Anatomy Case study
1.Infant was noted to have a good cry but unable to movie it’s
right arm
(a) Name the condition of patient and define it
Ans. Condition of the patient- Erb’s paralysis
Site of injury: One region of the upper trunk of the Brachial
plexus is called Erb’s point . Six Nerves meet here. Injury to the
upper trunk causes Erb’s paralysis.
(b) what muscles are primarily responsible for shoulder abduction
and give it’s nerve supply
Ans. Abduction from 0°-90°:
1. Supraspinatus -Suprascapular nerve (C5, C6)
2. Deltoid
- Axillary nerve
(C5, C6)
Abduction from 90°-180°:
1. Serratus anterior - Nerve to serratus anterior (c5-c7)
2. Upper and lower fibres of trapezius – Spinal part of accessory
nerve and branches from C3, C4
C. Explain Brachial plexus with a neat labelled diagram:
Ans. Brachial plexus arise from the anterior primary rami of spinal
nerves from C5-C8 and T1, with occasional contribution from C4
and T2.
The origin of brachial plexus may shift 1 segment upward or
downward:
Prefixed plexus: The contribution of C4 is large , C5 is present, T1
is small, T2 is absent
Postfixed plexus: The contribution of T1 is large, T2 is present, c5
is small, C4 is absent
Brachial plexus consists of roots, trunks, divisions, cords,
branches.
Roots and trunksC5 and C6 join to form the upper trunk.
C7 forms the middle trunk.
C8 and T1 join to form the lower trunk
Divisions of trunksEach trunk divides into ventral and dorsal division
Cords:
Lateral cord is formed by the Union of ventral division of upper
and middle trunks.
Medial cord is formed by the ventral division of lower trunk.
Posterior cord is formed by the union of dorsal divisions from all 3
trunks
Branches of the roots:
1. Nerve to serratus anterior (C5-C7)
2. Nerve to rhomboids(C5)
3. Branches to longus colli and scaleni muscles (C5-C8)
Branches of the trunks:
Suprascapular nerve (C5 , C6)
Nerve to subclavius (C5, C6)
Branches of the lateral cord:
1. Lateral pectoral nerve(C5-C7)
2. Musculocutaneous nerve (C5-C7)
3. Lateral root of median nerve (C5-C7)
Branches of medial cord:
1. Medial pectoral nerve (C8.T1)
2. Medial cutaneous nerve of arm(C8.T1)
3. Medial Cutaneous nerve of forearm (C8, T1)
4. Ulnar nerve (C7, C8, T1)
5. Medial root of median nerve(C8, T1)
Branches of posterior cord:
1. Upper Subscapular (C5, C6)
2. Lower Subscapular (C5, C6)
3. Nerve to Lattissimus dorsi (C6-C8)
4. Axillary nerve (C5, C6)
5. Radial nerve (C5-C8, T1)
(d) Give nerve supply of the extensor compartment of forearm.
What the condition when this nerve is damaged
Ans. The extensor compartment of forearm is supplied by radial
nerve.
Conditions when this nerve is damaged1. Saturday night Paralysis/crutch Paralysis
2. Wrist drop
(e) Mention any 3 muscles of hand which are supplied by median
nerve
Ans. Abductor pollicis brevis
Flexor pollicis brevis
Opponens pollicis
(2)
(b) what is the major blood supply of the organ related to this
condition m
Ans The bronchial arteries supply nutrition ti the bronchial tree
and Pulmonary tissue.
On the right side there is one bronchial artery
On the left side, there are 2 bronchial arteries
(d) Write any 5 difference between left and right organ related to
this lung
e. Name the lobes and fissures in the organ related to this
condition:
Ans. Left lung:
Left lung consists of 1 fissure and 2 lobes.
Oblique fissure divides the left lung into 2 lobes
Left lung consists of :
(a)Upper lobe
(b)Lower lobe
Right lung:
Right lung
Right lung consists of 2 fissures and 3 lobes.
Fissures of right lung:
(a) Horizontal fissure
(b) Oblique fissure
Lobes of the right lung:
(a) Upper lobe
(b) Middle lobe
(c) Lower lobe
Important questions
1Q. Describe the shoulder joint under following
headings: 1. Articular surfaces
(2) Ligaments
3. Relations
4. Bursae
5. Movements and muscles associated
6.Applied anatomy
Ans. Shoulder joint is a synovial joint of ball and socket
variety.
1. Articular surfaces: a. glenoid cavity scapula
b. Head of humerus
2.Ligaments : a. Capsular ligaments
b. Glenohumeral ligaments
(Superior, middle and inferior)
c. Coracohumeral ligament
d. Transverse humeral ligament
3. Relations:
a. Superiorly: Subacromial bursa
Supraspinatus
Deltoid
b. Inferiorly: Triceps long head
Axillary nerve
Posterior circumflex humeral artery
c. Anteriorly: Subscapularis
Coracobrachialis
Biceps
Deltoid
d. Posteriorly: Infraspinatus
Teres minor
Deltoid
4. Bursae: Subacromial bursa, Subscapular bursa and
infraspinatus bursa
2q. Describe elbow joint.
Ans. Elbow joint is a synovial joint of hinge variety
1. Articular surface:
a. Cupitulum and trochlea of humerus
b. Olecranon process Of ulna
c. Olecranon fossa of humerus
d. Upper surface of head of radius
e. Trochlear notch
2. Ligaments:
a. Capsular ligament
b. Ulnar collateral ligament (Triangular shaped)
c. Radial collateral ligament (fan shaped)
3. Relations:
a. Anteriorly: Brachialis, Median nerve, Brachial
artery, Biceps brachii tendon
b. Posteriorly: Triceps brachii and anconeus
c. Medially: Ulnar nerve, common flexors, flexor
carpi ulnaris
d. Laterally: supinator, common extensors,
extensor carpi radialis brevis
4. Movements :
Flexion : caused by Brachialis, Biceps brachii,
Brachioradialis muscle
Extension: caused by Triceps brachii and anconeus
muscle
5. Applied anatomy:
a. Pulled elbow (Subluxation)
b. Elbow dislocation is common posteriorly and
often associated with coronoid process
fracture
c. Student’s elbow
d. Tennis elbow
3q. Describe wrist joint
Ans. Wrist joint is a synovial joint of Ellipsoidal variety
1. Articular surface:
Inferior surface of lower end of radius
Articular disc of Inferior radioulnar joint
Scaphoid
Lunate
Teiquetral bone
2. Ligaments:
Articular capsule
Palmar radiocarpal ligament
Palmarulnocarpal ligament
Dorsal radiocarpal ligament
Radial collateral ligament
Ulnar collateral ligament
3. Relations:
Antriorly: long flexor tendons
Median nerve
Posteriorly: Extensor tendons of wrist and fingers
Laterally:
Radial artery
4. Movements :
Flexion- caused by Flexor carpi radialis
Flexor carpi ulnaris
Palmaris longus
Extension: caused by Extensor carpi radialis longus
Extensor carpi radialis brevis
Extensor carpi ulanris
5. Clinical anatomy:
a. Wrist and IP joints are commonly involved in
rheumatoid arthritis
b. The back of the wrist is common site for a
ganglion
c. Wrist joint can aspirated from posterior surface
between the tendons of extensor pollicis longis
and extensor digitorum.
4q. Mention the muscles of arm and explain any 2 muscles
origin and insertion.
Ans. The muscles of the arm are:
1. Coracobrachialis
2. Biceps brachii
3. Brachialis
4. Triceps brachii
Biceps brachii:
origin- Long head arises from Supraglenoid tubercle of
scapula
Short head arises from coracoid process of scapula
Insertion: Both heads insert into the radial Tuberosity of
Radius
Brachialis:
origin- Lower half of front of the Humerus
Insertion- Coronoid process of ulna
Ulnar tuberosity
5q. Describe cubital fossa boundaries, contents with a
diagram
Ans. Cubital Fossa is a triangular hollow Situated on the
front of the elbow
Boundaries:
1. Laterally- Medial border of brachioradialis
2. Medially- Lateral border of pronator teres
3. BASE – represented By an imaginary line joining the
front of two epicondyles of the humerus
4. Apex- formed By the area where brachioradialis crosses
the pronator teres
Contents1. Median nerve
2. Brachial artery (Termination)
3. Biceps brachii tendon
4. Radial nerve
6q. Mention the origin, insertion, nerve supply and action of
Deltoid muscle
Ans. ORIGIN1. Anterior border of lateral 1/3rd of clavicle
2. Lateral border of acromion process
3. Lower lip of crest of spine of scapula
INSERTION1. Deltoid Tuberosity of humerus
NERVE SUPPLY- Axillary nerve (C5, C6)
ACTION1. Anterior fibres- flexors and medial rotators of arm
2. Posterior fibres-Extensor and lateral rotators of arm
3. Acromial fibres -abductors of arm
7q. Mention the muscles of extensor compartments of
forearm and explain origin, insertion, nerve supply and
action of any 2 muscles.
Ans. Superficial muscles1. Anconeus
2. Brachioradialis
3. Extensor carpi radialis longus
4. Extensor carpi radialis brevis
5. Extensor digitorum
6. Extensor digiti minimi
7. Extensor carpi ulnaris
Deep muscles1. Supinator
2. Abductor pollicis longus
3. Extensor pollicis longus
4. Extensor pollicis brevis
5. Extensor indicis
BRACHIORADIALISOrigin- Upper 2/3rd of lateral supracondylar ridge of
humerus
Insertion- Styloid process of radius
Nerve supply- Radial nerve
Action- Elbow flexion
Extensor carpi ulnarisOrigin- Lateral epicondyle of humerus
Insertion- base of 5th metacarpal bone
Nerve supply – Deep branch of radial nerve
Action – Extension and addiction of wrist joint
8q. Mention the muscles of thenar and hypothenar
eminence
Ans. THENAR EMINENCE1. Abductor pollicis brevis
2. Flexor pollicis brevis
3. Opponens pollicis
4. Adductor pollicis
HYPOTHENAR EMINENCE1. Palmaris brevis
2. Abductor digiti minimi
3. Flexor digiti minimi
4. Opponens digiti minimi
Flexor pollicis brevisOrigin- flexor retinaculum, crest of trapezium, capitate
bones
Insertion- Base of proximal phalanx of thumb
Nerve supply- Median nerve
Action- Flexion of metacarpophalangeal joint of thumb
Flexor digiti minimiOrigin- Flexor retinaculum
Insertion-Base of proximal phalanx of little finger
Nerve supply- Deep branch of ulnar nerve
Action- flexes little finger
9q. Name the Broncho pulmonary segments with a labelled
diagram
Ans.
10q. Mention the origin, insertion, nerve supply and action
of external and internal intercostal muscles
Ans.
Nerve supply-All intercostal muscles are supplied by the
intercostal Nerves of the spaces in which they lie.
Action
-
1. Internal intercostal muscles- Depression of ribs during
expiration
2. External intercostal muscles- elevation of ribs during
inspiration
11q. Discuss the external features of the heart
Ans.
• The human heart has four chambers. They are
1. Left atria
2. Right atria
3. Left ventricle
4. R8ght ventricle
• The atria lie above and behind the ventricles.
• On The surface of the heart, atria are separated
from the Ventricles by an atrioventricular groove
• Atria are separated from each other by an
interatrial groove
• Ventricles are separated from each other by an
Interventricular groove, which is subdivided into
Anterior and posterior parts
• Apex directed downwards, forwards and to the
left.
• Base directed backwards
• Surfaces of the heart: 1. Anterior
(2) inferior
(3) left lateral
• Borders of the heart: (1)Upper border
(2) Inferior border
(3) left border
(4) Right border
12q. Draw a labelled diagram of heart
Ans.
13Q. Describe the mediastinum under the following
headings: Definition, subdivisions and contents
Ans. Is the middle space left in the thoracic cavity in
between The lungs
The Mediastenum is divided into:
1. Superior Mediastenum
2. Inferior Mediastenum
Inferior Mediastenum is further divided into:
1. Anterior Mediastenum
2. Middle Mediastenum
3. Posterior Mediastenum
Superior Mediastenum contents:
1. Trachea
2. Oesophagus
3. Muscles- Sternohyoid and Sternothyroid
4. Artery- Arch of aorta
Brachiocephalic artery
Left subclavian artery
Left common carotid artery
5. Veins – Right and left brachiocephalic veins
Upper half of the superior vena cava
Left superior intercostal vein.
6. Nerves – vagus nerve
Phrenic nerve
Cardiac nerves
Left recurrent laryngeal nerve
7. Thymus
8. Thoracic duct
Anterior Mediastenum content :
1. Sternopericardial ligaments (Fig. 17.1)
2 Lymph nodes with lymphatics
3 Small mediastinal branches of the internal tthoracic artery
4.The lowest part of the tthymus
5. Areolar tissue
Middle Mediastenum contents:
1. Heart
2. Arteries-Ascending aorta
Pulmonary trunk
2 pulmonary arteries
3. Veins- Lower half of the superior vena cava,
(ii) terminal part of the azygos vein
(iii) right And left pulmonary veins
4. Nerves- cardiac plexus
Phrenic nerve
5. Lymph nodes
Posterior Mediastenum contents:
1. Oesophagus
2. Descending aorta and it’s branches
3. Veins- Azygos vein,
(ii) hemiazygos vein,
(iii) accessory hemiazygos vein.
4. Nerves- vagi
Splanchnic nerves
Lymph nodes
14q. Describe the coronary circulation or Arterial supply of
heart
Ans. The heart is supplied mainly by Right and left coronary
artery.
Right Coronary artery:
• Right coronary artery arises from the anterior
aortic sinus of ascending aorta
• It passes front and to the right between the root
of pulmonary trunk and right Auricle.
• It then runs downwards the right anterior
coronary sulcus
• It winds around the inferior border to reach the
diaphragmatic surface
• It then runs in the posterior coronary sulcus to
reach posterior Interventricular groove.
Area of distribution:
1. Right atrium
2. Greater part of right ventricle
3. Smaller part of left ventricle
Left coronary artery:
• Left coronary artery arises from the posterior
aortic sinus of ascending aorta
• It passes front and to the left between the root
of pulmonary trunk and left Auricle.
• It then runs downwards the left anterior coronary
sulcus
• It winds around the left border of heart and
continues in left posterior coronary sulcus.
• It anastamoses with left right coronary artery in
posterior Interventricular groove.
Area of distribution:
1. Left atrium
2. Greater part of left ventricle
3. Small part of right ventricle
15q. Describe the medial surface of right and left lungs
Ans.
16q.Mention the differences between right and left lungs.
Ans.
17q. Describe the stomach under the following headings:
Situation, parts, interior surface, blood supply, nerve supply
and clinical anatomy
Ans. Stomach is a muscular bag, forming the widest part of
the digestive tube.
Situation:
The stomach lies Obliquelly in upper left part of abdomen.
It occupies the Epigastric region, left hypochondriac region
and umbilical region.
In normal active person it’s somewhat J-shaped.
Parts:
The stomach is mainly divided into 2 parts:
1. Cardiac part
2. Pyloric part
Cardiac part is further divided into- Fundus
Body
Pyloric part is further divided into- pyloric antrum
Pyloric canal
Interior of stomach:
1. Mucuosa of an empty stomach consists of folds called
as Gastric rugae
• The rugae are longitudinal along the lesser curve
and irregular elsewhere
• The longitudinal rugae along the lesser curvature
forms the gastric canal
• The gastric canal allows the rapid flow swallowed
liquid along lesser curvature directly to lower part
before it spreads to other parts of the stomach.
2. Submucosal coat is made up of connective tissues,
Arterioles, nerve plexus
3. Serous coats consists of peritoneal covering
Blood supply:
1. Lesser curvature supplied by left and right gastric
arteries
2. Greater curvature supplied by left and right
Gastroepiploic arteries
3. Fundus is supplied by 5-7 short gastric arteries arising
from splenic arteries.
Nerve supply:
1. T6-T10(sympathetic nerves)
2. Anterior gastric nerve
3. Posterior gastric nerve
Clinical anatomy:
1. Gastric pain is usually felt in epigastric region because
the stomach is supplied by T6-T9 segments of spinal
cords.
2. Peptic ulcer can occur in the lower end of esophagus,
stomach, or Duodenum
3. Gastric ulcer can occur along the lesser curvature of the
stomach
4. Gastric carcinoma can occur along the greater curvature
of the stomach.
18q. Describe duodenum under the following heading
Situation, parts, interior surface, blood supply, nerve
Supply
Ans. Duodenum is the widest, shortest part of large
intestine
Situation:
• It extends from pylorus to dudenojejunal flexure.
• It is curved around the head of pancrease in the
form of letter C
• It lies above the level of umbillicus, opposite to
1st, 2nd and 3rd vertebrae
Parts of duodenum:
Duodenum is 25Cm long and is mainly divided into 4 parts:
1. Superior part
2. Descending part
3. Horizontal part
4. Ascending part
Interior surface:
Presence of circular folds of mucous membrane, villi,
Microvilli.
Blood supply:
1. Superior pancreaticoduodenal artery
2. Inferior pancreaticoduodenal artery
Nerve supply:
1. T9-T10 spinal segments (sympathetic nerves)
2. Vagus nerve, through coeliac plexus
Clinical anatomy:
1. Duodenal carcinoma
2. 1st part of duodenum is common site of peptic ulcer
mostly due to direct exposure to acidic content from
stomach
19q. Describe pancrease under the following headings:
Ans. Shape: It is J-shaped
Situation• The pancrease lies at the level of 1st and 2nd
lumbar vertebrae
• Head of the pancrease is placed under the
concavity of duodenum
Parts:
1. Head(placed in c shaped duodenum)
2. Neck ( directed forwards, upwards and left)
3. Body(directed upwards, backwards and left)
4. Tail
Ducts1. Main pancreatic duct- begins at the tail, runs towards
right through the body, and enters within the head of
pancrease. The pancreatic duct and bile duct enter the
2nd part of duodenum and join to form Helatopancreatic
ampulla which opens into major duodenal papilla
2. Accessory pancreatic duct -Begins at the lower part of
head and opens into minor duodenal papillae.
20q. Describe liver: Shape, situation, surface, relations,
ligaments, blood supply, applied aspect
Ans. Shape- The liver is wedge shaped.
Situation• IT is situated in right upper quadrant of
abdominal cavity
• It occupies left hychondric region, epigastric
region and a part of right hypochondriac region
• Most of the liver is covered by ribs and coastal
cartilage except in the upper part of epigastrium
where it’s covered by anterior abdominal wall.
Surfaces1. Superior surface
2. Inferior surface
3. Anterior surface
4. Posterior surface
5. Right lateral surface
Ligaments• Falciform ligament
• Ligamentum venosum
•
•
•
•
•
Ligamentum teres
Superior layer of coronary ligament
Inferior layer of coronary ligament
Right triangular ligament
Left triangular ligament
Relations1. Superior surface- Diaphragm
2. Inferior surface • On the inferior surface of the left lobe, there is a
large Concave gastric impression
• Ligamentum teres
• Fossa for gallbladder
• The inferior surface of the Right lobe bears the
colic impression for hepatic Flexure of colon,
renal impression for right Kidney, and duodenal
impression for second Part of the duodenum.
3. Anterior surface• Falciform ligament
• Diaphragm
• Xiphoid process
4. Posterior surface• Bare area is related to diaphragm
• Groove for inferior venacava
• Right suprarenal gland
• Ligamentum venosum
5. Right surface- Diaphragm
Blood supply- Liver receives 20% blood from hepatic artery
and 80% from portal vein.
Clinical anatomy :
• Hepatitis- Inflammation of liver
• Liver is the common site of metastatic tumours
Venous blood from GIT with primary tumor
Drains via portal vein into the liver.
• Liver resection
• Liver transplantation
21q. Describe kidney: shape, situation, covering, parts, relations,
blood supply, applied aspect
Ans. Shape- The kidneys are bean shaped.
Situation• The kidneys occupy hypochondriac, epigastric,
lumbar and umbilical regions.
• The right kidney is slightly lower than the left
kidney due to the presence of liver in the right
hypochondrium.
• Vertically the kidneys extend from upper border of
Twelfth thoracic vertebrae to the middle of the
body of 3rd lumbar vertebrae
Coverings1. Fibrous capsule
2. Perirenal fat
3. Renal fascia
4. Pararenal fat
RelationsCommon relations of both kidneys1. Upper pole of each kidney is related to suprarenal gland.
2. Medial border of each kidney is related to ureter
3. Posterior surface of each kidney is related to –
a. Diaphragm
b. Medial and lateral arcuate ligaments
c. Psoas major
D. Quadratus lumborum
E. Transversus abdominis
F. Subcostal vessels
g. Left kidney related to eleventh to twelfth rib and
right kidney related to twelfth rib
Other anterior relations of left kidney –
1 Left suprarenal gland
2 Spleen
3 Stomach
4 Pancreas
5 Splenic vessels
6 Splenic flexure and descending colon
7 jejunum
Other anterior relations of Right kidney1 Right suprarenal gland
2 Liver
3 Second part of duodenum
4 Hepatic flexure of colon
5 Small intestine
Blood supply of kidneysRenal artery gives 5 segmental branches. 4 branches from
anterior division (apical, upper, middle, lower) 1 branch from
posterior division
Applied anatomy1. Kidney is likely to have stones As urine gets concentrated
here.
2. Kidney stone lies on the body of the vertebrae
3. Common diseases of kidney are nephritis, tuberculosis of
kidney, renal Stones and tumours.
4. In cases of chronic renal failure, dialysis needs to Be done.
Structure/parts:
Cross sectional view of kidney shows:
a. Outer cortex
b. Inner medulla
c. Renal sinus
22q. Describe urinary bladder : Position, parts, ligaments and
blood supply
Ans. Urinary bladder is a muscular reservoir of urine, Which lies in
the anterior part of the pelvic cavity
Position- When the bladder is empty, it lies in the pelvis. But
when filled, it expands and extends upwards into abdominal
cavity reaching upto umbillicus .
External featuresAn empty baldder has1. Apex (directed forwards)
2. Base (directed backwards)
3. Neck
4. 3 surfaces( superior,right and left inferolateral, )
5. 4 borders ( Anterior, posterior, 2 lateral)
Filled bladder has1. Apex(directed upwardsl
2. Neck(directed downwards)
3. 2 surfaces ( Anterior and posterior)
Ligaments:
1. Lateral true ligament
2. Lateral Puboprostatic ligament
3. Medial Puboprostatic ligament
4. Median umbilical ligament
5. Posterior ligament
Blood supply: superior and Inferior vesical arteries
23Q. Describe uterus: Axes, parts, ligaments, blood supply,nerve
supply and applied aspects
Ans. Uterus is a child bearing organ in females, present between
urinary bladder and rectum.
Axes:
• Normally the long axis of uterus forms an angle of
about 90° with the long axis of vagina
• The forward tilting of the uterus relative to vagina is
known as antiversion
• The backward tilting of uterus relative to the vagina
is known as retroversion.
Parts:
The uterus consists of 4 parts:
1. Fundus
2. Body (Anterior and posterior surface)
3. 2 lateral borders
4. Cervix
Ligaments1. Anterior ligament
2. Posterior ligaments
3. Right and left broad ligament
Fibromuscular ligaments1. Round ligaments of uterus
2. Transverse cervical ligaments
3. Uterosacral Ligaments
24q. Describe testis: Parts, coverings, blood supply, nerve supply
Ans. Testis is a male gonad.
Structure –
• Each testis consists of 200-300 lobules
• Each lobule consists of 2-3 seminiferous tubule
• The seminiferous tubules join together at the
apices of The lobules to form 20 to 30 straight
tubules which enter The mediastinum.
• Here they anastamose with each other to form
Rete testis.
• In turn, Rete testis gives rise to 12-30 efferent
ductules which emerge near the upper pole of the
testis and enter the epididymis.
CoveringsTestis is covered by layers of the scrotum.
In Addition, it is also covered by three coats. From outside
Inwards, these are the tunica vaginalis, Tunica albuginea and
tunica vasculosa
Blood supply: Testicular artery arising from abdominal aorta at
the level of L2 vertebrae.
Nerve supply- T10 segments of spinal cord(sympathetic nerves)
25q. Describe superior mesenteric artery
Ans. Superior mesenteric artery arises from the front of the
abdominal aorta behind the head of pancrease.
It supplies all the derivatives if midgut. i.e:
1. Lower part of duodenum below the opening of bile duct
2. Jejunum
3. Ileum
4. Appendix
5. Caecum
6. Ascending colon
7. Right 2/3rd of transverse colon
8. Lower half of head of pancrease
26q. Write any 2 functions of peritoneum
Ans. Peritoneum is a large serous membrane lining the abdominal
cavity.
Functions:
1. Storage of fat
2. Provides passage for nerves, vessels and lymphatics
3. Facilitating movement’s of viscera
4. Protection of viscera
27q. Give the blood supply of ureter
Ans. Ureter is supplied by 3 sets of long arteries:
1. Upper part receives branches from the renal artery
2. Middle part receives branches from the aorta
3. Lower part receives branches from the vesical, middle
rectal or uterine vessels.
28q. Name any 2 ligament of uterus.
Ans. 1. Anterior ligament
2. Posterior ligament
3. Right and left broad ligament
29q. What is Trigone of bladder
Ans. Trigone if bladder is a triangular area situated in the lower
part of the base of the urinary bladder, where the mucosa is
smooth.
The internal urethral orifice is located at the apex of this trigone
The ureters of both the kidneys open at the Posterolateral angles.
30q. What are the Contents of spermatic cord?
Ans. Contents of spermatic cord is/are:
a. Ductus deferens
b. Testicular artery
c. Pampiniform plexus of veins
d. Ilioinguinal nerve
31q. Mention the branches of coeliac trunk
Ans. 1. Left gastric artery
(2) Common hepatic artery
(3) splenic artery
32q. Give the blood supply and nerve supply of ovary
Ans. Blood supply1. Ovarian artery
2. Uterine artery
Nerve supply:
1. Ovarian plexus
33q. Mention the different parts of large intestine
Ans. 1. Caecum
2. Appendix
3. Ascending colon
4. Transverse colon
5. Descending colon
6. Sigmoid colon
34q. What is the location and shape of spleen
Ans. Spleen is a wedge shaped organ.
It occupies hypochondriac region and a part of epigastrium.
Radial Nerve
PERSENTATION BY:
DANIEL (22BPTR101)
HABIBA(22BPTR102)
KRUTHIK(22BPTR103)
THRISHA(22BPTR104)
ATHARVA(22BPTR105)
KATHAL(22BPTR106)
JACKSON(22BPTR107)
SURCHANDRA(22BPTR108)
NONGPOKNGANBA(22BPTR109)
GAGANA(22BPTR110)
The Radial nerve is
the thickest branch
arising from the
posterior cord of
Brachial plexus .
• Root value of the
radial nerve is Ventral
rami of C5-C8 and T1
segments of the
spinal cord.
• The nerve Supplies
branches to the
triceps muscle.
•
•
It also supplies
branches to all the
twelve muscles of
the back of forearm
For e.g. Extensor
digitorum, extensor
carpi ulnaris,
Extensor indicis,
etc.
Axilla:
•Radial nerve lies against the
muscles forming the posterior wall
of axilla, i.e. subscapularis, teres
major and latissimus dorsi.
• It then lies for a short distance in
arm behind brachial artery.
Axilla:
Then it enters in the lower
triangular space between
teres major, long head of
triceps brachii and shaft of
humerus. It gives two
muscular and one cutaneous
branches in the axilla.
Radial Sulcus
•Radial nerve enters
through the lower
triangular space
into the radial sulcus,
where it lies between the
lateral and medial heads
of triceps brachii along
with profunda
brachii vessels.
• It leaves the sulcus by
piercing the lateral
intermuscular septum.
Radial sulcus:
Long and lateral heads form
the roof of the radial sulcus.
In the sulcus, it gives three muscular
and two cutaneous branches.
Front of Arm
•The radial nerve descends on
the lower and lateral side of
front of arm deep in the
interval between brachialis on
medial side and
Brachioradialis with extensor
carpi radialis longus on the
lateral side to reach capitulum
of humerus.
Cubital Fossa:
•The nerve enters the
lateral side of cubital
fossa.
• There the radial nerve
terminates by dividing into
superficial and deep
branches.
•The deep branch supplies
extensor carpi radialis
brevis and supinator.
•Then it courses between
two heads of supinator to
reach back of forearm.
Front of Forearm
•The superficial branch leaves
the cubital fossa to enter
lateral side of front of forearm,
accompanied by the
radial vessels in its upper twothirds.
• At the junction of upper twothirds and lower one-third,
the superficial branch turns
laterally to reach the
posterolateral aspect of forearm.
Wrist and Dorsum of
Hand
•The superficial branch
descends till the anatomical
snuffbox to reach dorsum of
hand, where it supplies skin
of lateral half of dorsum of
hand and lateral 2½ digits till
distal interphalangeal joints.
Back of Forearm and
Wrist
The deep branch of radial
nerve enters the back of
forearm, where it supplies the
muscles present there .
Lower down it passes through
the 4th compartment under the
extensor retinaculum to reach
the back of wrist where it ends
in a pseudoganglion, branches
of which supply the
neighbouring joints.
Axilla:
Muscular branch:
1. Long
head of triceps brachii
2. Medial head of triceps brachii
Cutaneous branch:
Posterior cutaneous nerve of arm
Radial sulcus:
Muscular branch:
1. Lateral head of triceps brachii
2. Medial head of triceps brachii
3.Anconeus
Cutaneous branch:
1. Lower lateral cutaneous nerve of arm
2. Posterior cutaneous nerve of forearm
Vascular branch:
Branch to profunda brachii artery
Lateral side of arm
Muscular branch:
1. Brachioradialis,
2.Extensor carpi radialis longus,
3.Lateral part of brachialis
(proprioceptive)
Terminal :
Superficial and deep
interosseous branches
Cubital fossa
Muscular- Extensor carpi
radialis brevis
and supinator
Back of forearm
Muscular- Abductor pollicis longus,
extensor pollicis brevis,
extensor pollicis longus,
extensor digitorum, extensor
indicis, extensor digiti minimi
and extensor carpi ulnaris.
Wrist:
Articular- To inferior radioulnar, wrist
and intercarpal joints.
Forearm
Cutaneous and vascularLateral side of forearm
and radial vessels.
Anatomical snuffbox and dorsum of
hand
Cutaneous and vascular- Skin over
anatomical snuffbox, lateral half of
dorsum of hand and lateral 2½ digits till
their distal interphalangeal joints.
Articular -To wrist joint, 1st
carpometacarpal joint,
metacarpophalangeal and interphalangeal
joints of
the thumb, index and middle fingers.
The radial nerve is very
commonly damaged in the
region of the radial (spiral)
groove.
Common causes:
Sleeping in an armchair
with the limb hanging by
the side of the chair
(Saturday night palsy) or
even the pressure of the
crutch (crutch paralysis)

Fractures of the shaft of
the humerus. This results
in the weakness and loss
of power of extension at
the wrist (wrist drop) and
sensory loss over a
narrow strip on the back
of forearm, and on the
lateral side of the dorsum
of the hand