Head Neck and Face

ª GSE : General Somatic Efferent

Efferent ª SVE

ª GVE Ú GSE

VII, IX, X III

ª GVA ÚGVE

Afferent ª SVA

ª GSA

ª SSA : Special Somatic Afferent

PARASYMPATHETIC GANGLION 06:40

1. Ciliary Ganglion VI
2. Pterygopalatine VII
Ganglion
3. Otic Ganglion IX
4. Submandibular X
Ganglion

EWN Short Cilliary Nerve

(Mid Sphincter Pupillae
Brain) Cilliaris Muscle

Best Discount
Superior
code for All
Salivatory
Nucleus Course of
(Pons) eGurukul/
DBMCI is
Inferior Salivatory Nucleus (Pons). KUCH40

1
 DEEP CERVICAL FASCIA 0:4

Pre Tracheal Fascia à

• Forms false capsule of Thyroid Best Discount
• Ligament of Berry – modification of Pre tracheal Fascia. code for All Co
• In lower part it merges with fibrous pericardium urse of eGuru
kul/DBMCI is K
Pre Vertebral Fascia à Once the Brachial Plexus, pushes the sheath into axilla UCH40
â
Forms AXILLARY SHEATH

2
 Investing layer: Covers Trapezius & Stenocleidomastoid
Lower part divides & form Suprasternal space
Carotid Sheath: Contributed by all 3 Fascia (IL+PTL+PVL)
Common Carotid Artery
Internal Carotid Artery Contents
Internal Jugular Vein
Vagus Nerve

Cervical Spinal Nerves comes out b/w Scalenus Anterior & Medius
â
Forms Branchial Plexus
• Phrenic Nerve: Nerve in front of SA & behind PVL
• Sympathetic Chain: Nerve in front of PVL & behind Carotid Sheath
• Recurrent Laryngeal Nerve: Between Tracheoesophageal Groove
1. Buccopharyngeal Fascia: Covers Buccinator Ms also
2. Alar Fascia: Not seen radiologically
3. Prevertebral Fascia

Best Discount
code for All Co
urse of eGuru
kul/DBMCI is K
UCH40

3
INVESTING LAYER – follows Rule of 2

• 2 Ms à SCM & Trapezius

• 2 Gland à Parotid & Submandibular

• 2 Spaces à Suprasternal & Supraclavicular Space

• 2 Ligaments à Stylomandibular & Sphenomandibular ligament

• 2 Pulleys à Digastric & Omohyoid muscles

Dural venous sinuses 4 :

Dural folds à • Falx Cerebri

• Falx Cerebelli
• Tentorium Cerebelli
• Diaphragma Sellae

Sigmoid Sinus
+ Internal Jugular Vein
Inferior Petrosal Sinus

4
Incoming Channels of Outgoing channels of Cavernous
Cavernous Sinus • Superior Petrosal Sinus
• Inferior Petrosal Sinus
From Orbit Superior Ophthalmic Vein
• Superior & Inferior ophthalmic vein â
• Central vein of Retina It’s an emissary vein that is without valve

From Brain
• Superficial Middle Cerebral vein
• Inferior Cerebral vein

Best Discount
From Meninges
• Sphenoparietal Sinus code for All
• Middle Meningeal Sinus Course of
eGurukul/
Relations of cavernous sinus :
DBMCI is
KUCH40

• Anteriorly : Superior Orbital Fissure

• Posteriorly : Apex of Petrous temporal bone

5
 MUSCLES OF MASTICATION 6 : 0

TEMPORALIS

Function: Elevation of Mandible

Retraction of Mandible

Insertion: Coronoid process of Mandible

Origin: Temporalis fossa

MASSETER
Function : Elevation
Protraction

Best Discount
code for All
Course of
eGurukul/
Medial Pterygoid
Functions : Elevation + Protraction
DBMCI is
Lateral Pterygoid
2 belly: Superior head
KUCH40
Inferior head

Insertion: Pterygoid Fovea (Neck of

Mandible)

Action : Protraction & Depression

(Main) (Only muscle)

# Medial Pterygoid : Only muscle of mastication supplied by Trunk of V3 nerve

Remaining muscle are supplied by Anterior division of Mandibular nerve

6
 Muscles of pharynx : 0

• Structures passing Superior & Middle constrictor: Stylopharyngeus & IX nerve

• Structures piercing Thyrohyoid membrane (between Middle & Inferior Constrictor)
a) Nerve: Internal Laryngeal Nerve Supply above vocal cord
b) Vessel: Superior Laryngeal vessel
• Structures below Inferior constrictor (In trachea – esophageal groove)
1) Inferior Laryngeal Vessel Supply below vocal cord
2) Recurrent Laryngeal Nerve
Best Discount
Pharyngobasilar Fascia / Sinus of Morgagni
code for All
• Space between Base of skull & Superior constrictor
Course of
• Present inside the Pharyngeal muscles.
eGurukul/
(1) Auditory Tube
(2) Levator Velli Pallatini DBMCI is
(3) Ascending Palatine Artery KUCH40
(4) Palatine branch of Ascending Pharyngeal Artery

Killian’s Dehiscence: • Zone of weakness present between TP & CP

• It’s site for Zenker’s Diverticulum
Upper border of SC
+ PASSAVANT’S RIDGE
Palatopharyngeus

7
Larynx 94:50

MUSCLES OF LARYNX

Posterior Cricoarytenoid m/s Only Abductor of vocal cord. ?

(Safety Muscle of larynx)

During whispering : Lateral Cricoarytenoid adduct vocal cords

â
But there is a space between 2 Arytenoid Cartilage
â
Air can pass through.

INTER ARYTENOID MUSCLE

Adduction of vocal cord + Adduction of Arytenoid
â
Complete closure of Rima Glottidis

8
 THYROARYTENOID MUSCLE
• From inner surface of Thyroid cartilage to Lateral surface of Arytenoid.
• Relaxation of Vocal Cord

VOCALIS MUSCLE
• Medial to Thyroarytenoid – (It’s a modification)
• In Anterior 1/3rd attached to Vocal cord à Causes Tension of Vocal cord
• In Posterior 2/3rd not attached to Vocal cord à Causes Relaxation of Vocal cord
â
\ Called as MODULATOR OF LARYNX
CRICOTHYROID à Supplied by External Laryngeal Nerve
• Only intrinsic muscle of larynx seen outside

• Contraction à Bend Thyroid forward

â
Tension of Vocal cord à TUNING FORK OF LARYNX

Best Discount
code for All Co
urse of eGuru
kul/DBMCI is K
UCH40

Aryepiglotticus
• Modification of Oblique Arytenoid
• Closes inlet of Larynx

9
Cranial Cavity 117:10

Best Discount
code for All
Course of
eGurukul/
DBMCI is
•
•
OPTIC CANAL:- Optic Nerve + Ophthalmic Artery
SUPERIOR ORBITAL FISSURE:- III, IV, V2, VI
KUCH40
Meningeal branch of Lacrimal artery
Superior & Inferior Ophthalmic vein
• FORAMEN OVALE: Mandibular Nerve
Accessory Meningeal Artery
Lesser Petrosal Nerve
Emissary Vein
• FORAMEN SPINOSUM: Middle meningeal Artery + Nervus Spinosum (V3)
• FORAMEN LACERUM: ICA + Sympathetic plexus + Greater Petrosal Nerve
• INTERNAL AUDITORY CANAL: VI + VII + Labyrinthine Artery (Branch of AICA)
• JUGULAR FORAMEN: IX + X + XI
Inferior Petrosal Sinus
Sigmoid Sinus
• HYPOGLOSSAL CANAL: Hypoglossal Nerve

10
TRIANGLES OF NECK :00

Best Discount code

GREAT AURICULAR NERVE
for All Course of
• C2-C3
eGurukul/DBMCI is
•
•
Runs with External Jugular Vein
Supplies Lobule of Ear KUCH40
• Angle of Mandible Skin
• Lower Parotid region
• In Frey’s Syndrome, the regenerating Auriculotemporal nerve accidently fuse with
Great Auricular Nerve > Buccal Nerve > Lesser Occipital Nerve
(MC) (Supplies behind ear)

SPINAL ACCESSORY NERVE

• Supplies SCM & Trapezius.
• Injury to SAN in Post Triangle à SCM Spared.

Involved Trapezius
â
• Difficult in Shrugging of Shoulder
• Middle fibres à Difficulty in retraction of Scapula
• T2+ Serratus Ant à Difficulty in overhead Abduction
• Mild Winging of Scapula

11
 Embryology

Paraxial Mesoderm à Somites:

• Formed between D20-D30 (aka Somite Period)
• Primitive Somites : 42-44 pairs
â
Definitive Somites : 36-38 pair

Best Discount
code for All
Course of
eGurukul/DBMCI
is KUCH40

Lateral Plate Mesoderm

Somatopleuric LPM Splanchnopleuric LPM

(1) All Parietal Layers (1) All visceral layers
(2) Dermis of front, Limbs (2) Smooth muscles
(3) Appendicular Skeleton +
Cardiac muscle @ the cranial end

1
 Exceptions of Smooth muscle derived from Splanchnopleuric LPM
i. Papillary Muscles – from Neuroectoderm
ii. Cilliaris Muscles – from Neural Crest Cells (NCC)
iii. Sm of Ascending Aorta, PT & Coronary Artery – from NCC
iv. Sm of Sweat gland, Mammary gland, Myoepithelial Cells – from Surface Ectoderm

SEPTUM TRANSVERSUM

• Undifferentiated LPM @ the cranial end of embryo

• Most cranial structure in the embryonic plate before foldings
• Derivatives:- Central Tendon of Diaphragm
• Fibrous pericardium
• Liver stroma including Kupffer cells
• Ventral Mesogastrium à Lesser omentum

Best Discount code

Development of Diaphragm 26:37
for All Course of
DIAPHRAGM DEVELOPMENT
eGurukul/DBMCI is
A – Body wall mesoderm Muscular part
B – Dorsal mesentery of Oesophagus Crura
KUCH40
C – Septum transversum Central Tendon
D – Pleuroperitoneal membrane
Incorporated by muscles

Failure of muscle tissue

to develop inside
Evertration of Diaphragm
• Similar to CDH
• Not a True Hernia
Persistence of Pleuroperitoneal canal
â
2
 Bochdalek foramen
â
Congenital Diaphragmatic Hernia
• Common on left side
• Complication à left lung
Hypoplasia

Pharyngeal arches 3 :2

MESODERM
1st Arch: Meckel’s Cartilage à Malleus & Incus
2nd Arch: Stapes + Styloid Process + Stylohyoid ligament + Lesser horn of hyoid & upper body
â
Except Foot plate – from Otic Capsule
3rd Arch : Lower body & Greater horn of hyoid
4th Arch Laryngeal cartilages
6 Arch
th

3
Development of face & palate : 3

FACE DEVELOPMENT

i. Mandibular Process from Ist Arch

ii. Frontonasal Process

• Lower Lip à Mandibular Process A. Non fusion of both MNP à Midline

• Upper Lip à Maxillary Process + MNP Cleft Upper Lip
• Ala of Nose à LNP B. Non fusion of MNP with maxillary
Process à Unilateral Cleft Lip
C. Maxillary Process fails to fuse with
LNP à Oblique Facial cleft (No NLD)

Best Discount code

for All Course of
eGurukul/DBMCI is
KUCH40

4
 Limbs
Brachial plexus 00:10

BRANCHES FROM ROOTS

i. Dorsal Scapular Nerve à Levator Scapulae
Rhomboides Major & Minor
ii. Long Thoracic Nerve à Serratus Anterior à # Winging of Scapula

BRANCHES FROM TRUNK (UPPER TRUNK)

i. Supra Scapular Nerve à • Supraspinatus (0-15° of Abduction of shoulder)
• Infraspinatus
ii. Nerve to Subclavius à Subclavius Muscle
< Accessory Phrenic nerve joins with Phrenic Nerve

BRANCHES FROM CORDS

A) LATERAL CORD
• Lateral Root of Median Nerve
• Musculocutaneous Nerve à Biceps, Brachialis, Coracobrachialis
Skin of Lateral forearm – Lateral cutaneous Nerve of forearm
• Lateral Pectoral Nv. à Pierces Clavipectoral Fascia
â
Supply Pectoralis Major

1
B) POSTERIOR CORD
• Upper subscapular nerve à Subscapularis
• Lower subscapular nerve à Subscapularis + Teres major
• Nerve to Lattismus dorsi
• Axillary Nerve à Deltoid, Teres Minor
• Radial Nerve

C) MEDIAL CORD
• Medial Root of Median Nerve
• Medial Pectoral Nerve à Pectoralis minor & Pectoralis major
• Medial cutaneous Nerve of arm
• Medial cutaneous Nerve of forearm
• Ulnar Nerve

ERB S PALSY
- Injury to Upper trunk \ Spared in Erb’s
â
Root Nerve involved à C5 + C6 Corachobrachialis

â â
Axillary Nerve C5-C6 Musculocutaneous Nerve C5C6C7
DELTOID BICEPS & BRACHIALIS
â# â#
Adduction Extended Elbow
+
Pronated forearm

POLCIE MAN’S TIP HAND

KLUMPKE S PALSY
Injury to Lower Trunk à C8-T1 involved
â Median Nerve & Ulnar Nerve
Intrinsic Muscle of Hand
(Lumbricals & Interossei)
â#
Hyper extension of MCP & Flexion of IP joint } CLAW HAND

T1 # Sympathetic Loss of face à HORNER’S SYNDROME

2
SCAPULAR ANASTOMOSIS 30:17

• Anastomosis between 1st part of Subclavian Artery & 3rd part of Axillary Artery

Clavipectoral fascia 37:08

3
• Structures enclosed à
o Subclavius
o Pectoralis Minor
• Continued as à Suspensory ligament of Axilla
• Structures piercing
i. Vein à Cephalic Vein
ii. Artery à Thoracoacromial Trunk
iii. Nerve à Lateral Pectoral Nerve
iv. Lymphatics à going to Apical L.N

Osteology of ul :00

Hand-flexor retinaculum 0:38

SUPERFICIAL RELATIONS:

Best Discount code

for All Course of
eGurukul/DBMCI is
NOTE:- • Ulnar artery forms à Superficial Palmar Arch
• Radial artery forms à Deep Palmar Arch
KUCH40
4
 Muscles of Hand 7:

THENAR MUSCLES

i. Abductor Pollicis Brevis Median Nerve

ii. Flexor Pollicis Brevis
iii. Opponens Pollicis
- Deep muscle
- Only thenar muscle attached to 1st Metacarpal
Rest are attached to Phalanges
â
\ Can Rotate MC
# of MC à Benet’s #
â
Opposition of thumb impaired Best Discount code
iv. Adductor Pollicis aka Graveyard of Ulnar Nerve for All Course of
Only Thenar muscle supplied by Ulnar Nerve (Supply at the last) eGurukul/DBMCI is
KUCH40

5
HYPOTHENAR MUSCLE
i. Abductor Digiti minimi
ii. Flexor Digiti minimi
iii. Opponens Digiti minimi – Deeply placed Ulnar Nerve
- Only hypothenar attached to 5th MC
â
\ Opposition movement.
iv. Palmaris Brevis – Subcutaneous muscle

Lumbricals (4) Origin : Flexor Digitorum Profundus

L1 Unipinnate à Median
L2 Nerve Flexion of MCP joint
L3 Extension of IP joint
Bipinnate à Ulnar Nerve
L4

INTEROSSEI à Supplied by Ulnar Nerve

PALMAR INTER. DORSAL INTER.

• Unippinate • Bippinate
• Adduction • Abduction Best Discount code
• Middle finger devoid of P.I • D.I absent on Thumb & Little finger for All Course of
• CARD TEST used • Middle finger – double D.I eGurukul/DBMCI is
KUCH40

6
Nerve Injuries 7 :30

RADIAL NERVE

(A) à In Axilla [CRUTCH PALSY]

• FLEXED ELBOW
• WRIST DROP
• FINGER DROP
• SENSORY LOSS ON DORSUM OF HAND
(B) à In Spiral Groove [SATURDAY NIGHT PALSY]
• WEAKNESS IN ELBOW EXTENSION
• WRIST DROP
• FINGER DROP
• SENSORY LOSS ON DORSUM OF HAND
(C) à In Front of Lateral Epicondyle # Best Discount code
• # NO WRIST DROP
for All Course of
• FINGER DROP
• SENSORY LOSS ON DORSUM OF HAND eGurukul/DBMCI is
(D) à PIN Injury [RADIAL HEAD #] KUCH40
• # NO WRIST DROP
• FINGER DROP
• # NO SENSORY LOSS
7
MEDIAN NERVE 0:00

INJURIES
(A) à HIGHER INJURY SUPRACONDYLAR #
• APE THUMB DEFORMITY (d/t Opponens pollicis)
• FDS & Lateral ½ of FDP #
• POINTING INDEX FINGER (while making Fist)
(B) à LOWER INJURY CARPAL TUNNEL SYNDROME
• APE THUMB DEFORMITY
• NO POINTING INDEX FINGER
• As palmar cutaneous branch is spared
• Sensory loss is seen only on fingers & not on palms
(C) Anterior Interosseous Nerve Injury
• Inability to flex distal IP joint of index finger & IP joint of Thumb
â
Collapsed ‘OK’ Sign

Best Discount code

for All Course of
eGurukul/DBMCI is
KUCH40

8
ULNAR NV 107:38

ULNAR PARADOX à due to FDP muscle.

Higher # à Less severe claw hand (Distal IP can’t flex due to FDP)
Lower # à More severe claw hand

Posterior Abdominal wall 11 :

Best Discount code

for All Course of
POSTERIOR RELATIONS OF KIDNEY
eGurukul/DBMCI is
à Psoas Major + Quadratus Lumborum + Transverse Abdominis KUCH40
à Subcostal Nerve + Ileohypogastric + Ileoinguinal Nerve
9
 Upper end of femur 1 : 0

ANTERIOR VIEW POSTERIOR VIEW

Gluteus Minimus à
• Supplied by Superior Gluteal Nerve
• Fx: Medial / Internal Rotation of Thigh
• Insertion: Anterior surface of Greater Trochanter

Gluteus Medius à
• Supplied by Superior Gluteal Nerve
• Fx: Abduction @ Hip Joint
• Insertion: Lateral Surface of Greater Trochanter
• TEST: Trendelenburg Test

Gluteus Maximus à
Best Discount code
• Supplied by Inferior Gluteal Nerve
for All Course of
• Fx: Extention of Hip joint
eGurukul/DBMCI is
• Insertion: Gluteal Tuberosity KUCH40

Ileopsoas Muscle à • Insertion: Lesser trochanter

Pectineus Muscle à • Insertion: Pectineal line

10
 • Pudental Nerve Coming from Greater
• Interior Pudental Vessels Sciatic notch to lesser
• Nerve to Obturator Internus Sciatic notch

Greater Sciatic Notch Lesser Sciatic Notch

• Muscles : Piriformis • Obturator Internus
• Superior Gluteal nerve & • Pudental nerve
vessels • Internal pudental vessels
• Inferior Gluteal nerve & vessels • Nerve to Obturator Internus
• Sciatic Nerve
• Posterior Cutaneous Nerve of \ In Pudental block
thigh â
• Pudental nerve We give at Ischial spine
• Internal pudental vessels
• Nerve to Obturator Internus

Best Discount code

for All Course of
eGurukul/DBMCI is
KUCH40

11
Foot 1 :3

ARCHES OF FOOT

• Phalanges never participate in Arch formation.

NOTE: • Medial Cuneiform à LARGEST

• Intermediate Cuneiform à SHORTEST
• 2nd Metatarsal à LONGEST \ Easily fracture
Talocalcaneonavicular Joint à Main joint for Medial Arch
(Ball & Socket Joint) Supported by SPRING Ligament Best Discount code
Calcaneocuboid Joint à Main joint for Lateral Arch for All Course of
(Saddle Joint) Supported by Short & Long Plantar Ligament eGurukul/DBMCI is
TALUS is the summit for Medial Arch KUCH40
CALCANEUM is the summit for Lateral Arch
SLINGS

i. Medial arch à INVERTORS ii. Lateral Arch à EVERTORS

• Tibialis Anterior • Peroneus longus
• Tibialis Posterior • Peroneus brevis
• Flexor Digitorum Longus

12
 Lower Limb- Cadaveric Images Discussion
Anterior compartment of thigh 00:10

Contents of femoral triangle 05:50

Best Discount code

for All Course of
eGurukul/DBMCI is
KUCH40

1
Adductor muscle 0 : 0

AFTER REMOVAL OF ADDUCTOR BREVIS & LONGUS Best Discount code

for All Course of
eGurukul/DBMCI is
KUCH40

2
Medial compartment of thigh 1 :

Gluteal region 1 :1

3
 NERVES & VESSELS

SUPERIOR GLUTEAL NERVE Supplies

• GLUTEUS MEDIUS
• GLUTEUS MINIMUS
• TENSOR FASCIA LATA

SCIATIC NERVE & IT’S RELATIONS

4
A STRIN CO ART ENT

O LITEAL OSSA

Best Discount code

for All Course of
eGurukul/DBMCI is
KUCH40
5
Posterior compartment of leg :

6
Flexor retinaculum : 0

OOT

7
 1st layer of sole

Best Discount code

for All Course of
eGurukul/DBMCI is
KUCH40

2nd layer of sole (2 tendons + 2 muscles)

8
3rd layer of sole (3 muscles)

Interossei

9
2nd DIGIT has 2 DORSAL INTEROSSEI GREAT TOE and LAST TOE are Devoid of INTEROSSEI

ANTERIOR COMPARTMENT OF LEG 5: 5

10
DORSUM OF FOOT :10

11
 Neuro anatomy
Tracts 00:10
ASCENDING TRACTS

DESCENDING TRACTS

Best Discount code

for All Course of
eGurukul/DBMCI is
KUCH40
1
S IN T A A IC TRACT

D RSA C N TRACT

2
S IN CERE E AR TRACT

RA IDA TRACTS

3
 R N SE ERD S NDR E
Spinothalamic Tract Dorsal Column Tract Pyramidal Tract

• I/L loss of Pain, • I/L loss of Conc. • I/L Flaccid paralysis at

temperature, Crude propioception the level of lesion
Touch & Pressure at the Fine touch, • I/L Spastic paralysis
Vibration, below the level of
level of lesion
Steriognosis at lesion
• C/L loss of Pain,
& below the
temperature, crude touch level of lesion.
& Pressure below the
level of lesion.

Brian stem :

4
 INTER ED NC AR SSA
• Contents:-
1. Infundibulum & Tuber cinerum
2. Mammilary body
3. III nerve
4. Post Perforating substance : Grey matter area perforated by Posterior Cerebral
artery.

• Ant Perforating Substance

• Outside interpeduncular fossa
• Perforated by ACA & MCA

Nucleus present in floor of IVt h Ventricle

i. VIII Nucleus
ii. VI Nucleus # to Facial Colliculs à LMN of VI Nerve
iii. XII Nucleus
iv. X Nucleus

Best Discount code

for All Course of
eGurukul/DBMCI is
KUCH40
5
 Lateral Lemniscus (Auditory pathway)
à # C/L Hearing Loss

Spinal Lemniscus à # C/L loss of

Pain & temperature from body
Trigeminal Lemniscus à # C/L loss
of Pain & temperature from face

Medial Lemniscus à # Loss of

Conscious proprioception, TOUCH,
Vibration, Pressure, Stereognosis.

Syndromes :

Benedict’s Syndrome Weber’s Syndrome

• # ML à C/L Loss of conscious • # III nv:
Proprioception Touch, Vibration • I/L Ptosis
Stereognosis • I/L Divergent Squint
• # SL à C/L Loss of Pain & Temp (Body) • Loss of Light & accommodation
• # TL à C/L Loss of Pain & Temp (face) reflux
• # III nerve à • I/L Ptosis • # UMN of VIII nerve
• I/L Divergent Squint • C/L Paralysis of Lower face
• Loss of Light & • # Pyramidal Tract
accommodation Reflux • C/L Hemiplegia
6
Millard Gubler’s Syndrome Ponto Cerebellar angle Syndrome (Acoustic
Neuroma)
• VI nerve : I/L Medial squint • VIIth nerve # à I/L Facial Paralysis
• VIII nerve # : I/L Facial Paralysis • VIIIth nerve # à I/L Progressive
• Pyramidal Tract # : C/L Hemiplegia deafness
• Aka Abduscent Alternative • MCP / ICP # à I/L Ataxia
Hemiplegia

7
 Medial Medullary Syndrome Lateral Medullary Syndrome
• ML # à C/L loss Conscious • Aka Wallenberg Syndrome
proprioception Touch, Vibration, • ICP # : I/L Ataxia
Stereognosis • Vest. Nu # : Vertigo, Vomiting
• XII nerve # à I/L Tongue paralysis • Nu. Ambigus : I/L Bulbar Paralysis.
• Pyramid # à C/L Hemiplegia (IX, X, XI)
• Spinal Lemniscus : C/L Loss of Pain &
temp (body)
• Spinal Nu of VI nv : I/L Loss of Pain &
temp (face)

Cerebellum 11 :

IST G
i. Molecular Layer
9 Stellate cells à inhibitory cells
9 Basket cell à inhibitory cells
ii. Purkinje Layer : Large flask shaped cells à inhibitory cells
• Only cells forming efferent from cortex
Efferent out of cerebellum.
• Project to the nuclei – Deep cerebellar nuclei in white matter
• Dentate Nu. – Largest – Nu of Neocerebellum
• Emboliform Nucleus
• Fastigial Nucleus
• Globose Nucleus
iii. Granular Layer
9 Granule cells à excitatory cells
9 Golgi Cells à inhibitory cells

Best Discount code

for All Course of
eGurukul/DBMCI is
KUCH40
8
 • Middle cerebellar Peduncle à • Largest Peduncle
• Purely Afferent

Sagittal section 1 : 1

RD
ENTRIC E

Best Discount code

for All Course of
eGurukul/DBMCI is
KUCH40

9
Transverse section 1 : 0

C R NA SECTI N

10
 ATERA ENTRIC E
Floor: • Caudate Nucleus
• Thalamostriate vein
• Choroid Plexus
• Fornix : Connecting Hippocampus to Mamillary Body
• Thalamus

Thalamus 1 :1

Best Discount code

for All Course of
eGurukul/DBMCI is
KUCH40

• Inputs of VL Ú Dentatothalamic Troct

Dentatorubrothalamic Tract
• Inputs of VA Ú Pallidothalamic tract from Globus Pallidus
• Inputs of ATN Ú Mamillothalothalamic Tract from Mamillary body
(PAPEZ CIRCUIT)
11
 Viscera
Mediastinal surface of lung 00:10

• Pulmonary Artery Ú Highest structure in Left Hilum

• Eparterial Bronchus Ú Highest structure in Right Hilum

Pericardial sinuses 10:13

Best Discount code

for All Course of
TRANSVERSE SINUS
eGurukul/DBMCI is
• Can be used to ligate Great vessels in Cardiac Surgery. KUCH40

1
 I UE SINUS

• Blind space behind LA for its expansion with out compressing Esophagus.

Coronary circulation 1 :31

Small Cardiac Vein: Accompanied by RMA & RC

• Largest ventricular branch of RCA Ú Right Marginal Artery
• Nodal Artery
ü Supply SA Node
ü It’s a branch of RCA in 65% cases
LCA in 35% cases Best Discount code
• Middle Cardiac Vein (MCV) is accompanied by PIVA for All Course of
eGurukul/DBMCI is
KUCH40
2
Liver :

• Ligamentum Teres: Remanent of Left Umbilical vein

• Ligamentum Venosum: Remanent of Ductus venosum

Best Discount code

for All Course of
eGurukul/DBMCI is
KUCH40
3
Peritoneal cavity 1:

• Anterior : PV, HA, BD

• Posterior : IVC, Right suprarenal
Gland, Body of T12 vertebrae
• Roof: Caudate lobe of Liver
• Floor: 1st Part of duodenum

Best Discount code

for All Course of
eGurukul/DBMCI is
KUCH40

4
 • In Supine Position Ú most dependant site Ú Hepatorenal pouch of Morrison
• Relations of Lesser Sac

i. Anterior: • Caudate lobe of Liver

• Lesser Omentum
• Stomach
• Greater Omentum
ii. Posterior: All structures of stomach bed EXCEPT SPLEEN

PERINEUM :10

Best Discount code

Perineal membrane separates Ú Superficial & Deep Perineal Pouch
for All Course of
eGurukul/DBMCI is
KUCH40

5
Superficial Perineal Pouch Contents Deep Perineal Pouch contents
• Ischiocavernous muscle • Membranous urethra
• Bulbospongiosus • External Urethral sphincter
• Superficial Transverse Perineal • Male Bulbourethral / Cowper’s Gland
muscle • Deep Transverse Perineal muscle
• Female = Bartholin’s Gland

Ischiorectal fossa

Best Discount code

for All Course of
eGurukul/DBMCI is
R NA SE TI N

KUCH40

6
• In the drainage of Ischiorectal Fossa Abscess Ú # to IRN & IRA

Vertebrae 3: 0

CERVICAL THORACIC LUMBAR

Body : Quadrangular Heart shaped Kidney Shaped
Vert. Foramen : Large & Small & Circular Large &
Transverse : (+) of Foramen (+) of Costal Rudimentary
Process Transversarium Facets
Spinous Process : Short & Bifid Long & Pointing Quadrangular
backward & shaped
downwards

Best Discount code for All

Course of eGurukul/DBMCI
is KUCH40