Anatomy

Updates
RECENT TOPICS OF 2017-18 EXAMS

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FUSION OF SUTURES & FONTANELLES

‰‰ Sternum parts and fusion
•• Manubrium with body fuses at old age (~60 yrs).
•• Four pieces of body (with each other) fuse at 14–25 yr
•• Coronal sutures close at the age of 40 years.
P
•• Lambdoid sutures close at 50 years.
•• Temporo-parietal sutures remain open until extreme old age.
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•• Xiphoid with body fuses at ~40 yrs. •• In vault of skull, closure of sutures begins on the inner side 5–10
‰‰ Fusion of skull sutures yrs earlier than outer side.
•• Metopic (frontal) sutures close at ~2 yrs (May persist in 5–10%).
•• Basiocciput fuses with basisphenoid at ~23 yrs.
•• Sagittal, coronal and lambda sutures begins to close from inner
side at the age of 25 yrs.
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•• Sagital suture closes between 25-30 years. •• Fusion occurs earlier in males than females.

AT
M
Age Closure of suture Remark
2-3 years Metopic (frontal) sutures May persist in 5-10% E
18 -23 years Basi-occipital sutures with basisphenoid
PD -
25-30 years Saggital suture -
40 years Coronal sutures -
50 years Lambdoid sutures S
Extreme of age Temporo-parietal Fuses at last

U
TU
Fontanelles
‰‰ Total number of fontanelles in human skull at birth are 6. The
anterior and posterior, two mastoid, and two sphenoid.
Fontanel Location Shape & size Usual time of P
closure
‰‰ Lateral and occipital fontanelles usually close within first 2 months.
‰‰ The condylar portion of occipital bone fuses with squama at 3rd
year, and with basiocciput at the 5th year
Anterior ƒƒ At the
junction of
ƒƒ Diamond
shaped
ƒƒ 18 months
-2 yrs P
coronal & ƒƒ ~ 2 x 2 cm
N

sagittal suture
Posterior ƒƒ Between ƒƒ Triangular ƒƒ 6-8 months. L
occipital & ƒƒ 1 finger tip ƒƒ Persistence
parietal bone size is seen
CE

ƒƒ Non-palpable
in first 6-8
in hydro-
cephalus &
E
weeks hypothy-
roidism.
M
RE

E
N
T
These Updates are from Primes Supplement 2018
Anatomy
Updates
RECENT TOPICS OF 2017-18 EXAMS

PAGE
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P
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PD E
Fig.: Timing of fusion of sutures

DEVELOPMENT OF KIDNEY & EXCRETORY SYSTEM S

‰‰ The intraembryonic mesoderm differentiates into paraaxial,
intermediate and lateral plate mesoderm.
TU
‰‰ The intermediate mesoderm forms → Urogenital ridge, which gives
rise to nephrogenic cord and genital ridge (which forms internal
‰‰ Ureteric bud is a outpouching/diverticulum of the mesonephric
duct near its entrance into cloaca during the 5th week of gestation.
U
It forms a conduit (channel) for drainage of urine from the kidneys.
The elongated stalk of the ureteric bud, called the metanephric duct,

‰‰
gonads).
The nephrogenic cord further differentiates into:- ‰‰
later forms the ureter.
The metanephrogenic or metanephric blastema (or metanephric P
•• The Pronephros → Degenerates mesenchyme, or metanephric mesoderm) is the portion of
undifferentiated intermediate mesoderm in contact with the tips
•• The mesonephros → Degenerates
•• The mesonephric duct → Forms a bud ,the ureteric bud of the branching ureteric bud . It is one of the two embryological P
structures that give rise to the kidney, the other being the ureteric
•• The metanephros, The metanephric blastema → Forms part of
N

bud.
definitive kidney
L
CE

E
M
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E
N
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These Updates are from Primes Supplement 2018
Anatomy
Updates
RECENT TOPICS OF 2017-18 EXAMS

PAGE
3
Primitive forms Structures formed Remember
1. Pronephros Induces mesonephric differentiation. ‰‰ Kidney is formed by: Metanephros.

2. Mesonephros
Degenerates by 4 wks IUL
Degenerates , remnant forms : Efferent
‰‰
‰‰
Ureteric bud is formed by : Mesonephric duct.
Ureter is formed by : Metanephric duct (the elongated stalk of
P
ductules of testes, epioophoron, ureteric bud).
paraophoron
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3. Mesonephric Ureteric bud
duct
3. Ureteric bud Elongated stalk of ureteric bud is called
metanephric duct which forms ureter. renal i
pelvis, calyces, collecting tubules (Collecting

AT
system of kidney)
4. Metanephros Forms definitive adult kidney M
& Metanephric i.e. Glomerulus, PCT & DCT, loops of Henle
blastema (ansa nephroni), stroma of kidney (Excretory
system of kidney) E
TYPES OF MUSCLES

Based on Muscle types Example

PD S
SHAPE Triangular Deltoid, Adductor longus, temporalis
Quadrangular Quadratus femoris
Diamond shaped Rhomboid major U
TU
Rounded/Teres Teres major
Worm like Lumbricals
Straight Rectus - abdominis P
FASCICULI Spiral (twisted Trapezius, pectoralis major, Latissimus dorsi, supinator
fasciculi)
Cruciate muscles Sternocleidomastoid, masseter, adductor magnus
P
N

( Crossed fasciculi)
Strap muscles
(Parallel fasciculi)
Sternohyoid & sartorius L
Fusiform muscles Biceps brachii, digastric & sartorius
CE

(Parallel fasciculi)
Oblique fasciculi / Unipennate ƒƒ Flexor pollicis longus (FPL), Extensor digitorum longus (EDL)
E
PENNATE ƒƒ Tibialis posterior, Peroneus tertius
(Feather like
muscles)
Bipennate
Multipennate
Rectus femoris, dorsal interossei, Flexor digitorum longus (FDL),
Subscapularis, acromial/middle fibres of deltoid, Flexor hallucis longus (FHL)
M
Circumpennate Tibialis anterior
RE

Composite/Hybrid
muscles
Which have more than one set of fibers (and usually different nerve supply) but perform the
same function. E.g.
E
Brachialis: Musculocutaneous nerve is motor and radial nerve is propioceptive,
Adductor magnus: Its adductor part by posterior division of obturator nerve and hamstring part
by tibial part of sciatic nerve. N
Convergent Temporalis
Sphinctor Orbicularis occuli, Orbicularis oris
Parallel Fasciculi ƒƒ Infrahyoid, Sartorius, Rectus abdomins, Digastrics, Biceps, Thyrohyoid, Pronator quadratus T
These Updates are from Primes Supplement 2018
Anatomy
Updates
RECENT TOPICS OF 2017-18 EXAMS

PAGE
4

P
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COLUMNS OF CRANIAL NERVE NUCLEI

PD E

S
U
TU
P
P
N

L
CE

Efferent columns of cranial nerves E

Type of columns Nuclei and destination
GSE (General
somatic efferent
ƒƒ Supplies muscles derived from head somites e.g. extraocular muscles, tongue muscles (nuclei are motor in nature).
ƒƒ Examples are:- [ Mnemonic: OTAH]
M
or Somatic motor ○○ Oculomotor nucleus in midbrain at the level of superior colliculus → Extrinsic muscles of eye except LR & SO.
RE

column) ○○
○○
Trochlear nucleus in midbrain at the level of inferior colliculus → SO of eye
Abducent nucleus in lower pons → LR
E
○○ Hypoglossal nucleus in medulla → supplies 7 tongue muscles (through CN 12) except palatoglossus .
SVE (BE or
branchiomotor
ƒƒ Supplies muscles derived from branchial/pharyngeal arches (nuclei are branchio-motor in nature).
ƒƒ Examples are:-
N
column) ○○ Motor nucleus of trigeminal nerve (CN5) in upper pons,
○○
○○
Nucleus of facial nerve (CN7) in lower pons,
Nucleus ambiguus in medulla T
(contd...)

These Updates are from Primes Supplement 2018

Anatomy
Updates
RECENT TOPICS OF 2017-18 EXAMS

PAGE
5

Efferent columns of cranial nerves

GVE (General ƒƒ Supplies preganglionic parasympathetic fibres to glands & visceral smooth muscles (nuclei are mainly secreto-motor P
visceral efferent in nature).
column) ƒƒ Examples are:-
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○○ Edinger Westphal Nucleus (EWN) (for oculomotor nerve) in midbrain at the level of superior colliculus → to
sphinctor pupillae & ciliaris
○○ Dorsal motor nucleus of vagus (CN 10) in medulla → Thoracic /abd viscera
○○ Lacrimatory nucleus in lower pons → to lacrimal & nasal glands via pterygopalatine ganglion & greater petrosal br
of facial nerve.
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Superior salivatory nucleus in lower pons → to submandibular & sublingual salivary glands via chorda tympani

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○○
○○ Inferior salivatory nucleus in lower pons → to parotid gland via otic ganglion (10th CN)
Afferent columns of cranial nerves
M
GVA & ƒƒ Only nucleus is nucleus tractus solitarius (Solitary tract nucleus)
SVA (BA) ○○
○○
It receives general visceral sensations (GVA) through CN 10 & vagus
It receives special visceral sensation (SVA or branchial afferent) of taste through CN 7 & 10
PD E
GSA (General ƒƒ There are 3 nuclei . All receive sensation through trigeminal nerve
somatic afferent ○○ Superior or main sensory nucleus lies in upper pons.
column) Spinal nucleus descends through medulla & C1 C2 segment of spinal cord.
S
○○
○○ Mesencephalic nucleus ascends up to midbrain. Only example of primary sensory neuron whose cell bodies are
within CNS.
SSA (Somatic ƒƒ Receive sensation through 8th (chochleo-vestibular ) nerve
somatic afferent Cochlear nuclei : (dorsal & ventral) at junction of medulla and pons. U
TU
○○
column) ○○ Vestibular nuclei receive fibres from SCC, utricle,saccule through vestibular nerve.
GVE (General ƒƒ Supplies preganglionic parasympathetic fibres to glands & visceral smooth muscles.
visceral efferent
column)
ƒƒ Examples are:-
○○ Edinger Westphal Nucleus (EWN) (for oculomotor nerve) in midbrain at the level of superior colliculus → to
P
sphinctor pupillae & ciliaris
○○
○○
Dorsal motor nucleus of vagus (CN 10)in medulla → Thoracic /abd viscera
Lacrimatory nucleus in lower pons → to lacrimal & nasal glands via pterygopalatine ganglion & greater petrosal br
P
N

of facial nerve.
○○
○○
Superior salivatory nucleus in lower pons → to submandibular & sublingual salivary glands via chorda tympani
Inferior salivatory nucleus in lower pons → to parotid gland via otic ganglion (10th CN)
L
CE

E
M
RE

E
N
T
These Updates are from Primes Supplement 2018