ANATOMY IMPORTANT TOPICS (1styear MBBS):

             Anatomy Important Questions:

                              (Compiled by Dr. Yasir Habib)

Gross Anatomy:

    Bones:

          Never compromise in this part as almost every region has some bone. Some bones are done separately while hand, foot, pelvis are done as a whole. Their anatomical position, side determination, features and attachments, clinical are important in vivas as well as spotting (osteology and X-rays). A bone or any viscera is to be held according to your anatomical position, not according to examiner’s anatomical position. Ossification of some exceptional bones i.e. clavicle (first bone to ossify and ossify in membrane), femur (secondary centre for lower end appear at end of 9^th month of IU life), humerus etc. is important. Law of ossification is very important. Sesamoid bones are also important.

   Muscles:

           Muscles of every region are important. Their origin, insertion, nerve supply, actions and their clinicals are important from written, viva and spotting point of view. Muscles of dual supply are important like brachialis, adductor magnus, pectineus (hybrid muscles).

  Nerves:

          Each and every nerve is important. Their root value, origin, course, termination, branches, areas of supply, plexuses, injury clinicals, regional nerve blocks are important. Cutaneous nerves and dermatomes of every region are important. Important are the nerves in contact with the bone.

 Blood vessels:

          You must know the beginning, course, termination, branches, tributaries, anastomosis and arterial arches, venous plexus and their communications (if any). Their injury clinicals are also important for PBQs (problem based questions). Always remember:  Profunda Femoris artery is the chief artery of thigh and Femoral artery is the chief artery of whole of the lower limb.

 Lymph Nodes:

         Lymph nodes and lymphatics of every region are important as the infection etc. can spread through them to the remote places of the body.

  Joints:

         All the joints are important. Their type, articular surfaces, factors stabilizing a joint i.e. ligaments, articular discs etc., relations, blood,nerve,lymphatic supply, movements, muscles producing movements, axes of movements, clinical deformities are important. Locking and interlocking mechanism of the knee joint is very important.

        If you have limited time for revision then just go through bones, muscle tables, joints, nerves, blood vessels and clinicals (given in appendix at the end of each region in ‘B D Chaurasia’s Human Anatomy’).

  Miscellaneous:

o   Breast

o   Clavipectoral fascia

o   Boundaries and Contents of Axilla

o   Brachial plexus & its  Diagram        

o   Carrying angle

o   Movements of Thumb

o   Rotator Cuff of Shoulder and its Importance

o   Intermuscular spaces

o   Anastomosis around scapula, elbow joint, knee joint and on the back of thigh.

o   Cubital and Popliteal Fossa

o   Bursae, Sheaths and their clinical importance.

o   Vincula Longa and Brevia

o   Flexor, Extensor and Peroneal Retinacula

o   Palmar and Plantar Aponeurosis

o   Spaces of Hand

o   Anatomical snuff box

o   Dorsal Digital Expansion

o   Difference b/w midinguinal point & midpoint of inguinal ligament

o   False pelvis & true pelvis

o   Fascia Lata

o   Femoral triangle

o   Adductor canal

o   Structures under the cover of gluteus maximas

o   Trochanteric and cruciate anastomosis

o   Structures passing through greater and lesser sciatic foramina

o   Arches of Foot.

o   Inlet & outlet of thorax

o   Respiratory movements

o   Wall of thorax

o   Azygos & Hemiazygos veins & their clinical importance

o   Lungs & Pleurae

o   Mediastinum

o   Pericardium & heart (diagram of arterial supply of heart)

o   Trachea & Esophagus

o   Diaphragm (from BD volume 2, chapter 26)

    Clinicals:

           Its better to do the clinicals from KLM. Following are some of the important clinicals:

§  Fractures of Humerus, Radius (Colles fracture), Ulna, Hip bone, Femur, Sprain of ankle joint due to high heels.

§  Peau d’orange appearance (breast)

§  Carcinoma of Breast

§  Horner’s syndrome

§  Dawbarn’s sign

§  Poland syndrome

§  Paralysis of Serratus Anterior, Latissimus Dorsi, Deltoid, Gluteus maximus, medius, minimus (gait disturbances)

§  Injury to axillary nerve, spinal accessory nerve, radial nerve (wrist drop), median nerve (carpal tunnel syndrome), ulnar nerve (claw hand), superior gluteal nerve, common fibular nerve (foot drop), sciatic nerve, tibial nerve, recurrent laryngeal nerve

§  Injury to axillary vein

§  Brachial Plexus Injuries

§  Clinical significance of cubital fossa

§  Tennis elbow, Pulled Elbow, Student’s elbow

§  Measurement of Radial pulse

§  Funny bone-Medial Epicondyle-why?

§  Duputren Contracture

§  Tenosynovitis

§  Dermatoglyphics

§  Frozen shoulder

o   Coxa Vara & Coxa Valga, Genu Valgam & Genu Varum

o   Bipartite & Tripartite patella

o   Knee jerk, Biceps jerk & Ankle jerk reflex

o   Femoral Hernia

o   Accessory Obturator Artery

o   Intragluteal & Intradeltoid Injections

o   Venous return from leg (peripheral heart)

o   Varicose veins

o   Housemaid’s Knee, Clergyman’s knee

o   Clubfoot

o   Foot drop

o   Sciatica

o   Referred pain of hip joint

o   Shenton’s line

o   Aspiration of Hip joint

o   Claw toe, mallet toe, hammer toe.

o   Pes planus & pes cavus

o   Unhappy triad (very important)

o   Fresher’s syndrome

o   Thoracic inlet syndrome

o   Funnel & pigeon chest

o   Disc prolapse

o   Posture changes in dyspnoea

o   Angina Pectoris

o   Cardiac Referred pain

o   Myocardial Infarction

o   Thoracocentesis

o   Pleurisy, Pneumothorax, Haemothorax

o   Carina

o   Mediastinal syndrome

o   Valvular heart diseases (Stenosis & regurgitation)

o   Precordium

o   Cor pulmonale

o   Aortic aneurysm, Co-arctation of aorta, Patent Ductus Arteriosus

o   Tracheal tug

o   Flail Chest

o   Sternal Biopsy

o   Cardiac tamponade

·        Pericardial rub, Pericardial Effusion, Pericardiocentesis 

   Surface Anatomy:

·        Axillary & Brachial arteries

·        Flexor & Extensor Retinaculum

·        Anterior and Posterior Tibial Arteries

·        Great & Short Saphenous Veins

·        Dorsalis Pedis Artery

·        Sciatic & Tibial Nerve

·        Extensor & Flexor Retinaculum

·        Suprasternal notch & Sternal Angle

·        Lungs & Pleura

·        Borders of Heart

·        Cardiac Valves and Auscultatory Areas (The tricuspid area is left 4^th intercostal space close to sternum) (Do it from Netter’s Atlas as        given incorrect in BD)     

    

      Histology:

·        Cytoplasmic Inclusions

·        Cell Junctions

·        Epithelium & Glands

·        Connective Tissue (Cells, Fibres, Classification)

·        Muscular & Nervous Tissue

·        Circulatory System

·        Lymphoid Tissue

·        Thick & Thin Skin

     General Embryology:

·        Spermatogenesis & Oogenesis

·        Comparison of Gametes

·        Ovarian & Menstrual Cycle

·        Acrosome Reaction & Capacitation

·        Sperm Counts

·        Fertilization

·        Chorionic Sac & Chorionic Villi Development

·        Implantation & its Sites

·        Ectopic Pregnancies

·        Placenta Previa (very important)

·        Derivatives of Germ Layers

·        Notochord

·        Neurulation

·        Somitogenesis

·        CVS Development

·        Folding of Embryo

·        Procedures for Assessing Fetal Status

·        Placenta (very important): See which part (maternal or fetal) is asked

·        Placental Anomalies

·        Parturition

·        Amnion, Amniotic fluid & their abnormalities

·        Multiple pregnancies (very important)

        General Anatomy:

·        Burns (from KLM or lecture notes)

·        Bones (Functions, Classification, Parts of a developing long bone, Blood Supply)

·        Rule of direction of Nutrient Foramen

·        Types of Cartilage

·        General & Skeletal Muscle Classification

·        Aponeurosis

·        Structure Related to muscles

·        Joints

·        Classification of Blood Vessels

·        Anastomosis

·        Lymphatic System

·        Nervous System (Typical spinal nerve & Autonomic nervous system)

·        Ossification