ANATOMY

Parts of Brain
Part Division Structures
Forebrain Telencephalon Cerebrum
Diencrphalon Thalamus,
Hypo, meta, epi thalami
Midbrain Crus cerebri, substantia nigra
(Mesencephalon) Tegmen
Hindbrain Myelencephalon Medulla
(Rhombencephalon) Metencephalon Pons, cerebellum

BASIC ANATOMY OF BRAIN

 Meninges of brain: Outer dura-mater; Middle arachnoid and inner pia mater
 Falx cerebri separates the two cerebral hemispheres.
 Falx cerebelli Separates the two lobes of cerebellum
 Tentorium cerebelli separates occipital lobes and cerebellum.
 Grey Matter: Consists of cell bodies of neurons and axons and dendrites which are mostly
unmyelinated.
 White Matter: Consists predominantly of Myelinated fibres ( W=inverse M)
 Brainstem consists of midbrain, pons and medulla.

Brodmann Areas of Cerebral Cortex

Area Function
1,2,3 Primary sensory cortex, lies in the postcentral gyrus
4 Primary voluntary motor cortex, lies along the posterior part of the pre
central gyrus adjoining the central sulcus
17 Primary visual cortex ; lies in the calcarine fissure of the occipital pole.
18, 19 Visual association area
22 Wernicke’s speech area (includes part of area 39, 40 also); lies in the
posterior part of the superior temporal lobe.
41 Primary auditory area;
44,45 Broca’s speech area, lies in the posterior part of the inferior frontal gyrus

THALAMUS
 Major synaptic relay station and is concerned with processing of ascending sensory information to
the cerebral cortex.
 Blood supply of thalamus: Posterior communicating , posterior cerebral and antereior choroidal
arteries
 Lateral geniculate nucleus: Visual ―Lateral for Looking (Visual)!‖
 Medial geniculate nucleus: Auditory ―Medial for Music (auditory)

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LIMBIC SYSTEM
 Includes cingulate gyrus, hippocampus, fornix and mammillary bodies.
 Limbic system is concerned with emotional behavior, sexual behavior and food habits. (The famous
4 Fs: Feeling, Fighting, Fleeing, Feeding and sex)

HYPOTHALAMUS
―Head ganglion of the autonomic nervous system”
Functions of hypothalamus include:
 Endocrine control
 Neueosecretion—Oxytocin (paraventricular nucleus) and vasopressin (Supraoptic nucleus) and
vasopressin (Supraoptic nucleus) are secreted by hypothalamus and transported to the posterior
pituitary.
 General autonomic effects—Anterior HypSothalamus mediates Parasympathetic activity and
Posterior hypothalamus mediates Sympathetic activity (―APPS‖)
 Temperature regulation (posterior hypothalamus regulates heat conservation, Anterior hypothalamus
coordinates cooling)
 Appetite regulation (Hunger –lateral feeding centre –destruction  anorexia and starvation);
(Ventromedial satiety centre—destructionhyperphagia and obesity).
 Thirst and water balance (supraoptic nucleus)
 Sexual behavior, emotion, fear (Septal nucleus—destruction a rage).
 Circadian rhythm maintenance (biological clocks—suprachiasmatic nucleus)

MIDBRAIN
 Connects the pons and cerebellum to the diencephalon.
 Contains the cerebral peduncles (Corticobulbar, Corticospinal tracts), red nucleus, substantia nigra
and the cranial nerve nuclei of III and IV and a portion of the large sensory nucleus of V.
 Ascending sensory fibres travel in the lateral and medial lemnisci.

PONS
 Pons means ―bridge”
 It lies between the medulla and midbrain and is connected to the cerebellum by the middle cerebellar
peduncle.
 Contains the nuclei of the V, VI, VII and VIII cranial nerves

MEDULLA
 Continuous through the foramen magnum with the spinal cord, and above with the pons.
 Connected to the cerebellum by the inferior cerebellar peduncle.
 Contains the nucleus ambiguous (motor to IX, X and XI) and the nucleus solitaries (Sensory VIII,
IX and X). Most prominent Cranial nerve nuclei are IX, X, XI, and XII.
 The dorsal column nuclei cross to form the medial lemniscus.
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SPINAL CORD
 45 cm long
 Extends from the upper border of the Atlas (C1) to the lower border of L1 or upper border of L2.
 31 spinal nerves – 8 cervical, 12 thoracic, 5 lumbar, 5 sacral, 1 coccygeal
 Lumbar puncture done at the L4-L5.
 Blood supply by a single median anterior spinal artery and two pairs of posterior spinal arteries.

CEREBELLUM
 First fissure to appear during development : Postero lateral fissure..
 Flocculonodular lobe is the smallest lobe.
 4 nuclei: Nucleus Dentatus, emboliformis, fastigii, globosus (―DEFG‖)
 Most primitive part of cerebellum – Archicerebellum – concerned with balance and equilibrium –
Nucleus Fastigius.
 Paleocerebellum – Tone and Posture of the body – emboliformis and globosus nucleus
 Neocerebellum- Most recent part – concerned with planning and programming of voluntary
movements- Dentate nucleus.

CRANIAL NERVES
 Thinnest/Most slender and smallest CN- Trochlear
 Cranial Nerve with longest intracranial course – Trochlear
 Thickest cranial nerve - Trigeminal
 Largest branch of trigeminal nerve – Mandibular nerve
 Most common affected cranial nerve with raised intracranial pressure due to long intracranial course
– false localizing sign – Abducent nerve
 Most common cranial nerve affected in spinal anaesthesia – Abducent
 CN with longest intraosseous course – Facial
 Most common injured motor CN – Facial
 CN nuclei in relation to the floor of fourth ventricle – Vagus, abducent, and hypoglossal
 CN carrying parasympathetic fibres – III, VII, IX, X
 CN with both motor and sensory components – V, VII, IX, X

SKULL
 Total 22 bones – Bones of cranium 8, Bones of face 14
 Bones of Cranium – Paired (Parietal, Temporal), Unpaired (Frontal, occipital, sphenoid, ethmoid
 Strongest and only mobile bone in the face - Mandible
 Main Skull Sutures: Sagittal Suture – Between two skull bones; Coronal sutures – between frontal
bone in front and parietal bones behind; Lambdoid suture : between right and left parietal bones and
occipital bones behind.
 Vertex : highest point of the skull on midline sagittal suture
 Bregma or anterior fontanelle meeting point of coronal and sagittal sutures.
 Lambda or posterior fontanelle : Meeting point of sagittal and lambdoid sutures
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 Structures passing through foramen ovale : MALE (Mandibualr nerve, Accessory meningeal artery,
Lesser petrosal Nerve, Emissary vein )
 Petrous part is the hardest part of temporal bone
 Each maxilla articulates with 9 bones : 2 Cranial and 7 facial.
 2nd bone to ossify in the body is Mandible.
 Ramus of mandible provides insertion to all the muscles of mastication.
 Angle of mandible 110 degrees

SCALP
Layers of the Scalp
 Skin
 Connective Tissue (superficial fascia)
 Aponeurotic layer
 Loose areolar tissue (Sub aponeurotic ) layer
 Pericardium

FACE
Facial muscles involved in various expressions
 Grinning – Risorius
 Doubt – Mentalis
 Blinking/Winking – Orbicularis Oculi
 Pain, Frowning – Corrugator superciliary
 Aggression, Concentration – Procerus
 Joy – Zygomaticus major
 Grief/ Sadness – Depressor anguli oris
 Crying – Levator labii superioris
 Horror and Tremor – Platysma

 Face is supplied by facial artery, a branch of external carotid artery

 Facial vein is the largest vein of the face

MUSCLES of MASTICATION
 Masseter, Temporalis, Lateral pterygoid, Medial pterygoid
 Elevation of mandible( closing the mouth): Masseter; Temporalis, Medial pterygoid (of both sides)
 Depression of mandible (Opening of mouth); Lateral pterygoid (mainly) of both sides, (Lateral lowers)
 Protraction (protrusion) of mandible; Lateral and medial pterygoid, Masseter
 Retraction of mandible : Temporalis
 Side to side or chewing movements: The lateral and medial pterygoids of two sides act alternately.

TONGUE
 Largest papilla: Vallate papilla (8-12) in number, Smallest and most numerous papilla: Filiform/
Conical papilla
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 Intrinsic muscles: are arranged in longitudinal, vertical and transverse groups. Supplied by
Hypoglossal nerve.
 Extrinsic Muscles: Geniolglossus, Hyoglossus, Styloglossus, Palatoglossus
 All glossus muscles are supplied by hypoglossal nerve except palatoglossus which is supplied by
cranial part of accessory nerves
 Safety muscle of tongue: Genioglossus. – its attachment to the mandible prevents the tongue from
falling backward and obstructing respiration.

SALIVARY GLANDS
 Largest salivary gland; - parotid gland weighs 25 grams and is inverted pyramid in shaped.
Ectodermal in origin.
 Parotid duct (Stensen’s duct) 5cm long. It opens in the vestibule of the mouth at the level of the 2nd
upper molar tooth.
 Submandibular Gland is a mixed type (serous and mucinous) type of compound recemose gland.
 Submandibular duct (Wharton’s duct) is 5 cm long and runs forwards on the hyoglossus between the
lingual and hypoglossal nerve.
 Sublingual gland is the smallest major salivary gland; almond shaped; and lies beneath the mucosa.
 Submandibular Gland and Sublingual glands are endodermal in origin. In addition other glands of
the digestive tract like the liver and pancreas also are endodermal in origin except the parotid which
is ectodermal.
 Most common place of occurrence of salivary calculi – Submandibular glands
 Ranula is large mucocele arising from sublingual gland.

NECK
 Posterior Triangle
1. Boundaries
 Anteriorly by posterior border of sternocleidomastoid
 Posteriorly by anterior border of Trapezius.
 Base by the middle third of clavicle

Floor is formed by prevertebral layer of deep cervical fascia covering splenius capitis, scalenus medius
and levator scapulae.

2. Inferior belly of omohyoid divides the posterior triangle into

 Upper larger occipital triangle and
 Lower smaller supraclavicular (subclavian) triangle

3. Contents of posterior triangle

 Four cutaneous branches of cervical plexus:
- Lesser occipital (C2)
- Great auricular (C2,3)
- Anterior cutaneous nerve of neck (C2, 3)

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 - Supraclivicular nerves (C3,4)

 Spinal accessory nerve (CN XI) – plastered to roof of posterior triangle.

 Muscular branches for levator scapulae and trapezius.
 Brachial plexus branches:
- Nerve to rhomboids
- Nerve to serratus anterior
- Nerve to subclavius
- Suprascapular nerve

 Arteries:
- Subclavian artery
- Transverse cervical artery
- Occipital artery

 Anterior Triangle
 Boundaries:
 Posteriorly, by anterior border of sternomastoid
 Medially, by midline of front neck
 The upper boundary (base of triangle) is formed by base of mandible.

4. The anterior triangle is further subdivided into 4 parts by the superior belly of omohyoid and
digastric muscles: 1. Submental triangle 2. Digastric triangle 3. Carotid triangle 4. Muscular triangle.

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UPPER EXTREMITY
 First bone to ossify in the body (between 5th and 6th week of intrauterine life (between 5th and 6th week)
– Clavicle.
 Only Long bone which ossifies in membrane – Clavicle
 Only long bone which has 2 primary centres of ossification – Clavicle
 Only long bone which lies horizontally – Clavicle
 Only long bone which has no medullary cavity – Clavicle
 The clavicle is often fractured at the junction of medial 2/3 and lateral 1/3 and this is the weakest part.
 Clavicular fracture is the most common birth fracture.
 Scapula is also known as shoulder blade.
 The lateral angle also known as glenoid angle is the thickest and sometimes called "head of scapula".
 Superior angle of scapula is opposite T3 spine.
 Coracoid process of scapula gives origin to coracobrachialis medially and short head of biceps
laterally, upper surface receives insertion of pectoralis minor.
 Long head of biceps attached to Supraglenoid clavicle
 Long head of triceps – infraglenoid tubercle
 Serratus anterior – Boxer’s muscle.
 Paralysis of serratus anterior- winging of scapula
 Lattisimus dorsi – Climber’s muscle
 Superior angle of scapula – T2
 Spine of scapula – T3
 Inferior angle of scapula – T7
 Muscles from scapula getting inserted on the lesser and greater tubercle of humerus forms Rotator
cuff.
 Muscles of Rotator cuff: Subscapularis: Lesser tubercle
Supraspinatous : Under impression of greater tubercle
Infraspinatous: Middle impression of greater tubercle
Teres minor: Lower impression of greater tubercle
 Contents of axilla are i. Axillary artery and its branches, ii. Axillary vein and its branches. Iii.
Axillary lymph nodes, long thoracic and intercostobrachial nerves.
 Subscapularis muscle is attached on the lesser tubercle of the humerus.
 Muscles attached to the Greater tubercle of the humerus (from above downwards): Supraspinatous,
infraspinatous, Teres minor.
 Bicipital groove or intertubercular sulcus lies between the greater and lesser tubercles of the
humerus. Pectoralis major arises from the lateral lip of the groove and Teres major rises from the
medial lip of the groove. Floor of the groove gives attachment to latissimus dorsi. ―Lady between
two majors‖.
 ―Axillary nerve‖ passes through the anatomical neck of the humerus.
 Anterior Compartment of arm
 Muscles : Coracobrachialis (pierced by musculocutaneous nerve), Brachialis, Biceps brachii
 Arterial Supply: Brachial Artery
 Nerve supply: Musculocutaneous nerve
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 Action: Flexion of arm and elbow joint.

 Posterior Compartment of Arm

 Muscles : triceps
 Arterial Supply: Artery profunda brachii (Largest branch of Brachial artery)
 Nerve Supply: Radial Nerve
 Action: Extension of arm and elbow joint.

 Lateral border of cubital fossa : Medial border of Brachioradialis

 Medial border of Cubital fossa : Lateral border of pronator teres
 Floor of cubital fossa: Brachialis and supinator muscle
 Contents of cubital fossa from medial to lateral side: Median nerve, Brachial artery, Bicipital
aponeurosis, Radial nerve.
 All superficial muscles of forearm (namely Pronator teres, flexor carpi radialis, palmaris longus,
Flexor carpi ulnaris, flexor digitorum superficialis) take origin from the Common flexor origin
(front of the medial epicondyle of humerus)
 Tendon of palmaris longus pass superficial to the flexor retinaculum.
 Tendon of Flexor digitorum superficialis passes deep to flexor retinaculum.
 All the superficial muscles of forearm are supplied by median nerve except flexor carpi ulnaris
which is supplied by the ulnar nerve.
 Pisiformis is a sesamoid bone in the tendon of the flexor carpi ulnaris.
 Structures passing superficial to flexor retinaculum: Ulnar nerve, Ulnar vessels, and tendon of
palmaris longus
 Structures passing deep to the flexor retinaculum: Median nerve, Tendons of Flexor digitorum
superficialis, Flexor digitorum profundus, Flexor pollicis, longus.
 Carpal Tunnel Syndrome is caused by compression of median nerve in the carpal tunnel.
 Lumbricals (4 in no.) take origin from the tendons of flexor digitorum profundus and are numbered
from the lateral to medial side.
 Action of lumbricals: Flexion of MCP joints and extension of the IP joints.
 1st and 2nd lumbricals are supplied by the Median nerve. 3rd and 4th lumbricals are supplied by the
Ulnar nerve.
 All interossei are supplied by the Ulnar nerve.
 Palmar interossei adducts the fingers (PAD). Dorsal interossei abducts the fingers. (DAB)
 Paralysis of lumbricals and interossei (collectively known as intrinsic muscles) produces claw hand
deformity.
 The median nerve is known as Laborer’s nerve and controls the coarser movements of hand as it
supplies all the long muscles of forearm. It is also called as eye of the hand.
 Muscles of the thenar eminence are supplied by Median nerve.
 Injury to the median nerve at the wrist causes Ape thumb deformity.
 The ulnar nerve is known as Musician’s nerve as it controls the fine movements of fingers.
 The muscles of hypothenar eminence are supplied by the ulnar nerve.
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 The injury of the ulnar nerve at wrist produces Claw like deformity.
 All the muscles of the forearm are supplied by the Radial nerve or its branch Posterior interosseous
Nerve.
 Injury of radial nerve in the axilla or arm causes Wrist drop.

THORAX
 1st to 7th ribs are called as true ribs as they articulate to the sternum through their cartilages.
 8th to 12th ribs are false ribs. The costal cartilages of the 8th, 9th and 10th ribs end by joining the next
higher costal cartilage. The costal cartilages of 7th, 8th, 9th, 10th form the costal margin. 11th and 12th
ribs are free ribs.
 The right lung has 3 lobes and the left lung has 2 lobes.
 Right lung has 10 broncho-pulmonary segments and left lung has 8 pulmonary segments.
 Length of trachea is 10cm.
 Trachea divides at the level of the lower border of the 4th thoracic vertebra.
 Heart lies in the middle mediastinum.
 Base of the heart is formed by both atria, but mainly by the left atria.
 Left border is formed mainly by left ventricle and partly by left auricle.
 Right border of heart– right atrium.
 Inferior border- Right ventricle mainly but small portion by left ventricle.
 Apex of heart – Left ventricle
 Anterior surface: mainly formed by right atrium and right ventricle and partly by left ventricle and
partly by left ventricle and left atrium.
 Inferior surface rests on diaphragm. 2/3 part formed by the left ventricle and 1/3 rd by the right
ventricle.
 Left surface is formed by the left ventricle.
 SA node is situated in the upper part of sulcus terminalis of right atrium.
 AV node is situated in the lower part of right atrium just above the opening of the coronary sinus
 Whole of the conducting system except the left branch of AV bundle is supplied by the Right
coronary artery.
 Largest vein of the heart: Coronary sinus
 All veins of the heart drain into coronary sinus except anterior cardiac vein and venae cordis
minimae.
 Largest lymphatic vessel in the body- Thoracic duct.

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ABDOMEN

 External oblique muscle arises from lower eight ribs.

 Internal oblique muscles originate from lateral 2/3rd of inguinal ligament, anterior 2/3rd of the
intermediate area of iliac crest,Thoracolumbar fascia.
 Transverse Abdominis originates from Lateral 1/3rd of inguinal ligament, Anterior 2/3rd of the inner
lip of iliac crest, thoracolumbar fascia, Lower six costal cartilages.
 Rectus Abdominis originates from the pubic crest, medial head from anterior pubic ligament.
 Contents of Rectus sheath:
- Rectus abdominis
- Pyramidilis
- Superior epigastric artery
- Inferior epigastric artery
- Superior and inferior epigastric vein
- Lower six thoracic nerves including lower five intercostal and subcostal nerves.

 Cremaster muscle is supplied by genital branch of genitofemoral nerve and is responsible for the
cremasteric reflex.
 Superficial inguinal ring is a triangular opening situated in the aponeurosis of external oblique
muscle just above the pubic crest.
 Deep inguinal ring is an oval opening opening in the fascia transversalis situated at the mid inguinal
point just lateral to inferior epigastric artery.
 Contents of Inguinal Canal: Spermatic cord and ilioinguinal nerve in males. Round ligament of
uterus and ilioinguinal nerve in females.
 Policeman of abdomen: Greater Omentum.
 Contents of lesser omentum/porta hepatis – hepatic artery, portal vein and bile duct
 Stomach bed: (Dr. Sunil Sen Kills Patients Cruelly and Mercilessly.)
Diaphragm, Suprarenal gland (left), Splenic artery, Kidney (Left), Pancreas, Colon (splenic flexure),
Mesocolon transverse.
 Length of duodenum 10‖ (1st part – 2‖, 2nd part – 3‖, 3rd part – 3‖, 4th Part – 1‖)
 Duodenum is retroperitoneal except its 1st and last part.
 The 2nd part of duodenum contains the opening of common bile duct (marks the junction of the
foregut and midgut) and pancreatic duct.
 Blood supply of duodenum – from coeliac trunk and superior mesenteric artery.
 Commonest position of the appendix – Retrocaecal or 12’o clock followed by the pelvic or 4’o
clock position.
 Blood supply of Appendix – appendicular artery (a branch of lower division of iliocolic artery.
Iliocolic artery is a branch of Superior Mesenteric artery)
 Nerve supply of appendix – T9 and T10.
 Mc. Burney’s point – Point lying at the junction of lateral 1/3rd and medial 2/3rd of the line joining
the umbilicus to the right anterior superior iliac spine. It is the point of maximum tenderness.
 Beginning of Abdominal aorta – T12 of the aortic opening of the diaphragm.
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 Ending of abdominal aorta – L4 by dividing into right and left common iliac arteries.
 Ventral branches of abdominal aorta which supplies the gut:
- Coeliac trunk
- Superior mesenteric artery
- Inferior mesenteric artery

 4 lateral branches of abdominal aorta

- Inferior phrenic arteries
- Middle suprarenal arteries
- Renal arteries
- Testicular or ovarian arteries

 Dorsal branches of Abdominal aorta:

- Lumbar arteries
- Median sacral arteries

 Branches of Coeliac Trunk – Left gastric artery (Smallest branch), Hepatic artery, Splenic artery.
If coeliac trunk is damaged, spleen is the organ which suffers maximum.
 Portal vein is formed behind the neck of pancreas at the level of L2, by the union of the superior
mesenteric and splenic vein.
 Biliary apparatus formed by
- Right and left hepatic ducts
- Common hepatic ducts
- Gall bladder
- Cystic duct
- Bile duct

 The fundus of the Gall bladder is located at the angle between the lateral border of rectus abdominis
and the 9th costal cartilage.
 Postero medial wall of neck is dialated to form Hartman’s pouch in which gall stones lodge.
 Blood supply of Gall Bladder – Cystic artery which is a branch of hepatic artery.
 Opening of ampulla of vater is guarded by Sphincter of Oddi.
 Spleen is related to 9th to 11th ribs
 Spleen becomes palpable at double its size.
 The pancreas develops from the junction of the foregut and midgut and so it gets its blood supply
from the coeliac trunk and superior mesenteric artery.
 The endocrine cells of the pancreas are most numerous in tail.
 Liver is the largest gland of the body.
 Structures passing through porta hepatis from behind forwards – Portal vein, hepatic artery,
Hepatic duct.
 Blood supply of liver – Hepatic artery and Portal vein.

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 Falciform ligament of liver attaches the antero-superior surface of liver with the anterior abdominal
wall.
 Ligamentum teres represents the obliterated Left umbilical vein.
 Kidney extends from T12 to L3.
 Left Kidney is slightly higher than the right and is nearer to the median plane than the right.
 Blood supply of Kidneys- from renal artery.
 Functional unit of kidney – Nephrons.
 Kidneys develop from pronephrons, which changes to mesonephrons and then to metanephrons
finally giving rise to adult kidney.
 The angle between the lower border of the 12th rib and the outer border of erector spinae is called
renal angle.
 Each ureter measures 10” or 25 cm.
 Constrictions of ureter – at Pelvi-ureteral junction, brim of lesser pelvis, at its passage through the
bladder wall.
 Blood supply of Suprarenal Glands :
-Superior suprarenal artery – branch of Inferior phrenic artery
-Middle Suprarenal artery – Branch of abdominal aorta
- Inferior Suprarenal artery – Branch of Renal artery
 Right suprarenal gland drains into IVC, where as left suprarenal gland drains into left renal vein.
(Same thing happens with right and left gonadal veins).
 Male urethra is divided into 3 parts – Prostatic part, Membranous part, Spongy or penile part.
 Widest and most dilatable part of urethra – Prostatic part of urethra
 Ejaculatory duct and prostatic utricle opens into the Prostatic part of urethra.
 Membranous part of urethra is the 2nd narrowest part of urethra, least dilatable part of urethra,
shortest part of male urethra and is surrounded by sphincter urethrae.
 Spongy or penile part of urethra: The external urethral orifice is the narrowest part of the male
urethra.
 Ovaries are entirely covered by the broad ligament except at the mesovarium.

 Ovarian artery arises from the abdominal aorta just below the renal artery and supplies the ovaries.
It also supplies uterine tubes, uterus and ureters.

 Length of each fallopian tube – 10cm or 4‖.

 Interstitial or intramural or uterine part of the fallopian tube is the shortest and narrowest part of
the tube.
 Ampulla is the widest and longest part of the tube. Fertilization occurs here.
 Infundibulum is funnel like fimbriated opening into the peritoneal cavity and remain attached to
the ovary and is known as ovarian fimbriae. This fimbriae picks up the ova at the time of ovulation.
 3 types of epithelial cells of the fallopian tube
- Columnar or cubical – which propel the ova towards the uterine cavity
- Goblet cell – non ciliated nutritional cell.
- Peg cells – Rod shaped cell
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 Angle of anteversion of uterus – The angle formed by the long axis of uterus with the long axis of
vagina. It is 90 degree. One of the factors which prevents prolapse of the uterus.
 Angle of anteflexion – The angle of the body of uterus with the cervix is called as angle of
anteflexion. This is 120 degrees.
 Fertilised ovum is implanted on the posterior wall of the fundus.
 Broad ligament is a fold of peritoneum which is attached to the uterus at the lateral pelvic wall.
 Part of the broad ligament lying between the uterine tube and the ovarian ligament is called as
mesosalpinx.
 Contents of Broad ligament :
- Uterine tube
- Round ligament of uterus
- Ligament of ovary
- Uterine vessels
- Ovarian vessels
- Epoophoron and paroophoron.

 Round ligament of uterus runs between the layers of broad ligament. It maintains the angle of
anteversion. It functionally neutralizes the backward pull of uterosacral ligament.
 Uterosacral ligament connects the cervix with the periosteum of the sacrum. It pulls the cervix
backward against the forward pull of the round ligament.
 Mackendrot’s ligament or transverse cervical ligament or cardinal ligament connects the lateral
aspects of cervix and of the upper vaginal wall to the lateral pelvic wall. It prevents the uterus from
dragging down during rise in the intra abdominal pressure.
 Sole motor nerve of diaphragm – phrenic nerve.
 Openings of diaphragm – VENACAVAL (T8), OESOPHAGEAL (T10), AORTIC (T12)

LOWER LIMBS
 Longest and strongest bone of the body – FEMUR
 Neck shaft angle is about 125 degree in adults. In females this angle is little less
 Angle of femoral torsion is formed between transverse axes of the upper end and lower end
of femur. It is about 15 deg.
 Lateral boundary of femoral triangle – medial border of Sartorius
 Medial boundary of femoral triangle – Medial border of adductor longus
 Floor of the femoral triangle – Medially by adductor longus and pectineus. Laterally by
iliacus and psoas major.
 Contents of Femoral triangle (from medial to lateral side) : Femoral vein, Femoral artery,
Femoral nerve
 Anterior wall of femoral sheath is formed by the fascia transversalis and the posterior wall
is formed by fascia iliaca.

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 Lateral compartment of femoral sheath contains the femoral artery and femoral branch of
genitofemoral nerve. Intermediate compartment contains the femoral vein.
Medialcompartment is the smallest compartment and is known as femoral canal. Femoral
Nerve lies outside the femoral sheath lateral to femoral artery.
 Femoral hernia is more common in females as the femoral canal is wider in females due to
wider pelvis.
 Main muscles of the anterior compartment of thigh – Sartorius, Quadriceps femoris (Rectus
femoris, Vastus Lateralis, Vastus intermedius and Vastus Medialis), Articularis genu.
 Sartorius is the longest muscle of the body.
 Nerve supply of the anterior compartment of thigh – Femoral nerve.
 Adductor canal/subsartorial canal/hunter’s canal extends from the apex of the triangle,
above to the tendinous opening of adductor magnus.
 Anterior wall of adductor canal – Vastus medialis
 Posterior wall of adductor canal – adductor longus above and adductor magnus below.
 Medial wall of Adductor canal is formed by strong fibrous membrane joining the anterior
and posterior wall.
 Contents of Adductor Canal: Femoral artery, femoral vein, Saphenous nerve, Nerve to
Vastus medialis.
 Medial compartment of thigh is also known as adductor compartment. Main action of this
compartment is adduction of thighs
 Muscles of the medial compartment of the thigh – Adductors longus, brevis and magnus;
Gracilis and pectinius.
 Arterial Supply of the medial compartment of thigh –Profundafemoris artery, Obturator
artery.
 The muscle Adductor Magnus has dual nerve supply; its adductor part is supplied by the
Obturator nerve, and its hamstring part is supplied by the tibial part of sciatic nerve.
 Muscles of the gluteal region – Gluteus externus, maximus, medius and minimus,Superior
and inferiorgamelli,Obturator internus and Quadratus femoris.
 Gluteus maximus is the chiefextensor of the hip joint. This muscle helps in rising from the
sitting posture.
 Gluteus medius and minimus are powerful abductors of the thigh.
 The Hamstring muscles form the posterior compartment of the thigh. Muscles are
Semitendinosus, Semimembranosus, Long head of bicepsfemoris, Ischial head of
adductormagnus.
 The hamstring muscles originate from the ischial tuberosity and is supplied by the tibial part
of sciatic nerve. These muscles act as flexors of knee and extensors of hip joint.
 Popliteal fossa guarded superolaterally by Biceps femoris; Superomedially by semi
tendinosus and semi membranosus, supplemented bygracilis, sartoriusand
adductormagnus; inferolaterally by Lateral head of Gastrocnemius, Inferomedially by
Medial head of Gastrocnemius.
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 Floor of the popliteal fossa is formed by Popliteal surface of femur, capsule of knee joint
and oblique popliteal ligament.
 Contents of Popliteal Fossa: Popliteal artery, Popliteal vein, Tibial nerve, Common
peroneal nerve, Posterior cutaneous nerve of thigh, Genicular branch of Obturator nerve.
 Patella is the largest sesamoid bone and develops from the tendon of quadriceps femoris.
 Pre-patellar bursa lies in front of lower part of patella. Chronic enlargement of this bursa
leads to Housemaids knee.
 The anterior border of tibia is subcutaneous and forms the shin.
 Nutrient artery of tibia is the largest nutrient artery of the body.
 Commonest site of fracture of tibia – Upper 2/3rd and lower 1/3rd of the shaft. This part is
slow to heal due to poor blood supply to this part.
 Fibula is ideal spare bone for bone grafting. Fibula is very important for maintaining the
stability of the ankle joint.
 Common peroneal nerve can be rolled against the neck of fibula and this nerve ids commonly
injured here.
 Muscles of the anterior compartment of leg are –
- Tibialis anterior
- Extensor hallucis longus
- Extensor digitorum longus
- Peroneus tertius
All are supplied by Deep peroneal nerve or anterior tibial nerve.

 Paralysis of the muscles of anterior compartment leads to foot drop.

 Superficial muscles of the posterior compartment of leg – Gastrocnemius, Soleus, Plantaris.
They are strong plantar flexors of foot at ankle joint.
 Soleus is called as peripheral heart, because of its contraction blood is pumped up.
 The sesamoid bone present in the tendon of lateral head of gastrocnemius – Fabella
 Tendo-calcaneus is the thickest and strongest tendon of the body.
 Deep muscles of posterior Compartment of leg are Popliteus, Flexor digitorum longus,
Flexorhalluces longus, Tibialis posterior. They are supplied by Tibial nerve.
 The femoral artery is the continuation of the external iliac artery. It begins at the mid-
inguinal point. It continues at the opening of the adductor magnusinto the popliteal artery.
 Largest branch of the femoral artery – Arteria Prfundafemoris. ->It supplies all three
compartments of thigh..
 Popliteal artery is continuation of Femoral artery at the opening in the adductor magnus.
Blood pressure of lower limb is recorded from the popliteal artery.
 The popliteal artery ends by dividing into anterior and posterior tibial arteries at the
lower border of popliteus.

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 Terminal branches of Popliteal artery – Anterior Tibial artery (smaller) and Posterior Tibial
artery (Larger)
 Artery of the anterior Compartment of leg – Anterior Tibial artery
 Vein used for intravenous infusion in infants and in patients with peripheral circulatory
failure – Femoral Vein
 Largest and Longest vein of the lower limb – Great Saphenous vein.
 Great saphenous vein contains 10-15 valves which prevent backflow of blood. Incompetence
of these valves lead to varicose veins.
 Largest branch of Lumbar plexus of nerves- Femoral nerve
 Largest branch of Sacral plexus (L4,5,S1,2,3) – Sciatic Nerve
 Sciatic Nerve is the thickest nerve of the body.
 Terminal branches of Sciatic nerve – Tibial and Common peroneal nerve
 Nerve of anterior compartment of leg – Deep peroneal nerve
 Nerve of lateral compartment of leg - Superficial Peroneal nerve.

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