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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. 2. 3. 4. Skin Connective tissue (blood vessels travel through this tissue) Aponeurosis 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

temporal fossa. frontal sinus. Maxillary (V2) Foramen Rotundum • Mandibular (V3) . maxillary sinus. Orbital Fissure Sup. 5. orbital contents. cheek. palate. Dura. skin covering nose. nasal cavity.Sinuses Superior Sagittal Sinus Right 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 Straight Sinus Left Transverse Sinus The Cranial Nerves There are 12 pairs of cranial nerves: 1. Sensory from: Eyes. 3. lower eyelid. upper teeth. Innervates Superior Oblique Muscle (moves eye down and out). Orbital Fissure Sup. Conjuctivia. Ethmoid sinus. ant. upper eyelid. lower lip. 2. dorsum of nose. 4. Innervates Sphincter Pupillae for pupil constriction. Nerve Olfactory Optic Nerve Occulomotor Trochlear Trigeminal • Olfactory (V1) Exit from Skull Cruciform Plate Optic Canal Sup. Orbital Fissure Function Smell Vision Innervates Eye Muscles except SO. nasal cavity. ear. external acoustic meatus. Skin of lower face. upper lip. cheek. part of scalp. nasopharynx.

Innervates hypoglossus. ant. 9. mylohyoid muscles. dura in mid cran fossa. 7. masseter. Internal Acoustic Meatus Jugular Foramen Jugular Foramen Jugular Foramen Hypoglossal Canal Vestibular – Balance Cochlear – Hearing Innervates sternocleidomastoid and trapezius muscles. lower teeth. and styloglossus mucles and intrinsic muscles of tongue. 12. 8. Osteology of the Skull Foramina: Foramen Cribiform Plate Optic Canal Ovale Rotundum Spinosum Superior Orbital Fissure Nerve Content Olfactory (I) Optic (II) Mandibular (V3) Maxillary (V2) Occulomotor (III) Trochlear (IV) Ophthalmic (VI) Abducens (VI) Facial (VII) Vestibulocochlear (VIII) Mid Meningeal Artery Glossopharyngeal (IX) Vagus (X) Accessory (XI) Hypoglossal (XII) Medulla Oblongata Meninges Internal Carotid Artery Internal Acoustic Meatus Stylomastoid Jugular Hypoglossal Magnum Carotid Canal . 10. 2/3 of tongue. Innervates lateral rectus muscle. mandible. genioglossus. belly of digastric. 11. Orbital Fissure Internal Acoustic Meatus ant. Abducens Facial • Temporal • Zygomatic • Buccal • Mandibular • Cervical Auditory (Vestibulocochlear) Glossopharyngeal Vagus Accessory Hypoglossal Sup.Foramen Ovale 6. Innervates temporalis.

The Muscles of Facial Expression 1. Temporoparlis The Muscles of Mastication 20. Masseter 22. Depressor anguli oris 14. Nasalis 8. Levator labii superioris alaeque nasi 7. Occipitofrontalis 2. Risorius 13. Levator anguli oris 9. Palpebral ligament 5. Medial pterygoid Blood Vessels of the Face Facial Artery: . Procerus 4. Zygomaticus major 12. Temporali 21. Zygomaticus minor 11. Levator labii superioris 10. Orbicularis oculi 6. Mentalis 17. Platysma 19. Lateral pterygoid 23. Depressor labii inferiorisi 15. Orbicular oris 16. Buccinator 18. Corrugator supercilii 3.

Cervical Glands • • • Submandibular Parotid Sub Mental The Muscles of the Neck . Transverse Facial appears at ant border of parotid gland. Mandibular 5. Buccal 4. Zygomatic 3. Facial Vein: • Commences at medial angle of eye • Runs to angle of jaw • Joins Internal Jugular Vein. • Runs to parotid gland and forms nerve plexus. The Facial Nerve • Motor nerve for all muscles of facial expression • Leaves skull at stylomastoind foramen.• • • • Branch of External Carotid Crosses border of jaw at ant. Temporal 2. • The 5 nerves are: 1. border of jaw Runs up to medial angle of jaw.

The Brachial Plexus: .

Sagittal Section of the Brain: Fornix Septum Pellucidum Pineal Body Corpus Callosum Genu Cerebellum Medulla Oblongata .

Pons Thalamus Lumbar Nerves .

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This contains the: • Round ligament in females • Spermatic cord in males • Ilioinguinal nerve in both. • 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. . Scarpa’s Fascia (membranous layer) Then comes: • External Oblique • Internal Oblique o Neurovascular plane supplying abdominal wall. Camper’s Fascia (fatty layer) 2.Horizontal Section of Normal Brain Gastrointestinal Revision • Two layers of superficial fascia – 1.

• The lower border = the ARCUATE line • Below the level of the Arcuate line = transveralis fascia • Then comes peritoneum. 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.• The posterior section of the rectus sheath is only in the upper 2/3. 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. • • • • The Liver • • • Bare Area (right lobe) Falciform Ligament Cornary Ligament . Lets testis descend. NB.

Pyloric Sphincter • Duodenum NB.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. Body. Fundus. LOOK AT STOMACH ARTERIES DIAGRAHM Space which lies deep to the stomach = the LESSER SAC Epiploic Foramen = opening to lesser sac • .

gastro-duodenal artery. 7. 5. The colon 1. 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. anterior and posterior vagus nerves. 2. Transverse colon Splenic Flexure Descending colon Sigmoid colon Rectum Caecum Ascending colon Hepatic Flexure NB. The ileum attaches to the caecum and the jejunum to the duodenum The sigmoid colon has its own mesentery. 4.NB. 6. 8. superior pancreaticoduodenal artery. Jejunum and Ileum • • • • Note Appendix Caecum Jejunum – has fewer vasa recta than ileum Ileum – has many more vasa recta than jejunum NB. Arteries: R+L gastro-epiploic vessels L+R gastric arteries. Mesentery Ileocaecal Transverse colon junction Sigmoid colon Ileum Jejunum Retroperitoneal and Mesentery Organs Retroperitoneal Ascending colon Descending colon Rectum . 3. The transverse colon has APPENDICES EPIPLOIC.

ovaries The Duodenum – 4 parts  NB.  Know opening of Hepatopancreatic duct (little opening inside) Ascending Part Superior Part Descending Part Inferior Part .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. Mesocolon – surrounds parts of colon • Meso-appendix • Transverse mesocolon • Sigmoid mesocolon • Broad ligament of uterus. Inside the duodenum are ridges called papillae. Mesentery (proper) – jejunum and ileu 2.  The Ampulla of Vater is the union between common bile duct and pancreatic duct. uterine tubes.

The Pancreas – 4 parts Body Neck Head Tail • • • • Head Neck Body Tail Abdominal Vessels .Arteries .

Abdominal Vessels – Veins Biliary System NB. at . The common hepatic duct combines with the cystic duct to make the common bile duct. R+L heptic ducts join to form the common hepatic duct. The common bile duct combines with the pancreatic duct the Ampulla of Vater.

Lymphatic Drainage The Superior Mesenteric Artery L. Gastric Artery Splenic Artery Common hepatic Artery Superior Mesenteric Artery. Lies over horizontal section of duodenum The Celiac Trunk .

2. Splenic Art. Lumbar Plexus – Above Inferior Mesenteric Artery The Abdominal Aorta .The celiac trunk has 3 branches: 1. L. 3. Common Hepatic Art. Gastric Art.

Internal Iliac Artery External Iliac Artery Muscles of the Posterior Abdominal Wall .