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Blockage of the
Subclavian or Axillary
artery can be bypassed
by anastomoses
between branches of
the Thyrocervical and
Subscapular arteries:
Transverse cervical
Suprascapular
Subscapular
Circumflex scapular
PIP – FDS
DID - FDP
May be accompanied by
anesthesia over lateral
aspect of forearm
Transcervical fracture
disrupts blood supply to
the head of the femur via
retinacular arteries (from
medial circumflex femoral
artery) and may cause
avascular necrosis of the
femoral head if blood
supply through the ligament
to the head is inadequate.
Cause of injury:
caused by
improperly placed
gluteal injections
but may result from
posterior hip
dislocation
Hamstrings muscles:
1. Biceps femoris
2. Semitendinosus
3. Semimembranosus
Action: extension of hip
joint and flexion of knee
joint
Nerve supply – Tibial
nerve (short head of
biceps femoris is supplied
by the common fibular
nerve)
It is fracture-dislocations of
the ankle joint
Reason - forced eversion
(abduction) of the foot
The Deltoid ligament
avulses the medial
malleolus and after that
fibula fractures at a
higher level
Pott's fracture
It is important because
of its role in the
metastasis of cancer
cells.
Most lymph (> 75%),
especially from the
lateral breast
quadrants, drains to
the axillary lymph
nodes, initially to the
anterior (pectoral)
nodes for the most
part.
Most of the remaining
lymph, particularly from
the medial breast
quadrants, drains to the
parasternal lymph
75% 25% nodes or to the
opposite breast.
Most vulnerable
structures – intercostal
nerve and posterior
intercostal artery
because they are not
covering by ribs.
Paradoxical
movement: dome of
diaphragm of injured
side pushed superiorly
by abdominal viscera
during inspiration
instead of descending
Cardiac Shadow
Right border is formed by:
1. SVC,
2. Right atrium
AV node – RCA
AV bundle (and
moderator band)- LCA
Superior lobe:
1. Apical
2. Anterior
1
3. Posterior
Middle lobe:
3
4. Lateral
2
5. Medial
Inferior lobe: 6 4
6. Superior
8 5
7. Anterior basal
8. Posterior basal 10
9. Lateral basal 9
7
10. Medial basal
Superior lobe:
1. Apicoposterior
2. Anterior
1
3. Superior lingular
4. Inferior lingular
2
Inferior lobe:
5. Superior
6. Anterior basal 3 5
7. Posterior basal
8. Lateral basal 4 7
9. Medial basal 9 8
2. Costodiaphragmatic Recess is
deepest place in pleural cavity, around
the chest wall, there are two rib
interspaces separating the inferior
limit of parietal pleural reflections from
the inferior border of the lungs and
visceral pleura:
2 1. Midclavicular line - between ribs 6-8
2. Midaxillary line - between ribs 8-10
3. Paravertebral line between ribs 10-12
Contents :
Right & Left gastric
vessels
Connective and fatty
tissue
and Portal triad:
Bile duct
Portal vein
Proper hepatic artery
Posteriorly: IVC
Superiorly: Caudate
lobe of the liver.
Rectouterine pouch
(pouch of Douglas):
deeper point of
peritoneal space in
vertical position of the
female body between the
rectum and the cervix of
uterus.
It is space of the pelvic
abscess location.
Hernia of stomach or
intestine through a
posterolateral defect
in diaphragm
(foramen of
Bochadalek).
It is seen in infants
and the mortality rate is
high because of left
lung hypoplasia.
1. Appendices epiploic
2. Sacculations
(haustrations)
3. Taeniae coli
The taeniae coli meet
together at the base of
the appendix where they
form a complete
longitudinal muscle coat
for the appendix.
It is a point at the
junction between the
lateral 1/3 and
medial 2/3 of a line
joining the right
anterior superior iliac
spine with the
umbilicus.
6 SMA Branches:
(1) Inferior
pancreaticoduodenal
2 arteries
(2)Jejunal and (3)
4 Ileal branches
(4) Ileocolic artery
Ascending branch
Anterior cecal artery
Posterior cecal artery
(5) Appendicular
artery
(6) Right colic artery
3 (7) Middle colic artery
Posterior to the
3 neck of the
1 pancreas is the site
of formation of the
PORTAL VEIN.
2
(1)Splenic vein
joins with (2)
superior
mesenteric vein to
form (3) portal vein.
Internal hemorrhoids
2
frequently develop in
chronic alcoholics
2 because of liver cirrhosis
2 and portal hypertension
syndrome.
Suprapubic aspiration:
Urine can be removed from
the bladder without penetrating
the peritoneum by inserting a
needle JUST ABOVE the
pubic symphysis.
The needle passes
successively through skin,
superficial and deep layers of
superficial fascia, linea alba,
transversalis fascia,
extraperitoneal connective
tissue, and wall of the bladder.
Septicemia leads to
meningitis and cavernous
sinus thrombosis, both of
which can cause neurological
damage and are life-
threatening.
Epistaxis (nosebleed)
most often occurs from
the anterior nasal septum
(Kiesselbach's area),
where branches of the
sphenopalatine,
anterior ethmoidal,
greater palatine, and
superior labial (from
facial) arteries converge.
All 4 muscles of
mastication are
innervated by V3:
1. Temporalis –
elevation &
retraction
2. Masseter -
elevation
3. Medial
pterygoid -
Note: In case of mandibular nerve elevation
damage mandible (when it is 4. Lateral
protruded) deviate toward the side of pterygoid -
lesion because of Lateral pterygoid protrusion
weakness.
Anterolateral –
infrahyoid muscles
1 Posterolateral –
COMMON CAROTID
ARTERY [1]
Medial – larynx,
TRACHEA [2],
pharynx, esophagus,
cricothyroid muscle,
recurrent laryngeal
1 nerve [3]
Posterior –
parathyroid glands
1 [4]
3