New SARP Series Anatomy
Contents
CHAPTER 6 THORAX Theoretical Concepts .................................................................................................................................................................................... 192 Multiple Choice Questions.......................................................................................................................................................................... 221 Answers and Explanations .......................................................................................................................................................................... 228
CHAPTER 1 GENERAL ANATOMY
CHAPTER 7 ABDOMEN AND PELVIS
Theoretical Concepts ......................................................................................................................................................................................... 2 Multiple Choice Questions............................................................................................................................................................................... 8
Theoretical Concepts .................................................................................................................................................................................... 240
Answers and Explanations ............................................................................................................................................................................... 9
Multiple Choice Questions.......................................................................................................................................................................... 302 Answers and Explanations .......................................................................................................................................................................... 316
CHAPTER 2 GENERAL HISTOLOGY CHAPTER 8 HEADAND NECK Theoretical Concepts .......................................................................................................................................................................................12 Theoretical Concepts .................................................................................................................................................................................... 334
Answers and Explanations .............................................................................................................................................................................44
Multiple Choice Questions.......................................................................................................................................................................... 395 Answers and Explanations .......................................................................................................................................................................... 406
CHAPTER 3 GENERAL EMBRYOLOGY
CHAPTER 9 NEUROANATOMY AND BACK
Theoretical Concepts .......................................................................................................................................................................................52
Theoretical Concepts .................................................................................................................................................................................... 422
Multiple Choice Questions.............................................................................................................................................................................68
Multiple Choice Questions.......................................................................................................................................................................... 457
Answers and Explanations .............................................................................................................................................................................71
Answers and Explanations .......................................................................................................................................................................... 463
CHAPTER 4 UPPER LIMB
IMAGE-BASED QUESTIONS Image-Based Questions ............................................................................................................................................................................... 471 Answers and Explanations to Image-Based Questions .................................................................................................................... 492
Theoretical Concepts .......................................................................................................................................................................................76 Multiple Choice Questions.......................................................................................................................................................................... 121 Answers and Explanations .......................................................................................................................................................................... 130
AIIMS May 2017 ............................................................................................................................................................................................ 499
CHAPTER 5 LOWER LIMB Theoretical Concepts .................................................................................................................................................................................... 142 Multiple Choice Questions.......................................................................................................................................................................... 177 Answers and Explanations .......................................................................................................................................................................... 183
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Multiple Choice Questions.............................................................................................................................................................................40
Chapter
One
New SARP Series Anatomy Bones Skeleton is divided into axial skeleton and appendicular skeleton. q Axial Skeleton: Forms central axis of body. Includes skull, hyoid bone, vertebral bones and thoracic cage (Ribs and sternum) q Appendicular Skeleton: Bones of upper limb and lower limb
Classification of Bones Based on types of Development q Cartilaginous bones: Bones are formed by cartilage which later ossify into bones, e.g. Long bones, skull base,
General Anatomy
vertebra q Membranous bones: Bones are formed by membranes. These membranes are then transformed into bone.
Clavicle, Maxilla, Skull vault
According to shape q Long bones, short bones, flat bones, irregular bones.
Long Bones q Consists of two ends and intervening shaft q Presence of medullary cavity
PREVIEW
q Vertically placed q Ossify by means of cartilage
Types of epiphysis q Pressure: Take part in joint formation. They transmit weight
• Head of humerus • Lower end of radius etc q 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 q Atavastic: Phylogenetically independent but fused to nearest bone for nutrition e.g. • Coracoid process of scapula • Ostrigonum q Aberrant Epiphysis (Aberrant, Not usual): Not always present, e.g. • Head of 1st metacarpal bones • Base of other metacarpal bones
Structure of bone
Short Bones q Short in post and it can be in any shape. According to their shape, these bones are named. For example,
Trapezium, cuboid.
Flat
2
q 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.
New SARP Series Anatomy
Chapter 1 • General Anatomy
Irregular Bones
Age
Occurs in
q Irregular and not fit into any category of shape. For example, Hip bone.
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)
Nearly all bones Completely ossified
Macroscopic Classification of Bones Classified into compact and cancellous bone q Compact Bone: More bone tissue and less empty space. Dense in nature. q Spongy (cancellous) bone: More space and less bone tissue.
Remember
Microscopic Classification of Bones q Lamellar bone: Collagens are arranged in orderly manner in form of concentric sheets.
Hiltons Law
q Woven bone: Woven bones are arranged in random manner.
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.
REMEMBE R High Yield
q
Law of Ossification
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.
q 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) q In upper limb, nutrient foramina are directed towards elbow. In lower limb, they are directed away from knee
joint q Fibula violates law of ossification
other type of Bones Applied Anatomy
q Pneumatic bones: Bones with air cavities. e.g. maxilla, frontal, sphenoid, ethmoid and mastoid. q Sesamoid bones: Bones formed in tendons.
q q
Blood supply of Long Bones q Nutrient artery: Enters nutrient foramen, which is formed in middle of shaft
q
q Direction towards growing end of bone (metaphysics)
q
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
q Long bones are also supplied by periosteal arteries, metaphyseal arteries, epiphyseal arteries.
Joints in the Body
Ossification Centers q Site of bone formation
Primary cartilaginous joint
q 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
q
Table 1: Ossification of various bones of body and the respective age q
Age
Occurs in
Third month (fetus)
Ossification begins in long bones
Fourth month (fetus)
Most 1° ossification centers appear in diaphysis of long bones
From birth till 5 years of age
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
q
Secondary cartilaginous joint q q q q
Symphysis menti Symphysis pubis Manubrio sterna joint between vertebral bodies
Sutures q q q q
q
3 Contd....
1st chondrosternal joint (rest of chondrosternal joint are synovial) joint between epiphysis and diaphysis Between basiocciput and basisphenoid
4
Serrate: Sagittal Denticulate: lambdoid Squamous: Temporoparietal Plane: between palatine process of maxillae Schindylesis: between rostrum of sphenoid and upper margin of vomer
Syndesmoses q
Inferior tibiofibular joint
Gomphosis q
Tooth fit in the socket
PREVIEW
Woven bones are formed during pathological conditions, which are then replaced by lamellar bones.
q
New SARP Series Anatomy
Chapter 1 • General Anatomy
Primary Cartilagenous
Joints Joints are junction between two or more bones.
q
Space between bones are occupied by hyaline cartilage
q
It is then replaced by bone, hence it is temporary
q
It is immovable, hence strong.
secondary Cartilagenous (symphysis) q
Articular surface covered by thin layer of hyaline cartilage and bones are united by fibrocartilage
q
These are permanent and present throughout the life
q
These joints are found in midlines
Fibrous Joint q q q
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
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).
q q q q
Interphalangeal Joint of fingers and toes Elbow Ankle
Pivot q q
Saddle q q q q
Carpometacarpal joint of thumb Sternoclavicular Calcaneocuboid Joint between malleus and incus
Condylar
Atlanto-axial Radioulnar
q q
Plane q q q
Ellipsoid
Knee Temporomandibular
Intercarpal joint Intertarsal joint Facet joint (between the articular facet of adjacent vertebra)
q
Articular surface covered by Hyaline cartilage
q
Synovial membrane lines entire joint except the articular surface
q
Joint cavity is filled with synovial fluid
q
Joint is covered by fibrous capsule
Types
types of synovial Joints Hinge
q
Wrist joint, knuckle joint and atlanto-occipital joint
q
Plane: Articular surface are more or less plane. Permit gliding movement
q
Hinge: Pulley shaped. Permit movement in one plane – transverse axis
q
Pivot: Formed by bony pivot surrounded by an osteoligamentous ring. Permit movement in one plane-vertical axis
q
Condylar: Consists of 2 distinct condyles, in which one is reciprocally concave. Permit movement in transverse axis
q
Ellipsoid: Include convex male fitting into ellipsoid female. Permit movement in transverse axis, anteroposterior axis (not in vertical axis).
q
Saddle: Are reciprocally concavo convex
q
Ball and Socket: Consists of globular head fitting into cup-shaped socket
Ball and socket q q q q
Classification based on Function
Shoulder joint Hip joint Talocalcaneo navicular joint Articulation between incus and stapes
q
5
6
q q
Immovable: No mobility Slightly movable Freely movable
PREVIEW
• Gomphoses: Otherwise known as peg and socket
synovial Joint
New SARP Series Anatomy
Chapter 1 • General Anatomy
MULTIPLE CHOICE QUESTIONS 1. Which of the following is multipennate muscle: (Recent Question Dec. 2016) a. FPL b. EPL c. Deltoid d. FHL
7. Bone which is pneumatic: (PGI May 2015) a. Maxillary b. Parietal c. Temporal d. Frontal e. Ethmoidal
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
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
3. The Haversian system is found in: a. Diaphysis of long bones b. Cancellous bone c. Epiphysis d. Spongy bones of children
(AI 2000)
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
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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
q
[Ref: vishram singh general anatomy, 138] q
Deltoid middle fibers – multipennate.
Pneumatic bones: Bones with air cavities. e.g. maxilla, frontal, sphenoid, ethmoid and mastoid.
8. Ans. a. Long bones
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: langmens embryology 127] q
9. Ans. c. Schindylesis
[Ref: vishram singh general anatomy, 75] q
Diaphysis of long bones contains compact bones, which contains osteon.
4. Ans. c. Growth activity is negligible here [Ref: vishram singh general anatomy 80] q
Active growth occurs in metaphysis.
5. Ans. d. Base of 2nd metacarpal [Ref: BDC General anatomy 34] q
Aberrant – head of 1st metacarpal and base of other metacarpal bones.
6. Ans. d. Coracoid process of scapula. q
Coracoid process – atavistic
7. Ans. a. Maxillary, d. Frontal, e. Ethmoidal [Ref: vishram singh general anatomy 74]
Long bones show enchondral ossification. Skull base, vertebra
[Ref: vishram singh general anatomy 95]
10. Ans. d. Synchondrosis Joint between epiphysis and diaphysis: Primary cartilaginous. 11. Ans. a. Symphysis q
PREVIEW
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
9. Vomer-Sphenoidal rostrum junction is: (Recent Question Dec. 2013) a. Syndesmosis b. Synostosis c. Schindylesis d. Gomphosis
ANSWERS AND EXPLANATIONS 1. Ans. c. Deltoid
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.
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