RN1/19

ANATOMY
ReWise: Notes
High yield notes of all subjects, for last minute revision

• Must know topics repeatedly asked in exams in one place

• Covers all the 19 subjects topic-wise
• Bullet points, flow charts, tables and lists for easy reading
It’s really clear that the most precious
resource we all have is time.
-Steve Jobs
So let’s use it wisely
 CONTENTS

1. ANATOMY
I Pharyngeal Arches
II Uro-genital system
III Development of Heart
IV Types of Epithelium
V Types of Joints
VI Structures Passing Through Skull Foramina
VII Muscles and Nerve Supply of Upper Limb
VIII Muscles and Nerve Supply of Lower Limb
IX Dermatomes of Upper Limb & Lower Limb
X Radial Nerve-Distribution
XI Median Nerve-Distribution
XII Ulnar Nerve-Distribution
XIII Sensory Supply of Hand
XIV Injuries to Brachial Plexus
XV Coeliac Trunk
XVI Superior Mesenteric Artery (SMA)
XVII Inferior Mesenteric Artery (IMA)
XVII Parts of Brain
RN1/19 Anatomy

ANATOMY

I. PHARYNGEAL ARCHES

From mesoderm of foregut

Initially 6 arches

Arch
Ectoderm cleft
Endodermal
pouch

A. First arch (Mandibular arch)


Meckel’s cartilage  Malleus, Incus

Bones of face - Mandible, Maxilla, Zygoma, Palatine bone and part of
temporal bone.

Mandibular nerve - Post trematic nerve.
Chordae tympani - Pre trematic nerve (From 2nd arch)

Mastication muscles, mylohyoid, ant. belly of Digastric
Tensor tympani, tensor palati, sphenomandibular ligament

Pinna
B. 2nd arch (Hyoid arch)

Stapes, stylohyoid process and ligament, smaller cornua of hyoid bone,
superior part of hyoid body (Riechert’s cartilage)

Muscles of face, occipito frontalis, platysma, post belly of digastric,
stapedius, auricular muscles

Facial nerve
C. 3rd arch

Grtr. cornua and lower body of hyoid bone

Glossopharyngeal nerve

Stylo pharyngeus muscle
D. 4th & 6th arch

Superior laryngeal N.(4th) Rec. laryngeal N.(6th)

Laryngeal cartilages and muscles.

1st ectodermal cleft  external acoustic meatus.

1
 Anatomy

Failure of closure  Congenital Coloboma

A. 1st pouch  Anterior 2/3rd of tongue,
Tubotympanic recess (Auditory tube & middle ear cavity)
B. 2nd pouch  Tonsil
Tubotympanic recess
C. 3rd pouch  Inferior parathyroid & thymus
D. 4th pouch  Superior parathyroid
E. 5th pouch  Ultimobranchial body - Fuses with 4th
Somites (Formed from paraxial mesoderm)

Somitomere 1 & 2 - Muscles supplied by Oculomotor.

Somitomere 3 - Superior oblique supplied by Trochlear.

Somitomere 4 - Muscles supplied by Mandibular.

Somitomere 5 - LR supplied by Abduscent.

Somitomere 6 - Muscles supplied by Facial nerve.

Somitomere 7 - Stylopharyngeus supplied by Glossopharyngeal.
- Occipital somites 1 & 2  Laryngeal muscles - vagus.
- Occipital somites 3 & 5  Tongue muscles - hypoglossal.
First arch syndrome  Treacher - Collins Syndrome Mandibulo facial
dysostosis

Anterior 2/3rd of tongue - 1st arch - Mandibular

Anterior 1/3rd of tongue - 3rd arch - Glossopharyngeal

Posterior most 4th arch - Superior laryngeal N.

II. URO-GENI TAL SYSTEM


From intermediate mesoderm and primitive UGS

Primitive UGS UGS

Vesico urethral canal divides into urinary bladder and primitive urethra

UGS has pelvic and phallic parts

Excretory part of kidney (Nephron)  from mesonephros (a part of
nephrogenic cord)

Collecting part of kidney (collecting tubules, calices, pelvis, ureter) 
from ureteric bud (a part of mesonephric duct)

Intermediate mesoderm Primitive UGS

Nephrogenic cord
Vesicourethral
canal
Metanephros Metanephric duct
Urinary bladder Primitive urethra
Excretory part Ureteric bud

Collecting parts

2
 Anatomy


Cloaca  Primitive UGS + Rectum

Trigone of bladder  Primitive urethra + pelvic part of UGS

Female urethra  Primitive urethra + pelvic part of UGS

Prostatic urethra  Primitive urethra + pelvic part of UGS
Post part from ureteric bud

Membraneous urethra  Pelvic part of UGS

Penile urethra  Phallic part of UGS

Prostate  Buds arising from primitive urethra and pelvic part of UGS

Para urethral glands of skene  Buds from UGS

Fallopian tubes  Unfused part of paramesonephric ducts

Uterus  Fused paramesonephric duct (Utero-vaginal canal)

Hymen  UGS

Vagina  Vaginal plate (B/n uterovaginal canal and UGS)

Upper 1/3  Uterovaginal canal

Lower 2/3  UGS

Genital tubercle  Clitoris and penis (Glans)

Genital swellings  Labia majora and scrotum

Labia minora and shaft of penis from primitive urethral folds

Genital ridge  Ovary and testes

Mullerian duct (Paramesonephric duct)
Female  Uterus and upper vagina
Fallopian tubes
Male  Appendix of testes
Utricle of prostate


Male  Appendix of epididymis

Epididymis, seminal vesicle
Vas deferens, ejaculatory duct
Female  Appendix of ovary
Gartner’s duct
Epoophoron and paraophoron

Mesonephric tubules
Male 
Female  Epoophoron and para ophoron

Gubernaculum
Male  Band B/n testes and scrotum
Female  Round ligament of ovary and uterus

Processus vaginalis
Male  Tunica vaginalis


inhibiting substance in males

Primordial germ cells  from Yolk sac endoderm

3
 Anatomy

III. DEVELOPMENT OF HEART

Bulbus cordis

Ventricle
Atrium
Sinus venosus

Dist 1/3rd  Truncus arteriosus

Bulbus cordis Mid 1/3rd  right & left ventricle
Prox 1/3rd  Primitive RV

Body  Right atrium

Sinus venosus Left horn  Regresses (taken into coronary sinus of ventricle
Right horn  Right atrium

A. Right horn

Right common cardinal vein  SVC

Right umbilical vein  Disappears

Right vitelline vein  IVC

Ventricle  Primitive left ventricle

Atrium  Right and left atrium

Foramen
SP SP SS ovale
OS

AV Jointed
cushion

B. Inter ventricular spetum


Joining of bulbar septum, AV cushion and IV septum.

Lower: end of septum secundum  CRISTA DIVIDENS

Truncus arteriosus divided by  SPIRAL SEPTUM

Right umbilical vein  Disappears in intra uterine life

Left umbilical vein  Ligament teres

Right umbilical artery prox  Superior vesical artery

Left umbilical artery distal  Medial umbilical ligament

IV. TYPES OF EPITHELIUM

A. Simple sqamous

Pericardium, pleura, peritoneum - mesothelium

Heart - endocarolium

Blood vessels and lymphatics - endothelium

Alveoli

4
 Anatomy

B. Columnar

Simple - stomach, large intestine

Striated (uniform microvilli) - small intestine

Brush bordered - GB (Gall Bladder)

Cliated - Respiratory tract, uterus, fallopian tubes, testes, middle ear,
eust tube, central canal of spinal cord, ventricles.
C. Cuboidal


surface, pigment layer of retina

D.

Eust tube, vas deferens, male urethra

Ciliated - trachea and large bronchi, nose
E.

Keratinised - skin

Non-keratinised - mouth, to tongue, tonsil pharynx, esophagus, vagina,
cornea
F. Transitional (Urothelium)

Renal pelvis, calyces, ureter

GLANDS

Unicellular - Goblet cells

Merocrine - Most glands, ordinary sweat glands

Apocrine - Atypical sweat glands, mammary gland

Holocrine - Sebaceous glands

V. TYPES OF JOINTS

Immobile (synarthroses)
- Cranial stures, 1o cartilaginous joints

Slightly movable (Amphiarthroses)
- Syndesmoses, 2o cartilaginous joints

Freely movable (Diarthroses)
- Synovial joints
Fibrous

Sutures
A. Schindylesis  A type of suture B/n rostrum of sphenoid and Ala of
vomer
B. Syndesmoses

Interosseus radio - ulnar joint



Tympano stapedial joint

B/n lacrina of adj... vertibrae
C. Gomphoses

B/n teeth and socket
5
 Anatomy

Cartilaginous
A. Primary (synchondroses) (Hyaline cartilage)

B/n epiphysis and diaphysis

1st costo sternal joint

Spheno - occipital joint

Costo - chondral joint
B. Secondary (symphysis) (Fibro cartilage)

Symphysis pubis

Symphysis menti

Manubrio sternal joint

B/n vertebral bodies (IV disc)

Sacro coccygeal joint
Synovial
A. Plane

Intercarpel, intertarsal, inter metacarpel, inter metatarsal, joint B/n
articular surface of vertebrae
B. Hinge (Ginglymus)

Elbow joint, IP joint, knee joint, ankle joint
C. Pivot (Trochoid)

Atlanto arcial joint (‘No’ joint)

Superior & interior radio-ulnar joint
D. Condylar

TM joint, knee joint
E. Ellipsoidal

Wrist, MP joint, atlanto occipital joint (‘Yes’ joint)
F. Saddle

1st carpo metacarpal joint, calcanea cuboid

Stenuoclari joint, incudomalleolar joint
G. Ball and socket - shoulder, hip

VI. STRUCTURES PASSING THROUGH SKULL FORAMEN

A. Optic canal

Optic N., Ophthalmic artery
B. Infra orbital groove and foramen

Infra orbital nerve (brachial of maximum) and vessels
C. Foramen ovale (MALE)

Mandibular nerve

Accessory meningeal artery

Emissary veins

Lesser petrasal N. (If no canaliculus innominatus)
D. Foramen spinosum (MEN)

Meningeal braches of mandibular nerve

Middle meningeal artery

Emissary veins
6
 Anatomy

E. Carotid canal and foramen lacerum


ICA

Symptoms plexus around ICA - Partially traversing

Venous plexus - Partially traversing

Deep petrosal nerve - Partially traversing

Gtr petrosal nerve - Partially traversing

Nerve of pterygoid canal - Partially traversing

Meningeal branch of ascending pharyngeal artery

Emissary veins
F. Jugular foramen

Inferior petrosal sinus  Anterior

IX, X, XI cranial nerves  Middle

Meningeal branches of ascending pharyngeal artery  Middle

Inferior jugular vein and sigmoid sinus  Posterior

Meningeal branch of occipital artery  Posterior

Emissary vein  Posterior
G. Foramen magnum

Lower end of medulla meninges.

Anterior and posterior spinal artery

Lower end of cerebellar tonsil

Vertebral artery

Spinal accessary nerve

Apical part of dens
Cruciform lig and membrane tectoria
H. Stylomastoid foramen

Facial nerve

Styloniastoid brachial of posterior auricular artery
I. Foramen rotundum

Maxillary nerve
J. Internal accoustic meatus

Facial nerve and nervus intermedius

Auditory nerve

Labrinthine vessels
K. Mastoid foramen

Emissary veins B/n occipital veins and cavernous sinus
L.

Occulomotor, trochlear, abducent

Frontal and lacrimal brachial of ophthalmic N.

Superior and inferior ophthalmic veins.

Branchial of ophthalmic artery

Nasociliary nerve (Brachial of ophthalmic N.)
M.

Zygomatic nerve

Maxillary nerve
7
 Anatomy

VII. MUSCLES AND NERVE SUPPLY OF UPPER LIMB


Deltoid  Axillary nerve

Coracobrachialis  Musculo cutaneous

Biceps  Musculocutaneus

Brachialis  Musculocutaneus and radial (proprioceptive)

Triceps  Radial nerve

Anconeus  Radial nerve

Lateral half of FDP  Anterior interosseus nerve (Brachial of median
nerve)

FPL  Anterior interosseus nerve (Brach of median nerve)

Pronator quadratus  Anterior interosseus nerve (Brach of median nerve)

Medial half of FDP  Ulnar nerve

Flexor carpi ulnaris  Ulnar nerve

FDS  Median nerve

Palmaris longus  Median nerve

Flexor carpi radialis  Median nerve

Extensor compartment  Posterior interosseus N.Brach of )


- Abductor pollicis  median nerve

- Flexor pollicis  median nerve
- Opponens pollicis  median nerve

1st & 2nd lumbricals - Median nerve
-  Adductor pollicis
- Hypothenar  Adductor digiti minimi
- Hypothenar  Flexor digiti minimi Ulnar nerve
- Opponens digiti minimi
- Palmaris bravis

VIII. MUSCLES AND NERVE SUPPLY OF LOWER LIMB

A. Muscles of anterior compartment / extensor compartment of thigh

Sartorius: Nerve supply is femoral nerve

Quadriceps femoris
- Rectus femoris
- Vastus lateralis Nerve supply is femoral nerve
- Vastus medialis
- Vastus intermedius

Articularis genu: Nerve supply is femoral nerve
B. Medial / adductor compartment of thigh

Adductor longus

Adductor brevis

Adductor magnus (adductor part) Nerve supply is obturator nerve

Gracilis


C. Posterior compartment of thigh

8
 Anatomy


Semitendinosus

Semimembranosus Sciatic nerve

Biceps femoris

Hamstring part of adductor magnus
D. Gluteal region

Gluteus maximus  Inferior gluteal nerve

Gluteus medius

Gluteus minimus Superior gluteal nerve

Tensor fasciae lata

Obturator internus
Nerve to obturator internus

Superior gamellus

Quadratus femoris
Nerve to quadratus femoris

Inferior gamellus

Obturator externus  Posterior division of obturator nerve

Piriformis  Ventral rami of S1S2
E. Ilias region

Iliacus: L2 & L3 spinal nerves
Flexors of hip

Psoas: L2 & L3 spinal nerves
F. Anterior / extensor compartment of leg

Tibialis anterior

EHL, EDL, EDB Deep peroneal nerve

Peronius tertius
G. Lateral / peroneal compartment of leg

Peroneus longus

Peroneus brevis
H.

Gastrocnemius

Soleus

Plantaris

Popliteus Tibial nerve

FDL, FHL

Tibialis posterior

IX. DERMATOMES OF UL & LL

(Refer colour plate)

X. RADIAL NERVE - DISTRIBUTION

A. In axilla

Posterior cutaneous nerve of arm

Long head of triceps

Medial head of triceps
B. In radial groove

Lateral head of triceps

Lower lateral cutaneous nerve of arm

9
 Anatomy


Posterior cutaneous nerve of forearm

Medial head of triceps

Anconeus
C. Lower lateral side of arm



Brachioradialis

ECRL
D. Deep branch (posterior interosseous nerve)

ECRB

Supinator

All muscles of extensor compartment of forearm
E.


(Refer colour plate)

XI. MEDIAN NERVE - DISTRIBUTION

A. In lower part of arm

Pronator teres
B. Cubital fossa

FCR, FDS

Palmaris longus
C. In forearm (Anterior interosseous nerve)

Lateral half of FDP

FDL

Pronator quadratus

Palmar cutaneous branch
D. In palm

 Abductor pollicis brevis
Flexor pollicis brevis
Opponens pollicis

1st & 2nd lumbricals

Cutaneous digital branches
(Refer colour plate)

XII. ULNAR NERVE - DISTRIBUTION

A. In forearm

Medial half of FDP

FCU

Cutaneous branches
B. In hand

Palmaris brevis

Hypothenar eminance

Adductor pollicis

Medial 2 lumbricals

10
 Anatomy


Palmar & dorsal interossei

XIII. SENSORY SUPPLY OF HAND

A. Insert diagram

Fig. No.A1-5

XIV. INJURIES TO BRACHIAL PIEXUS

A. Klumpke’s paralysis

Injury to lower trunk (C8-T1)

Mechanism - Undue hyperabduction
- Catching a tree while falling from height
- Pulling hand during delivery

Clinical features
- Complete claw hand
- Loss of sensation over medial side of arm and foream
B. Erb’s paralysis

Injury to upper trunk (C5-C6)

Posture of paralysed limb
- Shoulder adducted and internally rotated
- Elbow extended
-
- Forearm pronated
- Loss of supinator and biceps jerk
C. Erb’s point

6 nerves meet
- Ventral rami of C5 and C6
- Anterior and posterior division of upper trunk
- Suprascapular nerve
- Nerve to subclavius
Some important facts
A. All muscles of ‘tongue’ are supplied by ‘Hypoglossal nerve’ except
‘Palatoglossue’ which is supplied by ‘Pharyngeal plexus’.
B. All muscles of ‘soft palate’ are supplied by pharyngeal plexus except
‘Tensor veli palati’ which is supplied by mandibular nerve.
C. All muscles of ‘Pharynx’ are supplied by ‘Pharyngeal plexus’ except
‘Stylopharyngeus’ which is supplied by ‘Glossopharyngeal nerve’.
D. All muscles of ‘Larynx’ are supplied by ‘Recurrent laryngeal nerve’ except
‘Cricothyroid’ which is supplied by ‘External laryngeal nerve’.
E. Safety muscle of tongue is ‘Genioglossus’.
F. Safety muscle of larynx is ‘Posterior Cricoarytenoid’.
(Refer colour plate)

XV. COELIAC TRUNK



11
 Anatomy


Arises from anterior aspect of aorta at the level of T12-L1 junction.

It has 3 terminal branches.
A. Left gastric artery

Smallest of 3 branches

Branches
- 2-3 esophageal branches.
- Numerous gastric branches.
B. Common hepatic artery

Branches are:

- Right gastro epiploic artery

- Superior pancreaticoduodenal artery

- Right gastric artery

- Left hepatic artery
-
C. Splenic artery

Largest branch of coeliac trunk

Branches
- Numerous pancreatic branches - Largest is called arteria pancreatica
magna
- 5-7 short gastric branches
- Left gastroepiploic artery
- Splenic branches
(Refer colour plate)

XVI. SUPERIOR MESENTRIC ARTERY (SMA)




Branches
- Inferior pancreaticoduodenal artery
- Middle colic artery
- Right colic artery
- Ileocolic artery
- Jejunal and ileal branches
(Refer colour plate)

XVII. INFERIOR MESENTRIC ARTERY (IMA)




Branches
- Left colic artery
- Sigmoid arteries
- Superior rectal artery
(Refer colour plate)

12
 Anatomy

XVIII. PARTS OF BRAIN

A. Prosencephalon

Telencephalon - cerebrum (cavity is lateral ventricle)


(cavity is 3rd ventricle)

B. Mesencephalon - Midbrain (cavity is cerebral aqueduct)
C. Rhombencephalon

Metencephalon - Pons, cerebellum (cavity is 4th ventricle)

Myelencephalon - Medulla, spinal corel (cavity is central canal)
EXTRAMILES
A. Branches of IIA

Anterior division
- Superior vesical
- Inferior vesical
- Obturator
- Middle rectal
- Inferior gluteal
- Internal pudental

Posterior division
- Iliolumbar
- Lateral sacral
- Superior gluteal
Pubovaginalis
B. Pelvic diaphragm Pubococcygeus

Levator ani Puborectalic
Iliococcygeus

Coccygeus
C. Perineal body

10 muscles attached
-
- 2 deep transverse perineii
- 2 pubococcygens
- 2 bulbospongiosus
- Sphincter ani externus
- Fibres of longitudinal muscle coat of anal canal
D. Denonviller’s fascia

B/n rectum and prostate (in front of rectum)
E. Waldeyer’s fascia

B/n rectum and coccyx (behind rectum)
F. Urogenital diaphragm

Deep transverse perinei (2)

External urethral sphincter
G. Perineum


-
13
 Anatomy

- Deep membrane layer - Colle’s fascia


Deep fascia
- Superior layer
- Lines superior and inferior surfaces of urogenital diaphragm
- Inferior layer - Perineal membrane
H. Greater sciatic foramen

Superior gluteal nerve and vessels

Inferior gluteal nerve and vessels

Sciatic nerve

Posterior cutaneous nerve of thigh

Nerve to obturator internus

Nerve to quadratus femoris

Pudental nerve

Internal pudental vessels
I. Lesser sciatic foramen (PIN)

Pudental nerve

Internal pudental vessels

Nerve to obturator internus

14
Ace MBBS, NEET PG/NEXT, FMGE

www.docemy.com