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Quick Revision for N.L.E (Pmdc/Neb) Dr QUICK REVISION FOR N.L.E (PMDC/NEB) DR. ASIF ALI KHAN ANATOMY PORTION Quick revision of some important ducts - Bellini’s duct - Straight collecting tubules of the kidney - Bartholin’s duct - The major duct of the sublingual gland. - Cystic duct - Excretory duct of gall bladder. - Gartner’s duct - A remnant of Wolffian duct. - Mullerian duct - Bilateral ducts in the embryo that form the uterus, vagina and fallopian tubes. - Wirsung’s duct - Pancreatic duct. - Santorini’s duct - Accessory pancreatic duct. - Wharton’s duct - Duct of submandibular gland. - Vitelline duct - The narrow duct in the embryo that connects the yolk sac with the intestine. - Ducts of Rivinus - 5 to 15 ducts that drain the posterior portion of the sublingual gland. - Stensen’s duct - Parotid duct. - Pecquet’s duct - Thoracic duct. - Hensen’s duct - Ductus reunions. - Hoffman’s duct - Pancreatic duct or Wirsung’s duct. - Bernard’s duct - Accessory pancreatic duct or Santorini’s duct Weight of Some Important Organs 1. Pancreas --------------------------> 80 - 90g (85 gm) 2. Kidney -----------------------------> 150g (male) 130 g ( female) 3. Suprarenal Gland ---------------> 5 g 4. Uterus ------------------------------> 30-40 g 5. Testis -------------------------------> 10-15 g 6. Spleen ------------------------------> 200 g 7. Head --------------------------------> 3175 g 8. Thyroid -----------------------------> 25 g 9. Brain --------------------------------> 1400 g (1/50th or 2% of TBW) 10. Lung -------------------------------> 700g (R) 650g (L) 11. Heart ------------------------------> 300 g (Male) 250 g (Female) 12. Placenta --------------------------> 500g (at full term 13. Liver ------------------------------> 1600gm in males and 1300gm in female 14. Prostate --------------------------> 8g 15. Pineal gland --------------------> 0.1 to 0.2 gm Page | 1 QUICK REVISION FOR N.L.E (PMDC/NEB) DR. ASIF ALI KHAN Developmental events during the embryonic period 1. Developmental events Day/days of gestation 2. Fertilization Day 1 3. Blastocyst Day 4 4. Bilaminar embryonic disc Days 8 5. Implantation Day 10 6. Primary streak appears Day 15 7. Primitive heart tube Day 17 8. Neurulation, first pair of somite Day 21 9. Limb buds Days 26-28 10. Primitive gut Day 31 11. Physiological herniation Day 36 12. Face appears Day 37 13. External genitalia Day 53 14. Miniature human form Day 56 Developmental of fetus in weeks Age (weeks) Developmental Age (weeks) Developmental events events 9 Closed or closing eyes, more rounded head, and herniation of intestines in umbilical cord 10 Intestines in abdomen and early development of fingernails 12 Differentiated external genitalia and well defined neck 14 Erect head, well-developed lower limb, and early finger nail development 16 External ears standing out from the head 18 Vernix caseosa and early toe nail development 20 Lanugo hair 22 Wrinkled and red skin 24 Fingernails and lean body 26 Partially open eyes and eyelashes 28 Open eyes, hair, and slightly wrinkled skin 30 Toe nails and descending testes 32 Fingernails up to finger tips, and pink and smooth skin 36 Plumb body, absence of lanugo hair, toe nails up to toe tips, flexed limbs, and a firm grasp 38 Prominent chest, protruding breasts, testes in the scrotum or inguinal canals, and fingernails beyond finger tips Page | 2 QUICK REVISION FOR N.L.E (PMDC/NEB) DR. ASIF ALI KHAN Time of appearance of ossification centre BONE OSSIFICATION CENTRE TIME 1. Clavicle 8 week of menstrual age 2. Mandible and palate 9 week 3. Vertebral body and neural arch 9 week 4. Frontal bone 1 0-11 weeks 5. Femur, humerus, scapula, ileum, and phalanges 11 week 6. Skull base 12-14 weeks 7. Skull calvaria 16 week 8. Metatarsals and metacarpals Early second trimester 9. Calcaneum 24-26 weeks 10. Femur, humerus, scapula, ileum, and phalanges 11 week HISTOLOGY Types of epithelium Location 1. Simple squamous epithelium » The lining of the heart, blood vessels and lymphatic vessels » Lining of alveoli (Air sacs of lungs) » Middle ear cavity (internal eardrum) » Parietal layer of bowman capsule » Peritoneal pleura » Pericardial cavities 2. Simple cuboidal epithelium » Alveoli of glands of the body » Lining of kidney tubules and other ducts » ovary 3. Simple columnar epithelium » Digestive Tract: stomach, small & large intestine » Ciliated tissues: bronchi, fallopian tubes and uterus » Noncilliated (smooth) tissues: digestive tract and bladder, gallbladder 4. Pseudostratified columnar » Respiratory passages ( trachea, bronchi) epithelium » Male reproductive system (epididymis) 5. Stratified squamous » Keratinized: epidermis epithelium » Non-keratinized: – Lines of oral cavity, esophagus and vagina, – Opening lower 1/3 of anal canal – Oral opening/pharynx – Epithelium of cornea 6. Stratified cuboidal » Epithelium around follicular antrum epithelium » Epithelium lining on the ducts of the sweat gland 7. Stratified columnar » Conjunctiva of the eyes epithelium » Lobar ducts in salivary glands » Cavernous/penile urethra 8. Transitional epithelium » Renal pelvis » Ureter » Urinary bladder Page | 3 QUICK REVISION FOR N.L.E (PMDC/NEB) DR. ASIF ALI KHAN Anatomical Landmarks From Top To Bottom 1. C1-C2 Vertebra: Vocal cords 2. C2 Vertebra: Oropharynx and soft palate with mouth open 3. C3 Vertebra: Hyoid bone 4. C2-C3 Vertebra: Level of larynx in infants 5. C3-C6 Vertebra: Level of larynx in adults 6. C3-C4 Vertebra: Bifurcation of common carotid artery 7. C4 & C5 Vertebra: Thyroid cartilage 8. C6 Vertebra: Cricoid cartilage 9. C6 Vertebra: Beginning of trachea 10. C6 Vertebra: Beginning of esophagus 11. C7 Vertebra: Prominence » Thyroid lobe superior extent-oblique line of thyroid cartilage » Isthmus of thyroid gland-2nd through 4th tracheal rings » Thyroid lobe inferior extent-sixth tracheal ring » Spine at root of scapula-opposite third thoracic spine 12. T1 Vertebra: Thoracic inlet 13. T2 Vertebra : Superior angle of scapula-overlies part of 2nd rib-1st intercostal space superior to angle 14. T3 & T4 Vertebra junction: Jugular notch 15. T3-T4/T4 Vertebra: Carina 16. T3 & T4 Vertebra: Manubrium Sterni 17. T4 & T5 Vertebra: Sternal angle 18. T5 to T9 vertebra: Body of sternum 19. T5 to T9 Vertebra: Greater splanchnic nerve( sympathetic ganglia) 20. T5 to T9 Vertebra: : Apex of heart/mitral value-5th intercostal space 21. T5 to T8 vertebra: Base of heart/supine position 22. T6 to T9 vertebra: Base of heart/erect position 23. T6 vertebra: Oblique fissure of lung 24. T7 vertebra: Inferior angle of scapula 25. T8 vertebra: Vena caval foramen 26. T9 vertebra: Xiphoid process 27. T9 vertebra: Xiphisternal joint-T9 vertebra typically 28. T10 vertebra: Esophageal hiatus 29. T11 vertebra: Termination of oesophagus 30. T11-T12 vertebra: Lesser splanchnic nerve (sympathetic ganglia) 31. T12 vertebra: Least splanchnic nerve(sympathetic ganglion) 32. T12 vertebra: Aortic hiatus 33. T12 vertebra: Coeliac trunk branch of abdominal aorta 34. T12 & L1 vertebra: » Median arcuate ligament of respiratory diaphragm ( T12 & L1 junction) » Pulmonary valve - left 2nd intercostal space medial » Aortic valve-right 2nd intercostal space » Tricuspid valve - right lower sternum » Nipple in male - 4th intercostal space in midclavicular line Page | 4 QUICK REVISION FOR N.L.E (PMDC/NEB) DR. ASIF ALI KHAN 35. L1 Vertebra: » Trans-pyloric plane » Pylorus of stomach » 1st part of duodenum » spinal cord termination in adults » L1 superior border - Celiac trunk » L1 inferior border - Superior mesenteric artery 36. L2 Vertebra: Left renal vein 37. L1,L2,L3 Vertebra right side: 2nd part of duodenum 38. L2 Vertebra: left crus of diaphragm 39. L3 Vertebra: » 3rd part of duodenum » right crus of diaphragm » inferior mesenteric artery » subcostal plane » spinal cord termination in New born » spleen-obliquely along axis of 10th rib 40. Kidneys » Right kidney: – Superior pole-T12 – Inferior pole-L3 – Hilum-L1 » Left kidney: – Superior pole-T12 – inferior pole-L3 – Hilum-L1 41. L2 & L3 Vertebra: Pancreas head 42. L3 & L4 Vertebra: umbilicus(in supine/recumbent position) (disc between L3-L4) 43. L4 Vertebra: Bifurcation of abdominal aorta 44. L4 Vertebra: Supracristal plane/highest point on iliac crest 45. L5 Vertebra: Trans tubercular plane 46. L5 Vertebra: Origin of inferior vena cava 47. S1 Vertebra (sacral promontory): Anterior superior iliac spine 48. S1 Vertebra: Posterior superior iliac spine 49. Pubic symphysis - tip of coccyx Page | 5 QUICK REVISION FOR N.L.E (PMDC/NEB) DR. ASIF ALI KHAN ALL THESE POINTS ARE COLLECTED FROM PAST EXAMINATION SUCH AS FCPS-1 (GROUP 2010-15), PMDC-1 GROUP, USMLE-1, DIMS NOTES AND FIRST AID ANATOMY HIGH YIELD POINTS 1. Exaggerated over-curvature of thoracic area of vertebral Kyphosis column 2. Lateral deviation of vertebral column Scoliosis 3. Major feature of cervical vertebrae Transverse foramina L4 cervical vertebra 4. Vertebra located at level of iliac crest Ligamentum flavum 5. Ligament that connects internal surface of laminae of vertebrae Anterior longitudinal 6. Ligament that checks hyperextension of vertebral column Anterior longitudinal 7. Ligament affected by whiplash injury Pedicle ligament 8. Ligament which limits skull rotation Alar ligament 9. Defective portion of vertebra with spondylolisthesis in cervical Pars interarticularis, area 10. Defective portion of vertebra with spondylolisthesis in lumbar Lamina area 11. Common direction of all superior articular facets of vertebrae Posterior 12. Structure in contact with posterior surface of dens Transverse ligament of atlas (part of cruciate) 13. Ligament
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