100 concepts anatomy

8/19/2019 100 Concepts Anatomy

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Dr. Mavrych, MD, PhD, DSc [email protected]

Lower Brachial Palsy(Klumpke paralysis)

l All intrinsic muscles of the handsupplied by the C8 and T1 roots ofthe lower trunk affected.

l Combination lesions of ulnar nerve (“ claw hand ”) and mediannerve (“ ape hand ”)

l Loss of sensation in the medialaspect of the upper limb andmedial 1,5 fingers.

l May include a Horner syndrome


Injury to musculocutaneousnerve

l Usually results from lesionsof lateral cord

l Greatly weakens flexion ofelbow (biceps and brachialismuscles) and supination of

forearm (biceps muscle)

l May be accompanied byanesthesia over lateralaspect of forearm


Cutaneous innervationof the hand

Dorsum: 1,5-U and 3,5 R Palm: 1,5-U and 3,5 M

In reality, in case of superficial branch ofradial nerve lesion it will be skin deficitbetween 1 & 2 digits on the dorsum of thehand ONLY because of nerve overlapping


13. Cardiac catheterization

l The femoral artery isused for cardiaccatheterization

l It can be cannulatedfor left cardiacangiography & alsofor visualizing thecoronary arteries – along, slender catheteris insertedpercutaneously andpassed up theexternal iliac artery,common iliac artery,aorta , to the leftventricle of the heart


14. Injury of the gluteal regionFractures of Femoral Neck

l

A common fracture inelderly women withosteoporosis is fracture of the femoral neck .

l Fractures of the femoralneck cause shortness andlateral rotation of the lowerlimb.

l Fractures of the femoralneck often disrupt the bloodsupply to the head of thefemur.

l At present time the best wayin case of femoral neckfracture is hip replacement .


Avascular necrosisof femoral head

l Transcervical fracturedisrupts blood supply tothe head of the femur viaretinacular arteries (frommedial circumflex femoralartery ) and may causeavascular necrosis of thefemoral head if bloodsupply through the ligamentto the head is inadequate.

E - a v a l i d l i c e n s e w i l l r e m o v e t h i s m e s s a g e . S e e t h e k e y w o r d s p r o p e r t y o f t h i s P D F f o r m o r e i n f o r m a t i o n .

Ulnar and Median Nerve Lesions

lnar erve (“ law hand ” edianerve “ pe an

Median n lesion: Ape hand/benediction with lateral 3 digits are extended, wrist is extendedUlnar n lesion: Claw hand with medial 2 digits extendedRadial n lesion: Drop Wrist with flexion of the wrist

Injury to musculocutaneousnerve

and brachialisuscles) and supination of

orearm ceps musc e

Greatly weakens lexion fe ow biceps

a era cor

Lateral musculocutaneous n of forea

weakened adduction (coracobrachialis

superficial branch ofadial nerve lesion it will be skin deficit

between 1 & 2 digits on the dorsum of thehand

Cutaneous innervationof the hand

emoral artery ssed for cardiacatheterization

left cardiacngograp y a so

or visualizing theoronary arteries

A catheter can also be passed through a peripheral vein (femoral vein) into IVCR atrium, R ventricle, pulm trunk and pulm arteries. Intracardiac pressures, blosamples, and visualization of great vessels using Xray

ar ac cat eter zat on

femoral vein)

gluteal regionFractures of Femoral Neck

s or ness anateral rotation

Coxa Vara


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34. Peritoneal structures:Lesser omentum

Consist of 2 ligaments :l hepatogastricl hepatoduodenal

Contents :l Right & Left gastric

vesselsl Connective and fattytissue

and Portal triad :l Bile ductl Portal veinl Proper hepatic artery


Epiploic (winslow’s) foramen

l Anteriorly: The freeborder of thehepatoduodenalligament , containingportal triad (DVA).

l Posteriorly: IVC

l Superiorly: Caudatelobe of the liver .

l Inferiorly: The 1stpart of theduodenum .


Douglas (rectouterine) pouch

l Rectouterine pouch(pouch of Douglas):deeper point ofperitoneal space invertical position of thefemale body between therectum and the cervix ofuterus .

l It is space of the pelvicabscess location .


Culdocentesis

l Culdocentesis isaspiration of fluid fromthe cul-de-sac ofDouglas (rectouterinepouch) by a needlepuncture of theposterior vaginalfornix near the midlinebetween the uterosacralligaments

l Because therectouterine pouch isthe lowest portion ofthe female peritoneal

cavity, it can collectinflammatory fluid(pelvic abscess).


35. Smart Table

FOREGUT MIDGUT HINDGUT

EsophagusStomachDuodenum (1 st and2nd parts)Liver PancreasBiliary apparatusGallbladder

Duodenum (2nd , 3 rd,4 th

parts)JejunumIleumCecum (withAppendix )Ascending colonTransverse colon(proximal 2/3)

Transverse colon(distal 1/3)Descending colonSigmoid colonRectum (anal canalabove pectinate line)


FOREGUT MIDGUT HINDGUT

Artery: CA Artery: SMA Artery: IMA

Parasympathetic

innervation : vagusnerves, CNX

Parasympathetic

innervation: vagusnerves, CNX

Parasympathetic

innervation: pelvicsplanchnic nerves, S2-S4

Sympatheticinnervation:•Preganglionics: greater splanchnic nerves, T5-T9•Postganglionics:celiac ganglion

Sympatheticinnervation:•Preganglionics: lesser splanchnic nerves, T10-T11•Postganglionics:superior mesentericganglion

Sympatheticinnervation:•Preganglionics: lumbar splanchnic nerves, L1-L2•Postganglionics: inferior mesenteric ganglion

Sensory Innervation:DRG T5-T9

Sensory Innervation:DRG T10-T11

Sensory Innervation:DRG L1-L2

Referred Pain:Epigastrium

Referred Pain:Umbilical

Referred Pain:Hypogastrium

E - a v a l i d l i c e n s e w i l l r e m o v e t h i s m e s s a g e . S e e t h e k e y w o r d s p r o p e r t y o f t h i s P D F f o r m o r e i n f o r m a t i o n .

Lesser omentum2 ligaments

epatogastriclepatoduodenall

ight & Left gastric

vessels

ortal triad ile ductlortal veinlroper hepatic arteryl

Site of Pringles Manuver to block blood supply to liver and investigateLiver bleeds: block Hepatic Artery Proper, Hepatic Portal Vein, and CommonBile Duct. Use thumb anterior, and index posterior within Winslow foramen.If R side bleeds: aberrant R Hepatic artery from SMAIf L side bleeds: aberrant L Heptatic artery from L GastricIf double bleed accessory arteries come from elsewhere.

Epiploic (winslow’s) foramen

Douglas (rectouterine) pouchIn women only!

deeper point ofperitoneal space nver ca os on o efemale body between therectum nd the cervix ofu erus .

l pe v ct is space of theabscess location .

Culdocentesis

aspiration of fluid fromhe cul-de-sac ofougas

pos eror vag naornix

Vesicouterine pouch

Males have a vesicorectal pouch, fluid can accumulate in these peritoneal areas if there is a pelvic abscess.Morrison's pouch is where fluid accumulates if the person is lying down (between kidney and liver)

1st part duodenum issuspended by greater omentum and hepatoduodenal lig

Retroperitoneal Organs: SAD PUCKERSuprarenal glands, Aorta, Duodenum (2-3rd), Pancreas, Ureters, Colon, Kidneys, Esophagus, RectumDPC are secondary retroperitoneal

2nd part of duodenum iswhere Spincter of Oddi/ Ampula of Vader/major papilla of the Wirsung major Pancreatic duct empties

along with the common bileduct

IMV to splenic v tohepatic portal v to liver to IVCSMV joins splenic v toform hepatic portal v


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100 concepts anatomy

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