT
AXILLARY ARTERY
SCAPULAR ANSTOMOSIS
BRACHIAL, RADIAL AND ULNAR ARTERY
FLEXOR A\& EXTENSOR RETINACULUM
INTERMUSCULAR SCAPULAR SPACES
 THORACIC VERTEBRAE

Upper complete facet

T1
Lower demi- facet
T9 Upper demi- facet
T2-T9 Lower demi- facet
T10 T10
Upper demi- facet
Lower facet absent
Upper complete facet (shifted to pedicle)
T11
T11 Lower facet absent
Upper complete facet(on pedicle)
T12 Lower facet absent

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 SACRUM

(lateral  medial)
OILS Iliacus
O- Obturator nerve
I- Iliolumbar artery
L- lumbosacral trunk
S- Sympathetic trunk Piriformis (O)

Median sacral artery

Sympathetic trunk
Coccygeus

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 1ST & 2ND RIB

Scalenus posterior Scalenus medius

Subclavian artery
Serratus Scalenus anterior
Anterior (2) Subclavian vein
Serratus
anterior(1)
subclavius

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CLAVIPECTORAL FASCIA

Subclavius

Deltopectoral groove Clavipectoral Fascia

• Cephalic vein
• Deltoid br of Pectoralis Minor
thoracoacromian art

Structures Piercing the Clavipectoral Fascia :

1. Lateral pectoral nerve.
2. Thoraco-acromial artery.
3. Cephalic vein
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4. Lymphatics FB- ANATOMY-DR ASHWANI KUMAR
 AXILLA (T.S)

Ant. Pectoralis major

Pectoralis minor
Lat. Med.

Post. Lateral cord

Medial cord
Long thoracic nerve
Serratus anterior

Subscapular nerve
Subscapularis

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 Pectoralis minor

Short hd of biceps Suprascapular nerve

Coracobrachialis

* Serratus anterior
M-Pectoralis major
L- Lat dorsi
M- Teres majot

* Bicipital groove
• Long head of biceps
• ACHA
 Levator scapulae

Greater tubercle
Supraspinatus
Rhomboideus minor Infraspinatus
Teres minor

Rhomboideus major
Lateral hd of triceps

Medial hd of triceps
Radial groove
Radial nerve
Profunda brachii vessels
 Lateral Medial

Brachioradialis

Radial nerve ECRL

Pronator teres
Supinator Median
Common flexor origin nerve
Common extensor origin
PIN
Brachialis (ulnar tuberosity)
Biceps brachii
(radial tuberosity)
Oblique cord
Remnant of Flexor pollicis longus
Triceps

Medial Lateral
FLEXOR RETINACULUM RELATIONS
Palmaris longus

Median nerve
Ulnar artery
Ulnar nerve
FCR

Tendon of FPL
FDS & FDP
Radial artery
 Iliacus

ASIS (Sartorius)

AIIS (Rectus femoris)

Lat. rotator Piriformis/OI/GS/GI

Med. rotator Gluteus minimus

Iliopsoas
 Articularis Genu
5th head of QF

Adductor magnus

Iliotibial trct Guy Ropes

Gerdy's tubercle Gracilis (Obturator nv)
Sartorius (femoral nv)
Semitendinosus (sciatic nv)

Area is protected by anserine bursa

 Remnant of tendon of Adductor magnus
Popliteus
Tibial collateral ligament
Fibular collateral lig

Posterior meniscofemoral lig

PCL
(ligament of Wrisberg)
 Flexor digitorum longus

Spring ligament
(plantar calcaneonavicular lig.)
Flexor Hallucis longus
• Between tubercles of talus
• Below sustentaculum tali

Sustentaculum Tali
Attachments
Anterior  posterior
Plantar aponeurosis 1. Spring lig
2. Tibialis post
3. Deltoid lig
4. Medial talocalcaneal lig
SEBACEOUS GLAND

Sebaceous gland
• Pear-shaped glands
• Pale staining cells that produce sebum
• Holocrine secretion.
HYALINE CARTILAGE
Outer fibrous
Perichondrium
Inner cellular

Type II collagen fibres

Interterritorial matrix

Territorial matrix

Chondrocytes making cell nest

ELASTIC CARTILAGE

Outer fibrous
Perichondrium
Inner cellular

Chondrocytes individually in lacunae

Elastic fibres
FIBRO CARTILAGE

NO PERICHONDRIUM

Bundles of Type I collagen fibres

Chondrocytes present in rows

SPLEEN
Not differentiated into cortex or medulla

White pulp

Red Pulp

Lymphatic nodule
GC

Eccentrically placed splenic arteriole

 PALATINE TONSIL
Stratified squamous epithelium
Tonsilar crypt

Lymphatic nodule
 LYMPH NODE

Capsule
Subcapsular sinus
Cortex

Trabeculae

Lymphatic nodule (B Lymphocytes)

Medulla

Paracortex (T Lymphocytes)

Medullary cords and sinuses

 Thymus
No lymphatic nodule

Hassal’s corpuscle
Cortex
Medulla

Incomplete
septation

Lobule
IMP TOPICS