CeCe eee OHS SESH SEEHEOHSSHEOHHHEHESESOSHOASO Anatomy ~ gM dan « 4 fuber [founder st modem Arciomy [Andreas vasaliys| de Human skelton — — 206 Bona Appenaltewlar steleton Axio Seeleton Cob bony + 0 bones ° ? goth upperlinbs - 64 "bona ees goth lower Limbs ~ 6> kone Ir eon > seat — bee = vercbral column - 26 vonse > Bile - af bong - > sure > typi bone, — mack region ge noe Verinbrae Tq Vertebral column ~ 33 “ho: bones in VE cb of vertbrde tn verre Fatal 10 fore 1 cocuyp Wore ge moir [constant] no oF verubyan present in — (berate req iy Castablel no vertebrae present in — [cour A wot P rhSrelerabmyrcle, + plymeleaed. ¥ voluntang # stated. oo ongin: Inveativg ed 8 fixed Ron oe (on StaHonany contraction pred colour in ® blue vobur in Areg vaun diagram « ia ate bond) (és bong oh > dumema — 2 => tadiys gulna — 4 > cavpals — \6 > melacarpak — 10 > phalangy ~ 2. . peagabtethrowghe re -@@ COC CORSE HReEB ene P@RPSOCMOBPOKRseasgeaeagaiein a... : ple ok fantom sist aan oA, ur Froviure— ¥ chivieal presente + sinking [Aaoopit of Up pey mb . 2 surPeun” “e Sterpe Sink rine } \ psur forms (Gurroclast akjoine rictend) y CRemmictend Synovial Jone saddle yo Rewmio clavicularolnt —— joint AER hk joint with Le rdep | T arn Other fone sgronal oni Ege kom hE jotmk with 7 Joint intra arth eerie oo. toe . ©. Tempore mand tbstag 7 : oo yee = joint he 8 [ioe t Flelavicle B the only long bone which har n miadult * we mg. ne ON as no mieten cauly] a only. orgy bo o(z fo ossify —> at GN week, Thtva utnine (eames me for ossification ~ Geatton ~ Pype of eae > [ar to ossify - nandibie) Palmosy — appear before bivth $ ossification centre — > all long bongs from one oxsiftecth cantees rept “ole secondan ~ Appear after tintsA cAavicletumetion ~ WeIGM ware erro mine bo(ntal ¢ spars et long tone, \PMHE MY Brot: trator conta clued i cond ne prac) — surface. eft physis oogla oh —> tyaline cartilage, Phaphyst [share > medullary couthy - Eptphys. 4 fiyaline caren Formy “earllegenens pout plan reason for fin bone Lngth, A join erwen eptphyels & dtaphysts primary ear tilagenous 7 Joint ie Grepags) * deotvast ve. of + (Biel wince te + Goat) — Cray wena) dlaplyse hare madollans cout. o~e CFOS CCH HSHHSESHPSECEOHSESES ESOL EDRECSHEE Mudaattachnent divide clavtele into 3 pats moe (oe latnel Ya ly Hm a Fe inmernd > (Stirs we FAI nT - | ovlal nc tae from Sup: curPate scm (neck) foom potelers urtace (chet J pectontgny ~* jrntater border —6) +(pettol Ss. shoulder pert susface = Incestton of mucele, [subelaviuc mace Crnuccle pectoral. region under peck. major) .scapula] choulder blade - ad —~ heron pro cas Supracplnows Foss sph —~ coracole process > tap lilt haber Ted rALSAU) Inte, Genet courtly spinon anfraglenold “ E ye Pamir Mi AY Tera meet Fb mg SF inv cotslspele porr surface. stage | de Extends om aMatb to 7Paib- (Bong aitz)- | er veytaloya. is the Stimal angle Jr Axe for stopwlex yotatlon passer Thevgh tnpest Tor angle Qa ————— ag rotation of scapula using adduction af-armp b A medicl rotation (0 inward wtidior, ereat ccc ceseaetaeaeatoesnerenaneosancne@eeossceeese nes a's e a ® s e e e a e ® @ e ° a e e ® e ° Ae e a © [seats pocen ~ eq taunt epics, } oe (reoee eeho a Is the independent bo nes bat Fused with Kar ghbouring- bone, p bonsa axe. 24 —[os tgoram of{Talls “Tarcal bone “4 c lone oF Pook | ane . | oe B Muscle atratchment of <0 raceld pro cer - oO pectorals minor» — 2ncorted a 2) © covaco brachtalis = — gin « ® srorehead of sicops brachy on gir -Co) 4 supra ganoid Twoercle, —> above the -glenoi d cavity « Laig herd sot bie brgth "GG es, wtragenid tuberate — — long head of reaps brachit ~ Gain below glonotd cauity - # Vata border oF scapula = fever minor - Ov iy, Tere mayor d # Supa spinaw fosa - supra cpinoy, muscle . ¥ Antra spinous fossa. - infra spnoys muscle +je peltoid muscle — spine. of scape Pe tet FOorigin~ loser border sane ceapule Spine oF seapula, revorston pmax Shoulderforar— ee Glanchumereh folate idle Bret rpost-po wer Craultipernatn) ula. Arcronslon pre ou clavicle + spine st-scapal . hewimion preaat Clavie - WD lek. rer Acvomion proces @® Amv: bovdey of clailege Provan ¢ L went sine Ava | chuicdtar lrg ~ ep unipennadtt mot pese fives — nipaba te muscle Rove yuMe Aer multi pennate fey - sdevenerscacaressccon aeatesncve ‘@eeee.eesesevnescoeeoseneeoseeae coerce neesoere' aston oF chowder) arm ab sholdewy Ant Filo eteniton of am ab Showtder > prst- Flsy ahduston of em ar shower __ ytlale Rloreg « 4 3 degree Pe orks? ye pes Sf peltoid Pubeanstly of tuners. [asaral Surface of mid shast2h Humans. wevenagply = Alay ae (ao | : ‘ee Cato drwacte ele) (Tera mi oF : HW giver one, sensory nerve - he ove: ag) AGeLortincows newe ne ay # supply to te (sin vg laser Yp oF deltoid muscle. ab. a (eee ioe eee) + gh ls Frown 9 on roe Regiments bulge onertas ] = am injection i lower Vp of dettold murcte- hot in upper Whe may davmoge, Arillay rene.# never ge 2m ejection In ee arm spam ® given 21> Fnac below Aewmian proc. ye RadiaLnene jury - = wristdrop , Peng Nos Aaion = Oassisr overhead abdiccton TY ROOFE Radioh name CTiteeps mutch) » —, one hgr puchartn neck © spre of 7, to 7, vertbrac. DO upper border spe ccapula © Medion bordé.r Acwmion prea) ¥ border clauicle ~— [spina Recomeny nerve} supply. only 2 mucler (@* Sesiarnave) / NN Traperyiy mus tle Som Cstarno Uido mastoid mused, ©) pottactton pF Shoulder ¢ reek. PP Sat evevrevesestesseavecssesrocveocasave|Pe@eeSaeeeeesseseetvsezevreesevnenesteneeeoeeae __ origin (0) — apper 8 sibs midchapt - Snsertton 2) mesial border 4 scapula. (int surfow) . oF NS = long thovacte herve, [soar oot - (es % &+) So e Aaten -| © overhead abduction, @D — -protractton éshowlder @ _forted inspiration. ——___O GLENOP cA vty fF Avtielams with head Humery* + (look erat joie) shoulder synovial fol nt Boll F cocket * # Glaasidcllerum filo cartilage te ® depth of abnotd ceuityqueno hone rae sourr $F Highly mo eg highly (anstable joi became ganaid cavity b matter then head of humeny + formadby 4 rvsee O .upr a eptvioto ya ®© Mfraspinahow een ea © Tree minor posenerty yreerted on Gres tartuberclh p-hament r sub stopolasss —} o> rrseyted on - Levertubercie, _ present Anteatodiy » ot kumar, fib us copsute. cotta muscle of body — gub seapulastt ret] PO Bae ers eersesaogaseacesseeraenesasaceRes ezvPeeeceuewenaesteseeeeeaee eaogeeeeoneosaene To ——__— ; —— P orstor curF dog not protect shoulder joint infesionly - A ynott-commen dislocation ot sthowlder joint is Antasios! Cantor dB loceaton) iy +yVMERUS BONE CUppeRENP) a () Heed of humens — £4 oF pressure epiphysis - © grav tubercle. ~ Ege “Traction epiphysrs © lever tubercle. @ eiepitalgwore / mcr habereular suleya. w pressure epiphyse ends of long bones. > weig) he beasing - nines + Traclioheplphyst —part“ot. bohe scoped ch du a [ss “iad dle puts \ won Arvealar don weigh £9 - Direater p loxertiochenter oF en | eosing - “ © mostoid prow temporal bone. @- peast s war chberdye + oo) @* Liectpiiesgicove- wo ‘weer Facberentar sulars st LabereLborder = pecrralB major iz inceted | Hon floor a bhedpital gove = Jatrastmys dorsi cipital gwor. - —[()-Téndoo: ef long 2 és biceps: byachii @ho Ascending eanch of Ant- efrenmter humeral orticatanen. _borgiead neck = Sunetton of upper end: ob ghagins rctretedd by Axillay nerve — a ge medial border [Rt : a s /@ | chert ee Humeny post surPane ~ | erm hane Redltal gro oe [snbg 16 G of Taicops Vag —> Radi od content of Paslio gaoove. | grove, eS el pire ( fadiatnane ~ (65 e es 1) : tel gp n medltat had @ pofarda eae oes ce titep oa Be ranch of S¥achtalasteay . SIVA pumtent arty te humeny , oe dasrelg Medtak heads of ‘Ticopt igin An. post surface. of humengs 7” 54 coon 3 ae ~“Poicogt ~ Sh ead. — lateral, medial » long haw. La woersend: OF hiameeay’. a . cme? Cte) s sk medial epicondyle , laterer epicondyle- & p Tyochlea 7), eopitrlum ~ 69 me — common gio erigin for Fore Arm. Coe common Extensor origin for fore aym. aWrANO9 stuclank ae aol dn red + epicondylitis: —> goltert El bru faces ade Vek stony itis —> tennis elbow ROSS SSHHOHSHSHSSEHSHHSHTB SF LECH HESHOEHHSEHSELE<=> olecvanon proces of ulna: &- ~ small Flatten ieeps-brachit : ~ Brachiealis : eapeabrachiolgai alip Extinslog ‘Polceps ¢ An conius- ae fre arm )— 5 bonay > olecranon procs > covonold pro an v ©. Fochlear mich ,SSS O SOS=S > peeps brack Muyed ale Rodial tuberosity A Toleops InserGd at olecranon pvt» ntirasseous raembrane,, > syloid procen pid le an ulna + Mtteday- of Badtvp. aise 7 ie ttedd-oF Ula. presenF inPextedy ‘ eo widdle Roslto nar jot - aes membrane, ee ig Pillip. dive.ctrd ‘From , . Radius to ulna, Ceovonward £ medals) Radio vlnacsoine - Sin no- GS bem cy synovial plvar ag vote head of-Pcclt ys toad of ulna Rodtal notch wha vlnar noth Podtur lig = Annwlar lig Ug — Articterdise |Ver lnteroseo™ movement Ns - Fe ps — Muscuao ciitane Sapination —— supingtor ¢ Biceps broek) pronation = prnaby tars, [teers Ineckan We Q: Traum a in fore Ann whch movemed F fx rove likely damaged - prenation ' crhrectian- ner perely zl pronation - positon 2F- forearm. + Became of Srachtoradialp »muscla, Spry by Ravel ie e # cupinaton & more pow erful. Ploged Pote arm which muscle will cause. Suplnation - S2sicops brachi DEORE SHSHSSCSHRSSCHSSCSSRBHSeSHSEHBHESHEEE(syndes mosie) « (iy ~ interasseous mei bran function — Transfer weight fom Radius te uha. pe (caelecn) eter ene reas Artanged from Latmalto mesttat olde tn 2 2 we ne Proximal i _ _ dittet [ . (smu) poraimet sous = $ caphaid lana Tatquetrat aD | a. | oo. (iets) - eat) (oeseent) (pyramid) (peasead) . pisteL 0 ~ Teapegiun “Tapepald ies Hamat + (MD ewadraagsy eayeeo arent) ecoptets 2 fe ousify at ahd wont of extra utmine life Heme @ to osity ey 34 moh ae 60L Berth ~ wo Coxpel ossped 7 fer tear ~ > bones oss'Frect ifm oscig =D) ee a GE In Bndon v6 flexor carpt Oasis mucle - ol a yD _SoeoseLunote - 4 Yeap age seaghold = Syene age Trapepiumn § ‘Trapegoid —S yearsage © \ . => ral bone — most com monly delocata Zarpat when leade qo carpal funnelsynchorre , Cs v medjan nerve. Ingury t Ape thumb deformihy for) ments hand ' oo — WRIST JOINT —Ulnacves not conto az, . ale also (eadio carpal joi * ailipsdidjamevo: compound joint: (synovial oind- hy. Sesveeevneveveevescenene Awticutot supediesty “2 fower enc of Radius § Artowlar dis infest sly > carpal lo Nez of proximal yo encopt plsciforin META CARPALS. # miniature (onghoug - 5 i number - prranget frum jatrat to mec ee ° a e e e e e e s ° e s aEE DI IEOISS~=’T OS — pase. (prmatmat) thaPt- —tad -@R tet) t form Enuckles. , we long bong hive only one epiphyenn » singh ¥ €piphyss — present at base of 3 metacamalbone. © forthe Rese 9,9 - Cptpaysts ak tad ‘i (Abgerant: ef epi epiphysis = "ay Findin ng oe devised from its nornet position . » Eg Heed of 2! meta carpet. have no lise ie er polition eae of? eo : . “Thumb > adductad ¢ medially read beau. ef opponence pollicis muscle: fi median N° an madian w tnjany / APE Tham de formiy postion e& bax or thumb Adducted’ ant Leb. eotetedSCOHCHEHROCS EHS KREHOEROEFOCH ELS oe SIntarphalynanat join 2 carpe metacarpal joint -— syroulot saddle jsiae 2, @,& , 2 Ploxion ak MPJOIDE — fumbsi cade mutcle —> flexion & PIP - FDS- muscle- (flexor digitonam supesti clalod . — > Lnton ak IP FDP muscle Cpr dighteaum prpfunduay.Arrotomy — 2" eLas os DNTEMBIE MVsCLE SOF HAND, Tntinsic muscle are anall muses v 20 tn number ¥ avranged In 5 rows f each hos 4 muselya. wes 68, T, Nery, . | © Tener gap: — Bose oh hams (formed by ee musely group) “Thenareminence- * ong GD raductor pallets — Thumb SAenTy” acy) olan or polllelt berets = Cariay. FS ior nane-| © opponence poutels - maagion nexie—| i% 1) poducto r polltels brevis © Hypo thenorgoup — akmedial border a hand Unornerve (Flexor aght oviaim it~ KHL Finger) F | . Leap branch - oes ao rn CD opponena digit minimij ! aman. ‘ P ee @ potmaris brevis A supertitedlnon @ Avdactor digit’ mintmit eaity© iurbA cals — Ff innunber Arvangod from aa media . Thumbside- 2 Tada Fin nedted “ by, nee ca \ Dnipinnat Ly dda Finger? muscle Unor neve 76'S — Ring fer 7 deep branch BipinnaG Lrg RL. Finger muscle, No lumbdeat is inserted into thwnb eeeeveveneswaeeeensd Fluxion at Mp joint ¢ exunsion at Jp jsint PrP “pep: fee : Flax digiterure profunde ag buebr caly + by tendon divides fri pore Auertion ~ potal digital expansion: ° e e e e e e e ® e e s eJl oo 6- Bhpinnan ® rs @ ewer pee oaby rusia + ae a eee “Tolesie ot Aston pedduction VL finger OP EMEP comeorigin - Shoft +f meracarpals aodntar 0) — pors al digital enponina mis Ulnar nenvedeatbrenas, lon_of Intrinsic. mascla fine movements fei mest o& hand- 2} = waiting. Typing” (movement whic hare fo be prectied) redoicnty ant ” “K: Ringmovemante + Wedmnely — vinar neve sath sy Te race = medionnerve- oa [omernene - | tasdian nerve conhel spf Eee making fie teheyrer sere» Labourers nenie eye of hand’sensonj ns of hand aN palm - ‘@Suevesvseeenvnesenaesoseeaeee SvreeaeesseseoaeoH eee # Sein above PIP joints — lateral sta. clgips —> medial nave media vie dig > ulnar newe- . # cing finger hyp mailman rene supply»Derinptome —> fy Bihe aves oF the skin supplied b ae pplt single spinal nerve 4 €, Gpimalnene) — No dermatome, Cio seneony supply) - C, Thumb — lg fore arm lak > forearm med yy ~ Sg Arm. = la 7 BO wed Yo Ty ; “glad supply (84) eEHand bp date co : Ei ota tindoyr ct Brechtoreacticl © lerevally Radial nyeny Flexor carpi radians @® — %, » Terma bran chet of bracil tne examined aytn) ase. in cubtteh asa medidy —olnar arty ak neck Radi, + tov fr ortoie aro in Hand @ saperfistet palmar arch, ® cep palmar arch. Cormed bay Redli al vined by Red aktratay’ aadicharen (POR) -preumenie F cogs meaty by dap poh Cfonmed by phnar erty) F compared “laterstty by raperfrack palmar branch oFSuperficial, patmar arch, aupertieial to long furor tndopy hunte fos, Pop, FPL ¥ y deep palmar exch v of Extended thumb . Flor digsup fuepar borg Fae deg prot +f present ak dpicLborler of Stendedtaumb « Branchat + — eommon digital artevicr. + “panceps pollit® arty <— Thumb. Readvals Indtet FOREARM Vo hes 2 compaytments. {@® pntador compartiient /Claisi? compatmant: artny <— index Finger rmscla ave anangd in 2 groups mT superttet al group —> Oo pronator tore mredran newe [D) gadmasis longus @ Present ad prowmalbo reer D fapor digteram supericrah ® euxcop © = ggatdse rection nave Antrior @ Favor poll ets longus (Fpt> | Mntwyoseysrere @ Prxor digitorum proRndus - "CFD a dexevod medtad Ye ret an were) Cohar nerve) ° “anterior intaseoss ween (Hypa a /eomposics musete.| y ecaum dual nerve supply postzaior compartment o& forearm / Gatansor compartment: en ee / by superficial gwoup: @ sane ol. . @) preekio rasta? @® extensor capt yotalis tongue - Qxtrsor caxpi yadialis brevis og — Postar oy @ uarsor carpi vinais inesosseos | CG) gatansoy digi tom neve (@ extensor” digit minima ; a woac cease eveamnenseeenee ~ Se®ea nese nateere erase) © supinator - a Aendonet thee. 4D — pbduetor pollicis longus me tie) eae oe poltetor @D eetnwor prlteis bres ineoweDus = for eg -@ Gxtancor polliets longus ee @ Extengor Endicis Floor of Anatomical Srufflyx ~ ceaphold , Trapeg tam , Been a 2 metacarpal foot — Sein, superficial Fasela Peep fascia y “fough membsanoua Shanth tee contain@ruperticlel branch ot Redralnen @® Cephalic veins content’ "Radia aFtny ome Fmetured carpel = scaphoid - ef — Tenderness In dat ones snutt lox pletor of pers : preseniee : pop) cot} nthe form o& glow hold ing potion, SOHC SRHSHOHHHSOHHOSHOSOHReOHRO CEH HKESEZ OASwubibel SA Trtanguter intr muscular space “+ infront-of ello wo : M3 bert formetly — Trancvere skin creates ¢ 2tendieg From ‘ meslinl gpteondiyle to Lee * F medial wall - paonatdrterss muscle . $ laxaed wal ~ Grachloradials muscle % Hoor 9 = Brachely ~ upper fp supinaier - tn lower Y pronator tars+ : brat : F ‘ . is noe : Daye eedtan nate . Bo = prochlal drtiy’g-Brinche 74 2 , T= Tendon of sieepstrachti” Ro Radtal nerve.COOPER HHHHHCOCHOSHOCHECHOLOHOHHELOEEOE Blood supply of upper limb BrachlocRpraleatey dewey ‘perbveln minor dite lay axtoy Branches 4 Ariley ertay : . Pokal, vlna % poate -= tonedanch - sup thoes osoy Ry Fito ai Mhenakga = THEE letaad TRovaci ¢ oay = Sborenchat sub scapalay exten ~ lnrgaberen hramele x Uomerel artery. Bigger in forays pos ciromtae thumeral arry . Jpocawae t-13 ood gly to lbveasts 2Nerve sappy — Brachial farus ee T ‘ pihay plays — [eanleat pany yeh ts , lambor pare — by pba sty t cere PRM LL 5, 15)05y 5p —— I Roorvelur = lolich spinal newe fern thepliyur. —_ Je AL The pap ave formed by Anterior patmasy tent ee pit Yomi I i ea Ph x doce Nok Fo vy 7 any plxua Cprtemor (ary dolret) .(coe). ogo Fecrorals matpr gina Roots 0 “Tonk. DhBlom, = cord = [ewes) 7 reese S a) aa upper ant. oi. Ie : — c © eto gubelostia | 6 oes PET | (als oe) pyille Tp madka, core (adore) (Prater divslon) Cea, Cy middle ant Ce > lowertrant vy prenenonit = EIR = (Pefertianr down deretopnenteorprnd) ee a tuetind) —nbrevcleviciakey "7 laviealey Clovleway ry Palle present in’ neck Y eens . Natal pectoral neve hess femal cord 3 Lattvel wot of median hewe ha ~ Oy musatlo cutenedys nee nagely — Biceps Broo) aseycah. Blo supped Brnchtalls foot composts is tog Radichnare—— eoracoboiadtiall® ) “of pm + oO Brahals — yi? ee pits mast |=a] <> medial cord : : : Cee) 71) medial wor of medsannene. (2st)? ' medial cukinsowe nerve Ai .C¢5,T)) medial pectoral nerve L¢T)) mediolcufancous nerve fore ano. (¢,T)) Ulnar nerve Gey 5 6,7)) ¥ medial pectoral neve - supply 7 pectoralis mere pectvalt. ro inor, ey median newe Fonnatton - ¢ ‘ 54 : ae os Ce SS ‘ : Inctlel Foote Boo - « —— Ulnarnerve - . preety : A Ca Brg ob addr ulnar nerve dome ue of median neve F Lfraser wnd- branchn — (Lapcapalaicmutle~ Ayboidonal Supply subs capulasts muscle = wpper subséapular newe (5,6) expels 5 Sule cig spreyes major ~ lower subscapular nerve Ces 505) “hot elodorseduerve. . Shy os mive to a (46567 ¢) up . musele for Aiming ea — A = Priillany nae ces, eg) Ro = Rodltebmene (es 6 55,08/7)) st branch of brachict plus - Radial newe [rect bye 3 “4 Toner rmedian neve became itm co coal Dherny nel). J Cnot direct tras Supply ali muselys of postertor compaatmnent ob Arm G. fore oxm, Le Boe Branchea feom trunk Supply supraspinatous , infra t “Tras # vpoer ment —> branch — Supyo scapwlay nerve ¢ Newe fo sub claviur Bnew meet together aad fre mecting point B ealted — evbe point a Sierra y « fleatt0) . Injury at thy matted erbS pol Supply sudbchavtias muscles Se ee Deformity “ate Hans(ea) tem is addnotsd § meslialy whated Elvow 75. Extended Forearm iS pernated intwe pavaleygal moverenit ave. -\abducton , Fuxton , supination. (ail other movemenys gucept mentioned are paralyzed) - Newes damaged ~ Gl these ReokValue fs Cg Cg Mouscliy powalyzed ~ — peltoid , Terecminor. couee' dur to un dve largest Foramen of boky | ‘Than’ Foramen magnun shape Tignguley oval S 9 crate 6 CFemass). ia tenraloa are) Muschi - pobratoy intomus muscle- “Taner mnagio {' obturator Extarnys ~~ outer morrin Glxcabregien pruytion CD). este : be de — frsevted guintda trochanimic fosea- = pier trochantaic fossa but on medial surtach), of qreake bo chantay oF fone on _ YS No oor: Sat, ce Nerve te obhyato inteynya Clsr51 752) softly lye _irswpply fe to Bemis supentor ebr - ert 4, # Carne [vertrat 4D yy oneeae2schial uberosty —— SS. schiolspine lo © pe Semi bendinosus | € Biceps femoris. ® Semi membranosus muscle. ® © | ~ u “gag eee pdductor magnus muscle Bebjal fubexal hy _Bebicthbaminy a lower Bangulay parr divided Into mediok ¢ fated side, eA Fony saeise! fe covered by Sechialbersa __ Inflammation —| Tobia bat. | (weavers ioottom) dit Frown | ax Ham} steings. prstmior compartment of thigh Foc (©) + Aschiad fubernatty. (2) = Inserted on either bone of leg Biceps femoris 5 ead of Abula- Insextian fest 3 muscle —> Tibta-ws > Tal y- by bs % 5285 > Heston ab Knee ‘pink ertnsien of Bip join [Rowsiine) aerion- Psehii a spi ne — Grea GY selene. ee north . _ Jechtal | Spine laser setoate fo a evertze tn inverted in demo male yo enePata p Oirnersurtace [pelvic SurPace gives orgin te # levarar an) muscles y : ferme pelite dlaphragen © ouarcurtace [glut sures oo by Pudendalneve g itemol pend SL YESSY ct may tection — suogpay 19 gndlection, pcliture* 183/54) Branth of Anvatoydivaion ; : of jntaynak sbiae a egirah, Supply pesinewin F - apm by ates eneernel Gentalion$ Ischial spine. B present yy + soeyhberus hy — Vechtetibesosthy M surPe te Seem splrou Ig — chal spr ne. g Sacnun | a teretiurte ce. * stauctores commg our F F Stroctoees 1G Rom, GREATER SCIATIC foramen. ® Hove the pisiformix Superior glual Nerve £ vessel. “ rts i31) bianeh of patoterdivat ob tnbernal ifiac artery supply to *glutas mediy zr muwly of gluteus emi nim came pelvic ctabsi ligation GpecLnge.— a t Tensor Parciatasg — asin fF walking /mnning ae al rater setly Aclion. malt al, rota! = “Trendelen bery tat of, thigh & hips FN Dpelurs fils “on oppovitty ‘ oF Geinediyy p mini mus muscle Panay ¥ vnilearal p paralysis o& mediusg mnivinup- AU “Drroing 5 jen] Bifaterct Porelys} 5 — wna daling re : ssgreucTures passing Below, pIRIFORMIS 6, — * Wnferor_ghumatnenes vessel,. (ts, 854) t Antator dty ston Infesor {linc astiny « Supty GhUcLs moximys x largest & wmost powerful, ot ghuxabregion, ()-@tliac crest ~ post 5 © pastener dural line i @® ‘ y atiachmant of- one Kgament g ane muscle 1 Sho Femoral. ka [igor sige low actus femoris [soongest lige Body] Snape —> awersd Y we ANS, stun “ L =< Bonbs © astached jn Intoytrochanterie line wf femur: function ~2 It prevents Back fal) v oF bunk Hypor er tenston of Hip Joint:qauscla — Rectus Femoris 4 domponent oF Quodviceps Femor\s- exwa fund — Flacion a CE 0 cae femoris — (@) ~ Alls @ vastus medialis ; pus jatanntdy aa eae @ vos inl pomior borieret femur vases laurels ¢ l= Antator surface of shat of Femur @ gyadsasps femovs CL) —> paualla \( | ( few epeyond patella tered n OF Qs F continu gyantha\ —— Tha aS hq: Thre tuberosity: © nis - ~@O @ Unical vse ~ povellaz g amached a 7s used “OP Ant FEMORAL NERVE Yr compartment” of thigh: gxtanion oF Free folnt locking, Ay dull Foy IM injection in vastus lateralis. 1-e gugero loreal Arigh_ to pedi aos ee Hemnatas, antans , Todder of Fneejoint™ can abo ge Injection 0 bp) s2eeoeeeeooe ec ccceescosenes. caanesneneeCOP ooo ere Mer eRe Coe ec eCoereeereeesoooce @ Qs which muscle will cause etunsion of knee whan Hip Jorne - is flaxat? ‘is + Rectus Femosis Acet cetabulum up shaped cowity sf all 3 bones From here, ® Acetoloular Fossa, kon oxticular. & — Lunote surface Conientoy), Anfetor. hettabular notch. i o = Pilea contilage _pifalehdd a “riorgin, ok: acztoutum yf depth. I provi passage Yor plood vessels Hod of femur Acetaloular braanchps oF obtwrator avy ¢ medial civeumPlyx femoralnote tomman 8 FOF frackare In WOH a yw Frackwe of neck + femurs ashblood from t ps} blood from Heck. from theneck > Fetinacwlor ranches oF yediol ctreumeles femeraLarcny |aterab elreumtter femorab Hip JOINT # synoviol join (Ball socket) # ighly mobile * Highly stole peer diclocat on, y 7 Ber asoctad woth # camino dislocation ~ # wos Acetabulum, sy = dash board inj iny Soll on extnded eg” in > Antavior compartment t_of thigh, - ~ © sarpivs : ns - femoral DO Guodiogs Femon's netve® © posters Gend= smalkenusd + mpartmente of thigh / adductor com partment “FOR cry ; @ Gracilis 5 — obturator dducto ¥ bret ; or els ® pectinlys| xe tad © paductor_ magna Coster = lox gest Frente jartmior clever} eoacesseonees. atalatatslete! leececcccseccces+ the Hipbone'to femur rie che (he 220) ©] © 01018101910 101 01001416 6 ele ole.e 6 elele le cle cic 4 Aiductor tqagnus Cityord 01 composite. muses) Adduttor —gechtat [Bamisting pout - ‘ pore ba Tibial wewe. obtwratoy Newe. # pectintua, i ntagiov pase pestator part te 2 4 Ne femoral Nene: cbhurabor verve. — > falon —— Mewetion g medial aviation of thigh g hip joint. + weak Flaxton of hip joints => main Flexor of tipjotnt.—s-[plio~ psas Biacu. & Psoat major . + of mused. of- postesor abicominat wall - va “ sygest'd- a bide tinchantey of Remar = ROPES > Gracilis — jnedtal compastinent- Yecaust they fe. Sartosus _ fneotor y frorn 3 different divedioy Semi tendinaius - posteoior 4 inserted — at upper end -medial surface + tia, £ insertion ws seperate! by’ Ansesine buca= Rost oF the medial suréaee of Mktg js subcutaneous . ¥ disadvantage ~ Wot a has Use blood supply: Floia Fracture. Meck common sit —> shat Junction upper 2s F lower Va n tc complication o fracture of Tela pelayed union» , § Non union Normol Hime. duration ee for pop east — 6 weeks: ood Supply eur for HbO yy weoks: pop cast Je another site in, tay “rethave poor blood ~ Anarene supply __Prcenor hor comjortmeant” of of ‘tagh oe Ih and: femora hangs : Pd IN nts rt ’ i 4d int vey peig'g pute’ “ee bas Sugraphyss - eee OF ne fea porbiemes die fe *- 3 eg ewan eoseccesserecccaceseeseaseeessess% femorar vescelp are covered by femoral sheath: Femoral SHEATH —» pep fascia encloses Femoraliess ey ane: layer post: layer + + formed by by fascia aliaca: foseta. Hanwersalts © Y ® —> Lone shaped 4un => dem long n> divided into 3 compartments by flemur septum @ labial compostmant ~ — gruyiat eompartmert —_ femoral pray-+emeral branch of Gentle femeraLnene “Ch b) . ® made /rnwrmedian compartment Venous compartment se -, moved vetn © et ropa anata - crt iprholey Ror canal, veep Ingul nak lymph node Lin of lege’ [es of kOsen muller: # drains Glens pent / chiton- Q~- lymph node drain external geniabia: —> sapertictal Ingwinal Iymphnode em eCeoeewececeoorn do eeoerecseesraveveteseosFemoral canal - cone shaped. base long 5 Apex - downside Base — Femoralaing closed by Femoral sephim + Femoral septum: paneral <— peatonaun- femoral ring ~ when intaodomt nal pressure? femoral septam vaphures -f perite neni along the Voom hesniaty: tris is called: femoral tenia - feuncesien “ot: Pemoral ving ~ —Antcterly Inguinal Ryjamenk- medialy — [acunor ¥jarent- postatodly — pectineal Fatcla loxzratty — Fibrous Seprun lemme Peo eSE ESOS HeseseeseSSEFHeSFeoeoHete® formed by Aponeurvsis of extenat obltgyie_mnuicel aoe Nigar laeanaG “Riangular ey tenston ef ~ inguinal Wgomont- 7 \ouboictubercle- Ke mecialen d # we cur the laurnar ligament to enlarge ‘the femoral zing by eutting the mediat walt: Femoral Hernia is more common in fmatalQ)} became — Dnider fernorat canat. @ 4 intea.abdo mina pressure ecoune Going repens F labour) wider pel Conese . (® shone temoral vescels “J Femonal “ARTERY =. Branch af Beta Wace arby., $glves branches ak lower end of a sheath + ® sopertiiolinercss Dasuyertiti al eftgpside ertany es hea Wie arvay- ® superPi da extonal pudendaLartiny - (ORCC SH CCC Coe ED eee CeCe EE Se EDeO OES ECdECES© veee branches g profane femoris avery @® tauscrlay branch ® peep eoternal podendal astay - abranch ¢ largest brancly ot femoral orery supply fo cal) 3, composrmeat sob sigh jrhas 3 branches - ° © natal crreumPlax Femorstaveny supply heod oF ur: @ fatack ctvecumtly Kmoral aitey @® perfovatorbrarahy = Alm naan . perto rae adductor magnyr muscle jige numer day FO femur a pertovaley bran + A yranch of femoral aray: (bescend ING GENIOULAR aerery | = + ouise tp adduct y canal tase brand of fomorel artery * pear His femoral axteny continue my poputeak cuceny - eeeeeeoovesd 2 = CocecewmeaeeevessecesoeevesseseCorre oneereeoscavecrescesecreaneereoneotece Femorat vein + Recelves folloutary + below femoral sheath: GREAT SAPHENOUS VEIN oP present in superfitol fasct Cs longest, etn superficie vein: # begin in foot or medialend of porsal yenow arch, je thon axcands Into &4 <7scing mediol maltoolua Anteater. SAPHENOUS OPENING —— wpening in deep fascia oF thigh v Fascio. Lata. susetling 19 femoral hernia # piesent sem below ¢ Zom latzrat fo pT (pubic tubercle? — at Femoral Hemio comes out frrough caphenous openly | r anguinat hernia is present above § medial to the publeTubercle qsv — used for yenous get in RBG operation COPONDRY ARTERIAL BYPASS GRAFTING (81PDS “suRGeRY) » wer vevert the valve lebre Bypass grating «a N L- Tastea, codventitia. unica, inima- (tomes outside) Average We ~ year ~ attr again Bypass + _supert al ingul nal Lyrnph nocks present: along the at ng rmination a GY tn In superficial fascia ae fe owronged in the fore ok wit! vpper land. medial oo 08) lower vertical On A\— uppermediaL odCorre eremeerewvreecrereerersecrsessconeooe upper medion dv hins: © perinium ¢ extirnat Genitalia . (D AnoLeanol below pectinataling @ Vagina belovo byrren- © cuperolarral angle ofvarus @ fenile part of male vrethra- scrotum s deatned by > superficial inguinal lymphnode - “rests — lamral aortic | para. aortic UN present In abdomen Femor at TRIANGLE -Boundasies - sb Trangulay \ncormuscubar space * * present In AUS compartment of- ‘thigh: present jin apper Ys ot thigh. > get medal Jorevad wail —> Saytoius mosdial borty - Flory —> medial to Medio to Leura « CD paductor longus ® pectinine @ psoas mejor @® AMiacug wall —> Addudoy longus- inascle tpattebboriertontent .— _ Arrangement — medial to latarot ® if van © nook lyry Erte VEO fora fory fonach nave FENORAL NERVE | - Not tontant ef femoral sheath: Coutside’) \nferiorly femoral thang Communi cate with Adductorcanck poo0eroe CANAL (ot) SUB SARTORIAL CANAL ‘CoP HONTERS CANBL poowtor ANAL errr (oP) HUNTERS CANE" * Friang wlar jntymuscular space: presen in media ee pad. compartment: of thigh « [s oF thigh « eompartmnen preeat’ 9 middle > sartorus muse" fo musckey + adductor long yp - upper a’ rad Bj 2 msc paductor magna —> betwen Yy- Voasere G Feo mnediok goat vit FEAR gyn Pibote septu? wal | 7 on _ ofr © Ine resior wo} [e > sulo Sartori ck eager pest een ae erepan se se ere é eaces Pewee sceeseoreesearesetoaogeeonare[Peer es ereceeae ccs ceceneecasccesevese @) sub cartovial Neweplexys ~ Supply séin § Fascia above adductor canak AdbuseY conuint © femoral artiny © femorat veln @2 divisions of cbturaty x Nerve Nerve 10 vastus meclialys. @ Dveseanding Genteutar avery | > adductor canal communtcalts infextoy with popliteal fossa by Adductoy hiatys that is present 19 adduttoy Magnus muscle popLitent fossh = Quadrangular intermuscutar space ; ae present In’ -postedoY zompartmeng of thigh apres user gob igh : 4 present behind the Enea" jornts Fie does not extend into leg -7 7 Uinen acpere ial curtace us femur Knee povlitius muscle — Fibula, ee mae eontibati 9 - G — Grosiiiye e ‘ = ppdducer meq 7 ANAC Sapna tern os ——— rmombrongeibose seni tauhon® cape Pemowts @ muse mugele ethend | Sworn = lamral ead” A muscle” + Gachoenemtit ” mucole Stee ase revo fo tarek Gasvoenemi ve + planrasis Floor oF popPUTEPL Fossh ~ — (D popltgal surbace of femur @ copsult of Knee joint Exansion of 2— @® oblique poplival ligament seni mabranosus @ ppicatascia eecoeecanr ese eetaneseopare y eeeertose seose© Ak Teta does not form the Floor of popliteal fossa- Sse eee eer conan 2- — popliteal artoy ¢ branchsy ® popliwalvetn ¢ tributary @® Wotad neve ¢ tte branche @ Geniealar branch of Sfuratorneve @ postater actancous Newe of thigh (popliteal lymph moder Ayrangement of Structures 3. vet @D upper Ya — — mediodte lateral AVN aa po pe | \ Oey popbtrck Tita nerve. + vey. : Seoeosetecevecegesecvestovsese SADUDIOT Ip poster. VON ANNOY Tihial Nesve postaior (superficial) e e e e a 6 a e o e e e e@ tower 13" — — medlat to lawral . ® hy A © woe 1 vein Arty Leg 4 3 compartmenta Jotexol Compartment ii peroneal compaiment — ieee merase ea nusclia es, dust P ) paronlus tongue > superficial Paronaal NAVE @ paronlus beevige (bs 5, $2) a faronenl er - branch a posteor dita artcay: ne suiotalar joint” .Bverston.. ef Pook laurval border of Fook is OFF the Jor rab cide on ourside geound sole Paces Antagonistic movement jo €vession 1s Anversjon Tnverslon of Poor oF Subtolar joint Is done by @Ubialis Anterior @ Thialis postion | ceeeneesedsinmasnsaacanensnssenseesubtalar joint js present In Foot below ankle. Talo calcantus Talocalcanoots navieutar -fotnte Jotnt fant synoviat ‘Aynowlal sail gsockel- Asiorcompartmanh ofleg / Grantor conponment oe The Wimalayos Are Nob Day Placis « @-0 © Trials antarior murele @ exenor Hallucts longus mutele (@D “Anwrior Tibial arteny - Supplied es @ deep paroneal nene Pe ® extensor digitorum longus muscle Nene” N\A @ parvontus Tertius “muscle. _ ches: nat” belong “by « pasoneatt compaatimend* (09 bataral. Com partment Pee eCeCeone recor eseecr ese # Adon Extend on of Foot at ankle joint es Dorsi Plexton e a e e a e e CY es e e e epostioy componment (| Flexor compastmenr & leg - Fi ruselta ore arranged in 2 groups: G,~ superfiislod group — — calP muse. <> Superficial to deep: From medial podiad — taro 2 condyle ef © Gatmg enemys muses honk Opts NS > Tbiot ® plantaris —— fe _ gym lateral = “yene r fat on dylo oF fem - Liga, ® sole.) Rudimentary muscle short telly ¢ long thread W'ke ls) - saliel line present tendon an portmior surtow tibia grsestion 2) — Gaswocnamius § solius both are invested a, common tendon on postini or surPace. of oalecantum Terido Achill ae + ido eat easy . ¥ ’ Chongptt Endon of ody 25 om wide- Action — ain plantar Flaxor oF foot at anklejoint mamas ¢ solaut fogetey called gp gastre soll in f ‘ihe e F Gost e Trheops savor <7 cae + golive mutt over comeg the beaie Initlaring of wool ie Fr - tebe ? (BT jearon ager Ah ee ecoseesenantesgase eseorteceeoenrseoeSPCC eeerHOCEEeeDneCH EOS ETE ESEeeEEE Hs ECO ®) % Gastrocnamiye ~ to Fil speod so called Top gear cbbody solius ~ also cated *; ers Hees ¥ dus to large Venous spac present-In solius musele hen solius contract: These venous sinus et are constricted ¢ blood is pumped fewerds thar. oe Ie solius stops wosking— in coset prolons bed ridden conde pr ( deep Veln thrombosis) oxi pest op ambulation i odviced ro prevent L mbvement) pvT IF mor posible the ymaox- low molendar voaight Repasi Cy.~ Deep gx up - (potterior compattment) _stuchures present o * pophiti funni ~ déeanor go Ink Fook - TH rivta © Tialis pomior muscle. c p a) mM © EL goxey digitoaummlongurmuscles — DPCPYA, ©wv® @ posterior tibial grteny Are resent TV) Tivial nave: . es, flexor ret i CF LG) eexor tatlacs longusmusds — tunterspoplitivs muscle ~— srnoll Thiang ular mutel present pehind the knee joint \niraca.peular Wine) — fom poptiial.girove of Tibia above soltel hina: of lonal condyle of femur (oy = pastator surface nes - Thiol newe. Aerion ~ unlocking of knee joint - Key rousde ecceseceresersersecvreatesees GCaeateegsanegCHeeeeoeseoetoeenooenorevovretssereseoreene 8 ot Anatomy fctass ws “a HERVE Supply OF THE Foot HERVE suppt i ¥# porsum oF fool + H sensovy supply — supesticiad paronealneie except - 2 Intercltaitar Oar 4 apaeding PEP PSP, wore eaopt- § ~ medial bordes of foot ~* saphexour were (Branch ef Pemovai nieve)

neclt ad planta vere -@- lateral Ma wallbed > | rarezal plantar nene Granchea et Thiel vewedSole &F Foot ol <4 ieee ae -\--> \artaad plantar neve - Carocdnerelrend) (Hitabnarve branch) © > calcanech branch oF Tibial nerve #3 dumatomm mn sole ~{% bs 5] 3 modified hinge vari eny & Jargest jot a compound jotnk- | Knee jolot v= cynovi al joint | | complex yoink | ewveeresceovenrtes @oeone eee aoseeteaszaseega oe“oii: BB kergestjel [OOP SH TSC HDe eH ECC Co eeZEBEEEOeOLES es Eee (3) linen aspera . Articulation = —_—— superiorly - eondy mn perorly - condylit of fer | compound Infetorly - condyles my Joint ‘Antotoity ~ pala eee eel Joins Formed — © femow Tibab joint’ ~> 2% nuroer — brachocaphat CG) supesor prodiactinum is ceperatd from tnPeaior medtactinusr ingdiastinum — space beroeen 2 lunga - = # stempvongl:® pretent, ak the level of Tyvertbra ¢ 24 rib seructures ab Ts Verte I) Ascending aorta ende “sat @beeeanging, Uisrael &, eto. sepine haygour vetn change ity direction from vigh to leFt- ygo ¥ > - Ty G) [Roms Ts Descandi qhorade! Barto“Fansverse section for gestion at level of- Ty, vertbra thoray 7 voab sbucture ore absent? — Ascending aorta descanding avna . Se ee ee rae eae ENTER COTAL MUSCLES #8 in number of outside to Ineide © extemal intercostol nwele ~ diction cisfibiy = — Cee forward med? ally © inwmal intercatobmutl, — section of fora — ~ downward backward ¥ lateray @® Tronsversus Thorecls - innermost musche. dtsestion Flat — + downward back ward 3 XS i laxnraity ® stern coctahis pnosior (4) , ®@ anvwrcostalis fntieit ~ middle. C'2) @D subeostesis — qoarnior (ig) erteccvecvec:s * @SeoaereCOCHSEHOSCSHEHHSHSHHETEHESLOREKDESESCREESHS ECE @ # mimoibor werve & ves run betoen. fntamabihtreastal ¢ Fransvertys thorasy mustly in costal grove of abe. costal GROOVERE precent_on InnersurPace ¢ lower border et aib - Ptlkon Floor oF vostuLgroove ovginats Antara Intereatrad mide] Superior te infesior (etn) v Unig) a Lae were) N @- crdothoracke Foseta @ — porters pura+ meision — along uppes borcks of vib never along the lowerborder . On 4 (ost ieely to cut on IneBion ‘along lower border ~ nena | MUSCLES PoP. RESPIRATION 7A Inspiration expt ration Quer Porced Quiet ee = sor} (ove) (qw=s00ml} Volume proudly -Mpiaphrag” (© pectoral major + No mucele @ eremet @pectoradis minor F passive Hi yatereostot: — (B stumoctoido Pdunto mostata- elastic. Tecail @ serratus of bung alvedt Binaaibe™ @ serratus 7 poscfior . Gl Exped aren can OH CEE adie § Btaphragm jeu = Inepiratory Resemve volume ep = Gapivatory Resemve volume . plantas dors : do: #@eeanaaeoe Foreed Crveesv] # Internat Mnleycoste rousele. Transverces, _thoresioa “p rmuschen Anesios ckdomtrat (oatCHOC SES OTeEHDSHHEHHESEEBERESnEeLESEHEOE i) DIAPHRAGM ~ THORACO ABDOMINAL DIAPHRAGM 3& ckelerabmurcle, # Drigin = — — Anaxtorly - sigma orig! . —— {pocmrioy surface of xphold proce) Jorratey - CostaLorigrn (2 sity (lower stesibe] inner surtete Tbh poreniorly — verte rat onigin Pniztior Surfece oF body oF Ly Ly by Vertzbvae. Insestion = — ge contra tendon of dHaphrag- MS = phrenic weeve (03 C4. Os) ide branch of cemnealpiarus £o,% 2504] Gg vet tn phrente nerve — from’ Ke \ mised nerve [motos tT sensory For cantvel part of-cltogphyagm) + pesipheral part oF diaphragm (dome. oFdtaphragm), v supplied by Lower six Tho sate neg CTT ens) Blood suftl) = cuperioy photonic. Atay — factb yanch et Descercing Hore asta ; ee ous tener Pheente: AveY — firstbranch ot abdomi nad asttack |e plodorninaL aorta bifureate into 2. common thkac axtaies & ob the level oF Ly verttina DIAPHRAGMATIC vpeENINGs fie lett Atewats lig of péoas , maior poner ‘ sae dtaphrogm. (Gé yes} Cutt} : | allo Bnown 44 oe median axcuat q- “® AotW opening 7 pe the Hh 4 porto Thoracic duct ok Raygnus vero simvoures passing ~ also Enown gr 0880 APONE yoni. | ne ; Le plsasmaler eporsans As _@eeeese@® csophagest opening — ace presen 4 In masenlay paitobdtophregn Faw Enown as mnvecutar opening ory emaralepening 5 - ® present at level of Tio vertebra # stuctre passing - * Esophagus # Vogus nawe - Both vogi muesAght lef) esophampabbranchay of Lett ashi artery: @© venacaval opening oF pethe evel ce T, vertata 4 presenti the tented tanden of diaphogro. $ Structures passing - In Beso Venacova ight phrenle newer of ake phrenic wewe passes “baugh the left Dome ctdiaprtegr | pemrbergous ver Riba * # passes Through leAr ons of diaphragm, 3 lerminake Into tapes Vane at Tg trminatdA into supesoyvenacava at Te | (@eeeoeteacvuevesveeveseoaeeee eveseeeeCaoeene ovFORAMEN oF MOR GA GNI /LAREYS SPACE 4p pesenty ot eral of Ty 7 costal cartilage F structuyes passing — + superior epigactic a2 oe superior epigastaic vely Superior epigasmic artes 4 + branch of intonalthoracioartay ¥ + ‘ranch of subclavian erwy- nediab <= ore —» Jamel arunsts \ygpmant Tegamant - miuel 4k Lamabar part of Sympathetic choin palsed through médtol | nae Ligament 'g extends from c,~ Tip ek coupe : ¥ fposavertdbyal in position: A thro ugh oxrar ex erat: Kgament pastes ~ sub costal pray velo, wee cna +6208 6 6 #0606 e -eeeeste.CHO CHRET ESHA HESRELOECLOvVEREHO CESSES HEOES 4 position ot Body ataphragm posture ne Thoreviccasity O — Highese supine painimus, ® — Lowest sitting fax mum @ midway shonding nid way ORttopNEA — Dyspnea in lyingdovon position became thoracic Cavihy volumes mlaimum “Trans por tatie oF copl 5 an ett Hen potent omfortable in sitting positon. become volume of thoracic cauity iZ mayimum. DIAPHRAGMATIC HERNIA yt CONGENITAL ““Reavired © Qc Megehdaloch hamia « pout. only trough wo esephagest opening - Land peat oreal hernia come ; / — present postaorly” ésophsgeat porn eacprage Chivitcl presentation - Balny born Hternl & emia . oth Respiratory y distvex, \ famiati on of Pemiotion corde &s1 | ot fundus Prectmect — urgartougey | ee of stomech \ also cabled Bae \ Slidingteraia- —— Rottanghemfepo Morgog-nis hernia - er v NO cy mp foro No barman - ‘Re Anatomy —5 cass at % ; as Aram See PLEURA & LUNGS fer ce Cohare § pmatnent) pstaiorbordar Citl defined) cosreltae norely Conly tn leet Hang) present aleove dome.ot diaphragm.” Boe i) costal surface geld to sibs 1 y) medial surface = Hilum present i . a= => Transverse Frssure, L/P oblique tissue stir t joordey > Anterorborder mnediostinalé—— pn Surface : cardiac neteh surface. maasecerecracrerecesosesseeaereesace 2ewe Ceeoneeaeseeeeseneoe Fissures in © oblique Fissure > presente in bath lungs, © Teosiverse &ssure —> only present in Right hag: ae Fresures CANNOT divide Hilum of lang . ALUM, + opening of an organ. Poot of lung attatched at bilum- contents of foot of lung i= @ Leer principle Bronchus on \ttside ¢ eparterial and high rside porteniak tronchys on A ul mone oytzry —> ene on each side ae ea J + fight att post @ pulmonary evn —> aon each side Inexrcose al avery ®& Gronchial arany —* 2 om tare side g 1. 07 6 horocic, fhortre: ' ight side sranch: “of aescandng, apply prenchial wee upto Yep fratony eronchiole ; . © panel velng —> aon eachsile @® pulme nary Newe ple: @® _tilax lymph moder - Broincho pulmonary lymphned em prbmonany Ligament - over covering at boob of lung - it ts the extension of mediastinal plura,+ bronchial. avtery supply 40 Bronchial tae upto - Respivovony BoNchio', eran SPREE” pypariatbronchus pulmonasy artery > superior puso nary ven aa eee ae interior pulmonary vein HILUM Anveriorta) > postestor(P) Pourioy —> posarior Vf upestey pulmonary vf superior i‘ velo. A] tsuroney 6-|-> bronchus 8 7 superior (> anegser sypenlrtsy “> antesior A . 8 . Penn . mfesior ES “asentor” paling °° 7 ~ putmonosy 2 vein vel, aveats, the vest flung cept upperlobe 4S typormiiaL bronchut axeat, (ait) to upperlobe efarhad bronchus BRONCHIAL TREE + yodine cortilage ~~ th > 10-5 em long a © : —» diametr— tem 1-5 om ~S Trochealts + 3 muscle : c Cemeoth > interned diametir — aon Ff chapes rouse) —> Extnsion — fore sternal velo lowerberder ets atte 8 ‘ ‘ ° ® 4 6 ;<> Trachon mode up oF Tachesbzings (15-a0 In newmber) v : © shaped ainae nyaline cartilage > an troches cartilage Is absent’ posteriorly which Is filled by Fiacheali s musde (Smooth muscle) <> epithelium of tachen — feaphratong epitheliuan « pseudo staotifiied ciliowd oolumnar epithelium Cappiet CEUs) secrete MUCUS # Blood surly: — angerior thysoid arty ay Branch of thyscarvical hunk eo granch of subclavian ~ + pepe grathio cepbalte velo - J,,- Bifureats ak this wel: Luft principle bron chus Aight pres 0 Bwonchys que) (shore wpeeveriod G lang narror9 oblique coring asen ~ san wide, +4 Right sided pnaumonitis 1s more commen because bacteria has gosy acess to Right hing. SHC ROSS HDS ESTE H ASSHOLES SHSESHEBSO SHOESRight Epartaicl upperlote Bronchus, Lowerlobe “Hgpoxtaial (lobar bronchus) Bronchus Lower redial Jove eve Hq. Regarding divisien of trachea. # — Trotkea divide at lwel of +} — Also same jn cadavers ~ Ty + — Living person trachea divice at -T. 4} - Abdeep incpivation ~ Ty Trashed —> principle bronchus ——> Lobar bronchus : (Primary bronchus: [secondary loro nchus cortege} cartilage} . Segmental bronchus CTertiasy wonchua’] Bronchiolga =o caxtiloge-> only superior lingua. 4- medial eee Inferior-lngula, 5 ~ latrol Homologous tr middleiobe # LL - 5eps of right-bung- G 7 G-Subboasol ‘SBps " Vo 7 pitt or boson. . 3~ lamral basal : ca 4— poswpior laasal iwmologous to sight _ 10 mradial basod Cnot sean th costal surfove) ASPIRATION — vomit In TRACHER rostatlor- Broncho pulmon any seqorene 4 in sitting poston > Rightlang lowerlobe > superior Basal/apical 4 In supine position: —>. Rightlung upperlabe > pr 4 prom position — proctieally no chance Asptration a weer eeeve ses eevesesne B@aeeP@aaresconeteoeeeoeovaeees @eaenevenee e ® ee e ee e ae eo e eeoeovedoes aee ee i) nerve syely oF ang =, pilnenany Nene ples sympathetic — “h- Ty Bronchodilotatien(Y Mees Secretion) povecympathetic — Vagus Nerve ‘ qavtorto bronchial musdaa couse explains aa # e_|_ Broncho consttction ; ohy copD preciyitaas arrnight Ch mucous secretion) PLEURA 4} ous covering of Lung # a parts =p visearal Linner) > poxekal (ower) * A # pain Insensitive. 5 - 1p pan sensitive + prrached to lung: except ax HilumLower tavel oF Anwatorly loxerally posteriorly Lang - — widglaviewlor mid Arillasy scapulax line. Mi i . : ne cathe) Ty | Crteiorangle ot 7 ; Scapula) pura. 3 eo a hab stig) + thay HEART # Location —> middle Mediastinum oe Aeove central tendon of diaphragm, # Behind tha stenum (Retosurnal) # 1 organ to be functional In body t 4 Heart beat begips on 2" day (4 week) of 2UL cravtncmusere -— # Invol untary eINseRIOR BorpeR — oF HEART ? LEFT BORDER of HEART fp striatid —> ducto intercalated disc : i # bninuckar : Be oprate ares A Lf fe lett common earbtidartny fen OSES © NL salah sulbcanius rte Eo LUPE Busicl. re “Pxpubmonary “avtoy - Right F tart venice: Let ventzi cle o# UPPER BORDER _ superior border oF ce of HEART eet tai um great Rudimentary + RIGHT BoRDER _ Right Abium &tinsion of Atium of HEART supeior venaravo. £ ‘infertor venacave.SURFHEES - & mn number D anitaie|surno costal surtaa —> Right ventric. ¢ Lepeventcle Cs) cis) if) snteter /piaghragmaticsustoce —7 sigh ventsicle. § lett ventricle cvs") ve) fii) postertorsurface/Bose of heart > eftrAbi um + 4 pulmonary velns ae PF (minor contri butiot) Wy) Rlghtloteral /Right surface —> night 4 Superior , anterior atu vena TF vena cau. awe v) lw lawrat /lert surtace “> lege ven bridle + Wet Ausiche ngex — formed by Wet ventyi cle, corresponds to Apex beat <> Location =U oY intarcestal space gem lataol to midstone line o 9 e e e e e e e . e e 6 q ® e e e e e e _“enameers of HEAFT sight Anium — \ nur atvial septa Aneior postaioy + Rough smooth “” SPE inal* origin of ms pectinatif —> [cRisTA TeRmIvALIS produce SULA TERMINALIS ON Right surface wtinding from superior Venacava, to InfenvorVenacava 4 cuvousTetmivnus contouns A Nops ~ Below the opening of Superior venacava, Jt Antwtor cardiac veins ~ 3 to 4 tn number veins of heart open in antator part of Right: Ablum: ad _SINUS VENPROM 4 * BM tributaries ot igh Aisha opens here excapt pantwior cardiac velnsa 2 “bukaies 1D) sepesior vena cone, = no value, fi) infextor” Venacowa — eustochiaa valve i) corpnary sinus = Tebasian valve. Ss Oe eect eee antator cardiac veins . © superior venacava. @® inamal yogular vein potmnonany veins © _ vmbilical velo“Veer ess EDO SOSeTeHeeSSOHEDS SELES SH ESE @ INTERATRIAL SEPTUM + Fossa ovalis ~ formed by Embnyological prowss present 4 \umbus Fossa. ovalls— formad by iy “Talangle 6 F Koch + Avenode, Inferorky <——| Fendi J» Bundle oe - eoronany Sorly collagen Fibers sinus yunnin T in a subendo cardial eae space: “Peuspid valve i RIGHT VENTRICLE crv) i anflow part outflow part _ PRO) 5 e re Se ae : : ppfundibulum)="> = Ccateliae muschy) . i qbdwiston of papillaymuscdy #13: posi rausclit — igh vertaice He pagilony muscly — LePt ventoicl 7 ESTENT > shape of cavity oF Right Venbicle on transverse section ~ CRETE semi LUNAR > shape cawlty of (eft ventricle en transverse section — CIRCULAR, B® Rovio oF wal) thickness —> — Rightventricle + ler ventricle C4 +3)CARDIAG VALVES * AV valves 3. ‘: : G) Triovspir GD MITRAL Lov) BieuspID ee em Diametsr-3ém ~ sesrauseultared — Best auscultotod ‘ok XIPHOID ak Apex’ BEAT SEIMLLUNAR VALVES + Ob; LD poLmonarY i) ApRTiC piamecy- asem piomey - 25¢m — Best auscutrated = Best auscultated ox left intacostal at Right intercostal, spate space STRUCTURE .of AV VALVES Blood supsly + ~ venous drainage — ["Fierovs RINGO) C lateral to sternum) “ho aot bndi oF > Ca muse veins onranged 1% 3. groups 1) CORONARY sinus ~ LARGEST VEIN of fenet ee Le trburaies Ngeot cordiac vein A) Right snarginal vein © middle, cardiac vein ©) small cardiac vei Dovlquevein of Ft privm /marshol vein 2) Postaior Veln of left VertateteCeECHHEHHTHSHHSHHHSHSHSESCHEOBTSEBSRBSEHSHSHEOSE © Gf) ANTERIOR CARDING VEINS: 6 NOT TRIBUTARIES OF CORONARY SINUS 7) VENA CORD] mI NIML/THEBASIAN VEINS > # multiple » minut ¢ open in all chambers 2 No valves CORONARY CARCULATION *, supply all pacemarers BiguT corowaRy ARTERY] 710) ~ Antsior Aortic sinus only branchya oF ASCENDING AORTA ee LERT CORONARY ARTERY)—> (0) — Ft postevioy Aortic sinus. — 4 [Rigi posTeRIOr Aortic sW03] > does not give origin to anything 4, . 7 ee clreunelex my than wee coy Bue OD Be, “nip destes arte} SS vet antetor degeahdng arteny (LAD) a BF 50 pacieny heart is supplied by 3 ARTERIGS (Lox LAD § RCA)Left Anterior de. seanding proxy (LADD 3 5 most commonly blocted arteny # chanasr of Blockage — 4oto 504. + tallud as prtery for sudden cardiac death. # Anterior wall sayocordi al infarction Bight stroumplex Arty 2 24 most commonly blocked Artzay 4 Bot gor chance of blockage lept clroumfler amoy 2 Least commonly blocked prtay 1s tp aot # laxral well myocardial inParction Dy Right: Behan, @ eighe venti cle ~ cor pare” exept ena axea” atloining io Antarioy inter venteicular grove * © ar cmall area ajoining 1 postator inter venisteular q770Ve “® poswior yatd og interven cular sepiuro: > go tnaan at AY Bundle © sn node , avnode » (Sarde a en jntervents cular Sephem Lert Bundle branch (minor post? to upper membranous port:Seseeseare eesti Hees evoeovessneeseeorese Area of dishhbution of Lert Coronary avtiny ; ee ee nO Rees 1 Left vvsium ti) Ft venbicle mejpy part excapt small area adjging tv postaior Intervenbi cular groove fii) small part oF Rightventicle Adjoining to Antésior interventicular grove Ww) Antrior 2/3" oF murventi cular septum: ¥) Righr Bund. branch, left Bundle. branch Cinajor part) » Bronchas of left coronay Artery ;— lef man artery (Main bunk of Fr coronary prany) om) om OBTUSE MARGINAL om ARTERIES omy 2 Lao A, Lor : , 5) Diagon av Wienies * granchey of Right coronany at © sa nodal avery @ Anterior Verhicular Avunet (multiple? (SEPTAL { 2 BRANCHES Aout marginal ortaies © 7 guns in Inferior border of heart ®© posterior septal arteri cs ® Avnodal artoy FEO postaror descan ding oxtery [pssarion inter venbiowar arty . Kea terminates on posterior surfact of thar by making Anostomesis with byminal part e Lex arty. _+ postx\oy descending prteny —> decides cardioe dominance cpp) Ao Right dominant hearts posteroy descending branch of Right coronary Avtuay lov) —> left-dominant heart y postevor descending prtay Cantsior branch oF Lex) Changes oF coronary dreulation of lett dominant haat +- cranes oF eee + mv nod. ¢ beyond ltr conducting system ic supplied by Leth cireumPlx atin). CARDIAC NERVE PLEXUS hee supply 27 _ Supericial peep, TL. _Gprecenr below s+. a Cprecent-Hehind thé, |” ‘arch of- aoyta) oxth of cotta) Fornation T-wN sympathetic — Thoracic splanchnic newex yagus HERVE a covdiac pain Fibres are present” in Gt thoracic gplanchrie newes only SPeaeeaFeaaveas Sead nes eaPFeeeSeoeSougseegevneseOOOOH SHESOHSSHRSSHSLEAODSHRSESEHESH EASE 4 T, wervé — gives @ byanch > INTeR Couto BenchiiL NERVE Supply to Floor of Alla, makes synapse with ineDIAL curANEo us NERVE of forearm 4 This channel cause Radiating cardlac pain in Lee upper Limb:widclavioutarlinas > wpe hgpochendsium Frans pyloric plane ti bower boris) gghic Vortoar rege Beghe varoarre§l | et lumbarregion dilated poraumbi Keak veins in portathy percna!o9, ight iliae Lape Hiae fosca Fossa dgpogauriam — whan waypladter hal See venbilicus pits — bf pemnatome-Tot also supply to - Appendix ¢ Gonads (restis@)ovoxy) $i for reFored pain” af sits for ORT CAVAL ANASTAM SIS Lute bvanch of Portal velo Anastomosis with velns of Antartor clodominat wok lay para Umbilical veins emcee meee aeaamasvasteneseese -_ «e@eeveFreee SP Fees eeeeeeseeeenvneatea ee eavsses sad yo ok CAVAL VEINS Cor) s18TEMic Veins ~ Superior venacara f infexiorvenacar # veins of Anterior ebdominalwal- gupertor epigashic vein yew neevior epigaststo vein. J avg. “F when PORTAL ItYPeRTeNSION - para Umbilical veins dilate «to form other sites for portocaval Gnostomosis in body > © # lower end of esophagus (Abdominah port) ~ pee bel em sees 4 esophagzal wibusasien ot 4, esophageot dibutany of Up t gastete vein. Hemlog ygous vein . cporeoLven) CEcowahveln) # when this anastomosis dla —> Esophageal varices item atémesis - ® vrper pore Arwl wee Anastomosis berween — Supertorrectalvein + dest acoko vel (portal vel’) Ccavel ven) Bleeding from analcanat dus to ~~ tzrnal hic wit portal pressure is calted a hamomtoidsPORTAL VENous sistem — a it begin in cagillaies and end in capillaries ‘ present in 3 place organs} of Body Oq2r - Porealvein is present (lames portal systent). © Kidney — Rena portal systim ® pituctory gland ~ Hypophyseal portal system « Citypoptusis) poreaLvein —> sem long «tne valve) formation ~ formed by unlon & 2 veing * sploenie vein € Superior mesentie vein. i behind te peck of pancreas al’ tyVertdbra. * a normal papoose = 5mm Hy _ ee 10 rm pe >lommig > Variceal, formation begins “ Spmm tq > Blessing begins isevere seeeeeseeeneenueaeteanaeneeeanveonevne TRANs PYLORI PLANE ~ — L, lower border + ib passes Ahwugh - © pylorus of stomach fundus of- gall bladder ® filam of both Hedneys @® ongin of supertor mesentr'e artery © Termination oF spineLeord . iy lower border (m adulis) Lwpper border Cin infants?) ABDOMINAL WALL = MUSCULAR WALL iN Antari Posterior — muscles ( muscles’) © psoas Major — Ws ~ Roos of Ly be SHinel @ psoas minor @ Aliocs — nrg - Meweto things uw. “ “@ Quadtohis laimbouws. fon neve Dpsoasmajor - lo)— Wansverse process of , to bg and body of Ty 10 Ly @ shacus \~ “(oy — alae Fossa oF Hipbone [pelvic surface) (2) - both muscty {nseitéd in o- common tindon on lesser trochantiy of- femur ; : ae. sina common Actio ~ main flarer of Hip)otn- Seth werk as sing Alin 9 $008WD Quedratus lumbomm - (6) - © iliac crest @ Transverne. procen of L, vertebra, (2) — inwertad ak trancverse procm oF Ly, Ly, ba, by ond lower border of 137 ib - BS Ty, big ty phy y by pools of sfinatnene ~ powon — —Bxtansen of abdomen at lumbar post of vertslral column: 4 Plaxlon ot abdomen doneby Rectas obdomins musue Jae eee Inusele oF Antaior oledorinal Te weal agh “Maximum eetension pears In which pat of vertebra colar =. -bambor part at we oR. wot: Flux on | ~ , eanviea pot, Smo Rotation =e Thoradké pi Je Wo moveraat = Socrm § coctyx: Le heoeeseG9 Aneror abdominal wall _ Gmusclyr ie ee nna ou Major Ce mula) Minor C@muselyy 4 eptrmad obliqnae % cremastar # Internal odtque % pyramid ali, Troncverse abdominis 3 Rectus olodominis Extemad obliqut muse — divectton of- Flore paenwoord forward hadially- (0) — midshatr oF lower gabs (2) — diac evest Ng - T,-%, (lower she therartc. New) # Sptetnatzeeleyuedpinediness, -. forms: Inguinal ig ocnants . . . on . Tendinews inker secien * poupart ligament . + ~ (3 complete, 7 3 intonyttz) 5 muscles off ginate Ns-T-T. “(TOE 4 internal oblique muscle {ntetnat oblique muse Vineo rae va . seminars 2 ~ Pro1n Laseyal 273 of gin ; lganat qd ores - Uren ferwerd,naduay Wfa¥puicerst F Tansversus sbdomina, sniorpudiclipnd (0) ~ latiral Ys" of inguinal fev igament~ sympbgy. Aioxen — = foreral to medial% Both musclas sptamoLoblique ¢ Hrancversut abSoniines ote. | insenzd ot linea alba of puble ere « a lower Fibvea of 20 f TA fuse fo form conjoint tindon evemastermuscte - (9) - middle Ya oF Inglg D+ pubte tubercle « * Aetion — suspension of- Testis 4 Rudimentany 1S feral (?) nes Cee branch oF Genito femoval nexve oD motor nye” (hy toed (Lie Ly yO by H¥ ceemastenic Reeve * + } smatnrezned by tiveor Gente “sie on upper macial thigh eauses - Elevation of- testis Brisk — In children DRoGts ; Fi ¢ ee cet): * pee iaventwok > femova.Lhranch fee a , : 0 Genito Renetal + prscariaiedl nerve (Li] eteerenr Yok — GenitaL wrench or Genito fereral nerve (1) SCocerecevesseavreonasceonvene 4eo8888(straight) Reltus AgoomINis — Rettus_ ABPOMINIS lo) - a trac medtalhead - Anterior pubic ligament leterabhead - pubic crest - (D — xiphoid prouss ¢ Gostalcarilage & F,6,5 viby- NS = T- Ty neve Rectus sheath - endoses Rectusabdomints muscle - Ly formed by appneurosis of Extcmalcblique, interatoblique 3 7 Francversus trea allog « obdoy . Roctus sheath ae Ractus Abdemnia mada by 2layey. rn © Anti or Layer — compl © pstartor layer ~ ier “Adhere to muscle « _f Fre tommutes Rectus gheath © conlink of —Or pus small pyronid chapedmuscle (@- pubic crest- ®rettus Abdominis @) = finao alba NO ® PrRemipauis —> ws ~ subcoctal vem Che)! © - 2hneres ¢ 2 vein ® superior epgamie Arey £ ven © infeney epigasrsic tray §Vein @ lower 4m long longer in mates (A) Diection — pownward, forward, redtally Ganson — extinds from coop Inquinalving fo Superficial inguinal ang - Fascia’ transuersalis -, dep nquinal, sy f present -agem above mid Inguinal point + Sapestiet ab jnquinal ting is a. Thangubr opening In exmmok oblique ‘Aporeniaesis iE 5S present above § mediak 4p pubic tubercle” ees eoesrersSearoaonaee aes anne seconzese@& ¥ Boundarler of Tnguinaleanal — # £8 duperfical Fatty la # Anuror wall — skin CPrscla. of camp) superficial Facta Le self Hitt brane deep Fascia if eetonol oblique Aponewnsis obsent-in Antesfor : At loteralend u— ener loteralend iti supported by 2o mused , Forex a # posttorwall — - @ fascia transversalis @ bitca. feaitone al connective tiseur @ posieral pettoneum . AemadiaLend it1s supported lay epee ‘tendo, 5 Formed by fusion oF | lowerFiloves of Snternaloblique nd Transverse. -- — abdorinis murcly gt Rook antanal oblique § Transverse Abdominis musclafilg Seorereesecanevevseneee 2 anquinol big A antemol-dolicnea muscle present (n 3 walls oF Tnguinal Canal - Antasioy , posttatoy , Rook © spermatic cord. - cor) — Round liqament of- Lary 2F Iioihguinalnarve Is absent ak denpaing ~ Enters by plereing rooR between comas our from Superfi'ctal ving AriamaLoblique ¢ and become sensory vA 8 ~ supey Artator 5 oF sexta , Root oF penis Q. Supely Ancaior Ya" op labia. majors. Mons penis SCROTUM NS 4 annoy (95 ; alae re postaior oy AN ee Ts. + pmo apf — 55 FF gevotum is supplied by widely seeroud spinal ners spinal onasthe sia is not possible. i soroturh “# paRTos muscle — ie veplacss Superfi cial fosela NS — Genital loranch of Genlto femored nerve extynal oblique muscyy wc ce teen ne atv ebennnaseseses *eeoseeeRound ligament of Uteny — Femur be deepring at come out trom superficialwng, € ingerted In labia mojova . }4 maintalns Dtirine Axts- 5 Antaverted eee Ante Hexed, also maintained by Utero sacral ligament SPERMATIC CORD = not a Single structwe, group oF Shucturer - BOGE ~ © pustur digrerene / vas deferens @ Tsticutor ovtegy , Artoy fo cluctus differen, “eremés ie arty ® pampirh form plasus of veins @ ried branch & Geniiofemoral newe 6) pomndire” of prcorsus ais, © _Lymphati es V lyinphatic drainage oF Superficial inguinal coe \ymphnodes + Testis para norttc Lymphnsé/ anzat aortic LymphnodeF#Rshaley arery is abranch of Abdominal Aorta arise ci level cel, + funciion of Ductug lon Vas differens — transportation ob pean (sperm canter) oat in vasectomy - 2 pampini form plexut of velpy ~ Tectiewarvem forme at 4 chap (nquinal wag « Eundiion - Temperatuse- a regulation _ on dilatation — temperture: * Yoxteo cele - permanente dilatation oe (racospermniA) s e s e es # processus vaginalis —F pevroneel preceit In fur bales in ‘ding of Ustiss descend of Wstis befins in 2month oF TUL 2 sponth of 20L ~ ‘tae Fossa. A roonth — peep taguinal-aing 2M, Chponth — — gust oF dag Inguinal . ang ah zp month = _eROSS INGUINAL the e canal Smonth “HIE — capex Frey ol inginad rg BM menth ae hE scxptuin 7 Ft a mth ans = Bottom oF serorum (Horh,)* ecovesings oF Spesmaticcerd - outside to inside . @ Evtamat epermatic fascig.— formed by Fetal oblique aponeursis. previous ' mol ot @) antemal spermatic fascla. . | formes by Fascla transversalis @ cremoster'e Fasclo.— formed by mtmnaloblique, Tronseneabdomirn, F cremostyic muscle bres PNQUINAL HERNIA aS PCB eFPennaseaaeeneoeeonned thdivect” # old age * young adult 3 Bilotal usually # Unilateral ucusdly 7 ¥ develope’ rough % develop through pestaior val) oF fi deep ring. Anquinalcanal . Rasseyboaces Ae “Poundarier 2 medial wath -linea semiluncsts forza wall— mfestor epiqastic arty: Bose — Inguinadligamens:content of fecrus Snanm - b Inferior eptgasbic artery tS Immediately medial fo deep inguinal ving branch of Sxtarnal jltac. axtiny # mc typeet tenia tn both OF ¢ Indivect i Prouctive mechanism of Inguinal canal : DF nS 4 closes the Inguinal canol [tre o- Shutter I othe superFretal- inguinal ving which is tanger _ Changes 1010, ati Ure nano ope duet i onteocti on of "go mucky ae Superficial sing 35 oping in A | nosrow shitlre are supe Tg anal © shuter mechanism = operated by antaynat dbligue muscle when intra-abdominal pressure 4 Po musdas contract ne Roof meets Plea (D slit valve_Inechanism —- operatrd by eoternat oblique muscle « gextanob del ae aponensos!s Seveveoesenvnovneaseeevann Lesa980000 ne nae enee ABDOMINAL ORGANS a O™N Bntvapentoneat, Retwo peri to neal O pestonum lof 9° liver £4 - Pancreas -splean puodenam stomach Kid ney. “#4 BATRA PERITONEAL ORAAVS ~ elo the peritoneum ~> pelvic organs £4 - vyinany bladder vies Rectum lower Yo. STOMACH C= Cardiac opening GD End —" no epineter pyloric opentag Gt) End — pylodc sphincterpats - 2 parts Fundus CARDIAC gj S seperarad by esophagea opening Body. es by incisura angulais. Usharp bend on leer cunvahap, PYLORIC ae seperated by sulcus intcrmediys CANA present: ak qyeatar cuvalure inetsuron Anqulais soleus intermading + 4 2 surfoeeg Np stornoch — Anbehorsurface, g posterior surFate. geantoy relation -- (D pancreas ne | - gechercnach .. | SOD. sTleniegrerny i © bed | SI @ diaphwagin’ wer emus . 1 @ Whe Hidrey g wre suprorrenal gland transverse colon does not Forrt stomach bed Q:@ Transverse mesooton @ spleenie flexure oF colon @ spar i- \ \@ GasTRC WALL — anslde to outside a. — lining epithelinn — simple columnarepithelium Orucos oF letomach © submucosa @® Museutaris entona. @® sexosa Goller calls ave absent in stomach In Rest of qrr ‘thay are present # lining epithelium of Esophagus — Non Feyalini ged stratified Squamous epithelium wlth qo cul. # Barrets £50 — when gastric githaliam 4 % Enevoaches (Replace« épithaltam of lower end of gso phagua seen In GERD- iwreqular” Polds ie gastite inegon. sirerchobili (Pood resemalY) “Rey axe longitudinal and requdar along User auvabure and forms a canal Gostric canal (of) MAGEN STRASSAE vapid passoge for Wtqutd diet ~# lescercuvabure is most common sila for Gastaie ulcer. Ae Gostiecanah Je formed dus to contraction of Oblique mucle| ayer Gastate pits % V © o ® 4 present in entive mucosa, of contain gostre glands: # glands In fundus § BoPy © zymo chief-coys — present in basal part oF : gastic pit. release pepsinogen . pepsinogen —-> pepsin . We “hotly engyoes © onyenric atl, [poste cals Gea at cid ° * as see Rolecae 4 Inteinsic: facto r of castle - Puoetion — 1S0 —l6o mol [ie chantection a food Stomach PA MOR Seong autdiic rot digest 80 4 food ra@ @ muceus weck con — poleace mucin Fmucin probe, MUCAsA from Hel glands én pyloste Antaum ¢ canal .— ple re eee cee ee ls rastin Hormone ae 4 Pstimulate oxyntic ceils to releote more Heh @ Mees weck a — present eveaywhere in Stomach PL is secretad only tn fundus $ body notin pylonu ® sv|emvensa - — melscner’s newe plexus Is poesent - © tnvsetaris feerna — . Peeeeereeeeeeereerereeerartee payentenc Nese plexus car) Aurbace 3 layer of smooth muscle — Innermost y incompless, @ oetigve muscle layer ~ _” _ completé layer © longitudina. » owlarmast , in complete foos pylodc-sphinctcr CUPS ~ congentat yp ertoopic pyloric sEnosis- J Stenosis oF Grewtar Musel- Fetient- Neonats ele = Non Billions ventt — Green colour absent yy Bila poecent tn duodenuypee - Inwrstitial cls cajal + present in Mnuseulans ertuna along greamreunature . 4 Gosnic pacemaker } Gasnic pesistalss beings along geatr cunvature » @ haventitia — peritoneus - Branch of celiac funk BS ~ astie. cstany — Oe game supply lesser eurvarare . ; ; : stat, @ Mage gate oy re £(D chore gate cwuetigs — Supply fundus ob stomach sronch BREA Chnwy Let gar ep? ploic as 7 ie 2 ees "UN, supply greeny curvature si @ Right gasho epiploic stay Brarch oF arp duodenal axtoy . Hers a-branch of common hepatic satay . TE Taigat ohioy lying stomach ~ UT GasTRic npreRy) \ f. Yonentn on The: side of 4reoGY curvature of tes 7 . 7 Stomech = omenton lwo meen ere seeeeraunaveveereen nunses:(OO POR ROO RAMEE HONREHNEORHOHEHMHAHHREHHD CELIAC TRUNK - Antalor branch of Abdominal Aorta. 7 tlt, 3 branches © ere gastric artery - cmalat branch of celiac tank @ common hepatic artey ® splaente: aswy. - largest branch of caliactrnk- VENOUS DRAINAGE of STOMACH Spesnic vein v portalvel in ynphatte droinage — lin group & Lymph nodes: Nene: sapy = ~~, Stmpathete os Te ~ Te won parasympathetic —> yoqus nerve Dror to Gasiic muscu 1 pes'stalis ¥ sacretions ae = @ Seoreio motor fo gasrie glands eee 5 @ inbikitory ? pyloric cphinctar Gastrhe emphying by dilatation of pylerte «sphincter. J Crelon) ‘ i + sympathetic weractive \sads tO Goshio Uleey formation ¥ dutto L secretion e& mucusPNTESTING onmtve long oe . —a hsm lo Jumen is new “jnustine Intchstine ae wider SAMALL UNTESTINE 4- pow duodenum — 2em tong ard pare Jejanure — wpper 245" OF Gmener lower 3)5” of G metres eaunaveenegeveen 4 port awn | antya perito read Dyopenvmn °c shaped Loop that is ieee ar welot bye bs. wis & “etrpextonea on xcape proximal f. 2 part of 7 dusdeoum eo iapctocat “covered ee * yepaiodaoaendt sence! Intrespeitonsat Jp mose common «by <2 heh alte for 9, —3 inh puodenah vler > wr) . Dg ~ 4 inch Ko whear 19 : pepe tear CY og sneh D, (parr oF —_——_ 0 inch = £5¢m E § z a 28 2e®eneoeevveCo eeecceccevrerescceceseseccceccenscoccs. puodenshivall — #4 layers ineidtto outside. AOmueose - columnar epithelium + aad goblet calla . dus to kegulaily arranged toro vill Drregulerly- microvilli - Brush border Eqi- GB, Per (Cproximat convolusd lebute) 4 vilig Finger Ike: projections of mucosa ® svsmveosa 3 — # Bruone’ gland axe present here- feos” (Bicartonate ton) rob lod} Teh Pa Inoreow. pa + pit of Stomach -» Lipa- Add of pti of duodenum-7 8 — Alrolt ne Neutyol pa- # 7 ¥ axigqun no-of aaa “oie present in by CH past). present oll ever’ the duadencenMUSCDLARIS EXTERNA 5 nade up of 2 layers oF smooth muscles Poney drewlay ; present in entixe qaT outer longitudinal except stomach Stomach - 3 layers By om part) + ulla of Vater open In Ds on major duodenal papilla at + Amp g-tocm distal to pylo ms 3 a formad bay Unton of 2 ducts 7 Zz © commen bite duck Ceo} me {mec -. tose © sain ponezatie dee ~ wwirsung duet + 4 on homes Hatta duct, . # ae hos sphinciy & oddi . Sphan ga of superior splunctay cholicochar” oud Infestor’ sphincey ehdado infestor’ sp! whee sphincter pancreatt a lewooeve | ee COnecesooseoersESeeeFConorsaeve ve: 44H Rewessery pancreatte duct | s opens tn Ds on IIKOR DUODENAL PAPILLA D3 Ca part) ¢~ x crossed by Superor mesenteric vessels antritorly estar tevic Aven) syndro: iat pee hes Supestor mesenteric ating § vein. Dg can be compressed by superior masentaste ow tay In exbemely lean ¢ thin person. LIGAMENT oF TREIT2 / suspensony muscle of Duedenum +- " eras of dhaphsaijm e e e e e e e ° e e e e © e q ° e e e e e e Ly ~ 05 dg rdF Paxus oo 53 5 DY Fluxus 03 % function - ib increase te angle of DS flexus en contracticn g helps in Ouocenah emphying jor ereeeeroresi tle Abnormal position of treitg ligament Is 4 Lavos BAND ~ TIS present 19 congenital molabroxption of qT dinteaL presentation = puodenal obstorction in Neonates: eilous vomit «~S@@eeeeaeea Blood supply et puedenury : - greed © spo. (sdp.panereati co duodenal) artoy ™ + Wranch of Ce ory ranch of common hepatic artany - cupply 0) #05, upto Ampullek. Vater, @ Bpo inferior ponereatice duodenal) axery «= ay oe ob fy = are by “+ agiepply froth ampules of ’ eandh superior nas enter avecny duo denal arty — another’ ranch Rebodwodenal avtzy. Gasvo presente ‘ehind D, psowr CL oF hamorhage tn perfo urd cluodenal wlar- CDE OSCHOSCSCHC HS ORO CCH HOPED HOD‘eeeeeeeeeseeeeeneeeeteseaoeoveasevnatoenee draine 1 re venous dvalnag®, 7 cuperior mesentvic + postalveln vein Neg UE smollintstne , Ty - Ty Sympathetic nerves $ JeTunum F 2LILM Jesonom 7 A Teyunury © upper 28 ok length @® vider bumen ® wall is thick © woreblood -- © ved coloured . “wall @masenty —- No Fak Crentonixyn) q \ © window - present Crransperancy tn sazsentay) Vagus nerve, thom © lower jg length @® Narrow lumen ® waltis thin. @ lesser Bleod- © pink coloured wall Ohne poyeré pach ~ present- v —a.small Finger tite aw (QALT)- Quérassoct att d Iymnrhold - — fat present @ ® masertoy (peti tonium) fot © Window — absentBlood supply t- — Jejunal § iltal branchy of superior mesentate. Arley # (ia-15 in number) * present on uetside Meck es DIVERTICULUM 2 Thue dherticultim (ail layers outpacing) aac) tatu! Irectatdlvereukure agpendla 4 present-in. .2:}, population # 2 Inches long Fe fe proximal te ifiocancal junction “} Wis the anos: ‘commen sn conga duo to persistant proximal part of- vitllo intstinal duct Normally it disappears ol 6! week of PUL bur persists in 24 populatiin Problem — inflammation of meckel diverteulum is the pitferential diagnosis of Acute appendleitls Co eer oor aarevenevrraceseocczsen@ | F some symptoms — vomit-, fever : Murphy! tried v Present In Acute appendicitis. Weis one oF the mal *) In Yeason for i Negative AppeNDIcecTomy, yp mecees divertiowur 2s the 2! mast commen sil tor ectopie pancreatic Baste \ 1S mnosk common site — gastric mucosa PANCREAS 4 2S largest gland oF body 4 largest — hve “ p predene in loop of duodenum -—- ak Aue) of Lifts verebra # T shaped eBave parts ~ @® rack @pody @tai\ Hie 1S Roboperltonacorgan except tai) e e e e © e q ® e e e e e e q 9 e ci e ® e oe. fk taul 15 presentin Imovenal ligament peaito nium . * # Teil iS closely velattd to Hilum of spleen % ounng sfernectomy tail « pancreas can be removed accidentalt eeeeesveeeesceaeoe4 mieed gland ¢ > endocrine — Efocring. ¥ BUY of ae are. present - mosimumn denty ave in Tail Balls a0) > produce insulin $puidental removal may lead to — totrogenic diabetss mellitus + Head of: pancreas 3 borders supesioy ~ spb axD7y Tre 7 gignes = Anastomosis beiween sp0§ 2pp Ingerioy - 2pD arty Pasuifaces ~' Rebopertinneat Antoior \ providue aitatchment fo greatzy amenrum and Honsueret mesocolon- postivior —=> i ~ Renakvelns B — Bileduel anfexior yenacavo, 2 - ee e @ e SOCSHOCOCHC SOE HORACE ESSE OOF HOSS eCOdOESCROSGCSCHSECOHOHUSHOEEOSCHSCeECHBeeOsaseeeseeeese 43 UNCNATE PROCESS +- 4 present in the lower bo rder of-head - 4 eossed Antnioly by superioy mesentaric- Artay g vein A postenor — Abdominal aorta vacinate process NECK oF PANCREAS 3~ Fk is the constricted pore between Head £ body Anterior — Gastoduodenct arty pestetor — portal vein Boy OF PANCREAS > Taberromentale 1 spleanicamtoy, fiehas 3 bore > Supertor~ —> pntaior infenor —> infesor + spluanic evry has a tortuous coure Grn) hecause {bins stomach bed facial artery also hos Covsses tunporo mondioularjeint) Gives multiple branches to 83 val our of which 2 branchss ore bigger# rbiggy branches axe @ Avera fancreatito. magna — supply Body © Arvin cauda paneveotis — supply tail sp Anterior border — provides attarchment to greater omentum and Transverse mesocolon sinfertorborder ~ Related to superioy necentaic arty F vein # postaior surface ~ 4 Abdominal Aorta fF Superior mesentaie Arty oF Body OF + lat crus of diaphragm ancreas pancreas, 4 leer Kidney LP sup rarenatgland PANcREATIC DUCTS :— yy of-head a ; ae j Neck. C= main pancreal’ - Tain panereate are” cy oy Tail svarts in vneinate process * Vp of Head —> drained by ACCESSORY PANCREATIC puer oper uncinate process is drained by thise SCH SCHT SSO COE SHOVES OEEOOCBSOSCOTOCS @eeenSCHOCCE HOSES SSOH ECOL OS EECHRESeCSEELCECHASASECE SPLEEN a LARGEST LYmpHolD oR GAN o INTRA PERITONEAL OROAN present in the WE Hypochondsi um between fundus ot stomach and Let dome & diaphragm - yw nto v i supestor bors Inferior order Antaiorend spleen is not palpable. jn ttealthy person 4 te should -be, more -than tole. ofits normalsige to be patyable. Wormel sige)- ‘erplaing - # HaRRIS DICTUM of, cpp NUMBERS > - 18,5,7,4- 11 * 3inch = asidth Streh < length Touna = weight (307 = 20 gre appx) sk Related to Bibs - 9, 10)l) 4 long axis ot spleen in long atts of tomb. & pleced obliqwuallysurfans - 2 surfare- O diaphragmatic @ Yiscoralsufae - Hilum is present on this suPace- Relarcd to viseeras # ohove the Hilum related to stomach — se gachic impression se below the Hilum wlotzd to ‘dray = Renal im pression # pntoiorly to Hlim yeland fo — — edlic impression. At Hilam related fo fail of pancrens > BoVAaeS 2 Shore of cupaloy border — —e'cVO™“” wy re ~ mesodem from gpuinic Haxor 4 tolon = pancreatic trapression jnultiple notches fray axe fusion lines of splemnteuly 40 TOL taulliple smal) lobuter dexvalve Ge in Loorsal mesogastnum of stomach) - SCHOPCOCSOCCHOEFCSCSEC SOE EHEODO SES SC LORAOLO CSSCROSCC CTC SCC HESSSS OSCE HOSE EHBHLCe aH ORESCAB OSE @: o& Actessony spleen — Splenicul’ which fail fo fixe with the main | Tact forms etsy span fost commonly present site —- Hilum oF spleen, Bd me precenrin = Tallet pancreas other sits —> Greater omentum unuswal sits > # left Broad ligament of utenss ¥ bin Lat spermatic cord - we look for it before doing anfectcd RBC SS peformad#ee Aeptan Any discos. wlth Remolysis ~ {pleanomegoly ts present” VER ne eee ae rh AtoneoL organ 4 Yetragerionse Tuan ge in Blrmats) po RS wage a [Boo gm 30 Q Uemaled \ocation ~ present in Right Hypochondi um , epi gasinum 4A smost park of Uver alo present In LeFt Hypo chonehdury . “SPT COSCSECOCHOECECSCHSSCHSeEOSSeEFERSGHOECF SC OSFCAEOSeLe4 fibvows capsule = — GUSS ONS CApsvLe Counyr covering) Formally in a healthy person — Infestoroorder ct liver ic palpable v only bordertn liver # bver hes 5 surface a Antehor surface. S Falti for ligament Cperitonead Wigamene) # supenoy surface, formed dur to oblituration J posterior surface Uigomentwnvenasum - “3 pustus vencsus a preel + infestoy surface \, yes — formed ducte oblitaation gementuin we of Wet Ombilicadveln + Right Surfa® - no Vigement- cary ony genasatbloed + Lopes ~ 3 lober — © courdatclobe © teetlore Based on functions (0 surgleal (6? @ sight lobe French - Bi smith division Entends Prom centre for cystic fossa to midd t-hepate “x vein Conv) # plant oF division —> ZANTLIES LING — (7) gait blaclder fossa COC OR OES SSSMS ECE OS ASER HERE HoESEO LEE+ cavppTe Loge - small lobe present on poswior surface of iver” eames ~ (ik receiver blood from both the ranches of. portal vein. Rightbranch of- portalveln > Right lobe Uupt-byanch of-portalueln ~> Left-lebe @® sie formed in caudate Lobe is drained by both brands of Hepatte duck @ Independent venous drain by muv 7 2v0 Jp Quedvatelobe — p smalllobe presen-on lhfeersustace e past of Acti lobe - of liver . . + giddler lobe ~4 occassionally found , port of aght lobe- B2G£eetovoadr @ 7 egeeon es e ao @ 2 @8e@Ss @ @w@PGeee eeeATIC SEGMENTS | COINALD SEqinENTS A % segments a complete segments Bach seqmont has Individual branch of © Hepatic artenf @ Hepatic vein © Hepatte duct @ portal veto . chupaTe Loge - one — © [> seqreant for © wert WSE ~ Thee - 2/22 ames ® KigwT Lowe = rcur ~ £,0,H WD 4 divided by Right portal hssuze + Right Hepatto vein Right pos taior caav) _ Right anttor + (or) Right |ataral - . 7 COV) Right med lor oo “8 ; _ 39. 4 liver Is divided by Hepatic veins into lobes § segments pOstCn oY surface Foldigorm ligament Anterlovsur Fac fe e ® a ‘ e e ° ° e e e . e o e e 6 6 ° e : @ e e © e e e e e s ° . e e e eInfenoy surfact faleiform liga ent” Gpilbladder PORTD HEPATIS — # Transverse groove L Y Bem long opening deliver. poprandel by ~ — Supevorly - coudatrlove ingerorly ~ Quadratelo be fee content -— | Antstor fp ‘postmtor “Hepat duct Hepatic astesy . porta jase vein +2 discrem shuctwes — — Hepatic nerve plexus Iyraphat cs > Hepatic veins They come our fromm the postistor sturPace \n the groove for ave SCO eeeeeeResce SoeesvesetCeeeasenaeaseeveesso liver has 2 openings — Thotis why no Hilum Blood suptly - provid oy, t # Hepatic artery ~ 207+ # portatvein 80]. Al metabolites qwaph oy Histology : spact o& DISS! ~ perisinusoidal space of liver content — Lto wll + its Function is vitamin A metabolism space, of MOLL ~ pespertad. space oF ver + tontint a branch of Hepatte duck poralvein , # Kupters cols — iepattc macrophages # mou power ot Resprieration — in liver (more than set) - ge Ya of liver Can gro fo Normal sige Jn 6 months. e e e e . e e a e ° e e 6 ° e ° e ° 6 ° . e ® « » e . ° e e . ° e ° ° ¢ eHepatic. Biopsy (Bx) z~ fe Right tid oxtilany Tine - (8)9)10 antercostad spaced upper limit is sMaib otherwise hung “rupture: Heparocyts - Hexagonal LARGE INTESTINE — EB metre- parts “oven & appendiy & Ascanding wlon ra pemtoneal. ‘Transverse. colsd Retvoperitonect nia descending colon ah + ng col .stgrneld colon / felvi colon, =" gene peritoneal” upeethh 4 Rectum — lower If, + Analcancl \aaqeitepar “go inchas ‘tong ee eveceecoctoccesceoipeccoseeee se eaapeoe: eegeceFeatures - @ saccule £ Haustra © Tenia. cot ——> 3 bunds oF longitudinal muscle ® appendices epiploicae:~s smali pouches oF reid with sooo iwi cev col apperdtces eptploicas. cute ces, longitudinal wnaseleflorgs —— Haustra ¥ Tenio- colt merges a loose of appendix ~ Helps in Identitication oF appendix dusing operation: + fn oppendix — Tenia eli ebsent- pTentacoli ~ fongibidinal muscle Fone ; chor In length than cireutar muscle * ap pppendicis'ept plotcas iseabeent in: “C) eédetim’ © Afpendix @ Roctum: Epithelium ~ simple columnar epithelia wlth goblet ces e e e e e e ° ° e e 6 je e @ ° o e e e e ° e s. . ° e CY e e . e ° e ° ° « eAPPENDIX + - cose ‘Appendix PNorrowest parte of 4 IT lumen sige - o3mm # Lngth - Bfe 20 em * Average length = 4m $ Fucdiverticulun - ports - Bose f TP mov bara ine present of MAC_BURNEYS poInT- oO igh cole oxy - @® Wo tolic artery apueente Plawe (tre site for Vaparve ; ischemia) Porove oS Anastomoses aks : FS / ng = as SCCSOSSOCOCESSEOE COS COB EHE SSE | e 7 7 SROEePeege eeeCHeeeesosceHoeseaeoreseaepenereeoeeeseese + Anodcanol > length ~ 3gmm = em | divided Into 8 parts - @® _ucos pare ismm long epithellum ~ simple columnar épltheli um (qbler eats) embryology - Deavalive of endoderm Bhod supply - Superior Vectal avtoy vein superior rectal rein . Nymph clvetncge = ntemol Vac lymphnod u Newesupply - Infertor Hypogashie plexus Gruronomic purus) No Paln sensation in f part © yeesn [Transition pert = nm lang spiel am “+ Non Keratiniged stratified squamous * Le. epithelium. ee a without sweatglands * sebaceous glands Hoty follicles Subryology - telockrmal derivative. 5. chaf elood supply — anfe stor rectal artery 7 ines wl - IPfevior reckalvein seni, ovat) teas Nene supply — ea rectal nerve (32% Sa) lwonch of pulendal nerve # goin sensation presents© baneus pore - min — shortest pare gpithatum - jon veratiniged etalified Seyamous epithelium « Spithelum with swoeaitgland a Sebaumusgland Hairfdlic 3 go ite i Linked by tueskin » presto features came os 2% poste Puborectalis, Vevator ent Rectum, VY“ Anal sinus ‘al colunns + Site tor pert). engituincat 5) cavek | Ine /Denrotrline }-—? Anol valves ‘Anastomosis, Stesuyp i, 1? I sub reucasa, — Rich venous Ss B35 puxns v a gives shightly Buekobur , . eee ss ust st arporathenerfiby Po ty . Bleed less $ Yeu pain fut cola: # constipation aovvalning atstoo} : : 4 4 | !% Roo ephinctays - & In number” OD snemal anal sphineeer . smoothmusde Involuntary sphincter NS ~ Inferloy Itypogosnse plxus P extends upto Lohitz line of Hilton covers upper 3/4, of anal-canak ® eeeoraat analsphinctey = covers the entire anaLcanak of seeletaL muscle, % Voluntary sphin ctor Nes — ented or rectal neve Sports - €, — peop pare —NoBony attatchonent sae selene? Bony a griteor 2 J sulpauraneont poe No bony ‘attarchimenh. “covers 34 part of Anat canal - e a e e ° e e e e ° 6 e 6 e e @ e © e ° e e 7. KJ ° e é ° e e e ° ° ° ° s e* Ano veckal.aing > formedhy fusion of @ pus vecrolts Oe, © intemar anal splinter. 4 Ccsential Por Anal cont nent TIDNeY + Reten peritoneal organs “peetbeation Th Normal. sig. & Haney Hxbx s ero normal weight — 1s0gm 4 Right. kUney Is Wile lowers in position because of the presence of her fb ehe rborders 7H SS tetera ee oveoeaartescecceogneMediod loorder — # tilum present on this border. siustures presenir a Hlim= ——pyior to pastor Taiburary of RS tnfaforvenatave ey Renalvein-b, Hminoks, ~ end branch of = penal Anoy - byl, 9 | Aibdomine. iv vey | Arorar P — Renal pelvis (ontinus as vrenry~ i le vena veln 1s 30mes Longer than tig yntvenatveln left Eidney Ye cee for ee te |Frsupre renal spire, Z on ty c bee eae vein v : Noy be conshicttd due to real ti Fright venalvein hos no frtloukases. ( jnflane ck eaevlaniva), .- a ° s 5 ° e e ° e e e Se 6 e ° ° ° ® e oo e . a. SupeARENPL JnoRENAL SLnuiD ~ Henopedtonanl”” 4 efi gashium at the lwel of pha. Ppresent at upper pol ot Kidney + shape Right Brena gland ~‘Trimgular wet Adrenal gland ~ semilunate oe Shape F- ‘al g) ey crescent ® a e @ e e e e 9 ° e e e* gland = 2port, Adrenal cortex —s mesodermal dertaithe. couteY) . dened meddle. —> Neuralcrest calls i Cinnary . | coca thn cals thoy relbant ees NORENAUINE, NOR ADRENALINE ee F ure tstieular votn ray be constricted dus fo cascholamings r which“ wads fo dilatatton oF pampini Form purus called verivowele = (nee in Upside) cortex =~ a parts” ide ‘to Tnside (Gone qomerloso. ~ tol neralotorticoids CF) Zona passieuleta, - gluco corticotds Le) Zona. Retioalets - Se Hormone. (pehydro ep ancio etoone) Blood supply = 3 prime Branthot a a superior cupravencl Artny ~» tof ploreni bry > Aodominal Serta middie, suprarenal Aste \ngenorsuprorenat Artoy 7 Ranal Artery weaver eeseseenaet+ © saecosratmave (Ty) “®)-an Inguinal neve ( L,) yeln — suprarenatyein. KioNey — surfaces - & ® Antotor # postator + poswwior relatton of Funay some on both sider. 4 Bmuselss . © psoos major faphragm © Guodreitus |umbonary 5 4 >@ @ Fransversus abdominis. © a Lpt ridney © ‘tho hype gasnic: nerve(tr) F Right Kldney velawd to w!*ib only ~ rest ave Same. Antoiorrelations — game on bohsidex ~- © pedtonen . @ coils ot small intr res ® supra renal glan+f vifferent- of boths idea: gt ld Right euney lrekth # liver 4 Stomach , spleen. J Hepalte Fucure + a spleanic plurure of colen wolon FA, Toney to Out OD Fibwus copsule - innermost eosily seperalole * ® petrenat fat / pesinephaic Fat ~ present along borer . y fills the Renalstnus ~ Cépasein venoduti lum) Ba -nenad toewg.|aesorme mean + fascia of EVCKER KeNDAL antator layer pocmennnee ® Pasco 9 TOLDT 4 present atong poser guvtate and lower pole» _ a nam mmm meee oe OO SHOHEHO owe ee aeLe Remain seperate and fuse superior pmedial g leecraliy eee ee e ® : | . > cuprerenal gland t precent iq t . seperous fascial, compartment. e 6 ‘ : Pesta e e be) (os 6 . e- e e Renabsegments > tach bidney 5 seyments- Histology = —> #No-oF nephrons in gach kidnay — (5 million + Renal pyramids, Medwla,— hes venal pyramids ¥ foto 12 in cath kidney Aper~ lum of kidney» ° ° e ° ° e . o 6 . » ° 5 » » Ld >: » » » ) , ,NEPHRON Secreto myparr J (nedulla) : coleoting pax # Glome rulus SIP a nie . (ora 2 # collec’ # Bowmans caps (ore) aay) ohacring ducts R pC coLuinnak open Jnto Duck of in eprrneun BALLIN) # loop of Henle ~ medulla 1 Minorealys LLBo! per- ERSORAY epemetivin ¥ @ with egusarworner (rego coorged) anes a Microvillt pct - COBRA Be eprTneLwym ‘emv" pena e| portHOUT BRUSH BORDER pore or e wn —_ e TRASITIONAL vvinonybledder” epiTHetion . ° ¥ + poocimal e (yave umivtllacells) Reaeae ie nerve supply ¢eKidney & vel e 7 a e ® wh (vagus nerve) ” _# cetine pews 7 To (Gare mato ae) F smooth Muscle 4 chous continuous peristalsis \engih ~ to Inches = a5 rp fb wprer Ya present in ~ Abdomen Dlameley 3mm 7 AFF Bem vretaric stone cap ° e e e e a floor he presenhin = pelvis s qe a poss thoowgh wet - 5 4 4 4 ayeti tonstietions — five in number Haus Fos stone infection © pe pelvi wetere junction — Begtoning - @ Arla oF lesser pelvis @ vesicovreten'e junction Terminatiay @® Veeare opening in trinaay bladdoy @® ersed ley Brood Upmant /s Purus differens + 4 Qfemany VT Cmabed Bhoodsi fly, ft vvetnr . ager) Renal ty middle YS2— tambo bvanches of Abdominat aorta, (4 pairs a lower I3 (Superior vesicalorte7y 9 intemal iter ontzay Ente Anger vesical aroy 5 Antaior divisions bidder absentin Qffematy replaced by vogtralmteny Bes lower iy G+ SAP NetieaLeatary UipIMeerDy , vaginal arory. TV CFPC HGOteteeesereceseovrecrceesbooeeneposterioy Yelati on oF vretty — game on bothsi des podomined post D Troncverce procs ot lumbarvertzbras. @ proot mejor ruscle- @ Genito femoral wewe penieieey OD satroitiae Joiner (plans. sypovialjot at) © internal tac artoy * kus xeray - eciepartmcerpeietder -Hray ablomen efter wok preparation , Dnvesti 7 ultvasound - essen -— “TErannapTion of OFETER + [Ermunation of CR pak poste larval angle gor of Mercier of Bladder trigone in vai nay bladder que to por of uinwry Bladdey fr longi tadinad muscle of ureter weer Laith oppasitaside at bose & Sater ‘loader tn gina anbform macular, = eleva 87 BAR OF MERCIER ureteric CREST CY) |"TT 7377 =F eee reese neeeeesenense _ Fin urelaic distance — = whan V8 eompy 2-5en Sem - whan ve Full Intonal vrethral ovfice - of Bladdertrigone. Intenel vrethral ovfice 4 sumounded by Sntonal vrethra sphincir- # made up oF Smosh mus ele Involuntang ; present-tn 8 Umally only fundion ~ preventt retrograde. ejaualation ovula vesicoe - present in BT — postator fr intemal vrethraLorifve # Elation in mucosa + present in T only +t produced by medtan lobe of prostatt (or) prespermaticlobe PIE vvutovesfeos enlarge > lead to 800° . b a Bladder outflow obstmctte; ¥ . eae precent in BPH PROSTATE GLAND - jb mate genital gland jl e Fs equvalent fo PARA URETHRAL GEAND OF SKENE ing + Normal sige ff w$ Normabvolume > ao - 25 ow lobes - + antextortobe se loxeralloe = — & tn num enlarge enlarge in Lt ae BeRetnoma, ok poste ort + mainte [petspermatelote cause B00 Bloodsupply - 4 interior Yesicol fray Venous drain — prostatic venous plexus tntmal Wiac veld coreecttl to the vertilorat ‘venous paras o Bateson - 4 present keboeet, he a gopsubea of prostats 1 Aaa copsintis Folie topivle 3 einer + outer Htormed by formed by pelvic Sascha “fpacren Pg 7 of gland 4 prostatectomy 55 dong. withoul removing capsule’ proseostgland & yemoved without cap fe THYEOV? QLANP js vernoved witty capsule@ URINARY BLADDER shape — Tebrahedral,- when emply — In pelvis: + ovold = — han full ~inthtvaabdomina . Hypogasbium « +f extrapentoneat organ ® Teroheyol - 4surFor # ovold -QsurFoce © superior QO Ano or tnfenloterol — 2 Innwmber @pstaior fe @® poswmior/Base __gpedtonlum power, wo eae . 2 Inferolanae’ ~ ( : Surtace y Fpamior > by Tetrahedyat shaye Gren) superior postmior _" TTT TT 7 sewer er Peese teas eoersecee aSUPRAPUBIC CYSTOSTOMY j - duxtng itr we donot entry Peritonin arn opening of viinanjbladder above pubie symphysis position ot inanjeladder - us is present Immediately postator or to Antortoy alodorninal wall in hy pogactatur in that damages ~ viinany ler o 4 wor oF VO _t- F mu.cose —» Transiti onabepithelian sulomacosn—7 Absentin BT layers of gmooth mv st 9 6 ° e e 9 . q e a 4 AJ 4 k Bulled Injuay lo hypogastdum ergot (perrusor muse) provscuton' sextema —> 3 4b gnx08a, _ erongerant = Spvals § whirls 7.7, serge commer : . hie cori oc. muscle weve sopr 2 —p Ty~ be amet Wewi emtgpntis Cparasyn| pathvetié) C52 4) \ ssugly pelvic organs