This comprehensive anatomy revision session covers critical clinical conditions including wrist drop (radial nerve injury to ECRL), finger drop (posterior interosseous nerve injury to extensor digitorum), carpal tunnel syndrome (median nerve compression with intact thenar sensation), flat shoulder (axillary nerve injury to deltoid), winging of scapula (long thoracic nerve injury to serratus anterior), foot drop (common peroneal nerve injury), and various cranial nerve syndromes including Frey's syndrome and crocodile tears. The session also covers embryological development of pharyngeal arches, neural crest cell derivatives, and their clinical significance in understanding congenital anomalies and neurological conditions.
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INI-CET Predictor Marathon | Anatomy Rapid Revision | Dr Pradeep Pawar Sir | PW追加:
Good morning.
Hi. Good morning. Good morning, Amit.
Good morning.
So welcome to this marathon series INI marathon series of anatomy.
Hi Sanvi good morning.
So we'll discuss this um we'll discuss some important topics.
important topics discuss about make it a point to give the grand test which is going on on PW me appest.
So once this session is over make it a point to give the crank test minimum.
Hi Goro let us start. Let us start which visuals which topics let it be an interactive session. So you talk I also talk. So let it be an interactive session. Okay. So starting with the first slide have a look at this.
Identify this clinical condition.
Identify this clinical condition. The first part you can you can answer. You can guess that's okay.
That's fine. Huh? So we'll make it a point to improve it. So what is this first clinical condition? The wrist has gone down. That's a wrist drop. Brrist drop, right? So this is brisk drop. And wrist drop occurs due to paralysis of which muscle? Ah, very good. Which is the muscle which causes extension at the wrist? Answer this. The muscle. Very good. The muscle causing extension at the wrist is E C R L. Extensor cap is longest. Right. And this extens radial nerve. Very good. So this is the radial nerve. Radial nerve injury would give rise to a wrist drop.
slide the fingers are down. Fingers drop. So that is finger drop and finger drop is due to injury to which muscle?
Finger drop is due to injury to which muscle drop finger drop.
So finger drop is due to injury to which muscle?
Yes. Yes. Very good. Very good. Go Sanvi. Very good. Mayit.
Very good.
uh finger drop is due to paralysis of yes extensor digtorum. This is extensor digtorum and this extensor digtorum yeah the bris drop this is bris drop.
So bris drop is due to injury to ecl paralysis of ecl supplied by radial nerve. Br finger drop is due to paralysis of extensor digtorum and this extensor digerum is supplied by which nerve?
Extensor dro is supplied by which nerve?
That's a posterior entroious nerve.
Postroious nerve. The posteriorous nerve injury to we get a finger drop. Finger drop. Radial nerve injury. Posttoous nerve is also injured. You get a wrist drop as well as finger drop. Radial nerve injury to post in nerve is a branch of radial nerve. So we get a wrist drop as well as a finger drop. But only posterior interious nerve injury.
So we get only a finger drop. Okay. Pure lesions of posterior toous finger drop wrist drop wrist drop is not going to be there in lesions of P I N. Posterous nerve that's a D branch of retal nerve. And this posting nerve pierces a muscle. Which muscle does the posting nerve pierce?
The supinator. Yes. Posting nerve pierce. Supinator muscle pierce. That's an MCQ for you. Sorry MCQs discuss in this course of anatomy. Fine. So this is clear.
Identify this clinical condition. What is this clinical condition? Yeah. Have a look at this.
Radial nerve above the elbow supplies the ECRL. Yes, that's on the lateral aspect of the arm. Lateral aspect of the arm.
Very good. Coming to the second slide.
Identify this. This is a flattening of the thear eminence. Baka, who's that?
There's a flattening of the thear eminence. Um, what is this clinical condition known as? Clinical condition.
This is the carpel tunnel syndrome.
Okay, that's a carpel tunnel syndrome.
And in this carpel tunnel syndrome, there's a flattening I mean there's a paralysis of the muscles of the thear eminence. So flattening of the kina remnants plus loss of sensations of the skin on this three and a half fingers.
Three and a half fingers skin sensations.
Can anyone tell me who supplies the skin over the thear eminence? The skin over the thear eminence is supplied by the palacaneous branch of medial nerve. The skin over the thear eminence is supplied by the palacaneous branch of medial nerve. And flex retractum.
So carpal teninal syndrome there's a loss of sensations of this three and a half fingers but the sensations of the skin over thear eminence is intact intact carpal tunnel syndrome that means the carp the medial nervous compress in the carpal tunnel five muscles are paralyzed three muscles of eminence lumbricles paralysis there'll be a loss of sensations of this three and a half fingers but the sensations of the skin over thear eminence yeah intact why Because this nerve now picutaneous branch of media nerve the flexor retinacum it goes above the flexor retinacum and supplies the skin over thear eminence right if the meter is injured in the forearm or in the arm sensations and sensations understanding this students yes structures passing above the flexor retinacum you have to know that structures passing above the flexor retinacum buo h structures passing above the flexor retinac Anyone uh anyone is alna nerve alna nerve and artery alna nerve and artery second is the palcutaneous branch of alnar nerve palcutaneous branch of alna nerve third is palmaris longus palmarus longest tendon fourth is palac fourth fourth is palacaneous branch of medial nerve Palmer cutaneous branch of medial nerve and fifth is the superficial palmer branch of superficial palmer branch of radial artery. Superficial palmer branch of radial artery. So yeah structures passing above the flexor retinaculum.
This is very important. Structures passing above the flexor retinaculum sequence of medial to lateral. Medial to lateral sequence sub medial is alandovan artery. Then is a palacinius branch of alnandov. Then is the palmeris longus.
Then is the palacinous branch of medial nerve and sub lateral superficial palmer branch of radial artery. Fine. Fine. So just remember this and which you have to know you should know thisinical question.
So person complains of loss of sensations over three and a half fingers but sensations over the eminence intact.
develop the meter nerve is compressed in the carpal tunnel and branchaneous branch of medor nerve flexacum supply.
Okay fine clear to all of you? Yes.
Coming to this identify this clinical condition. Yes. Look at that clinical condition but answer this. You should know this. Look at this shoulder and look at this shoulder. Any difference that you're seeing which difference?
Any difference?
Come on. Come on. Come on students.
Answer.
Any difference here? Any difference here. Come on students. Guess but guess. Make mistakes here. So later it'll be easy for you. What is this difference?
The shoulder contour. The shape of the shoulder is maintained. The shape of the shoulder is there. Contour of the shoulder. Contour. Whereas the shape of the shoulder. Look at this.
The shape of the shoulder. Huh. This is a flat shoulder. But flat shoulder. Flat shoulder. And this flat shoulder. There is a loss of rounded contour of the shoulder. Very good. So flat shoulder.
Flat shoulder. You can see the tubicles of the humorous. Tubicles of humorous.
The deltoid is paralyzed. The deltoid is paralyzed. This is flat shoulder. This is due to damage to the axillary nerve.
But clear damage to the axillary nerve.
The deltoid is paralyzed. Flat shoulder.
Flat shoulder is seen in lesions of paralysis of deltoid nerve. Axillary nerve.
Axillary nerve supplies two muscles.
Answer this. Axillary nerve supplies the deltoid. Huh? And which is the other muscle which a nerve supplies? Come on.
Come on. Come on. Be quick. Answer.
Axillary nerve supplies the deltoid and anything else?
Terris minor. Yes. Terus minor. Aillary nerve supplies the deltoid and terus minor. And it gives a cutaneous branch.
Cutaneous branch. Upper lateral cutaneous nerve of arm. Upper lateral cutaneous nerve of arm. That's a cutaneous branch. Huh? It supplies the skin on the upper lateral aspect of the arm. Very good. So actually you know muscles deltoid minor cutaneous branch that is the upper lateral cutaneous of the arm. And if there's a loss of if there's an injury to this upper lateral cutaneous of arm this sensations are lost. What do you call this as is regimen batch sign? Regimen bad sign. A very important thing, very important, very important topic for ioniz but regimen bad sign is due to damage to the axillary nerve.
Sensations over the upper lateral aspect of the arm is gone. Very good. So very nice.
Now see this what is this clinical condition what is this clinical condition very good Ankit very good very good clinical condition identify just see what is the difference here something is very prominent what is that easy come on come on can you answer this something is very prominent hereh the medial border of the scapula is prominent This is winging of scapula.
This is winging of scapula. Winging of scapula is due to paralysis of two muscles. It has seratus anterior. It has trapezius. Seratus ant paral winging paral winging. How do you differentiate between this differentiate? Winging of scapula is due to h. So have a look at this. I'll just write this down. Winging of scapula.
Winging of scapula. H at rest.
and on moment the person is just sitting and there's a winging of scapula. So this is due to paralysis of trapezius trapezius and when a person is performing a movement movement and then there's a winging of scapula.
So this is due to paralysis of seratus anterior yand. So winging at rest and winging on attempting moment that's seratus anterior yand fine.
What is the nerve to seratus anterior?
Root value root value of nerve to seratus anterior. Come on students you can answer this. Yes. Very good. Very good rush.
What is the root value of the long thoracic nerve or the nerve bell or the nerve to seratus anterior? Come on students, come on the root value.
If I tell you then it will be very easy.
Long thoracic nerve. Long thoracic nerve root value. What is the root value of the long thoracic nerve? That's C5 C6 C7. Root of the brachal plexus. C5 C6 C7. Root of the brachal plexus. Very good. Very good. Very good. Okay. Now coming to this coming to the spaces around the arm. Your spaces around the arm slide draw spaces around the arm important topic that's the scapula. But this is the spine and the acroian process. That's the humorus. I just make this slide for you. Uh what is this muscle here? Muscle. What is this muscle? What is this muscle? And what is this muscle attached to the scapula? 1 2 and three. Ch. Answer this.
What are these muscles attached to the scapula? But your grandest grand test which is going on on PWA grand attempt. Okay. You'll get a good practice of answering the questions. So this is the scapula. That's a medial border of the scapula. Dorsal aspect muscle number one. Number two, number three. Yes.
Bum. So this number one is the levator scapula. Roboidus minor and this is the roboidus major. Roboidus major. Fine. So levitus scapula roboidus minor robotus major. Okay. We are interested in something else. What is this muscle?
Cona muscle which begins from the infraoid tubacle and goes to the humorris. And what is this muscle?
Huh? What is this muscle and what is this muscle?
Clear visuals.
Answer this. So this is minor.
This is teris major.
And this is the long head of triceps.
Long head of triceps. Fine. Teris minor terrace major long head of triceps.
Fine. So what is this space?
What is this space?
What is this space and what is this space? Huh? So upper triangular space lower triangular space and quadrangular space. But MCQs you get this as visuals also. Visuals be MCQs. So be very clear about this. Terus minor, terus major, long head of triceps. You get three spaces. This is the upper triangular space, the lower triangular space and the quadrangular space. Quadrangular space. What is this structure which comes to the upper triangular space? Circumflex capular artery. Circumflex capular artery. What is this artery which passes through the upper triangular space? Huh?
Posterior circumlex humeral artery. And there's a nerve here. That's a axillary nerve.
uh axillary nerve and posterior circumflex hummeral artery. Axillary nerve and posterior circumflex humeral artery in the lower triangular space is the radial nerve, radial nerve and profundabi.
Profundabrichi artery and this is the circumlex scapular artery. Circumflex scapular artery but clear. So this can come in any form concept understand the concept understand the basics questions can be framed in any way basics right concepts so quadangular space contents axillary nerve and the posterior circumflex artery lower triangular space contents radial nerve and the profendra artery and upper triangular space content is circumlex scapular artery perfect boundaries they boundaries This slide is self-explanatory.
You'll understand triceps heads. One is one one is this long head of triceps which arises from the infraoid tubicle.
From here what is this head of triceps?
This is the medial head of triceps. And that's a lateral head of triceps. Radial giral spiral check. This is the medial head of triceps.
Spiral is the lateral head of triceps.
And this is the long head of triceps.
Triceps biceps heads. The long head of biceps arises from here. What is this?
Supraenoid tubacle.
Long head of biceps. The short head of biceps arises from the corooid process of scapula. Simple. Long head of biceps.
Supraeninoid tuble of scapula. Short head of biceps. Scoroid process triceps thin head long head infraroid tubercal lateral head above the spiral group medial head below the spiral group simple rish clear I hope this is clear to all of you yes yes identify this what is this what is this another very important topic what Is this triangular structure?
Any guesses? Any guesses?
Come on. Come on. Come on. Students, come on. You can answer this easy.
Huh?
Wait. Wait.
We'll discuss those things. Anatomical snuff box. Anatical snuff box. Yes. Very good. Can you tell me the boundaries of the snuff box? Boundaries of the snuff box.
I'll make one easy slide for you. That's the head of the radius, neck of the radius, radosity. That's the shaft of the radius. That's a sty.
That's sty of looking this from the dorsal aspect. Now you tell me what is this muscle? Muscle begins from the radius and ala is abductus longus. Abdolicus longus. This muscle begins from the radius is extensor policus brevis. Right? So abductor policysus longus and extensor policus previs they go together they form the lateral boundary of the anatomical snuff box. So lateral boundary of the snuff box is formed by the abductor policus longus and extensor policus brevis. Fine. The medial boundary is formed by extensor policus longus. Yeah that's a medial boundary of the softbox. Simple anatomical snot box will be very clear to you but confusing students right so I've made it very easy lateral boundary of the snot box abductor pololis longus extensor pololis brevis medial boundary is formed by extensor pololis longus the floor is formed by the styloid braces and two bones scaffoid and trapezium scaffoid and trapezium right content on radial artery content is the radial artery And the roof is formed by the syphalic vein and the superficial branch of radial nerve.
Content is radial artery. Content of snuff box radial artery and roof. Huh?
Syphalic vein and the superficial branch of radial. Perfect.
Minute you have to revise everything.
Understood. Clear. So boundaries clear boundaries confusion.
This two muscles go laterally boundary.
is going to form the medial boundary of the snuff box. Flows is formed by styosis, capoid and trapezium. Content is radial artery, roof, stalic vein and the superficial branch of radial nerve.
Yes, Vicki. Very good. Clear? So that's the snuff box. Yeah. Yeah. So look what is this boundary? That's a medial boundary. Your medial boundary. And what is this boundary? That's a lateral boundary of the snuff box. So your lateral boundary here, your medial boundary of the snail.
Perfect. Okay. Coming to this. Okay.
Tell me what is this? What is this area?
That's a that's a cubital fossa. That's a cubital fora. Okay. That's a cubital fora. And can anyone tell me the bound the contents of the cubital fossa?
Contents. Contents of cubital fora from medial to lateral side. Yes. This is one. This is two. This is three. And this is four. Contents of cubital fosa.
Anyone? Contents of cubital fossa from medial to lateral side is one is the medial nerve. Two is the brachial artery. Three is the tendon of biceps.
And fourth is the radial nerve. Radial nerve.
That's okay.
Contents of cubital radial nerve.
Alna nerve is not a content of cubital fossa.
Alna nerve is not a content of cubital fossa.
MBBS it's MBBR MBBR MBBR. It's MBBR.
It's MBBR.
It's a media nerve, brachial artery, tendon of biceps and the radial nerve.
MBBR fine. Can anyone tell me the floor of cubital fora is formed by what? Flow floor of cubital fora. The floor of cubital fora is formed by this comes in the MCQs. Floor is formed by the bracalis and supinator.
Supinator. The floor of cubital pa is formed by the bracalis and the supinator. Huh. Superficial branch rad.
Superficial branch of rad. Some books mentioned radial nerve. Some books mentioned superficial branch of radial nerve. Option and say answer right. You have to see the options and you have to answer accordingly. superficial branch of radian of the eye to that is the first answer rad of that's the second answer fine it's a superficial branch yes clear to all of you okay so that is about the cubatosa yes branches of axillary artery can anyone tell me the branches of axillary artery superficial branch is generally the first answer to be taken because kana rad comes on the lateral aspect divides into two superficial branch and d branch would d branch supinator pierce. So that is why superficial branch is generally taken as a content of cubital pa fine. Okay. Now branches of aillary artery. Axillary artery is divided into three parts by a muscle which is a muscle which divides the axillary into artery into three part.
That's the pectoralis minor. Pectoralis minor divides the axillary artery into three parts. So first part, second part and third part. First part, second part and third part. First part a branch, second part branches, third part branches. Come on students, can you answer this? What is the branch from the first part? First part branches superior thoracic superior thoracic artery. Second part branch here lateral thoracic and thoracco acromial.
Lateral thoracic and thoracchromial. And third part branches anterior circumflex hummeral artery posterior circumflex hummeral artery and the subscapular anterior circumflex humeral posterior circumflex humeral and the subscapular artery. Fine just remember this branches of aary artery it is divided into three parts by pectoralis minor first part a branches superior thoracic second part branches lateral thoracic and thoracic chromial and third part branches anterior circumflex numeral posterior circumflex humeral and the subscapular tell me which is the chief artery supplying the breast breast arteries supply there are many arteries which supply the breast yes ah There are many arteries which supply the breast. Lateral thoracic, thoracic, intercostal arteries. But which is the main artery which supplies the breast?
The lateral thoracic artery. Yoga. The chief artery supplying the breast is the lateral thoracic artery. And this artery is enlarged in females. Yeah. That's very important MCQ. Okay. So the chief artery supplying the breast is lateral thoracic.
Can you tell me muscular kid? something about the muscular kitinous nerve. This is how you should be able to answer.
Muscular kitinous nerve is a branch of which chord of the brachal plexus?
H muscular kitinous nerve is a branch of which chord of the brachal plexus? Any guesses?
Yes. Yes. Yes. First year batch will start. But wait next month. Next month is have patience.
Relax.
We'll we'll start this back soon. Okay.
Okay. Come on students. Muscular cutaneous nerve is a branch of the lateral cord. Very good. Root value.
Root value of muscular cutaneous nerve.
Root value of muscular cutaneous nerve is C5, C6, C7. Yes. What are the muscles supplied by muscular cutaneous nerve?
This is the biceps brachi. Biceps.
The brachialis and coracco brachialis. Cororacco bracalis. So muscle supplied by the muscularcutaneous nerve is the biceps, the bracalis and the coraccoalis. And then the muscularcutaneous nerve continues as what? It continues as the lateral cutaneous nerve of forearm. It continues as muscle supply. It continues as the lateral cutaneous nerve of forearm. Lateral cutaneous of forearm supply the skin on the lateral aspect of the forearm. It supplies the skin on the lateral aspect of the forearm. Clinical MCQ.
A person comes to your OPD complaining of loss of sensations of the skin on the lateral aspect of forearm. The nerve involved is answer is muscularcutaneous nerve. Perfect.
Very good Arish. So muscularcutaneous nerve as a quick and a short miss yadna h MCQs can come in any way. Right. So it's a branch of lateral cord root value of C5 C6 C7 supplies the biceps a brachalis and the corac braalis and it continues as the lateral cutaneous nerve of forearm very good arm is axillary huh Sanvi your forearm forearm this is forearm discuss deltoid minor cutaneous branch upper cutaneous arm we've seen that discus Actually no.
Okay. But you're coming to the next set of the slides. Can you tell me something about the hamstring muscles? Hamstring muscles. Which are the hamstring muscles? Hamstring. Hamstring. They support the pelvis on the femur. Which are the hamstring muscles? Come on.
Which are the hamstring muscles?
Any guesses? Yes. Sanvi, Arish, Vicki, Tamil, Marishab, which are the hamstring muscles?
Any guesses?
Hamstring muscles is the muscles in the posterior compartment of the thigh.
Posterior compartment of the thigh muscles. These are the hamstring muscles. Is make semiendinosis, semimebrosinosis, biceps feorous, biceps feoris and adapto magnus. Add magnus.
Okay. Semiendonosis, semimebrosis, biceps feorus and adapter magnus. These are the hamstring muscles. Can anyone tell me what is the nerve supply of all these muscles? The nerve supply of all these muscles is the tibial part of shiatic nerve. The nerve supply of all these muscles is tibial part of shiatic nerve.
Tibial part of shiatic nerve.
Tibial part of shiatic nerve. Take where biceps feorous has got two heads. Long head and short head. The long head is supplied by the tibial part of shiatic nerve. The short head of biceps is supplied by whom? Anyone? Come on. The short head of biceps femorous is supplied by the common peronial part of shiatic nerve. Common peronial part of shiatic nerve. So short head of biceps femorous hamstring.
It's not a hamstring. Hamstring semmitendinosis semimebrinosis long head of biceps femorous and adductor magnus. The short head of bisphorus is supplied by the common peronial part of shiatic nerve. It is not a hamstring. Yeah. It's not a hamstring.
Fine. Yes. Very good. Answer. Excellent.
Very good. Glutius maximus. But this is a very important muscle. Can anyone tell me what is the action of glutius maximus? Action.
MCQ. What is the action of glutius maximus? Bet you're sitting down and we stand up. We stand up from a sitting position. This is done by glutius maximus. Yeah. Yeah. Action care. What is this action? We are standing up from a sitting position. This is extension at the hip joint. B important. Extension at the hip joint is done by whom? The glutius maximus. Excellent. Very good specialist. So glutius maximus action is extension at the hip joint. That's a main action. Those action is abduction and lateral rotation.
Abduction and lateral rotation at the hip joint. But the main action extension of the hip joint. Flexion. Fction. Knee flexion. Knee fction.
Glutius maximus acts on the hip joint and through the ilotibial tract it acts on knee joint. It causes extension at the knee joint.
Glutius maximus directly knee joint act glutius maximus is inserted into the ilotibial tract and this ilotibial tract causes extension at the knee joint up glutius maximus through the ilotibial tract does extension at the knee joint.
Fine. So the main action of glutius maximus is extension at hip joint abduction and lateral rotation. What is the nerve supply of glutius maximus?
That's the inferior glutial nerve.
Inferior glutial nerve.
important. The inferior glutial nerve supplies the glutius maximus. Fine.
Superior glutial nerve supply. Superior glutial nerve supplies. This has been asked many times.
The superior glutial nerve supplies three muscles. Come on. Answer.
Superior glutial nerve supplies three muscles. H. Inferior glutial nerve is supplying the glutius maximus. But sun.
Inferior glutial nerve supplies the glutius maximus. The superior gluten nerve supplies what? Internal rotation.
It is external rotation. Lateral rotation. It's external rotation.
Glutius maximus internal rotation.
No.
Huh. Take huh.
So what is the uh what is the inferior glutial nerve supply? The inferior glutial nerve. Inferior glutial nerve supplies the glutius medius. The glutius medius. glutius minimus and the tensor facial latter. Tens of latter. This is a very important MCQ.
Huh. So what is the inferior glutial nerve supply? Sorry, the superior glutial nerve. Not inferior glutial nerve, the superior glutial nerve. The superior glutial nerve supplies the glutius medius, the glutius minimus and the uh internal rotation minimus action. Ah, very good. Very good.
Huh? Excellent. Excellent. Minimus action is medial rotation. Yes.
Specialist. Yes. So superior glutial supplies of glutius medius minimus and the tensor facial latter. Perfect.
Uh what is the main action of glutius medius and minimus? Huh?
Specialist.
Yes. Yes. Superior not inferior. Sorry.
Sorry. Sorry. Uh so glutius medius the main action is abduction. Abduction.
Glutius minimus the main action is medial rotation at the hip joint. At the hip joint so glutius medius main action is abduction minimus main action is medial rotation at the hip joint. At the hip joint fine so just remember that huh glutius maximus action medius and minimus action.
The third action of glutius medius and minimus they support the pelvis when one foot is off the ground. They support the pelvis when one foot is off the ground.
M uh if I'm standing on my right leg, I'm standing on my right leg. Right side glutius medius and minimus are going to support the pelvis on the left side.
I'm standing on my right leg. Suppose my right leg my left leg is off the ground.
The right side glutius medius and minimus are going to support the left side pelvis. Left side pelvis support.
Right side of glutius medius and minimus is paralyzed. The pelvis falls on the left side. This is what we call as trenelenburg sign. Tendalenber sign.
Yeah. Trenelenburg sign. So the action of glutius medius and minimuses support the pelvis when one foot is off the ground. They support the pelvis when from one foot is off the ground.
Fine. Okay. Pelvic femoral muscles.
Which are the pelvic femoral muscles?
Can anyone tell me which is the key muscle of the glutial region? Key muscle. Ke muscle. Key muscle of glutial region.
Can anyone tell me the key muscle of the glutial region is pyroformus?
So key muscle of the glutial region is pyiforis. Pyformis this is very important. Key muscle of the glutial region pyformis is key muscle. The moment we get this muscle you get everything in this region everything. So which are the pelvic femoral muscles?
Pelvic femoral muscles is that group of muscles.
So pelvic femoral muscles where the first muscle is pyroformis.
The next is superior gamlus.
Next is opturator internis.
The next is inferior galis.
And the last one is contractus feorus.
that is femorous. This is the list of pelvic femoral muscles. Why is the pyroiforis known as key muscle? Because see if you get the key you enter the room say if you get the pyiformis you get everything in this region region because above the pyiforis is the superior glutial nerve and vessels.
Below the pyroformis that's inferior glutial nerves and vessels shiatic nerve the nerve to quadratus femorous the pin structures everything is below the pyroformis.
That is why pyroformis is known as key muscle of the glutial region. Fine up.
So pelvic femoral muscles and sub action what is the action of all these muscles?
All these muscles are going to cause lateral rotation at the hip joint.
Lateral rotation at the hip joint.
Okay. I'll just show you the slide.
Slide. Okay. Slide. Fine. This is clear.
So just remember the pelvic femoral muscles.
Ah very good. Very good. Great. Uh, now one short shot short shot short shot short shot short shot short shot short shot short shot short shot short shot short shot as in a shorts MCQ short tendon winding around the medial malololis. Come on that's a very important MCQ which is a tendon which hooks around the medial malus. Medial malus on the medial aspect of the leg. There's a tendon which which which as it turns around the medial malus. What is the name of this tendon? Very important. Very important.
Very important. Can anyone tell me? Ah, very good. Very good. Sani that's fine.
I'll tell you. I'll tell you.
Which is the muscle which winds around the medial malus? That's the tibialis posterior. Huh? Medial malus.
That's a tibialis posterior. The muscle which winds around the medial malus is tibialis posterior.
medial malus and there's a tendon which goes around the medial malus which hooks around the medial malus that's tibialis posterioris posterior anterior antior anterior is in the anterior compartment the posterior compartment muscles they go behind between the medial malus and the tendoaculus tendo between the medial malus and tendoaculus is posterior compartment Look, just do one thing.
You just dorsif flex the foot and invert the foot. Dorsifer visuals.
You dorsif flex the foot. Just look at your foot. Dorsif flex and medially rotate or uh invert invert invert the foot. One tendon becomes very prominent.
That's tibialis anterior. That's how you remember it. So the tendon which winds around the medial malulus is tibialis posterior. And the tendon which winds around the lateral malulus is peronious brevis.
Longus long it's brevis.
It's peronious brevis.
Fine. Huh? So tendon which winds around the medial malus tibialis posterior lateral malulus is peronious brevis navicular tibialis posterior chief insertion is on navicular tuborosity perfect okay insertion on navicular tubity navicular bone navular bone tubity the main insertion of navicular tuberosity is tibialis posterior so tibialis posterior winds around on the medial nadulus and then goes and gets inserted mainly on the navicular tuberosity. Navicular tuberosity main insertion of the tibial is posterior group below the cuboid bone. Grew below the cuboid bone is for the peronous longus. These are all shorts. MCQ shorts one word MCQ short as a short media injection are MCQ shorts this you have to know so the groove below the cuboid is for peronius longest peronius longus layers of soul layers of soul I'll tell you one easy way to remember the layers of soul grade two and Yeah. Little finger.
Little finger. Great toe and little finger. How many layers of the souls are there? Char layers of the soul. This is first, second, third and fourth layer.
The way I'm telling you everything will be will be very clear to you. Great. So layers soul out of this the first and the third layer is intrinsic. Intrinsic.
Intrinsic they are in the foot. They begin from the bones of the foot. They get inserted into the bones of the foot. While the foot insert small small muscles and all the small muscles will end with brevis brevis muscles. So first and third layer muscles. These are small muscles. These are the brevis.
Put an abductor here. Put an abductor here. and put a flexor in between. This is my abductor here. Abductor here flexor in between abductor. So this is abductor of the great toe. Abductor halosis brevis.
Abductor of the little finger.
Abductor digit minimi brevis.
Abductor halosis brevis. Abductor digit time minimiz. And make flexor d flexor.
What is this? This is the flexor digtorum.
Flexor digital brevis. So abductors flex abductor halosis brevis abductor dig minimi brevis and the flexor digtorum brevis. Fine that's a easy way to remember. Up third layer take flexes on both the sides. Put a flexor here. Put a flexor here and put an adductor in between. Say first layer abductor.
Abductor beach flexor third layer flexor flexor beach adductor. Okay.
What would the name of this be? Flexo halosis brevis small muscle.
Flexer digit minimi brevis. And this is the adaptois.
Addis adapter hallucis.
So abductor, abductor, flexor in between. Third layer, flexor, flexor, adductor in between. That's a very easy way to remember the layers of the soul.
MCQ muscle. This is what you are supposed to remember. Which muscle is present in which layer of the soul. Perfect. Easy.
Enjoying. Abductor, abductor, beach flexor, third layer flexor, flexor, beach, adductor.
So these are muscles, small small muscles in the soul. Now second and fourth layer may muscles come from the leg muscles plus they are in the sole.
So you mix layer intrinsic as well as extrinsic muscles don't know and muscle intrinsic and extrinsic the second and fourth layer. Okay. So starting with the second layer right now which is this muscle muscle coming from the leg flexor halosis longus flexor digtorum longus legs flexalis longus flex dum longus legs these are extrinsic because and there are two intrinsic muscles there are two intrinsic muscles here flexor dro longus is similar to profundus flexor don profendus and there are small small bone like muscle muscles, small small bomblike muscles beginning from the stand lumbricles. Lumbrials and there's one more muscle in the sole is flexor digtorum accessorius. Flexor digtorum accessorius. So second layer intrinsic extrinsic colors because they're coming from outside. So who's the muscle coming from the leg? Flexor helysis longus flexor digital longus and soul muscle that's lumbrials and flexor digtorum accessorius. Fine. And now coming to the last layer of the soul. The last layer of the sole muscles, tibialis, posterior, peronous, longus, legs, and soul intra intrashy. That's the layers of the soul.
That's it. That's it.
Just have to remember this. That's very easy. That's a great that's a little finger.
That's how you remember.
Understood? Simple.
First the first and third layer intrinsic muscles muscles. So they end with brevis. First layer abductor abductor beach flexor. Third layer flex of flexor beach adductor.
And then second layer flexis longus flex addition of longus extrinsic lumpical and flex addition of accessories. And the last letter posterior peronous lungus and the intra clear to all of you but yes and then solve the MCQs grand test on PWA app to make it a point to give that grand test motivation but together.
Okay.
Fine. So now coming to the next what is this clinical condition?
Plant medial and lateral plant nerves.
Who's going to supply this muscles muscles? The medial and the lateral plant nerves tough branches of medial and lateral plant which are going to supply the muscles of the foot.
Okay. What is this? What is this clinical condition? Yeah.
Huh? What is this? Ah, excellent. Very good. Foot drop. Excellent. But foot drop. Foot drop. And foot drop is due to injury to which nerve? Excellent. Injury to which nerve leads to foot drop? Your first answer. First answer. First answer is always the common peronial nerve.
Common peronial nerve because common peronial nerve option to then take it as a deep peronial nerve because deep peronial nerve injuries are very less common. Deep peronial nerve injuries. Common peronial nerve winds around the neck of the fibula.
common. So, injury to the common peronial nerve. That's your first answer. H. So, that's the foot.
Excellent. Very good. Uh, this is a flat foot. Flat foot. Flat foot.
When the arches and arches is a flat flat, this is what we call as P planers or the flat foot. And there's a pest cavis j arches becomes exaggerated the arches becomes exaggerated to the foot becomes like a cave pes cavis deformity and when the when the foot becomes flat that's a ppl planus planus deformity pplanus pescus now when the person is walking on the tips on the toes talypse equinus talypse equinus When a person is walking on the heel is talypse calccenius. Walking on the heel is talypus. Walking on the on the toes is talypse equinus. Then what is this? Talypse vis. And what is this? Talyps vgus. Walking on the inner border of the foot is vgus. Outer border of the foot is vis. What is the most common deformity of the foot?
Most common deformities of the foot.
Talypsino.
Talypse ecoininous.
That's a commonest deformity. Talyps equinus.
Eichcoin is walking on the toes like a horse. Eichcoin. Vus is walking on the outer part of the foot. That's vus. So talypse ecoin vus. That's a deformity.
Very common deformity. Fine.
H okay fine clear. Now coming to this uh very good very good excellent ch uh just some MCQs bronopme segments bronco palmmy segments bronopmy segments can you tell me what runs between the bronopalmmy segments is beach who runs between the bronopmy segments like this like if I have to trace a segment I just follow this structure structure follow I'm able to define one bronopulme segment. What is that structure which helps us to define one bronopulmonary segment? Can anyone tell me this important MCQ?
ah bulo you become a cardiovascular thoracic surgeon in future and you are um you are removing a segment up uh you're removing a segment of the lung disease segment of the lung structure bronopul segments you will be able to define one bronopulmonary segment come on both important Yeah.
Any guesses? Fishes. Fishes.
Fishes is there. But there is something lying in the fure. That's very important. Pulmonary veins. Yes, you've got this right. The pulmonary veins.
Pulmonary veins. So, who's between the broncoal segments? The pulmonary veins.
As a cardiovascular thoracic surgeon, pulmonary veins trace. You'll be able to define this segment, this segment, this segment, different different different bronco pulmonary segments. Now each segment her segment artery artery pulmonary artery and a tertiary bronus.
Okay, just remember each broncoal segment is conical in shape as a cone.
It has got its own pulmonary artery. It has got its own tertiary bronus. But pulmonary vein pulmonary veins runs between the segments. The pulmonary vein is supposed to be intersegmental. That's the MCQ. Pulmonary veins are said to be intersegmental.
Intersegmental.
That's a very important MCQ. Fine.
MCQ. Foreign body entering the nose. A child puts a foreign body in the nose.
The foreign body directly goes where?
Anyone? The foreign body goes where?
A person a small child playing kale ra the child is playing the child puts a foreign body in the nose. The foreign body directly goes in which segment? A very very important MCQ foreign body entering the lungs entering the nose enters into which segment?
H foreign body in the nose enters into the posterior basil segment of the right lung the posterior basil segment of the right lung posterior basil segment of the right lung. So foreign body put in the nose enters into the posterior basal segment of the right lung. Because this posterior basal segment of the right lung is a continuation of the trachea.
But trachea continues as the right primary bronus. The right primary broncus continues as the secondary broncus for the lower lobe and this continues as the tertiary broncus for the posterior basil segment. So foreign body knows it directly goes to the posterior basil segment of the right lung. Very important.
Okay. And aspiration pneumonia is common in um aspiration pneumonia is common in which segment? Like a person is lying supine, the person vomits or the bacha is feeding the the child is being fed.
The child vomits aspirates the vomiters.
So when the child aspirates the child gets an aspiration pneumonia. Aspiration pneumonia is common in apical segment of lower lobe. Apical segment of lower lobe. Apical segment of lower lobe is superior segment.
Superior segment.
Aspiration pneumonia is common in apical segment of the lower loal segment.
Suprabasal yes segment of the lower loan superior segment any I mean MCQ comes in any different way.
So sub sub angle say you have to have a 360° view 360° view. So MCQ asks in any different angle you'll be able to answer right perfect a very important thing uh can anyone tell me this are the aotic arch arteries aotic arch arteries important important aotic arch arteries I'll just tell you the important things.
Uh near the near the diaphragm it's the most dependent part of the lung. When we lie supine sub lowest part of the lung it's the most dependent part of the lung in supine position is apical segment of lower low.
Right side right side. Right side mar right side. Okay. So when we lie supine sub lowest part of the lung is the apical segment of lower lobe. Jesse when we lie supine the lowest part of the peronial cavity is what? Answer this.
When we lie supine does any fluid in the peronial cavity enters into what? Answer this.
Any fluid in the peronial cavity enters into that pouch because lowest part body. What is that? Anyone? Anyone? The lowest part of the body in supine position is uh the lowest part of the peronial cavity in supine position is the hippatenal pouch of Morrison's Morrison's pouch. So fluid peronial cavity may a person is lying supine. The fluid will gravitate into the hippatenal pouch of Morrison's Douglas Vicki smooth specialist Douglas standing position when a person is standing if it's a female it will then gravitate down that is pouch of Douglas females may standing position may the most dependent part of the peronial cavity is the pouch of Douglas or the hippato um or the Rectoutrine pouch. Rectoutrine pouch of Douglas.
Huh. And in males it is males. Males it's the utro uh it's the rectto vital pouch. So males rectto vital pouch but I'll just write this down. So um in standing position in standing position the most dependent part of the body in males and females.
Males and females. Males may recto vicycle pouch.
Rectovycle pouch. In females recto utrine.
This is pouch of ducklas.
Pouch of ducklas in standing position. In lying position.
That's a Morrison's pouch.
That's a hippatenal pouch of Morrison.
Rect fine. That's fine. That's fine. Okay.
So, we were discussing about the aotic arch arteries. But aotic arch arteries there are some important things to remember.
Tell me if you can answer this arch of aot which is this arch artery.
This is the fourth arch artery that's the third arch artery.
Okay. Anyway just tell me arch of the aot is derived from what? Arch of the aorta is derived from Arch of the Aota is derived from pouch of Douglas is between the uh the pouch of Douglas is between the rectum and the uterus. It's it's between the rectum and the uterus. Sanvi, what happened Sanvi?
Clear. It's not clear.
Just wait. Just wait. Wait. Wait.
This is easy.
That's a That's a bladder. Bladder. This is the uterus. That's a uterus. And that's a rectum. That's a rectum. Huh?
Rectum.
So this is the bladder. This a uterus.
That's a rectum. So what is this pouch?
This is the rectoutrine pouch. Your females rectutrine pouch is the most dependent part of the body in standing position. Cardiac partic.
Okay.
Fine.
Okay.
Just try to understand. Just try to understand this. Uh this is what we call as a aotic sack. Aotic sack.
I'll just draw this. I'll just draw this. So how many fangial arches are there to begin with? There are six fangial arches, right? There are six fangial arches.
Huh. I'm telling you arches. Yeah, there are six fangel arches. Arch there's an artery of the arch.
artery.
Now you tell me this is the first arch artery. Just have a look your first arch artery. Your second arch artery here.
First arch artery. Second arch artery.
This is the third arch artery. Fourth arch artery. Fifth and sixth arch artery. Aotic arch arteries. So that's the third, fourth, fifth and sixth aotic arch artery. So this is the aotic sack.
Aotic sack you have first, second, third, fourth, fifth, sixth ch aotic arch arteries. Just listen, just listen quickly. I'll finish this quickly. I'll finish this. Out of this, the first arch artery is the maxillary artery. Very good. The second arch artery has stedial artery. Very good. The first arch artery majority of it disappears off. Second arch artery disappears off. So I'll just make it like this. So first arch artery is gone. Second arch artery is gone. So first is gone, second is gone.
Fifth is gone. Fifth be fifth is also gone. Fine. So what are we left with? We are left with third. This is the third arch artery.
That's a fourth arch artery. That's a sixth arch artery. That's the aotic sack. And this is the dorsal aot. That's a dorsal aot. I'll start now. The sixth arch artery.
Okay.
The sixth starch artery is going to form.
I just clear this so you'll be confused then fine. Okay. So this is the third arch artery. That's the fourth arch artery.
That's the sixth archery. The sixth arch artery is going to form the pulmonary artery. The sixth artery pulmonary artery. It gives a bud here.
for the lungs. This is an artery which goes to supply the lungs. So the sixth arch artery is going to form the future pulmonary artery. It gives a small artery to the lungs. On the right side, this part of the sixth arch artery between the lung bud and the aot disappears off on the right side. Your part on the left side this becomes the ductus arteriosis.
Ductus arteriosis.
So clear. So look sixth aotic artery forms a pulmonary artery. It gives a artery to the lungs right side. This disappears off and this part of the sixth artery between the lung and the aot ductus arteriosis of y the recurrent langela winds around the ductus arteriosis and goes up. So the left recurrent langela is found in the thorax. On the right side there's nothing to come up. There's nothing to wind around. So the right recurrent lingula winds around the fourth arch artery. The fourth arch artery say subclavian artery. So the right recurrent lingula winds around the subclavian artery. The left recurrent lingula winds around the ductus arteriosis. I hope this is clear. Yes.
Now which is this arch artery? Fourth arch artery. The fourth arch artery.
Okay. Fourth arch artery. So six is over. Now there are two arteries which comes and joins the fourth arch artery arteries.
Seventh cervical intersegmental artery.
Seventh cervical intersegmental artery comes and joins with the fourth arch artery. Your fourth arch artery join seventh cervical intersegmental artery.
The aotic sack divides into a right and a left horn. Huh. horns divide right and left horns I'll just explain this in brief now I'll start the left horn of aotic sack the left horn of aotic sack and the left fourth arch artery forms the arch of aot so arch of iota is derived from the left horn of aotic sack and the left fourth arch artery arch of iota so the left seven cervical intersegments cabana Left subclavian artery. Left subclavian artery is derived from the left seven cervical intersegmental. The right subclavian artery is derived from the right fourth and the right seven cervical subclavian artery. Subclavian artery.
Are you able to follow this arch of aot?
So arch of aot derived from the left horn of aotic sack and the left fourth arch artery. Arch of aot derived from the left horn of aotic sack and the left fourth arch artery. The the left seven cervical intersegmental seabana left subclavian artery. On the right side the right fourth arch artery and the right seven cababana right subclavian artery.
Fine. What is this right horn of aotic sack going to form? The right horn of aotic sack is going to form the brachio syphalic trunk. Brachiophalic trunk.
We are left with only one arch artery that is the third arch artery. The third arch artery is going to form what? The common kerotids.
The third arch artery is going to form the common kerotids. And that is why that is why on the left side on the left side the common kerotids and the subclavian arise from arch of aota. On the right side the common keroted and subclavian arises from the brachio syphalic trunk.
Fine.
fine chri okay so in short I've just explained this for you so explain short okay fine ch coming to this a Very very important MCQs. Bacho answer this. Skin over the angle of mandible is supplied by whom?
Skin over the angle of mandible. Come on. That's very important. That's very important. This you should know the entire face. The entire face sensory supply sensory supply of the face is trigeinal nerve except except except the skin over the angle of the mandible below supplied by great oricular nerve. Very good. Skin over the angle of the mandible is supplied by the great oricular nerve.
And this greater oricular nerve is a branch of cervical plexus. Excellent.
And you know there's a lesion of the skin over the paroted gland and the person hits with an with a pointer.
There's a perforating lesion of the skin over the paroted gland regeneration.
So there's a mixing of fibers of the oricular temporal nerve and greater oricular nerve. There's a mixing of fibers of the oricular temporal nerve and greater oricular nerve. Now when a child starts to salivate, the child starts to get sweating of the skin over the parroted gland. What's that?
The child starts to get sweating of the skin over the paroted gland.
But marginal mandibular is a branch of facial nerve. But specialist marginal mandibular nerve is a branch of facial nerve. It's a motor nerve. Marginal mandibular is a branch of facial motor.
Sensory sensory sensory greater oricular nerve that's phrase syndrome very good phrase syndrome clear so phrase syndrome there's a lesion of the skin over the paroted gland when the person salivates the person gets sweating of the skin because of the mixing of greater nerve and the oricular temporal nerve and this is what we call as phrase syndrome there's another syndrome when a child is having food when a child when an adult is having food or the person starts to get tears. What is that? What is that?
So, gustatory sweating, phrase syndrome and uh crying while having food. What is that?
Ah, what is that?
But there's a mixing in high lesions of fia.
In high leions of regeneration the fibers going to the lacrimmal gland gets mixed with the fibers going to the submandibular gland. This is what we call as the crocodile tears. Crocodile tears.
Very good.
Crocodile tears. Huh? Yes. Crocodile tears. Crocodile tears is seen in high leions of facial regeneration. The fibers going to the lacrimal gland gets mixed with the fibers going to the submandibular gland.
So when the person salivates the person starts to get tears, the crocodile tears. Yes, remember this crocodile tears. Very good. But answer cervical is supplies. Any guesses? Ana cervical is supply. An unsa cervical is supplies. This this muscle strap muscles. Yes. Strap muscles.
Answer. Cervical supplies the sterno hyoid.
Uh the sterno sterno hyoid. Sterno thyroid. Sterno sterno thyroid. The superior and inferior belly of omohyoid.
It supplies the strap muscles.
It supplies the strap muscles. Okay. So now you tell me what is the answer cervical supply? It supplies the sterno hyoid, sterno thyroid, the superior and the inferior belly of omohyoid. Right?
Tell me what is the ansa not supply?
That's a very important mus important MCQ. An unsa cervicalist does not supply one strap muscle. Conso muscle supply.
Uhhuh. Yes. Yes. Yes. Yes. Yes. Come on.
That's very important. The staff muscle which is not supplied by unsuservacus is thyro hyoid.
Thyro hyoid huh it lies on the anterior wall of kerot ship. That's fine. Thyro hyoid remember that's a very important MCQ. Thyro hyoid.
Thyro hyoid is not supplied by unscatheicalis and thyroid and genio hyoid is supplied by C1 supplied by C1.
So thyro hyoid and genoid that is supplied by whom? C1. C1 to all strap muscles.
Gino is not a strap muscle strap muscle but it is supplied by C1.
All strap muscles are supplied by unsa cervicalis except thyrohyd which is supplied by C1. Which other muscle is supplied by C1? Gino hyoid. Oh yeah.
Fine.
Okay. Can anyone tell me damage to the spinal accessory nerve in the posterior triangle versus spinal accessory nerve supply and the trapezius? Right. Spinal accessory nerve supplies the sternocltomastoid and the trapezius but it first supplies the sternoclto mastoid and then it comes in the posterior triangle of the neck to supply the trapezius sternoclto mastoid supply it first supplies the sternoclto mastoid I'll draw this for you I'll draw this for you just one moment Fine. So that's a sternoclamas. That's a trapezius.
What is this muscle muscle? I'm just drawing one muscle on which the spinal accessory nerve lies. That's a spinal accessory nerve. So the spinal accessory nerve lies on which muscle con muscle.
The spinal accessory nerve lies on which muscle that's the levator scapula.
Levator scapul. So spinal accessory nerve lies on the levator scapula. This nerve first supplies the sternoc supply then comes in the posterior triangle lies on the levator scapula goes to supply the trapezius. Fine.
Nerve damage. If the nerve is damaged here, sternoclly mastoid is already supplied.
Sternocleto is already supplied.
The sternoclly already supply.
So if the nerve is damaged in the posterior triangle of the neck, which muscle is affected? Trapezius.
So much very important clinical MCQ.
Important clinical MCQ. This in this posterior triangle we get large number of lymph nodes and uh there is absess of the lymph nodes. So lymph node go remove you're removing the lymph node or you're draining the absess. The accessory nerve is very superficial. When we are removing the lymph node the accessory nerve gets damaged and damage to the spinal accessory nerve in the posterior triangle of the neck leads to paralysis of trapezius not sternoclium mastoid. No not sternoclomomastoid. It's only only only trapezius.
What will the person complain of? The person complains of difficulty in shrugging of shoulder. The person complains of difficulty in overhead abduction. And there is winging of scapula at rest. Winging of scapula at rest.
Huh.
Okay. Fine. So what does a person complain of? Person complains of loss of shrugging, loss of overhead abduction and winging of scapula at rest.
Sternoclas there's no problem with sternocll.
Perfect idea. So just remember this damage to the spinal accessory nerve in the posterior triangle leads to paralysis of trapezius.
Fine. Okay. relations in the lateral wall of the cavernous sinus. Can anyone tell me the relations in the lateral wall of cavernous sinus? Yes. Cavernous sinus draw. This I've drawn as the cavernous sinus. Who's this here? What's this? And what's this?
Huh? This is the pituitary gland.
Pituitary. What is this below the pitutary gland? What is this? Spenoidal Spodal air spoin optic kaisma optic charisma. Tell me who's this, third, fourth, athalmic and the maxillary nerve in the flow is the sixth nerve and internal caroted artery. So this is the cavernous sinus.
Cavernous sinus. Yeah. Slide slide. So who's on the medial wall of the cavernous sinus? The medial wall of cavernous sinus is related to the pituitary gland and the spinoid sinus.
The roof is the optic kasma, the lateral wall may third, fourth nerve, athalamic and the maxillary nerve floor six nerve and the internal carroted artery. But recent books may mention even the maxillary nerve is away from the cavernous signs. Recent additions the maxillary nerve is also not related to the cavernous sinus in the lateral wall to internal character in the center floor.
Floor and medial floor and medial.
It's in the floor and medial. That's fine.
Floor clear to all of you? Huh?
clear it's in the floor and on the medial side that's fine that's a way of drawing MCQ you have to you have to really understand the MCQ recent recent additions maxillary nerve is also not present in the lateral wall roof roof roof this is the roof and this is of flow your floor fine ch great so relations of lateral cabinets and escape perfect excellent this is a very very important visual slide for you but this is a very important visual slide for you I'll point out certain things just try to identify them look if you can identify them huh okay what is this number one in red what is this number two. Um, what is this number three? And what is this number four?
These are the faces of the neck.
Yeah. Faces of the neck. Gold. What is this? 1 2 3 4.
Okay. Okay. Fine.
A very important visual slide. But very important visual slide. Come on. Answer this.
Whatever you know, that's fine. That's fine. You answer. You answer. You answer. Tell me what's number one. Yeah.
These are the deep cervical fasia. Deep cervical fasia to investing and thyroid cover that's pre-traal vertebral muscles cover that's prevertebral and the one which invest that's investing layer of deep cervical fasia. Okay. So three is pre-traal.
Pre-trichal fasia one is investing layer investing layer of the deep cervical fasia two is prevertebral prevertebral char sheet or isus carrot sheath fine can anyone tell me what is this structure they what is this structure this what lies medial to the carotal sheath medal to the carotal sheath message.
I don't know message. I I don't know.
What is this structure lying medial to the carotal sheet? Huh?
Huh?
Uhhuh. That's the sympathetic chain.
Sympathetic chain. Answer that's a sympathetic chain will be here anterior wall of carot sheath unervical anterior wall of carot sheath cervical this is the sympathetic chain this is very very important visual slide already it's already been asked many times so that is sympathetic chain can anyone Tell me what is this nerve?
What is this nerve?
Answerve.
How do you understand this?
This is the esophagus.
Answer is recurrent lang. Very good.
Very good. So that's a recurrent langular recurrent lul. Perfect. Perfect.
You tell me what is this?
Internal langel recurrent langel. Very good. Very good.
Huh? What is this now? Preverebral fasia.
That's fine. That's fine. Muscle and this is skeleanus anterior. This muscle is skeletonous anterior and nerve which lies on the skeleanus anterior that is frenic nerve. This is the frenic nerve.
That's a frenic nerve.
Okay. So this is the section of the neck frenic nerve frenic nerve. Uh the muscle is skeleanous anterior and the nerve lying on the skeleanus anterior is frenic nerve. Perfect. Okay.
Clear. Clear to all of you. I'll proceed.
Which doubt says Tamil Tamil man?
Fine.
So now you tell me the branches of external carroted artery. So that's the external carroted branches. Branches of external caroted artery. Easier. Uh so anterior branches. Anterior branches is superior thyroid artery. Lingual facial facial. Posterior branches is posterior oricular and occipital medial branch is ascending fangial and terminal branches superficial temporal artery and maxillary artery. Superficial temporal and maxillary artery that's a brachial plexus. Yes. Skeleinus anterior and medius beach is the brachal plexus. Smooth specialist your messages.
Yes. Plexus anterior and medius. That's brachal plexus. That's brachal plexus smooth specialist. H. Okay. Fine. Ch.
Uh. So ascending fangial artery is a branch of external carot. Ascending fangel artery is a branch of external carot. Can anyone tell me fangial artery is a branch of what?
Ascending fangel is a branch of external caroted but fangial artery is the branch of what? Anyone come on. Fangel artery is a branch of any guesses.
Yes. Guess guess this is very important.
Smooth specialist messages messages are seen.
Any guesses? Any guesses?
Fangial artery is a branch of maxillary artery. This maxillary artery, this maxillary artery enters the infratemporal fossa. This maxillary artery is divided into three parts by lateral terragoid muscle.
Just say axillary artery is divided into three parts by pectoralis minor.
Say the maxillary artery is divided into three parts by lateral terracoid. And the fangial artery is a branch of maxillary artery.
Fangial artery is a branch of maxillary artery. Remember that ascending fangial is a branch of external caroted and fangial artery is a branch of maxillary.
Okay.
Coming to this muscles of mastication. muscles of mastication temporalis.
This is the medial terragoid. That's a medial teroid. This is the I mean sorry this is the massitor. I'm so sorry massitor. This is the medial terragoid.
But angle pay bahar is massitor and is medal teroid and this is the lateral teroid. Lateral teroid. All the muscles of mastigations are formed in the first parangial arch. Muscles of mastication they are found in the first fangial arch. All the muscles of mastications are supplied by whom? The mandibular nerve. Mandibular nerve supply.
All the muscles of mastication are supplied by mandibular nerve.
Muscles they are going to cause elevation of the mandible except except answer this. All the muscles of mastication are going to cause elevation of the mandible except come on that's very important. The only muscle of mastication which causes depression of the mandible is any guesses.
The only muscle which causes depression of the mandible depression of TM joint arish lateral teroid. Excellent. Very good.
Very good. That's lateral teroid.
The only muscle of mastication which causes depression of the TM joint is lateral teroid. And look at this. What's this? Yeah. That's a articular disc of TM joint. The articular disc of TM joint is a degenerated part of lateral ter. Another very important MCQ.
Very important MCQ.
Now retraction is temporalis. Right. The only muscle I mean the articular disc of TM joint is a degenerated part of lateral tergoid.
And lateral teroid spasm. When the lateral tergoid goes in spasm, it pulls the articular disc in front.
It pulls the articular disc in front.
Can anyone identify this structure?
Yeah. What is that?
What is this structure?
Huh? Identify. What is this structure?
And what is this muscle? Any guesses?
that structure and that muscle.
PT E R Y G O I D. PT T E R Y G O I D.
That's a mass muscle. What is this muscle and what is this muscle? What is that structure?
Buxinator. This muscle is the buxinator.
And what is this structure which pierces the buxinator? Pierce anterior condal process is temporalist.
Correct. That's correct.
Anyone? Come on. Boom. Which is the structure piercing the buxinator?
That's very important. This is a structure which pierces the buxinator and it opens in the mouth opposite to the upper second molar tooth.
I can't zoom this.
I can't zoom this screen. This is a screened.
It's a duct.
It's the paroted ductinator muscle. And the structure piercing the buxinator is the paroted duct. This paroted duct pierces the buxinator.
Opens in the mouth opposite to the upper second molar tooth.
Upper second molar tooth.
Yeahna. That's very important. H. Okay.
Now just see this. Can anyone tell me what is this number? 1 2 3 4. I'll just put numbers here. This is number one.
This is number two. This is number three.
What is this? 1 2 3 4. You have fings.
Uh facial nerve supplies the buxinator without piercing it.
Very good. Very good. Very good.
Your fairings. This is another very important structure. Your fairings.
These are the circular muscles of the fairings. What is number one, number two and number three?
1, two and three. One is the superior constrictor, two is the middle constrictor. And three is the inferior constrictor.
Superior constrictor, middle constrictor, inferior constrictor. Can anyone tell me structures passing about the superior constrictor? Yeah.
Structures passing above the superior constrictor.
Structures passing above the superior constrictor.
This you have to know. This you have to know. Structures passing above the superior constrictor is the audiary tube. Audiary tube.
Levator pality.
Levator pality.
Levator pality muscle. Ascending palatine artery.
Ascending palatine artery and palatine branches of palatine branches of ascending fangial artery that's a very important MCQ uh structures above the superior constrictor that's the sinus of mock acne very good sinus of mock acne and structures passing through the sinus of mock acne one is the ustian tube or the audit tube the levator palaty muscle the ascending palatine artery and the palatine branches of ascending fangial artery. Okay. Then coming to the next one between the superior constrictor and middle constrictor. Between the superior and the middle constrictor goes the glossoparangel nerve and styoparanges muscle.
Glossoparangel nerve and styoparanges muscle. Okay. Then between the middle constrictor and inferior constrictor.
And the last one is below the inferior constrictor. Below the inferior constrictor. So between the middle and inferior constrictor and below the inferior constrictor. This is internal langel nerve and superior langial vessels.
internal lingial nerve and superior langel vessels. Below the inferior constrictor goes the recurrent langel nerve and inferior langel vessels.
Just remember this but this is extremely important extremely important. This is one this is two.
This is three and this is four.
Very good. Very good.
This you should know.
This is very important. Very important.
This you should internal it pierces the thyroid membrane. The internal langel nerve also pierces the thyroid membrane and supplies the pyroform fossa. Internal langel nerve also supplies the sensory supply to the larynx above the vocal folds. Recurrent langel nerve supplies the sensory supply below the vocal folds.
All the muscles of the larynx are supplied by recurrent lingial nerve except crycoyroid which is supplied by external lingial nerve. Huh? All the muscles of larynx are supplied by recurrent langial nerve except criccoyroid to external lingial nerve supply. Right? Huh? Structures above the superior constrictor or the sinus of morg. One is the ustian tube. Fusion tube elevator of the pallet that's a levator pality a ascending palatine artery ascending palatine is a branch of facial your facial artery branch and the palatine branches of ascending fangial artery I've given you the entire table Okay.
CH answer this structures passing to the superior orbital fissure. Okay. This is number one. Superior orbital fure. This is the superior orbital fure. Yes.
Superior orbital fure. This is the optic canal. This is the foramin rotendum.
Foramin o foramin spinosm foramin lassum.
So answer this. This is one. This is two. This is three. This is four. Five.
Six.
Huh? This is seven.
This is eight. Anterior condor canal.
Can you answer this?
Superior orital features. Superior orital features 3 46 of them nerve. 3 4 6 and ofthalmic division of triaminal nerve. Very good.
What passes to the optic canal is the optic nerve and the ofthalmic artery.
Optic nerve and opthalmic artery. That's the optic canal.
What passes to foram and rotendum? Yes.
Anyone? That's a maxillary nerve.
Maxillary nerve. Foramin rotendum.
Maxillary nerve.
Yes. What passes to foramin o? Foramin oval. Y. M a l e. Yeah. M is the mandibular nerve. M is the mandibular nerve. A is the accessory menial artery.
Lesser petroal nerve. E m emissary vein.
Emissary vein. Right.
Mandibular no accessory menial artery lesser petroal no emissary vein male why students out there uh I ask what is this sir foramino structures passing sir male very common so mandibular nerve accessory menial artery lesser petroal nerve emissary vein fine now foramin spinos foramin spinosm they what passes to foramin spinosm is the middle menial artery and nervous spinosis.
Nervous spinosis middle menial artery and nervous spinosis.
So what passes through forman spinosumm is the middlemanial artery and the nervous spinosis. Forammen laser internal caroted artery and the deep petroal nerve.
Internal caroted artery and the deep petroal nerve. Deep petrol now comes from the sympathetic plexus. Sympathetic plexus extra dural hemorrhage. Very good. Good.
Good.
Hemorrhage. Excellent. Very good.
Then it becomes very easy, very interesting correlative. Right.
But make an attempt to give the grandest grant.
Make it a point to give the give the grantest.
Internal acostic matus. Internal acostic miatus. Seventh nerve. Eighth nerve and labyrinthine artery.
Seventh nerve. Eighth nerve and labyrinthine artery.
Anterior condal canal. Hypoglossal nerve. Hypogloss seven eighth labyrinth artery and anterior condellular canal is hypoglossal canal. An anterior condellular canal but that is hypoglossal canal. What passes through that is hypoglossal nerve. Hypoglossal nerve.
Very good. Excellent. This all is very important.
for compartment anterior, middle, posterior, anti- middle and posterior.
Anterior compartment inferior retrosal sinus middle compartment 9 10th 11th cranial nerves and posterior compartment sigmoid sinus sigmoid sinus right so clinical clinical MCQ comes there's a tumor which compresses the tubular foram and so which of the following um symptoms will be seen so you have to remember This 9 10 cranial nerve. H. Yes. Good. Ch.
Take care. Can anyone tell me this? Ch.
Good. Good. Good. You tell me. What is this? What is this?
And what is this? Ch. Start. What is this number one?
What is this number two? And what is this number three?
Inferior petroal sinus goes to the anterior compartment. Yes. Very good.
Section of the larynx. But section of the larynx. Huh? Lar section. Can anyone tell me what is this one? This is number one. This is number two. This is number three. This is number four. Come on.
That's a section. Your larynx. This is a section of the larynx.
Come on. Come on. Come on. Come on. Come on. Come on. Bolo. Bolo. Bolo. What's that? What's number one? Guess. Guess coro.
Okay. So, one are the vestibular folds.
One is the vestibular folds.
Two is a vocal folds.
Three is the sinus or ventricle of lary. Sinus or ventricle of lary.
One is vestibular fold. Two is vocal fold and three is sinus of the lary.
important.
Who number four? Number four. Number four. Number four is the epiglotus.
Number four is the epiglotus. Fine. Huh?
Are we clear? But clear. This is the vestibular fold.
Vocal fold space. That's a sinus of the larynx.
And four is epiglotus.
section that's a sagital section. If you see it like this.
So yeah this is one fold this is second fold and this is this. So you same the same thing I've drawn this is number one this is number two this is number three. So one is vestibular fold vocal fold sides.
This is a coronal section.
So vestibular fold vocal fold is sinus of the larynx. What is the space? What is the space between the two vestibular folds? What is the space between the two vocal folds? Is remma glutitis and remma vestibuli.
So the space between the two vestibular folds this is one vestibular fold. This is one vestibular fold. The space between the two vestibular folds is remma vestibuli.
The space between the two vocal folds is remaglitis and between one vestibular fold and vocal fold the space that's the sinus of the larynx.
Fine clear.
Huh? Tell me if this is clear I'll proceed.
epiglotus.
This is a sagital section. That's a coronal section. Coronal sectionals and veital section and vocal f.
Okay, great.
We've just seen the jug forum. Okay, just tell me the nerves of the fangial arches. Let us understand the nerves of the fangial arches.
Nerves of the fangial arches. The first arch nerve.
Nerve. Nerves of the fangial arches.
We'll start with this.
Come on. Come on. Come on. Come on. Come on. Come on. The nerves of the fangial arches.
Any guesses? Which is the nerve of the first arch?
The N of the second arch facial. The N of the third arch is glossopherial. The N of the fourth arch fourth arch your four double ar of the fourth arch is superior langel nerve. And the N of the sixth arch is recurrent langial nerve.
Recurrent langel nerve.
Huh.
Which are the muscles of the first arch?
Muscles beha you have told me. So tell me the muscles of the first arch. The muscles of mastication.
Mastication. The muscles of mastication were temporalis, massitor, medial and lateral tergoids. For anterior belly of digastric.
An anterior belly of digastric. Myo hyoid.
Tensorality and tensor tempani.
Tensorality and tensor tempani.
Okay. Fine.
Okay. Okay. Okay. Come back. Take. So mandibular nervous the first arch. Which are the muscles formed in the first arch? One is the muscles of mastication for a tensipality tensor tempanany. The milo hyoid and the anterior belly of digastric. So these are the muscles of the first arch. Second arch muscles. The muscles of facial expression.
Muscles of facial expression. What else?
Stedius. Muscles of facial expression.
Stpadius then posterior belly of digastric and stylo hyoid stylo all this comes in the MCQs muscles of facial expression the the stedius the posterior belly of digastic and the stylo hyoid fine oh there's only one muscle in the third arch can you name this muscle third arch third arch third arch third arch a muscle nata Now name the muscle in the third arch.
Muscle in the third arch only one muscle name styoparanges that's very important but muscle in the third arch is stylo faranges.
Fourth arch may crycoyroid.
Criccoyroid and sixth arch may muscles of larynx. The rest muscles of the larynx and thighs.
Sixth muscles and muscles of the larynx and thighs.
This all is very important.
Okay.
Fine. So we proceed then.
Wow. That's a middle ear cavity. Come on. Come on. Come on. The the the the relations of the medial here. The middle ear. That's a anterior wall. Yeah.
Posterior wall. Aner. Posterior. Roof.
Floor.
Yeah. Medial wall and the lateral wall we have removed. Lateral wall.
So tell me the anterior relations.
Antior wall of middle ear shows two openings. One is the tensor tempest tube internal caroted artery.
Criccoyroid criccoyroid. Criccoyroid is a tensor of vocal cord which is supplied by external lingal nerve. Superior lingel branch external lingial nerve that supplies the criccoyroid which is a muscle of larynx.
Extrinsic muscle b musles of the larynx is supplied by recurrent langial nerve.
Fine. Okay. So coming to the anterior wall of middle ear the openings one is for the tensor tempananya is for the ustation tube and below the external carroted internal caroted artery. The posterior wall. The posterior wall shows an opening to the aditus to the mastoid.
Additus to the mastoid. P additus to the mastoid. Fine. Um the posterior wall shows uh this is for the pyramidal eminence you have stedious muscle attached and there's a uh there's a small passage for the cord tempani nerve your cord nerve under the roof is formed by tempani floor internal jugular vein internal jugular vein and there the tempanic branch of glossophrenial nerve floor Internal jugular vein and the tempanic branch of glossophenia.
The medial wall shows a elevation is promon tree. What is this promon tree and your promon tree is a tempanic plexus.
Oval window which is closed by foot plate of stippies. The round window which is closed by secondary tempanic membrane.
This is the facial canal. Huh. The facial nerve forms and prominence.
That's a facial canal. And this is the prominence of lateral semi-ircular canal. Lateral semic-ircular canal.
That's it.
Can anyone tell me what is the nerve supply of middle ear? You see diagram diagram is very very very uh self-explanatory.
What is the nerve supply of middle ear cavity? Nerve supply of middle ear cavity.
The glossopherrenial nerve through the tempanic plexus. Glossopherial nerve through the tempanic plexus is going to supply the middle ear cavity.
Glossopherial nerve through the tempanic plexus supplies the middle ear cavity.
Fine.
Okay.
Just remember the slide.
Huh?
These are the endodmal pouches. Endodmal pouches. From the first endodmal pouch, first endodmal pouch you get uh tubo tempanic recess is middle ear cavity and audiary tube.
This is very important. From the first endodmal pouch, from the first endodmal pouch, you get what is known as tubotmpanic recesses. This tubotmpanic recess forms the middle ear cavity and ustation tube. The second endodmal pouch forms the tonsil tonsils. The third divides into a dorsal and the vententral part.
The vententral part forms the thymus and the dorsal part forms the inferior parathyroids. Inferior parathyroids.
The fourth divides into a dorsal and ventricle. The dorsal forms the superior parathyroids and the ventricle joins the sixth to form ultimo bronchial body. Ultim branchal body and this ultim branch body forms the parapholicular sea cells of thyroid.
Ultim branchal body say parapholicular sea cells of thyroid. Parapholicular Ca cells of thyroid but parapholicular C cells of thyroid are said to be derived from neural crest cells. MCQ parapholicular C cells of thyroid are derived from up. First answer your first answer is going to be the neural crest cells. Okay, the first answer is going to be the neural crest cells option.
Your second answer is going to be the ultim endodmal pouches derivatives. Thymus is derived from the third endodmal pouch form inferior parathyroid. Fourth, superior parathyroid and the fourth joins with the sixth to form the ultim branal body. Huh? H very good. Very good. Very good.
Fine. No. H. Yeah.
This is very important.
Clear? I'll proceed. We'll proceed then MCQ. Which MCQ? Answer this one's area.
One's area is which area? Wik area is area number 22. That's a sensory speech area, right?
Broka's area is 44 45. That's a motor speech area. Motor speech area. damage motor aphasia.
Motor aphasia damage to sensory aphasia.
Sensory aphasia h and you tell me there's a connection between these two the brokers and the bony areas are connected. What is this connection known as?
Huh?
Right. It is written down. The connection between the brokas and vernicus area is known as unsenate faciculus connects brokas and vernicase area.
Unsenate faculus. But show answer.
Yes. So vericus area is area number 22.
Broka's area is area number 44 45. The connection between the vernicus and brokas area is the unsenate faciculus or aruate faciculus. Aruid faciculus blood supply of the motor or the sensory cortex. What is the answer for this blood supply of the motor area? Can anyone answer this?
Now guys answer this.
What is this artery here? That's a middle cerebral artery.
So the middle cerebral artery supplies the entire superal surface.
A small area here is supplied by whom?
Anterior cerebral artery.
And the occipital lobe is supplied by posterior cerebal artery.
H hello where are all of you? They ra I'm not able to see your comments. Ah very good a okay so tell me now what is this that's a central circus pre-entral post central so this is the motor area that's a sensory area motor area and sensory area of it part it is supplied by whom middle cereal and this part is supplied by anterior cereal so middle cerebral artery plus anterior cereal artery that's a blood supply of motor or sensory area motor or sensory area blood supply is middle and anterior cereal d it's not only middle cerebral it's both middle and anterior cerebral d middle as well as anterior cereal artery whereas blood supply of the occipital lobe of visual cortex visual cortex is supplied by mainly by visual cortex is mainly is supplied by posterior cereal artery plus middle cereal artery supplies the macula macula.
So this always comes what is the blood supply of the occipital lo or the visual cortex. Students answer this as posterior cerebel. But remember posterior cerebel supplies the major part. Posterior cerebel supplies the major part of uh occipital lo whereas for macula and macula is the area for fine vision and the macula is supplied by middle cerebral artery. So MCQ blood supply of the visual cortex. Your answer is going to be the middle cerebral and the posterior cerebral. only posterior cerebal it's posterior and the middle cerebal artery when the posterior cerebal artery thrombosis there's a there's a blindness with macular sparing blindness with macular sparing right because macula con middle cereal artery whereas the motor or the sensory area is supplied by two arteries middle as well as anterior cerebral arteries are middle as well as anterior cereal clear this is very important this this is very confusing but and this and that is why this questions are always asked okay I've been teaching this PG entrances since last 25 years clear okay fine so this is clear so blood supply of motor or sensory area MCA plus ACA.
Let's apply the visual cortexes.
Uh posterior cereal artery plus middle cereal artery as a macula.
Fine.
Clear to all of you.
I'll just tell you one one um one slide I'll draw for you. But see I just draw one easy slide for you.
There are three veins like this. There are three veins here and this three veins joints here veins say and this three veins joints here and this is what we call as the internal cerebral vein internal cerebral vein this is one internal cerebil that's another internal cerebral vein two internal cereal vein joins to form Okay. Two internal cerebral vein joins to form the great cerebral vein.
Great cerebal vein of gallon. And this great cerebral vein of gallon drains into what?
Straight sinus.
Huh. So internal cerebral vein is a deep vein of the brain. Huh? table. This is very easy. I'm I'm making it very easy for you. Two internal cerebal vein joins to form the great cerebal vein. Great cereal vein of gallant range into straight sinus. The internal cerebral vein itself is formed by joining of three veins. Three veins. One isalamo stride.
Talamo stride dra koidal.
And third is septal.
So thealamostry vein, coroidal vein and septal vein. Your pin veins say joints to form the internal cerebral vein.
Internal cerebal vein is a deep vein of the brain. Two internal cerebal vein joints to form the great cereal vein of gallon. And the great cerebal vein of gallon drains into straight sides. Now there's a vein which drains into the great cerebral vein of gallon. And this is the basal vein. basal vein and this basil vein is formed by the joining of three veins donocytes. Donocytes I'm drawing only one. So the basal vein is formed by the joining of anterior cerebral vein.
Anterior cereal vein. The deep middle cerebral.
Deep middle cerebral and the stride veins.
Anterior cerebil. The deep middle cerebil and the straight vein joins to form the basil vein. And this basil vein drains into the great cerebral vein.
Just remember this.
Okay, fine.
Look at this slide.
So what does this mean? Now you answer what is this? That's a internal cerebral vein. Internal cerebal vein joins to form this is a great cereal vein of cal and what is this? That's a basal vein.
Right? That's a basal vein.
That's a basal vein. So what drains here is a basal vein. Okay. That's a basal vein.
So internal cerebal vein two internal cereal vein joins to form the great cerebal vein. What drains into this is the basal vein. Your basal vein will form by joining of three veins.
Right. Now what are these three veins?
This is one. This is two. And this is three. This is the phalamos. This is a coroidal. And that's a septal vein.
Your coroidal vein. That's the septal vein. That's a that's a thealamostride.
That's a septal vein. Jos to form the internal cerebal vein to internal cerebal vein. Jos to form the great cerebal vein. And what drains into the great cerebal vein is the basal vein.
Fine. But just remember this.
Okay.
Now tell me what is this? What is this nerve? Yeah. Number one and two. Can anyone tell me brain stem?
You're seeing the brain stem from backside. What is number one and what is number two? Come on students. Yes.
Ankita. Ankita maj tell me what's number one and what's number two? Can anyone tell me what's number one and two?
H great terrible ve of gallon malf for bologa bolo you can know your answer okay tell me what's number one yeah midbrain yeah pawns yeah medula this this is the fourth ventricle yeah fourth ventricle fine so what is one and two that's the superior chiculus inferior caliculus superior choliculus inferior caliculus what is This nerve the only cranial nerve which emerges from the dorsal aspect. Anyone? The only cranial nerve which emerges from the dorsal aspect of the brain stem is tlear nerve.
Tle the only cranial nerve peaches area that's tlear nerve. What is this elevation known as? That's a facial colliculus. That's a facial colliculus.
And the facial colliculus is formed by the fibers of facial nerve as they wind around the abdence nucleus. Right? The fibers of facial nerve as they wind around the abducence nucleus that's that is the facial that's a facial uh chiculus right that's a facial caliculus what is this triangle this is the hypoglossal triangle that's a veagal triangle hypoglossal triangle and veagal triangle fine specific here tell me ch I'll just I'll just point out structures what is this number one What is this number two? What is this number three? And what is this number four?
Number four. Ch. Answer this. Answer this. But this is very important.
What is 1 2 3 4? That's a horizontal section through the brain.
Horizontal section taken through the brain. This is very important visual CT MRI and something is pointed you asked to identify what is this. Come on students come on a last part is left be active and answer. Yes. Come on. What's one GP? What is GP?
Okay. What's number one? Number one is the phalamus.
I mean sorry number one is the cordic nucleus.
That's a cordic nucleus. Number two is the phalamus.
Number three is the lentififor nucleus.
Lentififor nucleus is formed by globos paladus and putam. What is number four?
Number four is the internal capsule.
Internal capsule. What is this? Compass calosm. Composalm.
This is the phonics.
Phonics. Your phonics. And this is the lateral ventricle. That's a lateral ventricle cavity. That's a lateral ventricle. This is very important section. One is a cordic nucleus.
Lentififor nucleus. That's the internal capsule.
This is the phonics. This is the corpuscalism. That's a corpus callism.
Fine. Now I'll just tell you the attachment of cranial nerves. If you can answer this.
Look, this is the midbrain.
That's the pawns.
That's a medula. That's the pyramids.
That's the olives. That's the inferior cerebellar peduncle.
This is the middle cerebellar pedle. Ch start. What is this nerve? And what is this nerve? What is this nerve?
Sorry.
Answer.
Answer this.
Please inferior cerebellar pinnacle guesses H.
So this is uh this is the third now.
What's this now? Fourth. That's a fifth.
6 7 8 9 10 11. That's a 12th.
This is very important. So the third and the fourth nerves are attached to the midbrain. All the cranial nerves comes from the vententral aspect. Cranial nerves they come from the vententral aspect except the tlear nerve comes from the dorsal aspect.
So third and the fourth nerve is attached to the midbrain. The nerve attached at the junction of pawns with the middle cerebellar peduncle. Pawns and middle cerebellar peduncle junction that is fifth nerve. Fifth nerve to ponttomedary junction. Ponttomed middleary junction is 678.
Ponttoary junction that's 678 between the olives and the inferior cerebella pangle 9th and 11 and between the pyramids and the olives is the 12th 12.
Is this clear to all of you? Nerves attached to the brain stem. This is very very important.
That's very important.
Look at this. That's a third nove.
That's a fourth nose. That's a fifth nose. 6 7 8 9 10 11. And this is the 12th note.
Clear proceed. Shall we proceed?
Yes students are you able to understand enjoying so much sub okay all important topics we are trying to cover in this ionic CT marathon session of anatomy a special effort done by PW team clear to make it a point to give the grand test on PW app make it a point to Okay. So revision let us start. Okay. Okay. Okay. Come on.
Come on. Come on. Come on. So this is the anterior abdominal wall. H. What is this? That's a superficial inguinal ring. Deep inguinal ring. These are the layers of anterior abdominal wall. H rectus abdominis.
Fine. So deep inguinal ring is a defective fasia transposal. The superficial inguinal ring is a defect in external oblique aonurosis. External oblique aponurosis.
What is which nerve is present in the inguinal canal? Bak which is the nerve present in the inguinal canal. Nerve present in the inguinal canal is contents of inguinal canal. The contents of inguinal canal in males and females.
Contents of inguinal canal in males and females.
H males. spatic cord and ilo inguinal nerve. Females may round ligament and ilo inguinal nerve. So spermatic cord and the ilioal nerve females round ligament of uterus and the ilio inguinal nerve. Fine. Contents of spermatic be contents of spermatic cord.
One is vast difference. Second is artery to the V, the testicular artery, the cremastric artery, the pampniform plexus of veins, the genital branch of genital femoral nerve and the lymphatics from the testice. Lymphatics from the testice important contents of spatic or egg barus the vas difference the artery to the v was the chromastic artery the testicular artery the pniform plexus of veins the genital branch of gelato to femoral nerve and the lymphatics from the testice all this is tied together yeah ba up spermatic cord spatic cord fine okay testicular artery is a branch of what anyone can anyone tell Testicular artery is a branch of come on come on come on come on answer testicular artery testicular or ovarian gonadal artery that's a branch of any guesses any guesses any guesses any guesses come on come on come on but important testicular artery or ovarian artery gonadal artery that is a branch of Huh? Hello.
A direct branch from the abdominal aota.
Direct branch from abdominal aota. But branches of abdominal aota 2 3 4 5 two are terminal branches. Terminal branches are common iliacs. Three vententral branches. A celiac trunk. Superior eentric inferior mentric. Char lateral branches. Inferiorophrenic, middle, supraal, renal, gonatal.
Five dorsal branches. Dorsal branches mean four pairs of lumbar arteries and one median sacral artery. Four pairs of lumbar arteries and one is a median sacral artery. So just remember the branches of abdominal aot 2 3 4 5.
That's a pneumonic anterior division of branch. No Sanvi testicular artery is a branch of abdominal aot okay but come on can anyone tell me what is this foramin foram that's the epipoly foramin epiplo foramin epiplo boundaries epipamin boundaries boundaries boundaries epipam boundaries anyone epipam answer Anterior is the lesser momentum. Anterior is the less momentum containing hippatic artery, portal vein, bile duct. Hippatic artery, portal vein, bile duct. Huh?
Posterior is the IBC.
Superior is the cordate lobe.
Cordate lobe of libo.
Inferiorly is the first part of deodorum.
Inferiorly is the first part of deodor branches repeat.
So epip is the less momentum less momentum hippatic artery portal vein and bile duct.
Hippatic artery portal vein and bile duct. So anteriorly is the lessum containing hippatic artery portal vein bile duct. Posterior is IBC. Superiorly is the cordate lobe of liver. Inferiorly is the first part of deodorum. First part of important for branches of abdominal.
Branches of abdominal aota.
Say 2 3 4 5 two are terminal branches.
Two is terminal branches. That's common eliacs.
Common eliacs. Three is vententral branches.
Vententral branches. One is celiac trunk.
Celiac trunk vertebral level is T12.
Second is superior misentric artery.
Vertebral level L1. Inferior mentric artery vertebral level is L3.
Celiac trunk superior mentric inferior mental level. Celiac trunk um vertebral level is T12. Superior mentric L1 inferior mentric is L3. 44 44 are the lateral branches. Lateral branches my first is inferior frenic.
Second is middle supraenal.
Third is renal.
And fourth is okay. And five five is dorsal branches.
Dorsal branches may four pairs of lumbar artery and one median sacral artery.
Four pairs of lumbar arteries and one median sacral art. Take all clear sun clear.
I think it is going back.
So these are the branches of abdominal leota. Just remember that pneumonic 2 3 4 5.
Okay.
Uh there are a lot of my post on Instagram. Instagram post MCQs I I tell MCQs in a um understanding way in a different way.
Okay. MCQs we discuss like that.
So this is fine. Okay. But okay. Thank you. But thank you. Now look look I'll tell you something about fetal circulation important important fetal circulation okay so we start with fetal circulation that is the amal cord contents contents there are two amlicical arteries and this the left umblical vein so contents of umblical cord two aml arteries and the left amal vein I'm telling you fetal circulation but fetal circulation the left umblical vein goes and joints with what your left amal vein it goes and joints with the left branch of portal vein.
The left amal vein goes and joins with the left branch of portal vein.
Ambl vein it comes from the uh placenta.
Amlical vein comes from the placenta. It is carrying pure blood from the placenta. The left amal vein comes and joins with the left branch of portal vein. Up from the portal vein the blood will go to the liver.
Pure blood liver. The liver will use all this pure blood for its own metabolism.
Liver pura pure blood. So there is a bypass. There is a big bypass.
This is a IV and bypass from the left branch of portal vein to the IVC. This is known as the ductus venosis.
Ductus venosis. So vein blood to the left branch of portal vein. From the left branch of portal vein the blood goes to the IVC through the ductus venosis. Now from the IBC the blood comes to from the IVC the blood comes to the right atrium. Right atrium say see the blood left atrium through the foramin o foramin oval.
So right atrium say left atrium left atrium say left ventricle left ventricle say aota mega aota divides into two common eliacs. Common iliacs divides into an external iliac and an internal iliac. External and internal iliac. And from the internal eliac there are two umblical arteries. From the internal iliac these are the two umbilical arteries. So umblical arteries are branches of internal iliac.
Now suppose right atrium right pulmonary trunk and pulary trunk l but the lungs are not functioning. So again there is a bypass channel. What is this?
That's a ductus arteriosis. This is the ductus arteriosis. So what is this?
This is the fetal circulation. This is the fetal circulation. Very very very very very important fetal circulation.
So So that's a left umblical vein label.
That's a left umblical vein.
Vinosis IBC right atrium right atrium for left atrium left atrium. to the left ventricle aota common in elix that's oblical arteries suppose right atrium right ventricle through the pulmit trunk doctor's arteriois it goes to the aort now this is the urinary bladder your bladder arteries are in the pelvis pelvis they are going on either sides of the urinary bladder urinary bladder this is fetal circul ation after birth.
What happens after birth? Ch tell me after birth this obliterates off the left vein now becomes the ligamentum.
So left vegmentum ductus venosis ligamentum venosum ligamentum venos. So venosis ligament for oalis ductus arteriosis ligamentum arteriosum ductus arteros ligamentum arteriosum.
Now this part will obliterate.
This is the obliterated umblical artery and this is what we call as the medial umblical ligament.
So that's the oblitated aml artery medial umblical ligament and this nonoblated part of umblical artery becomes the superior vital artery.
Superior vycle artery. Understand? So artery parts from the bladder to the amlus this obliterates off. From the bladder to the amlus it obliterates off.
This is the medial umblical ligament.
This becomes a meal umblical ligament and this is the nonoblated part of the umblical artery. You b superior vycle artery. This forms a superior vital artery.
Fine. clear to all of you? So this is fetal circulation.
Important fetal circulation.
Okay, I'll proceed.
H fine.
That's the first part. Second part.
Third part of the diardum. That's a bile duct. That's a pancreatic duct. Uh this is the gallbladder.
There's nothing specific in this.
Identify this falsyiform ligament uh ligamentum. Falsify ligament is a peronium. Falsify ligament is a fold of peronium extending from the ant from the amlus to the liver. Falsify ligament.
It's a fold of peronium which begins from the amlus and it goes to the liver.
And the lower border of falsifform ligament contains what? The lower bottoform ligament contains the ligamentum ties.
So much the falsifiform ligament is a fold of peronium.
Falsify ligament is a fold of peronium which extends from the amlucus to the liver and the lower border falsifform ligament contains the ligamentum ties.
Fine.
Okay. Fine. So now you tell me what is this clinical condition? Haha. Unso.
Answer what is that clinical condition known as they pancreas that's an abnormal thing and this pancreas has encircled the first part of the first part of the encircle key what is this congenital anomaly known as the congenital anomaly is known as any guesses annular pancreas as pancreas is derived from two buds dorsal and vententral pancreatic buds pancreas dorsal and ventral pancreatic part normally the ventral pancotic bud migrates and joins the dorsal pancreatic partic migrate so that is annular pancreas annular pancreas occurs due to defective migration ation effective migration of vententral pancreatic blood.
Effective migration of ventral pancreatic blood leads to annular pancreas and a or pancreatic divism is due to nonfusion of the two butts.
important MCQ.
So dorsal and ventral bud fuse.
If the dorsal and vententral do not fuse it results in pancreatic divism and defective migration of the vent pancreatic half.
So this is going to encircle the diotinum and this is what we call as annular pancreas.
So annular pancreas occurs due to defective migration of ventral pancreatic bud and nonfusion of two buds results in pancreatic divism. Pancreatic divism nonfusion of two buds.
Can you tell me what is this congenital anomaly?
What is that congenital anomaly?
H.
Any guesses?
H answer this. What is a congenital anomaly?
I'll just tell you the relations of the kidneys.
Posterior relations of the kidneys. What is this? First muscle, second muscle, third muscle. So this is one, this is two and this is three. The one is what?
SAS major.
Second is contrus lumboreum.
And third is transverse abdominis.
Transverse. So as major congenital um quadratus lumboreum and transverse abdominis. What is this and this? This is the medial aquit ligament.
This is a medial aquit ligament. And what's this? Lateral aquit ligament.
Medial and lateral aquit ligament.
What is this? That's a subccoal nerve.
That's the ilio hypogastric nerve.
And that's the ilo inqual.
So subconl becomes a posterior relations of the kidney.
Important is clinical MCQs. While approaching the kidney from the posterior aspect, all the following structures will be uh encountered except clear while approaching the kidney from the posterior aspect. So major quatus lumbrum transverse abdominis medial arquit lateral arquid ligament.
This is the subcooal nerve ilioastic io nerve.
Okay.
Now just have a look at this. That was congenital polycystic kidney. Very good.
Congenital polycystic kidney is right.
Now secretary part of the kidney is derived from. Now these are very important MCQs.
I'm finishing now. The secret part of the kidney is derived from metanros. Yeah. Meta nephros.
So what does it form? It forms the Bowman's capsule.
It forms the Bowman's capsule. It forms the PCT, loop of Henley and DCT.
So secrettory part of the kidney is derived from metanros. So metanros, Bowman's capsule, PCT, loop off and DCT.
Collecting part of the kidney is derived from urric uric collecting ducts. Collecting ducts collecting tubules.
Minor calix major calix.
Pelvis urator.
Understanding but collecting part separately form secrettory part separately form secrettory part is derived from what metanros collecting part is derived from urric both these parts have to communicate with each other both these parts have to communicate with each other if the collecting and the secretary part do not communicate we get small small cyst in the kidney they so this is a congenital polycystic kidney congenital poly Cystic kidney. Failure of communication of collecting and the secretary part.
Failure of communication of collecting and secretary part results in failure of communication of collecting and the secretive part results in polycystic kidney.
Failure of uritric but to form.
Failure of the uritric bud to form blood enters the metanas and stimulates the metanas to form the kidney.
renal aenesis.
Are you following this? So see collecting part is different, security part is different. Security part is derived from metan metanros. Collecting part is derived from uritric part. Both these parts have to communicate communicate to polycystic kidney. If this collecting part this collecting part will enter the metanros and stimulate the metanros to form the kidney collecting part the kidney will not be formed is renal aenesis.
Renal aenesis fine.
Okay. So just remember these two things.
Okay. Answer this. Structures emerging from the greater shiatic pommen and re-entering through the lesser shiatic forammen. Can anyone tell me structures emerging from the greater shiatic forin and re-entering through the lesser shhatic for your con structures? This is pin pin structures. P is pudental nerve.
This is internal pedental vessels and N is nerve to opt internus.
So pin structures pin structures will emerge through the greater shiatic forammen and will re-enter through the lesser shhatic formen. That's a pudendal nerve internal pudendal vessels and the nerve to operator internals. Fine.
Important.
Fine. Now coming to this openings in the diaphragm. Openings in the diaphragm.
Openings in the diaphragm. Yes. Last last part.
Come on. Just have some energy. Put in some energy. Answer. Openings in the diaphragm. T8. T8 is IC and the right frenic nerve.
IC and the right frenic nerve. T10 is esophagus with the vagus esophagus with right and left leg. T12 is agous vein and thoracic duct.
Thoracic duct openings in the diaphragm.
Just remember very important goon. What is goon?
Fine.
So T8 IBC and right frenic T10 is es is esopus with Vegas. T12 is aus thoracic duct. Fine. Date of pectinate line that's in the anal canal that is known as watershed line. Dentate line SA line.
SA line.
These are the anal columns and this line is known as the dented line. Dented line is a watershed line. Is oper everything is different blood supply, nerve supply, lymphatics is everything is different. This is derived from end tom. This is derived from ectodom. Fine.
And there is a line here this white line of Hilton. That's a Hilton's line.
Hilton's line represents the mucoutaneous junction. Mucoitinous junction of anal canal.
Mucitutinous junction of anal canal.
That's Hilton's line. And this line is known as the dented line.
Dented line represents the muc. Dented line represents the watershed line.
Waterershed line.
Above the dented line sensory below the dented line is sensory. Above the dented line it is supplied by autonomic nerves that is insensitive to pain. Vicki dented line insensitive dented line it is supplied by somatic nerves. So it is painful. Above the dented line it drains into the internal iliac veins. Below the dented line it above the dented line it drains into the internal iliac lymph nodes. Below the dented line it drains into the superficial inguinal lymph nodes.
Superficial inguinal lymph nodes. Okay.
Now fate of misinphric duct in males.
Misenaphric duct in males. What does it form in males and females? Males may the complete genital system of males.
Complete genetic system of males is make epidmus.
Epinitimus v was difference ejaculated duct.
Uh what's difference? Semiinal vesicles ejaculated duct and misodorm of prostrate.
Misodm of prostrate.
So masonic duct in male forms the epidermis vast difference seminal vesicles ejaculator duct and misodal system males females it gets degenerated in females masonic duct gets degenerated gartner's duct gartner duct it forms a gartner's duct parameric duct just one more parameric duct what does it form in males in males it forms Appendix of testice.
Appendix of testice and prostatic utrial.
Prostatic utri in females parametric duct in females fundus body cervix alopine tubes and upper 1/3s of vagina upper one/irds of vagina can anyone tell me the lower 2/3s of vagina is derived from what? Come on, answer this students. Lower 2/3 of the vagina is derived from anyone.
Anyone? Anyone? Anyone? Lower 2/3 of the vagina is derived from eurogenital sinus. Eurogenital sinus.
Upper 1/3 is derived from paramedic.
Lower 2/3 is derived from the h eurogenital sinus. Eurogenital sinus.
Okay. But what is this? You tell me.
This is a sacrooxial terteratoma.
Sacrooxial teratma.
Sacrooxy teratma.
And why does this occur? Sacrooxial teratma occurs due to persistence of primitive streak. Persistence of primitive streak leads to sacrooxial teratma.
What is this? This is an sephali.
That's failure of cranial neuropore to fuse.
And this is spina bifidilla.
Failure of cordal neuropore to close.
Cranial neuropore close to spina bifida. Spina biped.
Function of primitive streak. Formation of three jumbless.
Okay. When does a cranial neuropore close? 25th day of intrauterine life. The cordal neuropore closes by 20 uh 28th day of intrauterine life.
neuropore close that results in spina bipa cranial neuropore close to and then okay fine functions of primitive streak is formation of three gem layers formation of three jumbless primitive streak degenerate that results in sacrooxial teratma if the primitive streak does not disappear it results in sacrooxial teratma fine Neural crest cells derivatives. What are the derivatives of neural crystals?
Anyone?
Adrenal medula.
Derivatives of neural crystals. This is very important. Adrenal medula, lepto menis, schwansel, melanocytes, ortolast, or blast. What else?
Facial skeleton.
Corial stroma.
Parapholicular C cells of thyroid.
Parapholicular C cells of thyroid which derivatives of neural crest cells.
Adrenal medula not cortex. Leptomenis orblast one cell. Uh this the dorsal root gangonion and the sympathetic ganglion. Dorsal root ganglion and sympathetic ganglion.
H the skeleton of the face, the corial stroma and the paraphilicular C cells of thyroid. Paraphalicular C cells of thyroid are said to be derived from neural crest cells. Option then it is ultimal body.
Then you write it as ultimal body.
Fine but clear. So this completes it.
This completes it. Yeah. Clear. This is clear.
Yeah. Clear this is persistence of primitive sacrooxial teratma and infali spinobipida fine but I hope the things are clear to all of you. Yes.
Okay. So this is um an attempt made by PW Med team especially for all of you students for your INICT uh and all the very best from the entire team of PW Med do well and uh come for the interview interview Zuruana make it a point to answer the grand test that is there on the PW Mel app PW melded app neural crest cells derivatives just remember the derivatives of neural crest cells MCQs but thank you so much thank you so much for your patient listening I hope you've understood uh I have tried to complete just go through it and come with flying colors all the very best once again from the entire team of PW M. Thank you so much. Bye-bye.
I'll stop you.
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