ANATOMY SMART RAPID REVISION 2.0🔥| FINAL 30 DAYS | FMGE JUNE 2026 | By Dr. BHARATH REDDYR #fmge

Added: 2026-05-30

[00:00:03]Hello guys, welcome to our channel.

[00:00:05]Today we are going to start the Mission 200 plus guys upcoming examination rapid revision program. In this we are going to cover the all 19 subjects rapid revision flash tool short series and also one of the most important image based discussion also we are going to have.

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[00:00:30]So I just wanted to remind you guys. So please believe that you can do. So you're already halfway there.

[00:00:37]Okay? So believe that you can do, you're already halfway there. And I know you already believe that you are going to complete the MBBS, you completed and now you're already be believing that we we are going to pass this examination with a good score. Right? So we will believe and we will go that through also and we will win this war. Right?

[00:00:57]Next. Coming to these notes. So those who are interested to buy these notes, this is the paid content guys. So we will be including the annotated version and also annotated version in the other group. If you want to buy this, please text on this Telegram ID or you can join the main Telegram ID and then you can text me from there. Okay? So we will let you to add in the other group with the PDFs.

[00:01:21]So let's start the discussion guys.

[00:01:23]Today we are going to discuss about the anatomy.

[00:01:26]So I hope you all know that this is the person and his name is Henry Gray.

[00:01:35]Okay? So whenever you listen to the anatomy, the most importantly you all might have heard about the Gray's Anatomy, right? So there is a famous show also. This Gray's Anatomy is first author was Henry Gray. On his honorary, we are just continuing that Gray's Anatomy all the editions. So Henry Gray is a first anatomist and also surgeon who completely he focused his career on the dissection of the cadavers and all the important structures relations to the anatomical body. He has contributed his his knowledge. And unfortunately, he was died due to the smallpox when he was researching about the cadaver and dissection and everything. Right? But his contributions to anatomy is really irreplaceable and we are very thankful for him for the all the knowledge that he shared from him to our generations. So, let's start the discussion, guys. So, first, the most important all the triangles and all the contents that we are going to learn today. So, first here, whenever you see any triangles or any borders, you have to see which border is which side. So, here you can see this is the lateral border. And here you can see this is the medial border. So, this is the lateral and medial and hopefully, this is the superior and this is the inferior. And what we have to see, what are the borders these are these are covered. So, here you can see this is the one muscle.

[00:03:09]Right? And here the another muscle. What are these muscles covering the medial side and the lateral side? So, on the lateral side, there is a sartorius muscle and on the medial side, there is a adductor longus muscle. And on the upward side, on the superior side, we have the inguinal ligament. We have the inguinal ligament. These are the main properties that you have to remember.

[00:03:33]And what about the content? So, when it is comes to the content of the femoral triangle. So, first thing that you have to remember, it is a femoral triangle, so there will be femoral artery, there will be femoral vein, and femoral lymph nodes. And also, there is a femoral nerve also. Along with that, there is a genitofemoral nerve. Genitofemoral nerve has the two branches. One is the femoral branch, the other one is the genital branch. And this is the femoral branch. So, these are the important content that we have in the the femoral triangle. Next, femoral triangle, if you observe here, you can see this is the separate sheet we have.

[00:04:20]Okay, what is this sheet? This is the femoral sheet. And what is the importance of this femoral sheet? Let's see here. So, this is the femoral sheet, guys. And femoral sheet is going to cover the in different compartments of the important structures. Okay? Into the three compartments. This is the first compartment. Here, the second compartment. This is the third compartment. What are the structures that is present in the femoral sheet?

[00:04:44]So, in the first compartment, we have the artery. Second compartment, we. And third compartment is the space. And in this space, we are going to have the lymph nodes. Okay? The lymph nodes are present in this particular uh third compartment. And also, in the first compartment, you have to remember the genitofemoral nerve. Just now we discussed here. Here, you can see this is the genitofemoral nerve. Where it is present? Along with the artery, the genitofemoral nerve that is present here. And here, you can see already what is this structure, guys? Superiorly, this is the inguinal ligament, right?

[00:05:21]And what is this structure? This is the sartorius, right? Also known as your honeymoon muscle. And this is your adductor longus. This is your adductor longus. These are the important structures. And here, you can see this is the femoral triangle and femoral sheet. Next, moving on to the What is this structure if you can observe? And this structure is known as a popliteal fossa. Semimembranosus and biceps femoris, gastrocnemius and gastrocnemius muscles. And here you can see this is the popliteal fossa on our flexor side. So what is the important content that is present in the popliteal fossa that you have to remember. So coming to the content of the popliteal fossa, we have the popliteal artery, popliteal vein, and popliteal lymph nodes. But there is no popliteal nerve.

[00:06:16]And what are the nerves that is important? That is our main question. So we have tibial nerve and also sciatic nerve.

[00:06:27]And most importantly, we also have the common peroneal nerve. Okay, these are the nerves that is present in this popliteal fossa. And what are the boundaries? On the medial upper border, semimembranosus. Medial lateral border, biceps femoris. And both the medial and the lateral of the lower lower half, that will be the gastrocnemius muscles.

[00:06:51]Right? Next, here you can see this is the flexor retinaculum. And what is the importance of the flexor retinaculum? So here you can see this is the flexor flexor retinaculum. And below the flexor retinaculum, we have the carpal tunnel.

[00:07:05]Right? In the carpal tunnel, we have the some of the important tendons. And also there is a particularly there is a nerve. Here you can see this is the nerve that is present that is the median nerve. So if there is a any damage to the carpal tunnel, so there is a palsy associated with the median nerve. And if you keenly observe, here you can see this is the one. And there also there is a nerve and also artery. This is known as a Guyon's canal. In the Guyon's canal, what is present, guys? One is ulnar nerve and other one is the ulnar artery. Okay?

[00:07:46]So, these two structures present in the Guyon's canal. And in the carpal tunnel, we have the median nerve. And what are the tendons that is passing through here? This is the flexor digitorum profundus and flexor digitorum superficialis superficialis is present here.

[00:08:03]Right? Next, moving on to the another structure, most important one, that is the anatomical snuffbox. In the anatomical snuffbox, we have the boundaries. So, one is the tendon of abductor pollicis longus. And also, there is a tendon Here you can see, this is the abductor pollicis longus. And next one, we also have the tendon of extensor pollicis brevis. Here you can see, this is the tendon of abductor uh pollicis brevis. This both are going to form the lateral side of the This is going to form the lateral side.

[00:08:41]And here you can see, the tendon of extensor pollicis longus. This will form the median.

[00:08:47]Okay? This will form the medial side.

[00:08:49]And what about the floor? Floor is formed by the carpal bones, trapezium and the scaphoid. And what about the content of the snuffbox? What is the importance? The content of the snuffbox is superficialis radialis nerve, superficialis radial nerve, and radial artery, and also cephalic vein. Okay?

[00:09:08]These three structures will be present.

[00:09:10]And where you are going to listen the pulse? You can listen the pulse from the radial artery. And what is the importance? If there is a damage, if there is a fracture of the scaphoid, especially if there is a fracture of the scaphoid, the patient will be suffering from the pain at the anatomical snuffbox. And also important for the to check the pulsations.

[00:09:32]Next, moving on to the Here you can see, this is the common test that has been asked in the examination. So, before that, I want you guys to know about the some of the important muscles and their action. So, we all know that there is a muscles of the gluteus muscles, right?

[00:09:47]So, gluteus maximus and also we have the gluteus medius and gluteus minimus.

[00:09:58]So, what are their main action?

[00:10:01]And what are the nerves that is supplied by? And the nerves that is supplied by the gluteus maximus is the inferior gluteal nerve. This is supplied by the inferior gluteal nerve. And these two is supplied by the superior gluteal nerve.

[00:10:20]And what is the mechanism of action? So, the gluteus maximus is going to do the hip extension.

[00:10:27]This will help in the hip extension and also lateral rotation.

[00:10:33]And coming to these two muscles, the gluteus medius and the minimus, this is important for the stabilization of the leg. Okay, whenever we are walking, the stabilization of the pelvis is very important, right? So, it will be helping in the abduction, hip abduction, and also medial rotation. This is the main mechanism of action is these two muscles. And whenever you are doing the normal walking, when you are other leg is lifting, so other side of the muscles that is going to stabilize, right? Hip in the medial rotation, it is going to stabilization. This is known as a main normal action of the gluteus medius and the gluteus minimus. If there is a damage to this particularly muscles due to the nerve injury of the superior gluteal nerve, what happens? Whenever you lift the leg, your pelvis will be going to tilt on the normal side only. This is the normal side and this is the affected side. So, if this muscles and the nerves that is not not properly working, what happens? Your hip will be tilting on the other side only.

[00:11:43]What is this test known as, guys? This test This test is known as a Trendelenburg test. Okay, this test is known as a Trendelenburg test. What is the nerve that we are checking here? We are checking for the superior gluteal nerve. We're checking for the superior gluteal nerve. And most importantly, what is the thing that you have to remember? The tilt of the pelvis on the normal side only. Okay? And the injury is contralateral lesion of the opposite.

[00:12:17]This is the one thing that you have to remember remember about the Trendelenburg test.

[00:12:22]Next, here you can see this is the important muscles that you have to remember. One is the lumbricals. Okay?

[00:12:29]The lumbrical muscles. And in the lumbrical muscles, you have to remember what are the important muscles, guys?

[00:12:34]They are the four muscles. Here you can see one, two, three, and the four muscles. And in these four muscles, you have to remember Again, I'm going to write one, two, three, four muscles. And in these four muscles, the first one and two muscles is actually supplied by the median nerve.

[00:12:55]And three and four muscles are supplied by the ulnar nerve.

[00:13:00]Okay? Next, here you can see the adductor pollicis. This adductor pollicis is not a lumbrical.

[00:13:08]Okay?

[00:13:09]This muscle is not a lumbrical, but it is also supplied by the ulnar nerve. This is also supplied by the ulnar nerve for the adduction.

[00:13:21]Okay? Next, we have the interosseous muscle. And interosseous muscles And here you can see this is the palmar side. Palmar side is mostly important for the adduction.

[00:13:32]Okay? And on the dorsal side, interosseous muscles are for the abduction.

[00:13:39]Okay? And what is the nerves that is supplied for both of them? The nerve supply for the both of them is the ulnar nerve. And this question has been asked in the previous examination already. And what is the test that you are going to do for the palmar and the interosseous muscles? The card test, right? Card test is performed for this both interosseous muscles. Next, moving on to the cubital fossa. Again, what I said, guys? Whenever you see these contents, you have to check for the boundaries.

[00:14:10]So, here you can see this is the superior boundary and this is the inferior. This is the lateral and here the medial. And again, what is the boundaries? So, the first boundary that is formed above, that is the epicondylar line.

[00:14:25]And what is the boundary on the lateral side? That is the brachioradialis muscle.

[00:14:29]And on the medial side, it is the pronator teres muscle.

[00:14:34]Right? These are the three muscles that is coming to the content. So, content that we have to know from here is on the medial to lateral side. So, from this side to other side. So, medial to lateral side. So, there is a mnemonic that you can remember, guys. MBBS? The first one is the median nerve. Here you can see this is the median nerve.

[00:15:01]And the second one, that is the B, the both are the arteries, the brachial vessels, vein and also artery.

[00:15:10]And the second one, other B, here you can see this is the B, other B, that is a biceps tendon.

[00:15:16]This is the biceps tendon.

[00:15:19]And the last one, S, that is for the superficial radial nerve. Superficial radial nerve. Not the main nerve, this is the superficial radial nerve.

[00:15:30]Next, moving on to the injury. Some of the important injuries that you should not forgot. And here you can see the patient is having the drop. The patient is having the drop. So, this drop is associated with the cranial nerve 11.

[00:15:45]This is associated with the cranial nerve 11. And what is that nerve? That is spinal accessory nerve.

[00:15:53]Spinal accessory nerve lesion. And what is the defect that is going to associated with this patient? There is a shoulder drop and also patient cannot shrug the shoulders. The shrugging is also absent for this patient. And 90° of the abduction the 90° of the abduction is not possible in this patient. Okay? And why? Because of the muscles that is involved here is the trapezius and also sternocleidomastoid muscles. This is the defect of the spinal accessory nerve. And similar to the another shoulder injury, especially the scapula. The scapula, if you observe the medial side of the scapula is more prominent. Okay? Comparing to the other side, the medial side of the uh scapula is more prominent. Why?

[00:16:43]Because this is due to winging of the scapula. So, we call this as a winging of the scapula. And what is the nerve that is involved here? Long thoracic nerve.

[00:16:54]This is the long thoracic nerve that is going to defect here. And the muscle that is involved is the serratus anterior.

[00:17:04]That is the serratus anterior. And another condition that you can see. And this condition is known as a Klippel Klippel Klippel-Feil syndrome.

[00:17:16]What is this Klippel-Feil syndrome? Here you can see the patient is having the kind of defectivity that is associated with the Sprengel's deformity.

[00:17:26]Sprengel's deformity and also the neck.

[00:17:30]This is the short neck and low hairline.

[00:17:35]All this condition is not associated with the any kind of the uh shoulder defect. This is actually associated with the defect of the cervical vertebrae.

[00:17:47]So, failure to form the cervical, the non-fusion or the failure of the cervical vertebrae is going to present in this the Klippel-Feil syndrome. Okay? Next, moving on to the important muscles that I want you guys to remember, that is the rotator cuff muscles.

[00:18:09]Okay? The rotator cuff muscles. In the rotator cuff muscles, you all know supraspinatus, subscapularis, infraspinatus and the teres minor. And where are these all present, guys? The one which is asso- attached to the all the muscles, those are the first muscle and also third muscle and the fourth muscle. These are attached to the greater tubercle. Okay?

[00:18:38]And second muscle, that is attached to the lesser tubercle.

[00:18:43]That is attached to the lesser tubercle.

[00:18:47]Okay? And what is the nerve supply? So, nerve supply for these muscles. So, supraspinatus is supplied by the suprascapular and same as the infraspinatus also. This is also supplied by the suprascapular nerve. And next, subscapularis.

[00:19:09]Subscapularis nerve, that is associated with the upper subscapular nerve.

[00:19:20]Okay, next, what is the teres minor?

[00:19:22]Teres minor is innervated by the axillary nerve.

[00:19:27]Well, this is the important muscle that you have to remember. What is the most common tear that is associated? The most common tear is associated with the supraspinatus.

[00:19:38]Next, this question has been also asked in the previous examination. Remember the main tendons that you have to recognize.

[00:19:45]Here you can see this is a tendon of the palmaris longus and here the tendon of the palmaris radialis. And same as the dissection image also. Here you can see this is the palmaris tendon and here the carpi radialis tendon. And this is the another tendon. What is this tendon, guys? Tendon of the flexor carpi flexor carpi ulnaris.

[00:20:09]And what is the nerve that is passing here? That is the median nerve in between. Here you can see. This is the median nerve. And these are the important points of this image also.

[00:20:19]Next, moving on to the another that is the abdomen. And in the abdomen we are going to find all the important in a very short time. Here you can see this is the line that is differing from the epigastric and the umbilicus. And what is the vertebral level? This is the L3.

[00:20:35]And just below the umbilicus and above the So, just below the umbilicus and above the cristae. Here you can see. This line is the L5. This line is the L5. And what is this importance of this lines? So, this is going to differentiate between the all the quadrants of the abdomen.

[00:20:53]And this line is a subcostal.

[00:20:57]And here this is a transtubercular.

[00:21:01]Transtubercular line.

[00:21:06]And umbilicus, umbilicus is the T10 dermatome.

[00:21:13]And the quadrants you all know, hypochondriac, hypochondriac, lumbar, and umbilical region, iliac, hypogastric, and the iliac region.

[00:21:20]Right? Next, recently in the INI-CET, the question has been asked about the identifications of the muscle and their importance. And here you can see, most important abdominal muscles is the external oblique muscle, internal oblique muscle. This is the external, this is the internal oblique. And coming to the more inside, there is a transverse abdominis muscle. And if you see from the xiphisternum to the pubic symphysis, the muscle that is forming is the rectus abdominis muscle. And what is this one, guys? This is the linea alba.

[00:21:49]This is the linea alba. And common question that has been asked, where is the nerve root is but nerve bundles are present. So, the nerve bundles is present in between internal oblique muscle and also transversus abdominis.

[00:22:06]Here you can see, right? The muscles and the nerves that has been seen here. So, the nerve bundles is present in between the internal oblique and the transversus abdominis. What are the muscles, guys?

[00:22:15]T7 to T11 and also T12 subcostal nerves that is present here. And next, coming to the rectus abdominis muscle, this rectus abdominis muscle is going to carry the rectus sheath. Okay? This has the rectus sheath. And what is the rectus sheath importance? The rectus sheath is going to contain the rectus ab- dominis muscle and also pyramidalis muscle. Okay? This is also contains a pyramidalis muscle. And along with the vessels, what are the vessels, guys?

[00:22:44]Superior and also inferior epigastric vessels.

[00:22:50]This covers the superior epigastric and the inferior epigastric vessels that is be present here. Next, coming to the triangles of the Calot's triangle and the hepatocystic triangle. So, this is the hepatocystic triangle, where you can see here on the superior side we are going to see the inferior inferior border of liver.

[00:23:12]Okay, on the medial side you're going to see the common hepatic duct. On the lateral side you're going to see the cystic duct. Right? On the lateral side we are going to see the cystic duct.

[00:23:23]Whereas Calot's triangle on the superior side there is a cystic artery.

[00:23:29]There is a cystic artery. And other sides is the same, common hepatic duct on the medial side and on the lateral side there is a cystic duct. Why this is important? Whenever you're doing the the cholecystectomy these borders are very important to understand for our understanding. Next, inguinal ligament.

[00:23:47]Okay, inguinal [clears throat] canal.

[00:23:48]How the inguinal canal is present? So, let's see the inguinal canal, guys.

[00:23:53]Inguinal canal, how it is formed. So, basically inguinal canal it has the four borders. One is the anterior, other one is the posterior, and also the roof and the floor.

[00:24:09]So, in the in the first in the roof we have the internal oblique muscles and transversus transversus abdominis muscles is present on the roof. On the anterior side we have the external oblique muscles.

[00:24:26]And on the floor there is a inguinal ligament.

[00:24:30]The floor there is a inguinal ligament.

[00:24:33]And on the posterior side we have the fascia. This is the transversalis fascia that is present. And whatever the content, so in the content, for example, if it is a females, we have the round ligament. And if it is a males, we have the spermatic cord. What are the spermatic cord contents? That is a external spermatic fascia, cremaster cremaster muscle, internal spermatic fascia, and testic- testicular vein and the artery and ductus deferens. This is the common questions that is has been asked. And what is the other important one? And what is this canal is carrying?

[00:25:07]This canal is also carrying the ilioinguinal nerve and genitofemoral geni- genital branch of the genitofemoral nerve. This question has been also asked. What is the nerve that is passing? And if it is injured during the surgery, what is the nerve that is involved? That is the ilioinguinal nerve. It is the most common nerve that is present here. And other nerve is a genital branch of the genitofemoral nerve. These are the importance of the female and the male and inguinal canal boundaries. Right? Again, come back to here. What is the fascia? This is going to form the posterior side. And how about the internal abdominis? This two is also known as a conjoint, guys. This is known as a also conjoint tendon. And this is going to form the roof.

[00:25:51]And external oblique, this is going to form the anterior.

[00:25:55]Right? And this is the importance of the inguinal canal. Next, moving on to the Hesselbach's triangle. So, we also have the Hesselbach's triangle. This is also most commonly asked. So, here you can see this is the Hesselbach's triangle.

[00:26:09]Again, you have to make sure this is the medial side.

[00:26:14]This is the medial side. And here you can see this is the lateral side.

[00:26:22]Okay? And here you can see this is the inferior.

[00:26:28]Let's see the boundaries.

[00:26:29]So, what is the inferior it is present, guys?

[00:26:33]Look at the picture.

[00:26:34]Here you can see this is the inguinal ligament.

[00:26:40]Inguinal ligament is present on the inferior part.

[00:26:44]And next, lateral side. What is laterally present, guys? See the vessels that is passing on the lateral side.

[00:26:51]This is the inferior epigastric vessels.

[00:26:55]Okay, only inferior epigastric vessels.

[00:27:00]Next on the medial side. Medial side, this is the muscle, right? Rectus abdominis muscle.

[00:27:10]So, most commonly in the Hesselbach's triangle, what is the defect that will be seen? Direct hernia that has been seen here.

[00:27:18]Okay, next coming to the ligaments.

[00:27:20]Here, the abdomen. So, the one which is connecting the the GI system plus liver.

[00:27:28]That is the gastrohepatic ligament. And gastrosplenic. The name itself telling the gastro and the spleen. And the spleno-renal also known as a lieno- renal that will be between the Here you can see, this is a kidney and the spleen. That is between the spleno-renal. Next, falciform ligament that is present in the liver, which will be dividing the first and the second quadrant. Points and the diseases that we have to remember in this condition.

[00:27:58]And also we have the hepato-duodenal ligament. In the hepato-duodenal ligament, that will be portal triad.

[00:28:03]What are the portal triad contains?

[00:28:05]Hepatic artery, common bile duct, and portal vein. And also we have the foramen epiploic foramen of the Winslow.

[00:28:13]And here you can see, this is the epiploic foramen. And in this foramen, what is the anterior side, guys?

[00:28:19]Anterior side you have the the most importantly the liver and also the importance of the gastric vessels and the portal triad. On the posterior side, here the posterior side vertebrae is present here. And on the posterior side you have the aorta. Okay, this is the importance of the omental foramen or also known as a epiploic foramen. This question has been also asked with the identification. Next, Couinaud segments.

[00:28:43]This is given by the Couinaud's classification for the liver segments.

[00:28:49]So, just apply the fist, you can remember this is the first segment and here the second, third, 4A, 4B, 5, 6, 7, 8. If you can observe, this is on the clockwise direction, right? This is on the clockwise direction. Just you have to remember A is above, B is the below.

[00:29:06]A is above, B is the below, right? So, we are seeing that 2 3 4 5 6 these segments that is going to see. And what is the main that is dividing here? The first thing that is dividing between these segments is the Here you can see the portal vein. Based on the portal vein, the caudate knot is classified this classification of the different quadrants.

[00:29:27]Next, moving on to the thoracic content.

[00:29:30]So, in the thoracic content, what we are looking here is we are looking at the mediastinum.

[00:29:34]Okay? We are looking at the mediastinum.

[00:29:38]Mediastinum is divided into the two types. One is the superior one and other one is the inferior.

[00:29:46]In the inferior, subdivided anterior, middle, and also posterior. We have divided into the anterior, medial, and posterior we have been divided. Let's see what are the important contents that is present in the all these important mediastinums and if there is an injury, what will be seen. So, let's start with the superior mediastinum. We have the ascending aorta.

[00:30:11]Ascending aorta has been seen here and also there is a trachea.

[00:30:18]Esophagus Whenever the esophagus, the most importantly the nerve that is also passing here is the vagus nerve.

[00:30:28]Okay? And there is a sympathetic trunk.

[00:30:32]Sympathetic trunk that is passing here.

[00:30:36]And also the the other structures like trachea Okay? And thoracic duct thoracic duct and recurrent laryngeal nerve.

[00:30:52]and phrenic nerve. All these structures will be passing from the superior mediastinum. Coming to the anterior mediastinum, and the anterior mediastinum, we have the thymus gland and also some of the fatty tissue.

[00:31:07]Okay, next. We also have the median, sorry, middle one. In the median, there is a heart.

[00:31:12]Most importantly, and also pericardium, right? Pericardium important structure will be present. And phrenic nerve. So, from the superior, it is going to come in the middle one.

[00:31:22]Next, posterior mediastinum. In the posterior mediastinum, we have the esophagus.

[00:31:28]Again, there will be a thoracic duct.

[00:31:33]Again, there will be a sympathetic trunk.

[00:31:40]And along with that, there will be a descending aorta. Okay? There is a descending aorta and also inferior vena cava and vagus nerve.

[00:31:53]So, these are the important that you have to remember about the mediastinum purposes. Next, here you can see, this is the sternum, right? This is the sternum and we are here we have the the angle of Louis.

[00:32:08]angle of Louis at the T4 level, at the T4 level. And what is the importance of this angle of Louis? This is going to divide the This is going to divide the aortic arch and branches.

[00:32:23]At this location only, we will be seeing the carina formation of the bronchus.

[00:32:30]And it will also divide the superior and inferior mediastinum.

[00:32:35]This is also divide the superior and inferior mediastinum. And the attachment here you can see this is the first rib this is the second rib. So the second rib is also attached in the angle of Louis. Even on the shadow if you can't observe in the x-ray remember whenever you see this angle of Louis that is the one where is the second rib is attached.

[00:32:56]And here you can see this picture. Okay?

[00:32:59]Just remember this picture. Okay, let's come here. So we have the So this is the sternum let's say. Here the first rib and this is the second rib, third and fourth rib. So basically they are the important structures that is present here. Whenever there is a nerve here this structure is present in the this point of view. And this is known as a nerve bundle. Okay, this is known as a neuro and also vascular bundle.

[00:33:34]There will be a nerve there is a artery and there is a vein. This is known as a neurovascular bundle. And this neurovascular bundle can be damaged even we are during the piercing of the injection. So whenever you have to pierce the injection you have to pierce here. Okay? This is the location you have to pierce.

[00:33:59]So what is this location is known as this? This location is known as a lower border of rib.

[00:34:08]Lower border of the rib is a location where you have to divide the pay where you do where have to injure where you have to do the injection whenever you are during the the most importantly during the pneumothorax needle thoracostomy we do right? So this is the location that you have to do. Never do.

[00:34:27]Okay? Never do at the site which is the site guys? That is the upper border.

[00:34:34]That is the upper border of the rib, we should not do. Why? Because of the presence of the neurovascular bundle.

[00:34:41]That's why we should not be doing here.

[00:34:44]And [clears throat] most commonly foreign body is gone into where? The foreign body is going to most commonly going into the right lung only. Why?

[00:34:53]Because the carina when it is divided, the right side of the bronchus the right side of the bronchus is going to be shorter and wider.

[00:35:06]Also, this is going to be vertical.

[00:35:10]So, that's why the most commonly foreign body is going to lodge here. This question has been asked in the recent INICET. Right? Next, moving on to the structure. This is the azygos vein structure. So, in the azygos vein structure, this is the superior vena cava. This is the inferior vena cava.

[00:35:28]Okay? And in the superior vena cava, this is the first branch. This is the right side of the brachiocephalic vein.

[00:35:34]This is the left side of the brachiocephalic vein. Okay? Next, coming to here. This is the first intercostal vein. First intercostal vein. And next, this is the second and third and fourth.

[00:35:50]What is this? This is the left side of the superior intercostal vessels. Okay? Next, this is the accessory accessory hemiazygos vein.

[00:36:07]Hemiazygos vein.

[00:36:10]And here you can see, this is the hemiazygos vein.

[00:36:17]Where is the main azygos vein, guys?

[00:36:19]Here you can see. This is the main one.

[00:36:21]Main azygos vein.

[00:36:25]Which is present on the right Okay, this is the supply of the venous system of the complete ribs intercostal muscles.

[00:36:35]Next, moving on to the structures that you have to identify from the cadaver or the radiological image. So, these one, the gas forming, this is the right main bronchus.

[00:36:45]Right, this is the right main bronchus.

[00:36:47]And here you can see this is the aorta.

[00:36:50]And here, the small one, this is the superior vena cava. And this is the ascending aorta and pulmonary artery.

[00:36:58]Pulmonary artery. This is the things that you have to remember. And this is the posterior most, that is a vertebrae, aorta you are going to see. Before that, a opposite to the the structures like bronchi, you are going to see the superior vena cava and also the pulmonary artery.

[00:37:14]Next, moving on to the lung hilum. So, in the lung hilum, what you have to see first of all. So, in the lung hilum, you are going to see the structures first of all, how many parts that is seen. So, this is the left side, this is the right side, this is the left side. So, how many lobes are seen? First and second, first, second, and third. They are the three parts that is seen. And what is this particular structure? This structure is known as a lingula.

[00:37:42]Lingula is present here. Okay? And coming to the structures, let's see. So, this is the right side of the lung, this is the left side of the lung. On the right side of the lung, if you can observe, this is how the border is formed. What is this border that is formed on the right side of the right side of the system? This is the azygos vein.

[00:38:04]Azygos vein. And below the azygos vein, we have the hilum. Right? In the hilum, we have the epiarterial and also the artery, hypoarterial, and vein.

[00:38:24]And what is this epiarterial hypoarterial? This is the bronchi.

[00:38:29]On the left side, we have the aorta.

[00:38:32]Here you can see, this is the aorta.

[00:38:35]And next, this is only the artery.

[00:38:39]And the other one is a bronchus. Only one bronchus is present. And vein.

[00:38:45]Okay? So, here we are going to see epiarterial hypoarterial artery. So, the artery is between the two bronchus in the right side. Whereas, in the left side, only the one bronchus, that is between the artery and the vein. Okay? And what is the structures that is passing on the above the hilum? On the right side, as yes vein. On the left side, aorta. Okay?

[00:39:05]This is the important parts that you have to remember. Next, moving on to the esopha- uh diaphragm. In the diaphragm, there is a three holes that is passing here. Caval hiatus, esophageal hiatus, aortic hiatus. In the caval hiatus, we have the inferior vena cava. And also, there is a phrenic nerve.

[00:39:27]And also, there is a phrenic nerve.

[00:39:30]Right? Phrenic nerve and the inferior vena cava. Especially, the right side of the phrenic nerve is present in the caval hiatus. On the esophagus, first one, the esophagus.

[00:39:41]And along with that, there is a vagus.

[00:39:45]And left gastric artery is also present here. Left gastric artery. And on the aortic hiatus, aorta, thoracic duct, and also, the most importantly, as yes vein.

[00:40:00]These three structures is passing on to the aortic hiatus. And diaphragm is supplied by the which nerve? Remember, it is supplied by the three nerve roots.

[00:40:10]How can you remember? Phrenic nerve.

[00:40:12]Okay?

[00:40:14]But actually, it is supplied by the phrenic nerve. For the mnemonic, I'm telling you this is the phrenic nerve and the nerve root of this phrenic nerve is the C3, C4, and C5.

[00:40:25]Next, here you can see at the T8 level vena cava opening, T10 esophagus opening, T12 aortic opening. Okay, that is the also the opening levels also you have to remember. And next coming to this structure, the embryology of the is embryology of the most importantly diaphragm, pleuroperitoneal membrane.

[00:40:45]These pleuroperitoneal membrane later develop the muscle.

[00:40:49]Okay, the main muscle is the body wall.

[00:40:51]This is the main muscle.

[00:40:56]And esophageal the esophageal mesoderm, this is going to form the crura of the diaphragm and septum transversum, this is going to form the central tendon.

[00:41:09]Okay. So, if there is a pleuroperitoneal is damaged, that means it is not developed. So, if it is absent, it is going to cause the congenital congenital diaphragmatic hernia.

[00:41:27]Remember, this is the hernia that is going to be presented in this patient. And why I given the CT image? This is the lungs, heart, and this is the intestine, and this is the lung. Right? This is the right side.

[00:41:42]Sorry, guys.

[00:41:44]So, most commonly it is associated with the left side only. So, this is the lung, this is the intestine. The intestines into the This is a lung window. Right? This is a lung window.

[00:41:56]And this congenital hiatal diaphragmatic hernia, as I mentioned, the left side is the more common than the right side.

[00:42:03]Okay? And posterior lateral is more common than the anteromedial.

[00:42:08]And most common type is the Bochdalek hernia.

[00:42:13]Bochdalek hernia more than the Morgagni hernia.

[00:42:17]And what is the contraindication? Bag and mask ventilation is contraindicated.

[00:42:23]Then what is the treatment? We have to give the IPPV or also BPPV. We have to give for this patient. And what is the important complication that is associated? The most common common complication will be the lung hypoplasia.

[00:42:39]Lung hypoplasia that is seen in this patient. This is the importance of the most importantly, you have to know about this pleuroperitoneal membrane and the CDH.

[00:42:49]Next, moving on to the aorta. Okay, moving on to the aorta and heart system.

[00:42:56]In the heart system, you have to know about the how the arteries that is divided. Okay, let's see how the arteries that has been divided.

[00:43:05]So, first of all, we have the aortic hiatus here, right? So, the aortic [snorts] aortic sinus is present here.

[00:43:15]So, in the aortic sinus, the left side is divided into the left main coronary artery. On the right side, it is divided as a right coronary artery, right?

[00:43:27]In the left right side of the coronary artery, so the right side of the coronary artery that will be divided as a sino- SA nodal artery and also the AV nodal artery.

[00:43:42]Okay, and right coronary artery is also going to have the right marginal artery.

[00:43:48]Sometimes, it is on the posterior side also, interventricular artery is also formed by the right coronary artery only.

[00:43:56]Next, left side is mostly on the anterior side only. So, LAD, that means anterior descending artery, LAM, that is a left marginal artery, and LCA, that is a left circumflex artery that is formed by the LCA. And most of us are the right side of the dominance in the left side.

[00:44:14]So, our most of the artery heart supplies will be based on the right coronary artery only. So, whenever you place the chest leads, for example, here you can see this is the V1, this is the V2, and V3, V4, V5, and the V6, right?

[00:44:30]So, here the formation that it has been forming into the this side. So, the two sides This is the V5 and the V6 mostly covering the lateral side of the heart.

[00:44:39]And these three is most importantly covering the anterior septal. Okay, main septum is going here, right? This is the main septum that is coming to the anterior septal. And this will cover the anterior side of the heart. And along with that, we also have the triangle, right? This is how we are going to form the This is the second one, first, and also third, okay? AVF.

[00:45:04]Okay, AVL and AVR. So, this is how the leads that we are going to place. Why this leads that I have I have been explaining here? Because this is associated with the importance of which artery is involved most commonly.

[00:45:18]So, we have here the normal ECG without any ST elevation. And what are the sides that is going to be covered? Let's see.

[00:45:25]So, the second one, third one, and also AV F. This is covered by the inferior.

[00:45:33]Okay? And next, V5, V6, this is covered by the lateral.

[00:45:38]Okay? And V4, V3, V2, this is going to cover the anterior septal, anterior septal, anterior septal. And mostly, these are the most important one. And we also have the V7 and also the V6.

[00:45:55]Or V8. I'm sorry, V7 and V8 only. So, the V7 V8 is The patient will be having the posterior MI.

[00:46:03]This is for the posterior MI that has been seen. If there is a leads, mostly we are not going to place this, but V7 V8 is associated with the posterior the MI. Next, what is the arteries? Here you can see. On the inferior side, we have the RCA involvement. On the anterior septal, this is the anterior septal, the most common is the LAD, and this is the most common overall also. And on the lateral side, that is the LCX diagonal branch or the left circumflex artery.

[00:46:36]Okay, these are the important arteries and associated sites. On the chest x-ray, what is the boundaries of the silhouette sign? So, the anterior boundary will be formed by the right atrium, and the base will be formed by the right ventricle, and the other side, the lateral side will be formed by the left ventricle. Which boundary is not formed? That is the question. The left atrium is not forming the boundary. And this is the lateral view, not so important, but you have to know about the anterior borders, the base, and also the lateral side and the medial side of the borders of the heart on the silhouette sign.

[00:47:14]Okay. So, this is the importance of the heart. Most mostly important of the The first thing that you have to remember is the arterial supply. Okay. Next, coming here. So, this is the urethra. Urethra is subdivided as a penile urethra, bulbar urethra, membranous urethra, and the prostatic urethra. In the males, this is going to be the 10 cm, and in the females, it is going to be the 4 cm.

[00:47:37]So, basically in the males, the most commonly this is associated with the urethral trauma. Urethral trauma is two types. One is the membranous urethral trauma is two types. One is the membranous, other one is the bulbar.

[00:47:51]Okay. So, bulbar is the most common, guys, comparing to the membranous type. So, bulbar type will be associated with the straddle injury.

[00:48:00]Okay? And membranous type is associated with the severe RTA injuries, especially pelvic fractures.

[00:48:07]Okay? So, in the straddle injuries, what happens? Whenever there is a damage in the bulbar urethra, so it can be the minor tear or it can be complete tear.

[00:48:16]So, if it is a complete tear, bulbar urethra, please look at here. So, if the urethra is damaged here, where is going to extravasate? It will go into the scrotum. It will go into the penis. It will go into the anterior abdominal wall. And here there is a superficial pouch. Here also it is going to into the superficial pouch. Right? So, it is going to extravasate the urine in the penis.

[00:48:39]And also in the scrotum.

[00:48:43]And also abdominal wall.

[00:48:47]And superficial peroneal pouch.

[00:48:52]This is the structures that is going to be seen. Next, the membranous urethra.

[00:48:56]Here only it is damaged, it is going into the prostatic or it is going to extravasate this in the deep only. So, it will be seen in the deep peroneal pouch.

[00:49:08]Deep peroneal pouch and also prostate.

[00:49:13]Okay? So, what is the thing that we can differentiate is that if the scrotum is involved, then it is a bulbar. If the scrotum is not seen, then it is a membranous. Okay? This is the difference between the urethral trauma. Next, uh moving on to the see CNS structures. So, in the CNS structures that you have to remember, the nerves, where it is coming from.

[00:49:35]Okay? So, so this is the medulla oblongata. Right?

[00:49:39]This is the medulla oblongata. And here we have the midbrain. And this is the pons.

[00:49:44]Right? Midbrain, pons, and the medulla oblongata. So, the first one, this is the CN II.

[00:49:51]Cranial nerve II.

[00:49:53]And here you can see this is the cranial nerve three.

[00:49:56]Okay, this is the cranial nerve three.

[00:49:59]And cranial nerve four, here you can see this is the cranial nerve four.

[00:50:05]And this is the major one, trigeminal cranial nerve five.

[00:50:10]Okay, next here in the this junction, this is the pontomedullary junction. In the ponto cerebra cerebral also we can cerebellar also we can cerebellar pontine segment. What are the nerves that is coming past here? So, the first artery, sorry, first nerve that is coming here is the CN6, that is the abducens nerve. And also here you can see the facial nerve. This is the CN7.

[00:50:37]And this is the CN8, that is the vestibulocochlear nerve.

[00:50:41]And here you can see this is the CN9.

[00:50:45]Okay, glossopharyngeal nerve. And next, here we have the 10th nerve. This is the CN10. This is the CN11.

[00:50:54]And the major one that is passing here is the CN12. Okay.

[00:51:00]This is the CN12.

[00:51:07]Sorry.

[00:51:10]See guys, this is the CN11.

[00:51:13]This is the 11, this is the 12. Okay, this branch is the 12th one.

[00:51:18]Right, this is the important one. And this blue color one all are sensory.

[00:51:24]Yellow color is mostly the motor.

[00:51:27]And sky blue color is mixed, both sensory and the motor.

[00:51:32]Better you can write so that you can remember for the long time. Okay. So, what are the what are these nerves that you have to remember? Here you can see clearly olfactory and also optic nerve, the part two for the vision, oculomotor trochlear, abducens. This is most important for the extraocular muscles.

[00:51:53]Trigeminal is sensory for the face and also jaw muscles like mastication muscles. And facial is for the facial muscles, that is the seventh. And the eighth one is for the hearing and the balance. And glossopharyngeal is for the muscles of the throat and tongue. And also the vagus is for the internal organs such as the diaphragm and also for the esophagus. And hypoglossal for the tongue movement. Spinal accessory for the neck and the back movements. And what are the sensory nerves that you have to remember, guys? The sensory nerves are the one, two, and eight cranial nerves. The motor nerves are the three, six, 11, and 12 nerves. And parasympathetic nervous system.

[00:52:33]Parasympathetic nervous system which will be contains of the three, seven, nine, and 10. If there is a injury to the ICP, increased intracranial tension, the most common nerve that is involved is the abducens nerve.

[00:52:47]I'm sorry. This is the abducens nerve.

[00:52:53]Right, these are the things that you have to remember. Next, also I want you guys to remember this.

[00:53:03]I'm drawing this is the pituitary gland.

[00:53:06]Okay, this is the pituitary gland.

[00:53:09]This is the sphenoid bone.

[00:53:12]Sphenoid sinuses.

[00:53:14]So, this is the structure that is present in between the pituitary gland and the sphenoid bone. Okay? So, there are the important artery that is passing here in between these two.

[00:53:26]And also along with that there are the nerves.

[00:53:28]Nearby there is a nerves. And also on the lateral side there are the four important nerves. So, by this time I hope you guys already understand what is the structure. So, this is the cavernous sinus.

[00:53:42]This is the cavernous sinus. In the cavernous sinus, what is this artery that is passing this? Inter- this is the internal carotid artery. Just beside the internal carotid artery, what is this now? This nerve is the cranial nerve six, abducens nerve. And on the lateral side, you have the first one. This is the cranial nerve three.

[00:54:06]And just below that, there is a cranial nerve four. And these two is a cranial nerve five. Okay, these are the important structures that is present.

[00:54:14]This is the sphenoid sinuses, and this is a sphenoid bone. Here, optic chiasm that is present here. Okay? Next, coming to the the arterial supply of the the circle of Willis. How the circle of Willis is divided? First, there is a vertebral artery that is coming from the the vertebral quadrigemina. And this is going to give the branch of the mostly on the posterior side. So, what is the posterior structures? Such as the brainstem. Importantly, how it is going to divide it? For the cerebellum and the uh brainstem, it is going to cover first as a AICA, that is the anterior inferior cerebellar artery. Then, the basilar artery, pontine arteries, and superior cerebellar artery, and also posterior cerebral artery. So, remember that posterior cerebral artery, this is also branch of the vertebral artery. So, please don't confuse with this branch might be coming from the internal carotid artery. Internal carotid artery is only giving the branches to the uh posterior communicating artery, anterior choroidal, ophthalmic artery, anterior cerebral artery, and also anterior communicating artery, and the middle cerebral artery. So, I'm going to cover gives the different color so that you can remember. So, first thing, this branches has been also asked guys.

[00:55:31]Okay?

[00:55:33]So, just remember the green is for the the artery, and red is for the structures that I'm marking here. For the internal carotid artery. And also the question that has been asked, what is the circle of Willis? Here you can see, this is the circle of Willis.

[00:55:48]And what is the circle of Willis is formed by the circle of Willis is formed by the posterior communicating and posterior cerebral artery plus anterior communicating artery and anterior cerebral artery. So, this is going to form the This four structures is forming the circle of Willis.

[00:56:12]Remember that MCA is not involved here.

[00:56:15]Okay? Middle cerebral artery is not involved here. Next, the skull foramen.

[00:56:19]Last year there is a question that has been asked from the jugular foramen, foramen rotundum, foramen ovale. Let's see. So, the first thing that is has been asked is a crib- cribriform plate at the ethmoid bone.

[00:56:32]There is a cribriform plate, and the nerve that is passing here is the cranial nerve one. And if it is a damage, what is a common presentation, guys? The patient will be presented with a CNCSF rhinorrhea will be seen in this patient.

[00:56:46]Okay? Next, the third one that you have to remember is a superior orbital fissure. What are the nerves that is passing here? The most of the nerves will be passing here. The third, fourth, fifth, and also the sixth nerves that is passing in the superior orbital fissure.

[00:57:01]And here you can see, just below that, superior rotundum, that is for the trigeminal second branch. Superior ovale, here you can see, this is for the fifth branch. The trigeminal third branch will be passing here. And in the jugular foramen, another three important nerves, the nine, 10, 11, and also internal jugular vein is passing here.

[00:57:20]Okay? And the foramen spinosum, middle meningeal artery that will be presented.

[00:57:24]If the middle meningeal artery at the location of the pterion, at the location of the pterion, if there is a fracture, the patient will be presented as a EDH presentation. EDH means epidural hematoma that will be presented in this patient.

[00:57:39]Next, this is the frontal lobe. This is the parietal. This is the temporal. And here the occipital lobes. So, so the Broca's area. Broca's area, what is the importance of this? So, the Broca's area, if it is a defect, the patient will be defected with the speech along with the motor symptoms. Okay? What kind of the speech the defect will be?

[00:58:02]Non-fluent speech.

[00:58:04]First thing. And next, here you can see this is the Wernicke's.

[00:58:09]If there is a Wernicke's, the patient will be having the fluent speech defect.

[00:58:15]Fluent speech defect. If there is a involvement of the frontal lobe, so this will involve the visual field.

[00:58:22]Remember the word keyword is the visual field.

[00:58:26]Parietal lobe. If there is a involvement of the parietal lobe, it will involve the visual plus motor.

[00:58:35]Okay? Next, parietal lobe is completed.

[00:58:38]If it is involved the temporal, that will involve the auditory.

[00:58:45]And if there is a involvement of the temporal can be also with associated with the auditory or can be gustatory also.

[00:58:54]Okay, temporal lobe epilepsy. Mostly, the patient will be having the aura that is associated with the gustatory hallucinations also. Next, occipital.

[00:59:04]Occipital is visual cortex.

[00:59:08]Visual cortex with the hemianopia. These kind of the defects that you are going to see in the occipital. Next, what is the Brodmann's area? This is the 44.

[00:59:17]This is the 22.

[00:59:20]And what is the connection between this?

[00:59:22]That is the arcuate fasciculus. Okay?

[00:59:24]What is the nerves that it's the artery supply for this bone. This is the inferior branch of the middle cerebral artery. This is the superior branch of the middle cerebral artery.

[00:59:35]This is the importance of these structures and the presentation because this question has been asked in the recent INICET examination. Next, coming to the importance of the venous sinuses.

[00:59:45]This is the superior sagittal sinus and here the inferior sagittal sinus. This is the vein of Galen and both all this will be forming here. That forms the transverse sinus and from the help of the transverse sinus and the sigmoid sinus it is going to form the jugular vein. And here you can see this is the masticator muscles. And on the mastication muscles, what is the the nerve supply, guys? The nerve supply for this is the mandibular nerve.

[01:00:11]This is supplied by the mandibular nerve. Fifth third branch that is supplying here.

[01:00:17]Temporalis function. What is the most common temporalis function? Retraction.

[01:00:23]More than the retraction, it will be elevation.

[01:00:26]And lateral pterygoid, which will be completes with the depression.

[01:00:31]And medial pterygoid, more main function. This is the main function.

[01:00:36]Depression. Medial pterygoid will be helping in the elevation.

[01:00:41]Masseter is also important for the elevation.

[01:00:44]What about the protraction, guys?

[01:00:46]Protraction is seen by the medial pterygoid.

[01:00:50]Okay, these are the importance of the muscles and the functions of the mastication muscles. Okay?

[01:00:56]So, this is the some of the important topics that I have been covered. Next, moving on to the another important one, that is the embryology.

[01:01:06]In the embryology, first see.

[01:01:07]Here you can see.

[01:01:09]This is the internal side. So, endoderm.

[01:01:12]This will convert later on the endoderm derivatives. On the outer side, you will be having the ectoderm that will separately develop as a the And middle, that will be the mesoderm.

[01:01:24]Okay? So, this is the pharyngeal clefts.

[01:01:27]Here you can see, these are the pouches.

[01:01:30]And here you can see the in-between one, that is the pharyngeal arch. Right? So, let's see one by one. What are the arches and their developments? Okay? So, I just wanted you guys to understand each arch and their important functions that has been asked. First arch is going to be associated with the M. Okay? It will give rise to the malleus, incus, and also the mastoid's structure.

[01:01:58]The mastoid structures is also coming from here. The Meckel's cartilage.

[01:02:03]The Meckel's cartilage and also the mandible.

[01:02:07]The now that is coming here, the now that is coming here is the mandibular nerve.

[01:02:16]Mandibular nerve.

[01:02:18]Next, second arch.

[01:02:21]S gives for the S structures. Stapes, styloid, stapes, styloid, and also upper and lower hyoid structures.

[01:02:34]What is the now that is coming here?

[01:02:36]That is a facial nerve.

[01:02:39]Next, third arch.

[01:02:41]So, upper and lower is present here.

[01:02:43]Just remember, it will be the low lesser, I'm sorry.

[01:02:50]This is not the upper only.

[01:02:54]This is the lesser, guys. Lesser cornu.

[01:02:59]Lesser hyoid bone. So, upper opposite, this is a lower. Lesser opposite, it is a greater.

[01:03:07]Greater hyoid structures will be present here. And the now that is coming here is the glossopharyngeal nerve.

[01:03:17]The glossopharyngeal nerve will be coming here.

[01:03:20]Okay, next.

[01:03:22]Coming to the fourth arch. [snorts] Fourth arch, the most of the structures will be laryngeal cartilages.

[01:03:32]Laryngeal cartilages.

[01:03:35]And what is the nerve that is coming here? In the fourth arch, there is a nerve, superior laryngeal nerve.

[01:03:43]Sixth arch. Fifth arch will be degenerated in the birth birth time only. So, the sixth arch is going to give rise to the recurrent laryngeal nerve, ductus arteriosus, that will be seen here.

[01:03:57]These are the important structures of the arches and the derivatives. Next, coming to the pouches.

[01:04:03]So, here we will see the pouches. What are the important pouches? So, the first pharyngeal pouch, this will give rise to the tympanic membrane, inner layer, Eustachian tube, and also mastoid antrum.

[01:04:24]Second pouch, second pouch is going to give rise for the palatine tonsil, mainly the lining. The third pouch is going to give rise for the thymus, and inferior parathyroid glands.

[01:04:46]Fourth pouch is going to give rise for the superior parathyroid glands. So, why I have given this picture here? This patient is suffering from the DiGeorge syndrome.

[01:04:59]DiGeorge syndrome is mostly the chromosome 22 Q 11 deletion.

[01:05:06]And most commonly, the third pharyngeal pouch is defect here in this patient. If the third pouch is defect, the patient will be absence of the thymus. So, that will lead to the T cell defect. And the patient inferior parathyroid glands are defect. So, there will be decreased calcium and the patient will be having the seizures.

[01:05:29]And other defects like VSD will be presented, mental retardation, cleft lip also seen in this patient. This is the condition that is associated in this patient. Okay? Next.

[01:05:43]Coming to the arteries and the derivatives. So, this is the first arch.

[01:05:48]So, the first arch is going to give rise to the maxillary artery.

[01:05:55]Next one. The second arch is going to give rise to the stapedial artery.

[01:06:01]But the stapedial stapedial artery is going to degenerate after the birth.

[01:06:06]Next, third arch. Third arch is divided into the three types. This is the common carotid artery and here you can see this is the internal carotid artery for the third arch. Okay, this is the third arch. Wait.

[01:06:21]I will mark late later. And next, fifth will be degenerating, right? Next, we have the fourth one. So, the fourth one is going to give rise to the aortic arch.

[01:06:31]Fourth one is going to give rise to the aortic arch and their branches. And other side of the fourth branch that is going to give rise to the brachiocephalic artery.

[01:06:42]And next, in the sixth arch, sixth arch is going to give rise to the ductus arteriosus in the birth and then it is also going to give rise to the subclavian artery. Subclavian artery is also coming from here only. Okay, this is the importance that you have to remember. And next, coming to the other structures that we have to know about the uh importance of this arches and their derivatives. I will mark like this. Please remember, this is the first, this is the second, and this is the third, and fourth, and this is the sixth. Fifth is already degenerated in the body. And this question has been asked with the image-based question, guys. So, please don't ignore this. Next, some of the important points that you have to know about the neural crest cells.

[01:07:32]Neural crest cells, what are their derivatives? In the neural crest cells, we are going to have the ganglions. Name the ganglion. All the ganglions will be coming here. For example, enteric ganglions and peripheral nervous system ganglions, and also the most commonly me- medulla medulla of the adrenal gland. That is also coming here. And also, we can say the melanoblast.

[01:08:00]And from the teeth, odontoblast.

[01:08:04]Odontoblast.

[01:08:06]Especially, there will be parafollicular cells.

[01:08:11]Parafollicular C cells also coming from here. And leptomeninges.

[01:08:18]Right, dura mater, all these leptomeninges.

[01:08:21]And also, other important one that you have to remember is the skull bones.

[01:08:26]All are coming from the neural crest cells only. Okay? Next, moving on to the tongue. The tongue development, first we will be knowing. This is developed by the first arch.

[01:08:37]And here, this is developed by the second. I'm sorry, this is developed by the third arch.

[01:08:43]This is developed by the third arch. And here, it is the fourth arch.

[01:08:49]Okay? Next, the nerve supply. So, the first two parts of the anterior, that is the sensory, is supplied by the lingual, general sensory. And for the taste, chorda the tympani.

[01:09:03]And both general and taste is supplied by the second 1/3, which will be supplied by the glossopharyngeal nerve. And the base is mostly supplied by the vagus.

[01:09:16]Okay? This is the importance of the tongue and their branches. And muscles, coming to the motor supply.

[01:09:23]Motor supply, all the muscles are supplied by the hypoglossal nerve only, except one. The except one is the palatoglossus.

[01:09:33]Palatoglossus is the except.

[01:09:37]This is supplied by the vagus.

[01:09:40]And not just this one, there are many exceptions also we have. Let's see what are those exceptions.

[01:09:45]Okay? This question can be asked in the examination. All the palatine muscles all the palatine muscles is actually supplied by the vagoaccessory.

[01:09:58]Okay? Vagoaccessory muscle. Except one.

[01:10:02]Except that is the tensor palatine.

[01:10:08]And these tensor palatine is actually supplied by the cranial nerve fifth nerve. Okay? This is the palatine. Next, larynx muscles.

[01:10:18]And the larynx muscles all are supplied by the recurrent laryngeal nerve.

[01:10:24]Another exception we have, that is the cricothyroid.

[01:10:28]Right? That is the cricothyroid. It is supplied by the external laryngeal nerve.

[01:10:34]Next, we have the pharynx.

[01:10:37]So, pharynx also all the muscles which will be supplied most commonly vagoaccessory nerve.

[01:10:43]Except except that is the stylopharyngeus and also cricopharyngeus.

[01:10:52]Cricopharyngeus is supplied by the recurrent laryngeal nerve. Stylopharyngeus is supplied by the cranial nerve five. Okay, these are the important muscles and their exceptions. Next, coming here, if you can observe what happened to this patient, this is a tongue palsy.

[01:11:12]Tongue palsy, mostly the motor only.

[01:11:15]Means, this is the palsy of the hypoglossal nerve. Because all the muscles are supplied by the hypoglossal nerve. Which is the normal side? This is the normal side. So, the tongue will be turned on the normal side.

[01:11:32]Why? Because palatoglossus is still normal, right? So, the palatoglossus is still normal. That's why the tongue will be turning on the normal side only.

[01:11:41]Okay, next, coming to the cleft lip.

[01:11:44]This patient is having the cleft lip.

[01:11:47]What is the defect of the cleft lip?

[01:11:48]What is the mechanism?

[01:11:50]So, remember that the cleft lip of the patient The patient is actually having the cleft lip. This is due to medial process medial process plus medial nasal maxillary sorry. This is the maxillary process.

[01:12:10]And the defect of the medial nasal process. If these both are not fused, if these both are not fused, the patient will be suffered with the cleft lip. Next, we also have the cleft palate. Cleft palate defect is mostly the patient is due to palatine shelves is non-fused.

[01:12:33]That is for the cleft palate. What is the most common cause? The patient The mother might be taking the antiepileptics or any syndrome.

[01:12:41]When is the surgery is done?

[01:12:43]3 months. Basically, we are going to do it the 3 months. The famous surgery that is the Millard surgery.

[01:12:49]But there is a rule of 10. What is the rule of 10? The patient should be having the 10 points 10% of the hemoglobin.

[01:12:59]And also the baby should be completed 10 weeks. This is known all as a rule 10 for the patients. For the 9 months, we are going to do for the palate.

[01:13:12]3 months is for the lip. 9 months is for the palate.

[01:13:16]Okay? Next.

[01:13:18]Next, we have the neural tube defects, guys. So, anterior neural tube defects and also posterior neural tube defects.

[01:13:28]So, when the anterior one is going to be closed?

[01:13:31]The anterior one is closed on the 25th intrauterine life. This is closed by the 28th intrauterine life. That means this is the third week.

[01:13:42]And this is the fourth week.

[01:13:44]So, the most common one, this is the most common in this most common, there is a anencephaly.

[01:13:51]And here the most common one is a spina bifida.

[01:13:57]Right? Here you can see. Overall the most common is a spina bifida.

[01:14:03]And in the most common for the anencephaly is on the anterior side.

[01:14:09]Craniorachischisis another anterior type.

[01:14:14]And this is a posterior.

[01:14:17]Here also this is a posterior.

[01:14:20]The most severe most severe is the myelomeningocele.

[01:14:31]And here you can see this is the anus.

[01:14:34]And here another cyst. This is known as a tail cyst teratoma.

[01:14:40]This question has been asked in recently. And what is the most common of the neural tube defects, guys? The most common is the multifactorial.

[01:14:48]Not just one, there is a multi-factorial.

[01:14:51]And the most established is the folate deficiency.

[01:14:55]And other one is the seizure disorders.

[01:14:58]Means seizure medicines.

[01:15:02]And what is the test that you are going to do? AFP that is positive, but to be specific, acetylcholinesterase is positive.

[01:15:13]Acetylcholinesterase is most specific.

[01:15:18]And what is the treatment or prevention?

[01:15:21]We are going to give the 4 mg folate.

[01:15:25]That should be started for this patient.

[01:15:28]Next, another defects that you can see, this is a omphalocele.

[01:15:33]This is the omphalocele. Omphalocele will be associated with the cover, right? Here you can see, this is the cover.

[01:15:40]And this is also associated with multiple defects, not just one, they are the multiple defects. And next, this is the gastroschisis.

[01:15:50]Both are the hernia only.

[01:15:52]And there is no cover.

[01:15:55]And no defects also.

[01:15:58]So, this is the major defects.

[01:16:00]And mostly this is coming from the within the umbilicus.

[01:16:04]And this is coming from the abdominal wall.

[01:16:09]Right? That one you have to remember.

[01:16:12]Next, moving on to the epithelia.

[01:16:16]Also, here I want you guys to remember another thing, that is the hernia.

[01:16:21]Physiological hernia.

[01:16:24]In the baby, the physiological hernia start at the SMA, that is the superior mesenteric artery, at the 270° anti-clockwise.

[01:16:34]270° anti-clockwise it is going to rotate, and along with that, how it is going to be seen. So, So is going to be seen at the SMA 270° starts at the 6 weeks and it ends by the 10 weeks.

[01:16:47]So this is normal, completely normal.

[01:16:54]Next, moving on to the next chapter.

[01:16:57]Here you can see first we will complete the cranial nerve palsy, especially the most important one that is the lower motor neuron upper motor neuron of the facial. Here you can see this is the upper motor neuron palsy, this is a lower motor neuron palsy. So upper motor neuron from the cerebellum cerebrum only we are going to have the defect. Whereas the the nerves that is passing in the lower motor neuron and its branches if it is damaged, lower motor neuron. So what happens? So basically the patients will be having the functions. So if it is a upper motor neuron, it is going to involve the contralateral and lower half of the face only. Lower half of the face. Whereas in the lower motor neuron, it is the ipsilateral side and it is involved the whole whole face will be involved here. Next, here the face or we can see the forehead is basically spared.

[01:17:51]And less severe. Comparing to the other one, this is a less severe and no drooping also seen in this patient.

[01:18:00]Okay? Next, coming to the lower motor neuron, this is most severe and also we can say this is the most common associated with the herpes simplex virus. Okay? Next, this one is also eyes will be open of this patient on the affected side and also drooping will be seen.

[01:18:21]Drooping will be seen. The drooping of the mouth will be seen and forehead is mainly involved.

[01:18:27]The forehead is also mainly involved.

[01:18:29]This is the difference between the lower motor neuron and also the upper motor neuron that you have to know. The simple squamous epithelium that is present in the various small muscles like blood vessels, alveoli, and also the lymphatic vessels.

[01:18:43]Simple cuboidal is present in the kidney tubules.

[01:18:47]Simple columnar epithelium all are condensed cilia. For example, uterus, digestive tract, and also the bladder lining. Next, pseudostratified. This is present in the trachea, upper respiratory tract. Stratified squamous, esophagus, vagina, and the mouth.

[01:19:04]And stratified cuboidal is present in the sweat glands, salivary glands, and the mammary glands. Stratified columnar is present in the male urethra, and also the glands and some of the ducts. Next, transitional epithelium is present in the bladder, urethra, and also the ureter. This is the most important case.

[01:19:21]It has been asked three times in the examination.

[01:19:24]Right? Next, moving on to the nerves and sorry, arteries and the pulsations. This is the temporal artery location on the forehead, and in the facial artery you are going to check at the jaw, and carotid artery in the neck region, brachial artery in the brachial fossa, and also the radial artery at the radial pulse site. And on the inguinal region you are going to check for the femoral artery. At the popliteal fossa, popliteal artery. And on the posterior tibial side, there is a posterior tibial. And on the dorsum side, there is a dorsal pedialis artery. Right? Next, coming to the joints. Joints question has been also asked. Let's see first the cartilaginous.

[01:20:02]Let's see. The first one is a cartilaginous cartilage. We have the synchondrosis and the symphysis. What are the examples for the synchondrosis?

[01:20:10]Epiphyseal plate, and also the sternum.

[01:20:13]The joint that been present between the first rib and the sternum. Because these are the immovable joints. Next, symphysis. The symphysis pubis, and also the fibrocartilage of the intervertebral disc between the two vertebrae. Next, fibrous joints. These fibrous joints are very strong. They doesn't move at all.

[01:20:31]And this is the sutures, another example syndesmosis, that is between the joints between the the tibiofibular joint and also radio-ulnar joints. And gomphosis, the roots of the gums. Next, moving on to the synovial joints. In the synovial joints, the most importantly, the ball and socket joint is present between the malleus and incus. Sorry. This is present between the incus and stapes.

[01:21:00]And also, you know that this is the shoulder fever.

[01:21:04]Right? Next. And here, the condylar joint is present in the knee and metacarpophalangeal joint and temporomandibular joint. Next, plane joint. Here you can see this is the one, right? Interphalangeal tarsal joint, interphalangeal carpal joints.

[01:21:22]Saddle joint is present in the between the trapezium and the carpal bones. And hinge joint is present in the elbow. The pivot joint is present in the C1 and C2, which is also known as a atlantoaxial joint.

[01:21:36]Atlantoaxial joints. These are the some of the examples that you have to remember. Next, the last segment that we are going to discuss today, that is a nerve roots. So, just I am going to place the some of the important nerve roots that you have to remember. So, the first one is the axillary nerve root, C5 and the C6. Next, suprascapular.

[01:21:58]This suprascapular is present with the C5, again the C6. And also, we have the musculocutaneous.

[01:22:07]Musculocutaneous is going to be have the three nerves, that is a C5, C6, and the three C7. Next, remember the phrenic nerve, just now we discussed. This is also C5, C6, and the C7. Next, long thoracic nerve.

[01:22:24]Long thoracic nerve, winging of the scapula, we discussed above. This is also contains the C5, C6 and the C7.

[01:22:32]Next, radial. Radial will be contains of the C5, 6, 7, 8 and T1. Next, same as the median nerve also.

[01:22:42]It is contains of C5, 6, 7, 8 and T1.

[01:22:47]You have to remember this one. This is the ulnar. Ulnar will be contains of the C7, 8 and only T1. Okay? Next, there are the two defects that is present. One the patient is a suffering from the Erb's palsy, other patient is suffering from the Klumpke's palsy. This involve the C5, C6, this involves the C8, T1. So, that means this is the upper trunk and this is the lower trunk. Right? Mostly, this involves the axillary nerve.

[01:23:15]Musculocutaneous nerve, suprascapular nerve. This will involves the ulnar nerve most commonly. Right? And also, cervical plexus.

[01:23:26]That will be involved. Cervical sympathetic plexus is also involved. So, the patient will be having the waiter's tip.

[01:23:35]Waiter's tip defect. This patient will be having the defect, claw hand.

[01:23:40]Along with that, the cervical plexus is also involved. So, the patient will be having the Horner's syndrome. Okay? What is the defect that is present in this patient, guys? If you observe this waiter's tip deformity, clearly see what is the defect that patient will be not having. The patient cannot abduct.

[01:23:59]Right? First thing, the patient does not have the medial rotation and patient does not have the pronation.

[01:24:07]And elbow is extended.

[01:24:11]Right? These are the defects that is associated with this nerve palsies, axillary, musculocutaneous and the suprascapular. Horner's syndrome, you all know that the patient will be having the ptosis and hidrosis and ophthal exophthalmos.

[01:24:30]And also loss of ciliary function.

[01:24:37]Meiosis.

[01:24:39]And this is the defect that is present with the Horner syndrome. Next, what is this uh joint? This is the clavicle.

[01:24:49]Most common site of the clavicle will be 1/3 of the lateral and 2/3 of the medial is the most common site fracture.

[01:25:02]And cleidotomy. What is the cleidotomy?

[01:25:05]This is the added uh iatrogenic fracture.

[01:25:08]So, deliberately we do during the shoulder dystocia.

[01:25:13]It's a treatment iatrogenic.

[01:25:16]Right? This is the clavicle. And it will start at the 6th week of the intrauterine life formation and by the 25 years.

[01:25:25]End by 25 years. That has to be remembered.

[01:25:30]25th year of the age, ossification will be completes.

[01:25:36]This is the clavicle importance. So, the nerves. Coming to that. This is the anterior. This is the posterior. We can say it's the This is the mostly extensor site. This is the flexor. How the nerves are important. So, on the anterior, the medial 1/3 will be supplied by the saphenous nerve. And in the posterior, 1/3 will be supplied by the sural nerve.

[01:25:57]And next, on the dorsum of the foot, that the little finger is supplied by the Again, it is supplied by the the sural nerve. And most of the part will be supplied by the superficial fibular nerve. And this small the part at the dorsum of the big toe, that is supplied by the deep fibular nerve. And on the foot, plantar that will be mostly supplied by the medial calcaneal nerve. This is also has been asked in the examination. Next, this is the humerus.

[01:26:28]This is the humerus, right? So, this is the surgical neck.

[01:26:32]This is the surgical neck. So, if there is a fracture at the surgical neck, it will involves the axillary nerve.

[01:26:42]Along with that, they are the posterior arteries.

[01:26:46]That is also defect. And this is a radial groove. If there is a damage at the radial spiral groove, this will involves the radial nerve and profunda vessels.

[01:26:58]This will involves the profunda vessels.

[01:27:01]Okay? And here, medial epicondyle or the lateral epicondyle, it will involves the ulnar nerve.

[01:27:07]This is a supracondylar and a supracondylar which will involves the anterior interosseous nerve and brachial artery.

[01:27:21]This questions has been also asked in the examination. Next, carpal bones. How can you remember the carpal bones, guys?

[01:27:27]Just remember with the mnemonic of the she looks too pretty.

[01:27:34]She looks too pretty try to catch her.

[01:27:41]Okay? She looks too pretty try to catch her. This is the mnemonic that you can remember. Okay? This is how the carpal bones will be seen. Next, coming to the tarsal bones. This is the calcaneum, talus, navicular. Okay? And cuboid, cuneiform.

[01:28:00]Okay? You can remember this one also.

[01:28:02]Next, again, this is the anterior, this is the posterior. Anterior medial will be the great saphenous one and in the posterior will be the short saphenous or the small saphenous vein.

[01:28:13]Okay, next some of the defects. What is this defect, guys? This is the ape thumb deformity.

[01:28:19]This is the ape thumb deformity, which will involve the median nerve.

[01:28:25]And here, this is the claw hand.

[01:28:28]Involves the ulnar nerve.

[01:28:32]And this is the wrist drop.

[01:28:36]Involves the radial nerve.

[01:28:42]And this is the foot drop.

[01:28:46]Involves the common peroneal nerve.

[01:28:49]Next, the arterial supply. Here you can see. So, this is the anterior or we can say palmar side.

[01:28:58]And this is the dorsum posterior side.

[01:29:01]So, on the anterior, the last two digits digits will be supplied by the ulnar.

[01:29:07]And this is supplied by the median.

[01:29:09]And again here, the mostly the nails, this is supplied by the median.

[01:29:14]And here it is supplied by the radial.

[01:29:17]And another two digits will be supplied by the ulnar. Okay?

[01:29:20]So, this is the thenar muscles.

[01:29:23]This is the hypothenar.

[01:29:27]Muscles, right? These are the important parts of this one. Next coming to the important ones that you have to remember, especially. So, the L4 will be the medial side. L5 will be the lateral side. Coming to the foot, again, the L5 will be the first big toe that is present in the L5. Next, coming to the L3 on the anterior side and S2 on the lateral side of the posterior. Next, coming to the hands. So, the C5 will be the first forearm on the anterior side.

[01:29:59]Then the C6 will be C6 will be the thumb and C8 will be the little finger. C7 is on the remaining fingers that will be asked. Next, these are the most important one anterior side of the dermatomes. Whatever I circle, this has been asked. You can remember those.

[01:30:15]Okay, this is the important part, guys.

[01:30:17]As I already said that if you guys want to access to the this smart revision notes annotated or the unannotated, you can text me on the Telegram and you can join that group by the paid content, okay? So, those who are new to this chapter, so sorry, new to this channel, please do subscribe and share with your friends and stay tuned for the all the other 19 subjects. Please do revise and do the question bank practice. Until then, happy preparation, guys.