Contents PREVIEW. xii. New SARP Series Anatomy CHAPTER 6 THORAX CHAPTER 1 GENERAL ANATOMY CHAPTER 7 ABDOMEN AND PELVIS CHAPTER 2 GENERAL HISTOLOGY

Transcription

1

2 Contents CHAPTER 6 THORAX Theoretical Concepts Multiple Choice Questions Answers and Explanations CHAPTER 1 GENERAL ANATOMY Theoretical Concepts... 2 Multiple Choice Questions... 8 Answers and Explanations... 9 CHAPTER 2 GENERAL HISTOLOGY Theoretical Concepts...12 Multiple Choice Questions...40 Answers and Explanations...44 CHAPTER 3 GENERAL EMBRYOLOGY Theoretical Concepts...52 Multiple Choice Questions...68 Answers and Explanations...71 CHAPTER 7 ABDOMEN AND PELVIS Theoretical Concepts Multiple Choice Questions Answers and Explanations CHAPTER 8 HEADAND NECK Theoretical Concepts Multiple Choice Questions Answers and Explanations CHAPTER 9 NEUROANATOMY AND BACK Theoretical Concepts Multiple Choice Questions Answers and Explanations CHAPTER 4 UPPER LIMB Theoretical Concepts...76 Multiple Choice Questions Answers and Explanations CHAPTER 5 LOWER LIMB IMAGE-BASED QUESTIONS Image-Based Questions Answers and Explanations to Image-Based Questions AIIMS May Theoretical Concepts Multiple Choice Questions Answers and Explanations xii

3 Chapter One General Anatomy Bones Skeleton is divided into axial skeleton and appendicular skeleton. Axial Skeleton: Forms central axis of body. Includes skull, hyoid bone, vertebral bones and thoracic cage (Ribs and sternum) Appendicular Skeleton: Bones of upper limb and lower limb Classification of Bones Based on types of Development Cartilaginous bones: Bones are formed by cartilage which later ossify into bones, e.g. Long bones, skull base, vertebra Membranous bones: Bones are formed by membranes. These membranes are then transformed into bone. Clavicle, Maxilla, Skull vault According to shape Long bones, short bones, flat bones, irregular bones. Long Bones Consists of two ends and intervening shaft Presence of medullary cavity Vertically placed Ossify by means of cartilage Types of epiphysis Pressure: Take part in joint formation. They transmit weight Head of humerus Lower end of radius etc Traction epiphysis: Non-articular and does not take part in weight transmission e.g. Greater and lesser trochanter of femur Greater and lesser tubercle of humerus and mastoid process Atavastic: Phylogenetically independent but fused to nearest bone for nutrition e.g. Coracoid process of scapula Ostrigonum Aberrant Epiphysis (Aberrant, Not usual): Not always present, e.g. Head of 1 st metacarpal bones Base of other metacarpal bones Structure of bone Short Bones Short in post and it can be in any shape. According to their shape, these bones are named. For example, Trapezium, cuboid. 2 Flat Flat in appearance and so there are 2 surface in front and behind for these bones. For example, Bones of thoracic cage, bones forming cranial vault.

4 Chapter 1 General Anatomy Irregular Bones Irregular and not fit into any category of shape. For example, Hip bone. Macroscopic Classification of Bones Classified into compact and cancellous bone Compact Bone: More bone tissue and less empty space. Dense in nature. Spongy (cancellous) bone: More space and less bone tissue. Microscopic Classification of Bones Lamellar bone: Collagens are arranged in orderly manner in form of concentric sheets. Woven bone: Woven bones are arranged in random manner. High Yield Woven bones are formed during pathological conditions, which are then replaced by lamellar bones. other type of Bones REMEMBE R Haversian system: Osteon fundamental functional unit of compact bone; consists of haversian canal and surrounded by concentric lamellae Volkmann s canal: Volkmann s canal connects haversian canal to each other and to surface of bone. Pneumatic bones: Bones with air cavities. e.g. maxilla, frontal, sphenoid, ethmoid and mastoid. Sesamoid bones: Bones formed in tendons. Blood supply of Long Bones Nutrient artery: Enters nutrient foramen, which is formed in middle of shaft Direction towards growing end of bone (metaphysics) Long bones are also supplied by periosteal arteries, metaphyseal arteries, epiphyseal arteries. Age Occurs in 18 to 23 years Bones of lower limb and hip bones ossified completely 21 to 25 years Sternum, clavicle and vertebrae ossified completely By 23 years (Females) By 25 years (Males) Hiltons Law Remember Nearly all bones Completely ossified The nerve supplying a muscle also gives a branch to joint and another branch to skin over the joint e.g. Nerve to Quadratus femoris: Hip joint; axillary nerve; shoulder joint. Law of Ossification The secondary center which appears first fuses last and that extremity of bone is growing end (growing end is in opposite direction to nutrient foramen) In upper limb, nutrient foramina are directed towards elbow. In lower limb, they are directed away from knee joint Fibula violates law of ossification Applied Anatomy TB and syphilis begin in the middle of shaft (Diaphysis). Metaphysis is the m/c site of hematogenous osteomyelitis in children. Metaphysis is prone to trumatic necrosis and avascular necrosis. Epiphysis is involved in Perthe s disease Hematogenous infection of bone m/c involves àmetaphysis of long bones Ossification Centers Joints in the Body Site of bone formation One primary ossification center appears before birth (Exception: Primary center of tarsal and carpal bones) and one or more secondary ossification center appear after birth Table 1: Ossification of various bones of body and the respective age Age Third month (fetus) Fourth month (fetus) From birth till 5 years of age Occurs in Ossification begins in long bones Most 1 ossification centers appear in diaphysis of long bones 2 ossification centers appear in epiphyses 5 to 14 years Rapid spreading of ossification from ossification centers 15 to 20 years Bones of upper limb and scapulae ossified completely Contd Primary cartilaginous joint 1 st chondrosternal joint (rest of chondrosternal joint are synovial) joint between epiphysis and diaphysis Between basiocciput and basisphenoid Secondary cartilaginous joint Symphysis menti Symphysis pubis Manubrio sterna joint between vertebral bodies Sutures Syndesmoses Gomphosis Serrate: Sagittal Denticulate: lambdoid Suamous: Temporoparietal Plane: between palatine process of maxillae Schindylesis: between rostrum of sphenoid and upper margin of vomer Inferior tibiofibular joint Tooth fit in the socket

5 Joints Joints are junction between two or more bones. Chapter 1 General Anatomy Primary Cartilagenous Space between bones are occupied by hyaline cartilage It is then replaced by bone, hence it is temporary It is immovable, hence strong. secondary Cartilagenous (symphysis) Articular surface covered by thin layer of hyaline cartilage and bones are united by fibrocartilage These are permanent and present throughout the life These joints are found in midlines Fibrous Joint A. Syndesmosis (tibiofibular); B. Suture (skull), Cartilaginous; C. Symphysis (vertebral bodies); D. Synchondrosis (first rib and sternum). Synovial; E. Condyloid (wrist); F. Gliding (radioulnar); G. Hinge or ginglymus (elbow); H. ball and socket (hip); I. Saddle (carpometacarpal) of thumb); J. Pivot (atlantoaxial). types of synovial Joints Hinge Pivot Condylar Ellipsoid Interphalangeal Joint of fingers and toes Elbow Ankle Atlanto-axial Radioulnar Knee Temporomandibular Saddle Plane Ball and socket Carpometacarpal joint of thumb Sternoclavicular Calcaneocuboid Joint between malleus and incus Intercarpal joint Intertarsal joint Facet joint (between the articular facet of adjacent vertebra) Wrist joint, knuckle joint and atlanto-occipital joint Shoulder joint Hip joint Talocalcaneo navicular joint Articulation between incus and stapes 5 6 Space between bones are joined together by fibrous tissue. Hence, these joints are immovable. Classified into: Sutures, syndesmoses and gomphoses Suture: Found in skull. Immovable according to shape of margins of bones, sutures are named in various types Syndesmoses: Bones are connected by interosseous ligaments Gomphoses: Otherwise known as peg and socket synovial Joint Articular surface covered by Hyaline cartilage Synovial membrane lines entire joint except the articular surface Joint cavity is filled with synovial fluid Joint is covered by fibrous capsule Types Plane: Articular surface are more or less plane. Permit gliding movement Hinge: Pulley shaped. Permit movement in one plane transverse axis Pivot: Formed by bony pivot surrounded by an osteoligamentous ring. Permit movement in one plane-vertical axis Condylar: Consists of 2 distinct condyles, in which one is reciprocally concave. Permit movement in transverse axis Ellipsoid: Include convex male fitting into ellipsoid female. Permit movement in transverse axis, anteroposterior axis (not in vertical axis). Saddle: Are reciprocally concavo convex Ball and Socket: Consists of globular head fitting into cup-shaped socket Classification based on Function Immovable: No mobility Slightly movable Freely movable

6 Chapter 1 General Anatomy 1. Which of the following is multipennate muscle: (Recent Question Dec. 2016) a. FPL b. EPL c. Deltoid d. FHL 2. In which of the following muscles, the muscle fibers are not parallel: (AIIMS Nov. 2016) a. Sartorius b. Sternohyoid c. Rectus abdominis d. Tibialis anterior 3. The Haversian system is found in: (AI 2000) a. Diaphysis of long bones b. Cancellous bone c. Epiphysis d. Spongy bones of children 4. All of the following statements are true for metaphysis of bone except: (AI 2003) a. It is the epiphyseal end of diaphysis b. It is highly vascular c. Growth activity is negligible here d. Common site of osteomyelitis in children 5. Which of the following is aberrant epiphysis? (Recent Question Dec. 2016) a. Coracoid process b. Greater tubercle of humerus c. Base of 1st metacarpal d. Base of 2nd metacarpal 6. Which of the following is an example of atavistic epiphysis? (Recent Question Dec. 2016) a. Greater trochanter b. Head of femur c. Upper end of radius d. Coracoid process of scapula MULTIPLE CHOICE QUESTIONS 7. Bone which is pneumatic: (PGI May 2015) a. Maxillary b. Parietal c. Temporal d. Frontal e. Ethmoidal 8. Enchondral ossification is/are seen in: (PGI Nov. 2015) a. Long bones b. Flat bones of skull c. Clavicle d. Mandible e. Nasal bones 9. Vomer-Sphenoidal rostrum junction is: (Recent Question Dec. 2013) a. Syndesmosis b. Synostosis c. Schindylesis d. Gomphosis 10. Joint between epiphysis and diaphysis of a long bone is a type of: (AIIMS 2004) a. Plane Synovial joint b. Fibrous joint c. Symphysis d. Synchondrosis 11. The type of joint between the sacrum and the coccyx is a: (AI 2005) a. Symphysis b. Synostosis c. Synchondrosis d. Syndesmosis 12. Median atlantoaxial joint is: (Recent Question Dec. 2016) a. Condylar b. Cartilaginous c. Fibrous d. Synovial Joint 13. Intracapsular articular disc is present in which joint: (Recent Question Dec. 2016) a. Sternoclavicular joint b. Elbow c. Hip joint d. Knee joint 1. Ans. c. Deltoid [Ref: vishram singh general anatomy, 138] Deltoid middle fibers multipennate. 2. Ans. d. Tibialis anterior The muscles with parallel fasciculi are sartorius, sternohyoid, rectus abdominis, digastric, thyrohyoid 3. Ans. a. Diaphysis of long bones [Ref: vishram singh general anatomy, 75] Diaphysis of long bones contains compact bones, which contains osteon. 4. Ans. c. Growth activity is negligible here [Ref: vishram singh general anatomy 80] Active growth occurs in metaphysis. 5. Ans. d. Base of 2nd metacarpal [Ref: BDC General anatomy 34] Aberrant head of 1 st metacarpal and base of other metacarpal bones. 6. Ans. d. Coracoid process of scapula. Coracoid process atavistic 7. Ans. a. Maxillary, d. Frontal, e. Ethmoidal ANSWERS AND EXPLANATIONS [Ref: vishram singh general anatomy 74] Pneumatic bones: Bones with air cavities. e.g. maxilla, frontal, sphenoid, ethmoid and mastoid. 8. Ans. a. Long bones [Ref: langmens embryology 127] Long bones show enchondral ossification. Skull base, vertebra 9. Ans. c. Schindylesis 10. Ans. d. Synchondrosis [Ref: vishram singh general anatomy 95] Joint between epiphysis and diaphysis: Primary cartilaginous. 11. Ans. a. Symphysis Sacrococcygeal joint: mid line joint symphysis secondary cartilaginous joint. 12. Ans. d. Synovial joint [Ref: vishram singh general anatomy 47] Median atlantoaxial joint: Pivot type of synovial joint. 13. Ans. a. Sternoclavicular joint [Ref: vishram singh general anatomy] Articular disc is seen in temparomandibular joint, sternoclavicular joint. 8 9

7 25 cm A4 size 19 cm Revise Anatomy In 15 Days YOP: 2017 Pages: 528 By K Raviraj, VD Agrawal Color: ISBN: Available on EduLanche.com