Second Year Semester One Revision

Cranial Bones
 Frontal bone
 Parietal bone (*2)
 Occipital bone
 Temporal bone (*2)
 Sphenoid bone
 Ethmoid bone

Facial Bones
 Nasal
 Maxillae
 Lacrimals
 Zygomatics
 Palantines
 Middle Nasal Conchae
 Inferior Nasal Conchae
 Nasal Septum
 Mandible

The Scalp

There are 5 layers spelling out the word SCALP

1. Skin
2. Connective tissue (blood vessels travel through this tissue)
3. Aponeurosis
4. Loose connective tissue (allows fluid/bacteria to pass from back of head into
eyelids)
5. Periosteum

NB. The veins of the scalp drain into the superior saggital sinus and then to the
confluency of sinuses. They have no valves and therefore can be a source of infection
in the brain.

Sutures
 Coronal
 Lamboidal
 Saggital
 Squamosal

Pterion
 Sphenoid
 Parietal
 Temporal
The Meninges

The surface of the brain is made up of 3 layers:

1. Dura Mater – toughest and thickest – forms venous sinuses and subdivides brain
with:
 Falx Cerebri – down centre of brain, separating two hemispheres.
 Tentorium Cerebelli – separating cerebellum from the rest of the
brain.
2. Arachnoid Mater – spider-like appearance. Thin, transparent, fibrous.
3. Pia Mater – attached to brain.

Between the arachnoid and pia mater layers lies the subarachnoid space. This contains
CSF which is continuously being produced by ependyma cell in the ventricles. CSF is
removed by arachnoid granulations, allowing CSF to enter the venous sinuses.

The Circle of Willis

Sinuses

Superior Sagittal Sinus Straight Sinus

Right Transverse Sinus Left Transverse Sinus

Communication at the
Internal Occipital Protuberance
(confluency of sinuses)

Sigmoid Sinus

Internal Jugular Vein

Air Sinuses in the Head

 Frontal
 Ethmoid
 Sphenoid
 Maxillary
 Mastoid

The Cranial Nerves

There are 12 pairs of cranial nerves:

Nerve Exit from Skull Function

1. Olfactory Cruciform Plate Smell
2. Optic Nerve Optic Canal Vision
3. Occulomotor Sup. Orbital Innervates Eye Muscles except SO.
Fissure Innervates Sphincter Pupillae for pupil
constriction.
4. Trochlear Sup. Orbital Innervates Superior Oblique Muscle
Fissure (moves eye down and out).
5. Trigeminal
 Olfactory (V1) Sup. Orbital Sensory from: Eyes, Conjuctivia, orbital
Fissure contents, nasal cavity, frontal sinus,
Ethmoid sinus, upper eyelid, dorsum of
nose, ant. part of scalp.
Dura, nasopharynx, palate, nasal cavity,
 Maxillary (V2) upper teeth, maxillary sinus, skin
Foramen covering nose, lower eyelid, cheek,
Rotundum upper lip.
Skin of lower face, cheek, lower lip, ear,
 Mandibular (V3) external acoustic meatus, temporal fossa,
ant. 2/3 of tongue, lower teeth,
 Foramen Ovale mandible, dura in mid cran fossa.
Innervates temporalis, masseter, ant.
belly of digastric, mylohyoid muscles.
6. Abducens Sup. Orbital Innervates lateral rectus muscle.
Fissure
7. Facial
 Temporal
 Zygomatic Internal Acoustic
 Buccal Meatus
 Mandibular
 Cervical
8. Auditory (Vestibulo- Internal Acoustic Vestibular – Balance
cochlear) Meatus Cochlear – Hearing
9. Glossopharyngeal Jugular Foramen
10. Vagus Jugular Foramen
11. Accessory Jugular Foramen Innervates sternocleidomastoid and
trapezius muscles.
12. Hypoglossal Hypoglossal Canal Innervates hypoglossus, genioglossus,
and styloglossus mucles and intrinsic
muscles of tongue.

Osteology of the Skull

Foramina:

Foramen Nerve Content

Cribiform Plate Olfactory (I)
Optic Canal Optic (II)
Ovale Mandibular (V3)
Rotundum Maxillary (V2)
Spinosum
Superior Orbital Fissure Occulomotor (III)
Trochlear (IV)
Ophthalmic (VI)
Abducens (VI)
Internal Acoustic Meatus Facial (VII)
Vestibulocochlear (VIII)
Stylomastoid Mid Meningeal Artery
Jugular Glossopharyngeal (IX)
Vagus (X)
Accessory (XI)
Hypoglossal Hypoglossal (XII)
Magnum Medulla Oblongata
Meninges
Carotid Canal Internal Carotid Artery
The Muscles of Facial Expression

1. Occipitofrontalis 10. Zygomaticus minor

2. Corrugator supercilii 11. Zygomaticus major
3. Procerus 12. Risorius
4. Palpebral ligament 13. Depressor anguli oris
5. Orbicularis oculi 14. Depressor labii
6. Levator labii superioris inferiorisi
alaeque nasi 15. Orbicular oris
7. Nasalis 16. Mentalis
8. Levator anguli oris 17. Buccinator
9. Levator labii superioris 18. Platysma
19. Temporoparlis

The Muscles of Mastication

20. Temporali
21. Masseter
22. Lateral pterygoid
23. Medial pterygoid

Blood Vessels of the Face

Facial Artery:
 Branch of External Carotid
 Crosses border of jaw at ant. border of jaw
 Runs up to medial angle of jaw.
  Transverse Facial appears at ant border of parotid gland.

Facial Vein:
 Commences at medial angle of eye
 Runs to angle of jaw
 Joins Internal Jugular Vein.

The Facial Nerve

 Motor nerve for all muscles of facial expression
 Leaves skull at stylomastoind foramen.
 Runs to parotid gland and forms nerve plexus.
 The 5 nerves are:
1. Temporal
2. Zygomatic
3. Buccal
4. Mandibular
5. Cervical

Glands
 Submandibular
 Parotid
 Sub Mental

The Muscles of the Neck

The Brachial Plexus:
Sagittal Section of the Brain:
 Septum
Pellucidum
Fornix

Pineal Body

Corpus
Callosum

Genu
Cerebellum

Medulla
Oblongata
Thalamus
Pons

Lumbar Nerves
Horizontal Section of Normal Brain

Gastrointestinal Revision

 Two layers of superficial fascia –

1. Camper’s Fascia (fatty layer)
2. Scarpa’s Fascia (membranous layer)

Then comes:
 External Oblique
 Internal Oblique
o Neurovascular plane supplying
abdominal wall.
 Transersus Abdominus
 Rectus Abdominus
o Contains tendonous intersections
o Superior and Inferior Epigastric Arteries
 Rectus Sheath

Near the pubic tubercle is a triangular slit in the

external oblique aponeurosis called the SUPERFICIAL
INGUINAL RING. This contains the:
 Round ligament in females
 Spermatic cord in males
 Ilioinguinal
nerve in both.
  The posterior section of the rectus sheath is only in the upper 2/3.
 The lower border = the ARCUATE line
 Below the level of the Arcuate line = transveralis fascia
 Then comes peritoneum.

NB. External Oblique – hands in front pockets (anteriorly and inferiorly)

Internal Oblique – hands in back pockets (anteriorly and superiorly)

 Inguinal ligament –
formed by curving
inward of the lower
border of the external
oblique aponeurosis.

 Superficial Inguinal
Ring – in external
oblique

 Deep Inguinal Ring – in

transversalis fascia

 Coverings of spermatic
cord derived from
layers of anterior
abdominal wall

 Tunica Vaginalis –
from peritoneum. Lets
testis descend.

The Liver

 Bare Area
(right lobe)

 Falciform
Ligament

 Cornary
Ligament

Posterior View of
the Liver
  Ligamentum Teres
(obliterated
umbilical vein)
contained within
falciform ligament

 Gall Bladder
 Portal Vein
 Hepatic Artery
 Caudate Lobe
 Quadrate Lobe
 Inferior Vena Cava
 Cystic Duct (runs to
gall bladder
 Common Bile Duct
– in porta hepatis
 Porta Hepatis

Gall Bladder

Neck

Body

Fundus

The stomach
 Pyloric Region, Fundus, Body, Pyloric
Sphincter
 Duodenum
NB. LOOK AT STOMACH ARTERIES
DIAGRAHM

Space which lies deep to the stomach = the

LESSER SAC

Epiploic Foramen = opening to lesser sac

NB. Arteries: R+L gastro-epiploic vessels

L+R gastric arteries, gastro-duodenal
artery, superior pancreaticoduodenal artery,
anterior and posterior vagus nerves.
The colon
 1. Transverse colon
2. Splenic Flexure
3. Descending colon
4. Sigmoid colon
5. Rectum
6. Caecum
7. Ascending colon
8. Hepatic Flexure

NB. The transverse colon has APPENDICES EPIPLOIC, teniae coli and haustrations
Ascending colon is fixed to the posterior abdominal wall (retroperitoneal)
Teniae coli – bands of muscle fibre in colon
Haustrations – polysac appearance of colon due to teniae coli.

Jejunum and Ileum

 Note Appendix
 Caecum
 Jejunum – has fewer vasa recta
than ileum
 Ileum – has many more vasa recta
than jejunum

NB. The ileum attaches to the caecum and

the jejunum to the duodenum

The sigmoid colon has its own mesentery.

Mesentery Retroperitoneal
Ileocaecal
Transverse colon Ascending colon
junction
Sigmoid colon Descending colon
Ileum Rectum
Jejunum
Retroperitoneal and Mesentery Organs

The mnemonic SAD PUCKER is commonly used to remember the retroperitoneal

viscera:

Suprarenal glands
 Aorta and IVC
Duodenum
Pancreas
Ureter
Colon (ascending and descending)
Kidneys
Eosophagus
Rectum

Mesentery Viscera

1. Mesentery (proper) – jejunum and ileu

2. Mesocolon – surrounds parts of colon
 Meso-appendix
 Transverse mesocolon
 Sigmoid mesocolon
 Broad ligament of uterus, uterine tubes, ovaries

The Duodenum – 4 parts

 NB. Inside the

Superior duodenum are
Part ridges called
papillae.

 The Ampulla of
Vater is the union
between common
bile duct and
Descending pancreatic duct.
Part
 Know opening
of Hepato-
pancreatic duct
(little opening
inside)

Ascending
Inferior Part
The Pancreas – 4 parts Part
  Head
 Neck
 Body
Body
Tail  Tail

Neck

Head

Abdominal Vessels - Arteries

Abdominal Vessels – Veins

Biliary System
NB. R+L heptic
ducts join to form
the common hepatic
duct.

The common
hepatic duct
combines with the
cystic duct to make
the common bile
duct.

The common bile

duct combines with
the pancreatic duct
at the Ampulla of
Vater.
Lymphatic
Drainage
 L. Gastric Artery
The Superior Mesenteric Artery

Splenic Artery

Common
hepatic Artery

Superior Mesenteric Artery. Lies

over horizontal section of duodenum

The Celiac Trunk

The celiac trunk has 3 branches:

1. Common Hepatic Art. 2. L. Gastric Art. 3. Splenic Art.

Lumbar Plexus – Above

Inferior Mesenteric Artery

The Abdominal
Internal Iliac Artery Aorta

External Iliac
Artery
Muscles of the Posterior Abdominal Wall