01.anatomy Sample

01 1
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GAMETOGENESIS
Pre-embryonic period ’ First a uueehs.

Embryonic period : 3 to 8 uoeehs.
Foetal period : 9 uoeels -till birth.
Primordial germ cell 00:01:38
It Vorms -the germ cells.

ft is produced by epiblast during aM uoeeK
male germ cell : Spermatozoa.

Female germ cell • Ovum.
Primordial germ cells migrate -to yolh sac by 4th uoeeh.

They reach gonads by 5th uueeK
male gonads Testis.
Female gonads : Ovary.
Primordial germ cells are pluripotent (ability to Vorm all germ

layers). I
1
Totipotent cells Ability to Vorm entire embryo and
extraembryonic tissue.
up to 8 cell stage, each cell is totipotent.
Anatomy •v4.0 •Marrow 6.0 •2022

01 Gametogenesis
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Oogenesis 00:12:43
Primordial germ cells migrate to cvarg bg 5th weeK

Primordial germ cell are converted to oogonium bg 3rd month.
month)
Primarg oocgte will remain in Diplotene phase until pubertg.
filter pubertg :
The primarg oocgte complete meiosis I and Vorms secondarg

oocgte (all the cgtoplasm) and ^rst polar bodg (no cgtoplasm).
Secondarg oocgte enters meiosis II
completes prophase and metaphase
metaphase arrest (lasts ¥or 54 hours)
Ovulation s
e^raVîan follicle release secondarg oocgte which is in
metaphase arrest.
GcraWtan follicle aVter the release Vorms corpus luteum.
Secondarg oocgte (in the metaphase arrest) will wait Vor 54
I? there is sperm entrg : Secondarg oocgte completes 5M

meiotic division and Vorms ovum and polar bodg II (formed
Vrom unequal division o? cgtoplasm and does not recieve ang
cgtoplasm). Corpus luteum will be converted to corpus luteum
o? pregnancg.

01 Gametogenesis, 5
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Spermatogenesis 00:31:24
Primordial cells reaches the testis and remain in dormant:

until puberty.
After puberty : They are con\/erted to spermatogonium.
Spermiogenesis It is the rearrangement of organelles lihe

formation of tail, acrosomal cap and shedding of excess
cytoplasm.
• I primary spermatocyte will form 4 spermatids.

• I spermatogonium will form G4 to SIA spermatids.
Differences between spermatogenesis and oogenesis :
Spermatogenesis Oogenesis
meiosis starts only after meiosis starts by
puberty intrauterine life
Polar bodies are not formed Polar bodies are formed
lprimary spermatocyte will Iprimary oocyte will form
form 4 spermatids Iovum (remaining are
polar bodies)

02
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1 WEEK DEVELOPMENT
ST
Fertilization 00:00:20
Occurs in ampulla o? Vallopian tube.

Occurs in 3 steps •
I. Spermpenetrates the corona radiata
a.Sperm penetrates the zona pellucida (ZP) » Sperm
—
binds to zona pellucida » Penetrates.
Acrosomal
—
Binding to ZP » Acrosomal reaction -4 Release o?
enzymes.
Substances released :
• Acrosin.
• Acid phosphatase.
• Hyaluronidase.
Acrosomal reaction —> Penetration into ZP.
— —
Penetration > Cortical reaction » Cortical enzymes
—
release secretions (cortical granules) > Keach ZP » ZP
changes its permeability -4 Presents polyspermia
—
3. Fusion o? male and female pronucleus.
Zygote formation 00:06:18
Formed within ia-a4 hours o? ovulation (secondary oocyte

in metaphase arrest will wait only Vor a4 hours ¥or sperm
Vusion).
—
—— —
Zygote » Cleavage > a cell division (a4 hours post
—
Vertilizatior) > 4-cell stage > 8-cell stage > ifo-cell—
stage (morula) » 3a cell stage (advanced morula) >
— —
—
Enters uterine cavity » Cavitation > Blastocyst.
space
• upto 8-cell stage • Totipotent cells +■ cells are loosely
arranged.
Active
AVter 8 cell stage : Compaction (cells attached with
tight junctions).

02
At the time of formation, blastocyst contains 58 cells.

• 53 cells in the outer cell mass, 5 cells in the inner cell
mass.
Zona, pellucida :
Blastocyte
• Prevents implantation.
• Prevents polyspermy.
Disappears by 5th day after
—
fertilization » Hatching of
—
blastocyst » Implantation
starts by
by 10-11^ day.
—
day > Ends
Implantation occurs in the upper part of posterior wall of

uterine cavity.
Bleeding at the time of implantation : Hartman’s sign (seen
in some patients).
Total number of cells at the time of implantation in the
blastocyst » loo-aso cells.
Intra decidual sign 5
Uterine endometrium during pregnancy » Decidua.
Blastocyst implanted in the deep layer of decidua •
Intra-decidual sign.
First sign seen in USQ in pregnancy.
Corresponds with formation of
gestational sac.
Ectopic tubal pregnancy 00:23:30
Implantation occurs in fallopian tube.

me part of fallopian tube

Q3 2nd Weel
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Hypoblast cells :
• These are cuboidal cells.
Are formed on the ventral aspect of the embryo.
It yives rise to exo coelomic membrane (lined by flat/
squamous cells).
This encloses a cavity called yolh sac.
USQ flndinq in a!^ uoeeh : Double bleb/bubble siyn.

It corresponds to the formation of amniotic cavity and yolh
sac.
Outer cell mass 00:06:56
6y 8^ day, trophoblast is divided into »

• Cytotrophoblast : Have deflnitive cell membrane.
• Syncytiotrophoblast : Do not have any definitive cell
membrane and is multinucleated.
Extraembryonic mesoderm
Extraembryonic
somatic Amnionic
mesoderm cavrty
- VolK Sac
cavity
splanchnic
mesoderm
Cytotrophoblast coelom
Syncytiotrophoblast

03 2nd We<
Develoi
Summary o? a^ weeK development :
• a layers 0? inner cell mass : Epiblast and hypoblast.
• a layers o? outer cell mass : Cytotrophoblast and
syncytiotrophoblast.
• a layers 0? EEm • splanchnopleuric E£m and
somatopleuric EEm.
• Amnion and chorion is formed.
Human Chorionic Gonadotropin/HCG 00:25:47
It is synthesized by syncytiotrophoblast.
It stimulates the production 0? proyesterone which is
essential to maintain the preynancy.
HCGj hormone assay is done in :
• The maternal blood : by 8th day.
HCQ hormone assay can be done on the $rst day o? the

missed period/lS^day a?ter ovulation (early mominy
sample).
HCQ hormone doubles aVter 48 hours.
HCG1 > aOOOlU :
• gestational sac present : intrauterine preynancy.
• Gestational sac absent = Ectopic preynancy.
Critical value oV HCGi is aOOOlU. beyond which intrauterine
preynancy yestational sac should be seen.
HCG, < aoooiu 5 Repeat the test a?ter 1 wech and i? HOGt
value becomes >aoooiu :
• Gestational sac present - Intrauterine preynancy.
• Gestational sac absent : Ectopic preynancy.
I? HCG\ is <aoooiu, in a precious preynancy s Repeat the HCGt
test a?ter 48 hours : space
I? doubled Intrauterine preynancy.
Increasiny but not doubliny s Ectopic preynancy.
Active

04 3rd Week
Development® eave Feedba,
Placentia
Formation o? the notochord
Motochordal process
ti- ectoderm
mesoderm
endoderm
Motochordal canal
Motochordal plate
De^nrtive notochord
Gastrulation 00:06:19
gastrulation and Meurulation occur in the third uieeh oV

development.
• o? germ layer.
gastrulation * Formation
• bJeurulahon Formation o? neural tube.
•
gastrulation formation o? germ layers)
Hypoblast being extraembryonic

mesoderm
displaced laterally

Q4 3rd Week.
PhysoliVerous cells in chordoma :

• Larye vacuolated cytoplasm.
• Mucleus in periphery.
Larye vacuolated cytoplasm with nucleus

pushed to periVery.
Subdivisions of intra embryonic mesoderm 00:19:08
l. Paraxial mesoderm ;
Forms somites.
A. Intermediate mesoderm :
Forms uroyenital system : Kidney testis, ovary
mesonephric duct, Para mesonephric duct.
5. Lateral mesoderm ;
Cavity in lateral mesoderm Vorms the body cavity (Pleural,
Pericardial, Peritoneal cavity).
i
*

04 3rd Week
Developer
Placenta
Meural tube
Dermatome (ectoderm)
Somite - muotome
epidermis
(ectoderm)
Sidney and gonads
(intermediate ût lining
mesoderm) (endoderm)
Somatic
Splanchnic mesoderm mesoderm
•Visceral serosa • Limb bud
•Smooth muscle o? gut • Parietal
serosa
Peritoneal cavity • Dermis
(coelom)
(d) End o? weeh 4. embryo undercutting is complete. Somites

have subdivided into sclerotome, myotome, and dermatome,
which Vorm the vertebrae, skeletal muscles, and dermis
respectively. Body coelom present.
Divided into 3
• ventral sclerotome ; Body o? vertebra
• Dorsal sclerotome : Spine o? vertebra.
• Lateral sclerotome : Vertebral arch.
Dermomyotome :
Subdivided into dermatome and myotome.
• myotome J Skeletal muscles o? the body.
• Dermatome : Dermal layer o? sKin.

Q4 3rd Wee
Develo
Placent
• Smooth muscles over pharyngeal arch arteries :
Meural crest cells.
Placenta 00:43:17
Placenta is derived Vrom both mother and baby.
Types o? chorionic villi
Chor ion »
Formed by
• extra embryonic mesoderm.
• Cytotrophoblast.
• Syncytiotrophoblast.
Chorionic Villi $
Firmer lihe projections arising Vrom chorion. 3 types :
• Primary chorionic Villi s
Formed by Cytotrophoblast Syncytiotrophoblast.
Formed by Cytotrophoblast, Syncytiotrophoblast

extra embryonic mesoderm (esm).
Tertiary chorionic villi :
extra embryonic mesoderm + 6lood vessels in eem +
Cytotrophoblast Syncytiotrophoblast.
I
Development o? placenta :
I
• Fetal component ; Chorion Vrondosum.
• maternal component • Decidua basalis.

Q4 3rd Wee|
Developi lent & .eave Feedba
Placenta
Fetus is cohered in the order •
Fetus — Decidua capsularis — uterine cavity —* Decidua

parietalis.
Seen in ultrasound as double decidual sac siyn.
Development o? placenta, and amniotic cavity

Decidua basalts —
Decidua parietalis
Chorion Vrondosum
Chorionic caVrty -
Amniotic cavity
Decidua capsularis
Chorion laeve
Vol* sac
uterine cavity
Placenta
Fused decidua
parietalis, chorion
laeve and amnion
Amniotic caVtty
Uterine cavity becomes small due to the yrowiny Vetus.

Decidua capsular is Vases with decidua parietalis.
Obliteration oV endometrial
cavity.
Chanye occurs by i4-i(o weehs oV yestation. &
5
Ultrasound signs in pregnancy 00:51:27
Ist siyn : Intra decidual siyn.

Corresponds to formation oV yestational sac.

05 OK
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FOLDING OF EMBRYO AND

FORMATION OF GUT TUBE
AVter 3rd weeh o? development -* 3 germ lagers

• ectoderm encloses a cavity called
amniotic cavity
• mesoderm.
• endoderm encloses the yolK sac.
Cranial most structure : Septum transversum.
Motochord divides intraembryonic mesoderm into 3 parts :
• Paraxial mesoderm.
• Intermediate mesoderm
• Lateral plate mesoderm.
In the lateral mesoderm -* Cavity divides it into a layers »
• Splanchnopleuric layer.
• Somatopleuric layer.
Above the prechordal plate -* Cardiogenic area where heart
tubes are formed
Septum transversum contributes to the formation o? =
• Diaphragm.
• Fibrous pericardium
space
• Liver. Active
The prechordal plate gives rise to buccopharyngeal
membrane.

Folding of Embrvt
and Formation of Leave Feedba
Gut Tube
Some parts o? the yolK sac get incorporated into the embryo
to Vor m the gut tube.
The parts o? the yolh sac lying outside embryo -* Form
umbilical vesicle.
The gut tube and the umbilical vesicle are connected by
vitelline duct.
Giut tube is divided into 3 parts :
• Foregut
• midgut : Lies opposite to the umbilical vesicle.
• Hindgut.
Buccopharyngeal membrane ruptures by 4^ weeh -* Oral
cavity communicates with Voregut tube.
final pit (proctodeum) formed opposite to cloacal membrane.
Cloacal membrane is present between the hindgut (cloaca)
and proctodeum.
fillantois divides the hindgut into A parts.
The part o? hindgut distal to allantois Cloaca.
The cloacal membrane will rupture by 1 9*1 weeh- Cloaca
communicates with proctodeum -* Qut tube communicates
with anal ori^ce.
The gut tube is derived Vrom the endoderm o? the yolH sac.
Features of the gut tube oo:17:oo
Foregut midgut Hindgut

extension Up to a"4 part a^parto? Lastl/3
o? duodenum duodenum transverse
(major duodenal after the major colons
papillae / duodenal papilla Descending
opening a? + Jejunum + colon *
Ampulla o? Ileum + Caecum Sigmoid colon
Vater). + Appendix + Rectum +
+ Ascending Anal canal.
colon + a/s
Transverse space
colon.
Active

06 OQ
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DEVELOPMENT OF NEURAL TUBE
Neurulation 00:00:25
• Process o? formation oV neural tube.

• Occurs in -third weeh o? development.
• Neural tube gives rise to brain and spinal cord.
Notochord gives signal to ectoderm -* Ectoderm thichens

and in turn Vorms neural plate.
Neural plate -* Neural tube.
The part o? ectoderm that Vorms neural plate : Neuro
ectoderm,
Remaining part o¥ ectoderm : Surface ectoderm.
Neural plate border Neural plate epidermis
space
Active

Q5 Development of
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• migratory cells.
Also called as mesenchymal cells.
Meural tube formation initially occurs at cervical region.
Meural tube communicates with amniotic cavity through •
neuropore :
I. Cranial
Cranial neuropore
• Closes by as*1day.
• Failure to close :
Onencephaly.
• Remnant oV cranial
neuropore : Lamina
terminalis (situated
in the anterior wall
o? 3rd ventricle).
a. Caudal neuropore :
• Closes by aB*1day.
• Remnant is terminal
ventricle.
• Failure to close s Spina
bi^da anomalies.
Caudal neuropore
Anencephaly

06 Develop)
Neural Ti
rrwMsnoecraior
(m**rarO
<HTX**C^)
Derivatives oV vesicles :
I. Telencephalon : Cerebrum and corpus striatum.
a. Diencephalon :
• Thalamus, hypothalamus, metathalamus,
subthalamus and epithalamus.
• Pars nervosa (posterior lobe o? pituitary).
• Retina and optic nerve.
3. mesencephalon ; midbrain.
4. Rhombencephalon •
• metencephalon : Pons and cerebellum.
• myelencephalon * medulla oblanyata
Ventricles 00:18:40
Cavities inside brain.

Cavity in the :
• Telencephalon Lateral ventricle.
• Diencephalon • Third ventr icle.
• midbrain : Cerebral aqueduct o? Sylvius.
• Rhombencephalon : 4*1 ventricle.

Anatomy
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Active space
Q3 CSF and
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Circulation o? CSF 5
Formed in lateral ventricle Foramen o? monro -* 3rd
-*
ventricle Cerebral aqueduct o? Sylvius -* 4*1 ventricle

-* Central canal o¥ spinal cord and subarachnoid space via
Voramen oV mayendie (median aperture) and foramen o?
Luschha (lateral aperture). These a Voramens are present in
inferior medullary velum.
Foramen mayendei -» Cisterna mayna.
Foramen Luschha -* Cerebello-pontine aryle cistern.
Cistern : bnlaryed subarachnoid space.

Subarachnoid space -* Dural venous sinus (mainly to superior
sayittal sinus) via arachnoid yranulations.
veins Superior
sagittal smuS
Arachnoid Sone
mater
Oura
Subarachnoid moder
space Subdural
Pia moder
Arachnoid
Cerebral
vein
Arachnoid Longitudinal
trabaculae Assure
Cerebral
cortex
Applications 00:06:18
I. Conyehrtal acqueductal stenosis • m/c cause o? conyenital

hydrocephalus.
3rd ventricle dilated.
a. Dandy#balher syndrome «
Atresia o? foramen mayendie and Luschha.
Arachnoid VilVi/yranulations :
Site o? absorption o? CSF. Also acts as a valve and prevent
the entry o? venous blood
CSF pressure > venous pressure -* Drains into dural venous
sinus via superior say ittal sinus.
• Acts as a valve and prevents entry o¥ venous blood

08 CSF ancj
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Pterion 00:14:14
It is a meeting point o? 4 bones (frontal + parietal + greater

wing o¥ sphenoid + squamous temporal bone).
middle meningeal arterg (Vrontal/anterior division) is seen
deep inside pterion.
Any Vracture o? pterion -* Laceration to mmA -* epidural
hemorrhage.
Epidural hemorrhage :
Arterial hemorrhage.
middle meningeal artery is aWected
Lucid interval seen mostly.
Mon contrast CT head Biconvex or idly or lens shaped
’
Subdural hemorrhage :
Venous hemorrhage.
Bridging veins are aVêcted
Lucid interval seen rarely.
Mon contrast CT head : Crescent shaped/C-shaped
Dandy-LOalher syndrome :
• Cyst in posterior cranial Vossa.
• Atresia o? Voramen magendi
and Voramen LuschKa.
• 4^ ventricle dilated
Dandy-WalKer syndrome

08 CSF am 41
Ventricli Leave Feedba
4. Inferior horn extends into temporal lobe.

Atr ium : meeting point of central part, posterior horn, and
inferior horn.
Parts of the lateral ventr ole
Anter or horn of Central part of

the lateral ventrole lateral ventre Ie
Posterior horn of
lateral ventricle
Inter ventricular
aqueduct
foramen
ventricle
Thrd ventricle
Infer or horn of
median
lateral ventricle
aperture
Central
Relations between basal nuclei (caudate nucleus) and

cerebrum (cavity) :
Poor o¥ anterior horn : Head of caudate nucleus.
Floor of central part : 6ody of caudate nucleus.
Roof of inferior hom ; Taji of caudate nucleus.
Celatons of the lateral ventricle
Anter or horn of Thalamus

the lateral ventrole
Posterior horn of
€>enu of the
the lateral ventre Ie
callosum
Rostrum of
the corpus Stria
callosum terminal is
head of the
caudate rucleus Infer or horn
of the lateral
caudate ventrole
nucleus Anter or
Tail of the
Septal area perforated caudate rucleus
substance nuclei

08
Frontal horn Caudate nucleus
internal capsule LentiVorm nucleus

ClauStrum
Thalamus
Corpus
calosum external capsule
Occipital horn o¥
right lateral
ventricle
Sulcus impressions on the Lateral ventricle
Fibres o?
Optic radiation
?orceps major
medial Lateral
Bulb o?
posterior horn Cavity o?
Calcar avis s
Calcarine sulcus
Posterior horn relations

Q8 CSF and 45
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-
delations o¥ thalamus sagittal section o? brain
body o? ¥orn<x
3rd ventricle 00:35:56
Cavity in the midline, with thalamus and hypothalamus on

either side.
Anterior wall s Anterior columns of fornix, anterior

commissure( Is* commisural Viber to develop), lamina
terminalis (remnant of cranial neuropore, no
blood- bram- barrier, circumventricular oryar).
Posterior wall :
l. Pineal yland (circumventr icular oryar).
a. Superior lamina of pineal yland (habenular
commissure).
3. Inferior lamina of pineal yland (posterior commissure).
Floor s
Tumor in pineal yland
l.Optic chiasma
-*Parinaud syndrome
a. Infundibulum.
(compresses dorsal part
3. Pituitary yland
of midbrain). &
4. Tuber cinarium.
S. mammillary body. 1
(0. Posterior perforated substance.
1. Teymentum of midbrain.
Poor of 3rd ventricle also forms interpeduncular fossa

08 CSF and
Ventrick Leave Feedba
4th ventricle 00:58:35
Cavity o? rhombencephalon. Forms metencephalon (pons and

cerebellum) and myelencephalon (medulla) .
1. Poo? : Superior (formed by nervous tissue -* LOhrte
matter) and inferior medullary velum CV or med by
non-nervous tissue made up oV Ependyma).
a. Floor ; Pons (lower) and medulla (upper).
3. Lateral wall : Cerebellar peduncle.
4. Floor :
ico
between pons and medulla : Striae medullar is (white
matter). I
Centre o? ôor : median sulcus.
Either side o? medial sulcus : Sulcus limrtans.
upper part o? sulcus limitans : locus coeruleus

Q8 CSFand 49
Ventricles
Floor of the fourth ventricle
•
1
'll 1 1 Pneal gland

1
FT* 1 i Superior colliculus
Inferior colliculus 1
Trochlear (iv) nerve 1
/ . 5
\ median sulcus 1
f Sulcus lirrwtans i
i •1 R
middle r
/I tl \ / Inferior J peduncles
wlT Striae meckjdlares

1
V " Tenia, of fourth ventricle
\
\/ 1
S Jf ~| hypoglosal nerve trigone
1
\\ fj 1 1
I vagal trgone 1
\ 1If/,
\ \ I III '
Cuneate tubercle
Obex
1
\\ / /1 Gracile tubercle
M ] »1 IJ Posterior median sulcus 1
1— Fasciculus cuneatus
1
Fasciculus gracilis 1
Cranial nerve nuclei in the floor of

the 4* ventricle
median &ulcus 1
medial ernmence
^CuS ittans
k1
1
/ \ Facia) coll iculus
7 vestibulai area
Hypogloss
ingle
2
&
?
1

09 Cd
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SPINAL CORD
External features 00:00:16
Adults : C I -to lower border o? L I.

=
Newborn C I to upper border o? L3.
Spinal cord reach the adult level aVter a years.
Anterior median
Assure
Anterolateral
sulcus
meninges :
It consists o? piamater, arachnoid membrane and dura.
Filum terminate : modification o? piameter from u to coccyx.
Arachnoid membrane ends at lower border of sa. space
Subarachnoid space also ends at lower border of Sa. Active
Plum terminate Cao cm) has a parts :
• Filum terminate internum ( iScm ) : From u to Sa
Present inside the arachnoid membrane.

09 Spinal Cord 53
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Dura
mater
Thoracic
spinal nerves
Lumbar
enlaraet
Conus medulians
Lumbar
Cauda equina spinal nerves
Filum
Conus medullaris :
• It is the lower taper ing end o? the spinal cord.
• Sacral and coccygeal nerves are arising Vrom it, only these
nerves are aWected in conus medullar is syndrome.
Cauda equina
• Bunch o? spinal nerves Vrom La to coccyx.
• Lumbar, sacral and coccygeal nerves are involved in
cauda equina syndrome.
Total number o?
• Spinal nerves 31 pairs.
• vertebra 33
Spinal segments do not always correspond with vertebra.
Spinal segment vertebra

upper cervical = CA ca : Same level
Lower cerival s CL CS ; One vertebra above
Upper thoracic : TS =
T3 TWO vertebra above
Lower thoracia ! TIO T7 : Three vertebra above
Nuclei in the cut section o? spinal cord ;
Substatia
Posterior horn (sensory)
e«elat inosa
(Continues as spina) UJhite matter
nucleus o?
Lateral horn (only ?etu)
White matter e<rey matter : collection
collection o¥ axons o¥ cell bodes
Mucleus proprius interior horn (motor)
media) 5 lateral
Mucleus Lateral nucleus
Intermediate nucleus
Clanse's column Visceral afferent media) nucleus
nucleus
Anatomy •v4.0 •Manrow 6.0 •2022

09 Spinal Cord
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sympathetic yanglion leave via yrey rami

communicantes (unmyelinated) that has postyanylionic
$bers and then enters the spinal nerve.
In somatic system : Fibres Vrom spinal cord directly yo
to taryet muscles via spinal nerve.
In AMS : Preyanylionic and postyanylionic neurons are
involved.
Tracts :
Collections oV axons in CMS haviry same oriyin, course, function
and termination.
Ascending tracts Descending tracts

motor tracts
Dorsal
column
Fasciculus
gracilis
Fasciculus
cuneatus-
—
Dorsal Lateral corticospinal
—
spinocerebellar tract tract
ventral Rubrospinal tract
spinocerebellar tract • Lateral reticulospinal
Spinotectal tract . tract
Spino-olivary tract vestibulospinal tract
ventral reticulospinal
tract
Anterolateral tract Tectospinal tract

Pathuuag Lateral
ventral corticospinal tract
spinothalamic
tract.
Dorsal uihrte column
Lateral white column
Anterior uihrte column
Pyramidal system : Initiation o? Vine, shilled, distal, voluntary

movements. $
extrapyramidal system • Regulation, modulation and
preparation Vor the movement.
Cerebellum : Co-ordination o¥ the movement.

09 Spinal Cord C7
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Corticonuclear tract (Bulbar tract) :

Origin : Qiant cell o? Betz.
I
Fibres pass through genu o? internal capsule.
I
Brainstem (midbrain, pons and medulla).
I
Cross to opposite side at various levels o? brainstem and
ends in the motor nuclei o? cranial nerves.
I
The nuclei and the cranial nerves arising Vrom the nuclei
(LmKl) innervate the target muscles.
Example * Hypoglossal nucleus present in the medulla (ôor o?
4th ventricle) and hypoglossal nerve are LmN and innervates
the tongue muscles.
Almost all the cranial nerves have bilateral innervation Vrom the
cortex except Vacial nerve. The lower part o? the facial
nucleus is innervated only by the opposite cortex.
In le?t cortical lesion, the right facial nucleus is aVêcted.

However, the upper part o? right nucleus (which supplies the
upper-right hal? o? Voce) will be normal as it is also space
innervated by the right cortex. Active
Therefore, only the lower-right hal? o? ?ace is a??ected in
this case.
Hence, in umM type o? Vacial nerve injury : Only contralateral
lower hal? o? ?ace is a??ected.

09 Spinal Cord
opposite side in the spinal cord and then reach the anterior
horn.
upto the anter ior horn, fibres are called as upper motor
Meuron (umM).
The anterior horn and the spinal nerves arising ?rom that are
called as Lower motor neurons (Lmn).
=
Decussation is 100% TS% cross at medullaj cross at spinal
cord
Lesion in the corticospinal tract :
• In the brainstem (above the pyramidal decussation) :
Contralateral weakness.
• In the spinal cord (no fibres come out o? the aVêcted
segment) : Ipsilateral weakness.
• In the midbrain - uieber syndrome $
3rd nerve + corticospinal tract aêcted.

Patient will have LmM type o? ipsilateral 3rd nerve palsy
+ contralateral weakness.
This is called crossed hemipleqia
mid brain
(section at superior colliculus)

09 Spinal Cord
Lea
Lesionto spinothalamic tract in the brainstem/spinal cord ’

Contralateral loss o? pain, temperature, crude touch and
pressure.
Mo loss o¥ Vine touch as it is carried by dorsal column tract.
(3, l, a) Sensory cortex
Fine touch and proprioception Pan and temperature sensation

sensations ¥rom right side o¥ body Vrom right side o¥ body
Dorsal column system Spinothalamic tract

Spinal Cq^, co
09
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These are Glares conning Vrom contralateral gracile

cuneatus nucleus.
I
Through the brainstem, the fibres goes up to the vPl nucleus
thalamus (source o? third order neuron)
I
Fibres Vrom vpL nucleus in turn project to primary sensory
cortex (area. 3, 1, a).
• Lesion to the medial lemniscus in the brainstem :

Contralateral loss o? $ne touch, vibration, stereognosis
etc as fibres are Vrom the opposite side.
• Lesion to dorsal column tract in the spinal cord :
Ipsilateral loss o? ftnd touch, vibration etc as fibres are
Vrom the same side.
Spinocerebellar tract 01:13:31
Carries unconscious proprioceptive fibres.
For posterior spincerebellar tract :
Fibres Vrom dorsal root ganglion

(source o? ftrst order neuron).
I
Qoes up to nucleus in the posterior horn
(darhe’s column Source o? second order neuron).
I
They pass in the dorsolateral part o? white column and
ascend as posterior spinocerebellar tract.
They enter the cerebellum through the inferior cerebellar

peduncle.
I
They go to sensory cortex (area 3,lî).

09 Spinal Cord RS
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Tabes dorsalis
TB spinal segment
Brown - Sequard syndrome :
Hemisection o? the spinal cord

Due to yunshot/hntVe injury.
impaired proprioception,
space
ihe touch, vibratory sense
and two point
dcscr miration (ipsilateral)
Active
Impaired pain, crude touch and
temperature sensation (Contralateral)

09 Spinal Cord 67
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Sensory loss = Perianal Perianal anaesthesia +

anesthesia present. Sensory loss over the pubic
region (lumbar nerves).
Bladder involvement : Bladder involvement very
a muscles affected are : late.
• Detrusor muscle via
pelvic splanchnic nerve
Sa, S3, S4 (nervi ententes)
• Sphincter urethra Via
pudendal nerve (sa, S3,
S4). causing,
urinary retention + urinary
incontinence.
Impotence s Impotence :
Involvement of Less frequently occurs.
bulbospongiosus and
ischiocavernosus muscles
(sa S3 S4 : pudendal nerve)
Saddle Conus medullaris vs Cauda Equina syndrome

anaesthesia
Deep -tendon reflexes

Reflex Segmental Merve
innervation
hnee reflex L3L4 Femoral
Biceps jerh CS CZo musculocutaneous
Brachioradialisjerh CS CG Radial
Triceps jerh C1C8 Radial

cq
10
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BRAIN STEM
External features of brainstem 00:00:16
Brain stem is made up o? 3 structures s

mid brain.
Pons.
medulla
medulla :
medial elevation called pyramid Pyramidal tract.
Lower end o? medulla -* Decussation o? pyramid
Lateral to pyramid -* Olive.
Inside olive -* Inferior olivary nucleus.
Between pyramid and olive XII (Hypoglossal nerve)
ftbers.
Lateral to olive -* IX, X, and XI nerves.
Pons »
Bridge between midbrain and medulla space
a rootlets : Active
l. Large sensory root o? trigeminal nerve.
a. Small motor root o? trigeminal nerve.

Brain Ste Leave Feedbacl
1Q
Posterior view of midbrain 00:09:16
a superior colliculi + a inferior colliculi = Corpora quadrigemina.

Superior colliculus -* Connected to Lateral geniculate
body -* Optic pathway ( mnemonic ; SLOw).
Inferior colliculus -* Connected to medial geniculate body
-» Auditory pathway (mnemonic • imp).
IV nerve -* Inferior colliculus -* Only nerve with dorsal exit.
Posterior view oV pons and medulla!
Lower part oV medulla -* Tubercles (gracile tubercle +
cuneate tubercle + inferior cerebellar peduncle).
Posterior view o? brainstem
midbrain -* Cerebral aqueduct o? sylvius -* Line in the center

-* Area behind it ! Tectum, area in Vront : cerebral peduncle.
Cerebral peduncle :
• Substantia nigra (SM) divides cerebral peduncle into
three parts.
• Tegmentum (area behind Ski).
• Crux cerebri (area in Vront o¥ SM).
Structures passing through crux cerebri :

• middle a/3rd -* Corticospinal corticonuclear tract.
• medial side -* Frontopontine fibers.
• Lateral side -* Parietoponto ftbers,
occipitopontine ^bers temporopontine fibers.

10 Brain Stem 7S
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Midbrain at the level of superior colliculus 0023:04
• Pretectal nucleus -* connected to the interstitial

nucleus o? Cajal Nucleus Vor vertical gaze.
Optic tract -* GVêrent flbers Pretectal nucleus
EWerent to Edinger uJestphal nucleus -* Direct indirect
I’ght reflex.
• Red nucleus.
• Rubrospinal tract decussates at ventral part o5?
tegmentum (ventral tegmental decussation).
• Tectospinal tract -* Dorsal tegmental decussation.
• 3 leminsci (anterior to posterior) «
medial lemniscus.
Trigeminal lemniscus.
Spinal lemniscus.
space
Active

10 Brain Stem 75
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Loss o¥ pain temperature in le?t side o? body -* Right

spinothalamic tract aVêcted Right lateral lesion.
Loss o? pain temperature in right Voce-* Right trigeminal
involved -* Right lateral brainstem lesion.
Midbrain syndromes 00:43:35
I. uleber syndrome :
• Lesion -* III nerve + corticospinal tract.
• Features -» i/l LmM III nerve palsy * c/l hemiplegia.
• Crossed hemiplegia.
5. Claude syndrome =
• nerve + red nucleus.
Lesion -* III
• Features -* i/l LmM III nerve palsy + c/l ataxia.
3. Benedict syndrome »
• LOeber + Claude + subthalamus involvement.
• Lesion -* III nerve + corticospinal tract + red nucleus +
subthalamus.
• Features -* i/l LmM ill nerve palsy c/l hemiplegia +
c/l ataxia hemiball ismus.
4. Dorsal midbrain syndrome = Parinaud syndrome :
Mot due to a vascular lesion.
mostly due to tumors/mass.
Ill nerve not involved (as lesion is dorsal).
Mo uoeahness (no corticospinal tract).
• Lesion -* Pretectal nucleus.
• Features upgaze palsy, Argyll Robertson pupil (as
pretectal nucleus is involved in light re^x).
Pons syndromes 00:48:25
l. millard-€\ubler syndrome :
• Features -* i/l LmM Facial nerve palsy + i/l vi nerve
palsy + c/l hemiplegia (due to involvement 0? VI* VII* |
nerve nucleus CST). |
a. Raymond’s syndrome »
• Features -* |/l abducent nerve palsy + c/l hemiplegia
(due to involvement 0? VI* nerve nucleus CST).

-j Q Brain
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il Loss o? corneal re^x.

ill Cochlear nuclei.
. Deafness.
iV
• AICA strobe.
• mnemonic FACIAL - AICA strobe + facial nerve invoved.
Clinical scenarios 00:52:24
Q. A 7S year old man presents ?or evaluation a? weabness. He

reports that two hours ago he was suddenly unable to move
his le?t arm or leg. He denies any d&îculty with speech. On
examination, he is able to move all facial muscles normally.
There is no ophthalmoplegia. On tongue protursion, the tongue
is deviated to the right. He is unableto detect lower or upper
extremity vibration on the le¥t. uJhere is the site o? the
lesion?
Answer s Right medial medullary syndrome.
Explanation :
LeVt sided weabness -* Right Pyramid involvement (medial).
Right sided deviation o? tongue -* Right XII nerve aVêcted.
(medial)
Le?t sided loss o¥ vibration sense -* Right medial lemniscus
aêcted.
Q. Right sided weabness j LeVt eye down and out, dilated.
Answer : uJeber’s Syndrome.
Explanation •
Right sided weabness -* Le?t corticospinal tract affected.
LeVt eye down and out, dilated -* CM III aêcted.
Ipsilateral CM 111 palsy + Contralateral Hemiplegia -* LLeber’s.
Q. unable toperform leVt hand ^nger-to-nose test.
Loss o? pain and temperature o? Ie?t Vace.
LeVt eyelid droop j Small pupil.
Loss o¥ pain and temperature o? right arm and leg.
Hoarse voice.
Loss o? gag re$ex o? Ie¥t side o? throat.
Palate raised on right side.
Answer : LeVt lateral medullary syndrome.
11 7Q
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CEREBELLUM
Lobes of cerebellum 00:00:40
(Light and left halves connected in midline by vermis.

Ala oV 0$
Semilunar Louble Semilunar Louble
I. Archeocerebellum/vestibulocerebellum :
* Floculus.
• Module.
• Lingula.
Regulates balance and equilibrium.
Lesion • Loss of balance, ataxia, nystagmus.
a. Paleocerebellum/spinocerebellum :
• Anterior lobe (Al).
• uvula.
• Pyramid.
Regulates tone of the muscles, coordination of movements.
Lesion : Hypotonia.
3.Meocerebellum/cerebrocerebellum ;
Regulates the smooth performance and planning of voluntary space
motor activity. Active
Lesion ’• Dysarthria, dysmetria, dysdiadochohinesia,
intentional tremors.

11 Cerebellum 81
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Afferent fibers to cerebellum 00:12:48
• Climbing ftber s
Comes Vrom inferior olivorg nucleus o? -the opposite side
(olive in medulla).
It goes to onlg one Purhinje cell.
• mossg Srber :
Divides into 4-S terminals.
Each -terminal Sorms cerebello-glomerulus north granular
cell and golgi cells (Sound in inner granular lager).
T shaped Stber Srom granule cells anastomose with a
large number oS Purhinje cells.

11 Cerebeto.,. _
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Superior Cerebellar Peduncle (SCP) »

• Aêrent fibers ;
Anterior spinocerebellar tract
Tecto-cerebellar ^bers.
• bWerent fibers Vrom dentate, emboltform and globose
nuclei
SCP decussates at the midbrain at the level o? inferior
COlliCuluS.
It ends in thalamus via red nucleus.
Inferior Cerebellar Peduncle (1CP) : bWerents Vrom Vasbgial

nucleus, pass through ICP and end in vestibular nuclei

12 Cerebrum 85
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Complete sulcus :
ore very deep and yive impresston to the lateral
ventricle.
• example : Anterior part o? calcarine sulcus, collateral
sulcus.
• Anterior part o? calcarine sulcus yives impression (calcar
avis) on the medial side o? posterior horn.
• Collateral sulcus yives collateral eminence.
Gyri & broadmann areas 00:03:56
Area 4 Pre central yyrus l° motor area

Area G Pre motor area (superior frontal yyrus).
Area 8 Frontal eye fteld (middle Vrontal lobe yyrus).
Area 44, 45 : motor area Vor speech : &roca’s area
(inferior Vrontal yyrus).
Area 3, 1, a ' Post central yyrus : 1° sensory area
Area S, 7 : Sensory association area (superior parietal lobe).
Hand and eye co-ordination (inVer tor par ietal lobe).
Area 17 : Visual cortex (around calcarine sulcus).
Area IB, 19 : Visual association cortex.
Area 41, 4a : Auditory area (anter ior part o¥ super ior temporal
yyrus). |
Area aa : uterniche’s area Sensory area Vor speech
(Posterior part o? superior temporal yyrus).
Premotor area • Complex role in speech, also suppress the

primitive regexes.

j2 Cerebrum R7
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Frontal eye fteld ’•

• It deviates the eye to the opposite side.
• The frontal eye fteld is connected to the contralateral
Para Pontine Reticular Formation (PPRF) which is the
nucleus for horizontal yaze.
• PPRF connected to the ipsilateral (oth nerve nucleus
which innervates the ipsilateral lateral rectus.
• The (oth nerve nucleus is connected to the
contralateral 3rd nerve by the m_F. This invervates
medial rectus on the contralateral side. Hence, brings
about deviation of eye to the opposite side.
Lesion in the right side frontal eye field : Not able to deviate
the eye to the left side.
byes deviate to the side of the lesion (righO.
Anatomical pathway for horizontal
eye movements
PPRF : Paramedian Pontine Reticular Formation-,

space
F&F : Frontal eye %eldj muF : medial longitudinal fasciculus-,
mR : medial rectus-, LR Lateral rectus.
Active

12 Cerebrum _ gg
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Angular gyrus • Gnosis : Ability to recognize an object by

touch, vision or sound.
Lesion in dominant parietal lobe :

Qerstmann syndrome is characterized by the loss oV Vour
specie neurological functions *
• Inability to write (Oysgraphia or agraphia).
• loss o¥ the ability to do simple mathematics (Acalculia).
• Inability to identify one’s own or another’s Angers
(Finger agnosia).
• Inability to mahe the distinction between right and
leVt side o? the body.
Paracentral lobe :
• Lower limb and the perineum are represented here
• It is the highest centre ¥or micturition.
Cingulate gyrus •
• It is a part o? the limbic system.
• Connects sensory inputs to emotions.
• Emotional response to pain.
• Regulation o? aggressive behaviour.
• maternal bonding.
• Decision maKing.
Damage to cingulate gyrus »
• Patients struggle to associate certain actions with
emotions.
• Patients do not realize that their actions can hurt others.

“| 2 Cerebru QI
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Hands lips get major representation in the cor tex.
medial
Homunculus
Aphasia '•
• Disorder of language.
• Involves only dominant lobe.
• Comprehension : Stood understanding of written and
spohen language.
Broca’s area :
• motor area for speech.
• In the inferior frontal gyrus.
• Area 44, 45.
LOemiche’s area ;
In the posterior part of superior temporal gyrus.
Area aa.
Receives word as a symbol
To recognise the symbols, fibres are sent to the angular
gyrus.
After recognition, fibers are sent bach to uOemicKe’s
area
uJemiche’s and Broca’s area are connected by means
Is
of arcuate fasciculus.
• Fibres reach broca’s area Anally.
For reprtition of words : Areas aa, 44, 4S should be normal and
connected to each other.

13 03
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WHITE MATTER OF CEREBRUM
Introduction 00:00:22
3 categories
I. Association f bers : Connect areas within same
hemisphere.
a. Commissural ftbers Interconnect similar regions in both
hemispheres.
3. -
Projection f bers Connect cortical to subcortical
structures
Association fibres 00:02:09
I. Short Association fibers.

a. Long Association fibers :
Examples of lorg association ^bers :
• uncinate fasciculus connects frontal and temporal lobe.
• Cingulum ’• Present over cingulate gyrus.
• Superior longitudinal fasciculus connects the frontal lobe,
parietal lobe, and occipital lobe.
• Inferior longitudinal fasciculus connects the temporal
lobe and occipital lobe.
• Fronto-occipital fasciculus.
Superior longtudinal fasciculus
Fronto-occipital fasciculus Short association f bers
space
Active
Cingulum
Inferior longitudinal fasciculus
Uncinate fasciculus

White Matter of qc
13
Cerebrum Leave Feedba
Applied anatomy :
I. Agenesis o? corpus callosum :
• =
AICAE.OI syndrome X linked dominant disorder,
a. Spirt brain syndrome *
• The two cerebrums are not connected
• Corpus callosum is absent.
Projection fibres 00:13:36
examples :
Internal capsule.
Corona radiata.
Fornix (contains all types o? white matter).
Internal capsule :
• Projection Viber.
• Internal capsule is present between caudate nucleus and
thalamus medially.
• LentiVorm nucleus on lateral side.
Parts o? internal capsule =
I. Anterior limb (present between caudate nucleus medially
and lentiVorm nucleus laterally).
a. eênu (present between anterior limb and poster ior limb).
3. Poster ior limb (present between thalamus medially and
lentiVorm nucleus laterally).
4. £etro lentiVorm part (retro Behind). =
S. Sub-lentiVorm part (sub • Below).
Fibres passing through parts o¥ internal capsule :
motor Sensory
Anter ior limb Fronto-pontme Anterior thalamic
radiations
Posterior limb Corticospinal tract, Superior thalamic

rubrospinal tract radiations
heou Cortical nuclear fibers Super ior thalamic

radiations

Blood supply of internal capsule 00:28:03
Blood supply oV anterior limb :
Superior
(Dorsal)
ICA
Inferior
(ventral)
I. Dorsal part oV anterior limb, Qenu Posterior limb -*

Striate branches o¥ mcA (Lateral striate artery).
a. ventral part o? anterior limb -* Recurrent Artery o?
Heubner.
3. Ventral part o? eenu -* Direct branches Vrom Internal
Carotid Artery.
4. ventral part o? posterior limb Anterior Choroidal Artery.
S. RetrolentiVorm part SublentiVorm part Anterior
Choroidal Artery.
Blood supply o? posterior limb :

I. Dorsal part -* Striate branches o? mCA
(Lateral striateartery).
a. ventral part Anterior choroidal artery (branch
o? intra cerebral part o? internal carotid artery).
3. Posterior cerebral artery.
Lesion in posterior limb o? internal capsule Dense hemiplegia,
Intra-cerebral branches o? internal carotid artery ; space

• Anterior cerebral.
• middle cerebral. Active
• Anterior choroidal
• Posterior communicating.
• Ophthalmic.

14 QQ
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BASAL GANGLIA
Basal ganglia 00:00:13
Basal yanylia & a misnomer. Correctly Known as basal nuclei.

HeVers to nuclei inside the cerebrum.
Situated lateral to thalamus.
Internal capsule (1(0 divides into :
• Caudate nucleus.
• Lent i?orm nucleus.
These are connected across the anterior limb o? internal
capsule, 3'Ving a striate appearance corpus striatum.
Corpus striatum contains :

Caudate nucleus. i
LentiVorm nucleus contains 5 —Neostriatum
• Putamen.
1
• globus pallidas aha paleostr iatum/pallidum.

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01 1

Pre-embryonic period ’ First a uueehs.

Primordial germ cell 00:01:38

It Vorms -the germ cells.

male germ cell : Spermatozoa.

Primordial germ cells migrate -to yolh sac by 4th uoeeh.

Primordial germ cells are pluripotent (ability to Vorm all germ

Anatomy •v4.0 •Marrow 6.0 •2022

Primordial germ cells migrate to cvarg bg 5th weeK

Primarg oocgte will remain in Diplotene phase until pubertg.

The primarg oocgte complete meiosis I and Vorms secondarg

metaphase arrest (lasts ¥or 54 hours)

Secondarg oocgte (in the metaphase arrest) will wait Vor 54

I? there is sperm entrg : Secondarg oocgte completes 5M

Anatomy •v4.0 •Marrow 6.0 •2022

Primordial cells reaches the testis and remain in dormant:

Spermiogenesis It is the rearrangement of organelles lihe

• I primary spermatocyte will form 4 spermatids.

Differences between spermatogenesis and oogenesis :

Anatomy •v4.0 •Marrow 6.0 •2022

Occurs in ampulla o? Vallopian tube.

Zygote formation 00:06:18

Formed within ia-a4 hours o? ovulation (secondary oocyte

Anatomy •v4.0 •Marrow 6.0 •2022

At the time of formation, blastocyst contains 58 cells.

Implantation occurs in the upper part of posterior wall of

Ectopic tubal pregnancy 00:23:30

Implantation occurs in fallopian tube.

Anatomy •v4.0 •Marrow 6.0 •2022

USQ flndinq in a!^ uoeeh : Double bleb/bubble siyn.

Outer cell mass 00:06:56

6y 8^ day, trophoblast is divided into »

Anatomy •v4.0 •Marrow 6.0 •2022

Human Chorionic Gonadotropin/HCG 00:25:47

HCQ hormone assay can be done on the $rst day o? the

Anatomy •v4.0 •Marrow 6.0 •2022

gastrulation and Meurulation occur in the third uieeh oV

gastrulation formation o? germ layers)

Hypoblast being extraembryonic

Anatomy •v4.0 •Marrow 6.0 •2022

PhysoliVerous cells in chordoma :

Larye vacuolated cytoplasm with nucleus

Subdivisions of intra embryonic mesoderm 00:19:08

Anatomy •v4.0 •Marrow 6.0 •2022

(d) End o? weeh 4. embryo undercutting is complete. Somites

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Placenta is derived Vrom both mother and baby.

Types o? chorionic villi

Formed by Cytotrophoblast, Syncytiotrophoblast

Anatomy •v4.0 •Marrow 6.0 •2022

Fetus — Decidua capsularis — uterine cavity —* Decidua

Development o? placenta, and amniotic cavity

Uterine cavity becomes small due to the yrowiny Vetus.

Ultrasound signs in pregnancy 00:51:27

Ist siyn : Intra decidual siyn.

Anatomy •v4.0 •Marrow 6.0 •2022

FOLDING OF EMBRYO AND

AVter 3rd weeh o? development -* 3 germ lagers

Anatomy •v4.0 •Marrow 6.0 •2022

Features of the gut tube oo:17:oo

Foregut midgut Hindgut

Anatomy •v4.0 •Marrow 6.0 •2022