CVS radiology

RADIOLOGY CVS 

1) egg on side appearance-- uncorrected TGA. 
2) boot shaped heart--TOF. 
3) BOX shaped-- ebstein anomaly 
4)flask shaped-- pericardial effusion. 
5) egg in cup appearance-- constrictive pericarditis 

6)snowman/figure of 8 / cottage loaf sign-- TAPVC. 
7)Docks/figure of 3/E- sign= coarctation of aorta. 
8) jug handle appearnce = primary pulm HTN. 
9) MALADIE DE ROGER DEFECT= SMALL VSD 
10) Hilar dance = ASD. 

11) goose neck sign= endocardial cushion defect. 
12)schimitar sign= partial anamolous pulmonary vein return. 
13)convex left heart border= L-TGA. 
14)straight left upper cardiac border= ebstein anomaly.
15) concave main pulmonary segment & right aortic arch= persistent truncus arterious 

16) calcifiction of heart= carcinoid syndrome. 
17)cardiothoracic ratio should be < 0.5 
18)lamda sign= small ascending aorta in hypoplastic left heart syndrome. 
19)severe stenosis - mitral valve diameter < 1 sq.cm 
20) uhl disease= parchment right ventricle 

21) IOC for aortic dissection-- MRI 
22) IOC for pericardial effusion= M- mode ECHO. 
23)IOC for valvular disease = 2 D - ECHO. 
24) INVERTED MOUSTACHE SIGN= MITRAL STENOSIS.
25) IOC FOR RADIOTHERAPY CAUSED FIBROSIS= BIOPSY

26)small heart 
*normal variant 
*emphysema 
*addisons disease 
*dehydration/malnutrition 
*constrictive pericarditis. 

27) CARDIAC SHADOW 
*right= superior venacava,right atrium,inf venacava 
*left=aortic knuckle,pulm artery,left atrial appendage,RV,LV 

28)mitral stenosis 
*straightening of the left border of the cardiac silhouette 
*double atrial shadow. 
*prominence of the main pulm artery 
*dilatation of the upperlobe pulm veins. 
*backward displacement of esophagus 
*kerley b lines 

29) non obstructive TAPVC 
*cardiomegaly with plethoric. 
*snow man or figure of 8 configuration. 

30)obstructive TAPVC 
*normal sized heart 
*ground glass appearance of lung due to severe pulmonary HTN. 

31)m.c calcification of aorta= syphilitic aortitis. 
32)ascending aorta commonest site of calcification. 

33)CCF 
*enlarged cardiac silhouette. 
*ground glass appearance 
*kerley b lines 
*prominence of upper lobe blood vessel. 
*pleural effusion, usually bilateral. 

34)even quantities as small as 20-50 ml of pericardial fluid can be diagnosed by echocardiography 

35) spring water cyst also k/a pleuro-pericardial cyst or pericardial coelomic cyst. 

36)SMALL VSD 
*normal 
*minimal cardiomegaly 
*minimal increase in pulmonary vasculature 

37) LARGE VSD 
*gross cardiomegaly 
*dilatation of both ventricles, left atrium,pulm artery. 
*increased pulmonary vascular marking,pulmonary edema &pleural effusion 

38)gross cardiac enlargement 
*multiple valvular disease. 
*pericardial effusion 
*ASD 
*cardiomyopathy 
*ebstein anomaly

Salivary Glands

[1] Most Common Tumor Of Salivary Gland = Pleomorphic Adenoma [Aiims 1998 , Ai 2002]

[2] Most Common Benign Tumor Of Salivary Gland =Pleomorphic Adenoma

[3] Most Common Benign Tumor Of Parotid Gland = Pleomorphic Adenoma

[4] Most Common Malignant Tumor Of Parotid Gland = Mucoepidermoid Carcinoma

[5] Most Common Benign Tumor Of Parotid Gland In Children = Hemangioma [2nd Mc = Pleomorphic Adenoma]

[6] Most Common Malignant Tumor Of Salivary Gland In Adult/ Child/ Overall = Mucoepidermoid Carcinoma

[7] Most Common Radiation Induced Neoplasm In Salivary Gland = Mucoepidermoid Carcinoma

[8] Most Common Malignant Tumor Of Small Salivay Gland = Adenoid Cystic Carcinoma ( Cylindroma )

[9] Only Salivary Gland Tumor Which Show ” Hot Spot ” On Tecnitium Scan = Warthins Tumor = Adenolymphoma = Papillary Cystadenoma Lymphomatosum

[10] Superficial Parotidectomy = (Is Also Known As) = Pateys Operation

[11] Tumor Which Almost Exclusively Occurs In Parotid = Acinic Cell Adenocarcinoma [Ai 2006]

[12] Most Common Site Of Pleomorphic Adenoma = Parotid Gland [Ai 2006]

[13] Head & Neck Tumor In Which Perineural Invasion Is Most Commonly Seen = Adenoid Cystic Carcinoma [Ai 2005]

[14] Warthins = Adenolymphoma [Aiims 2003 , 2005]

[15] Treatment Of Choice For

[A] Pleomorphic Adenoma = Superficial Parotidectomy( Pateys Operation) [Aiims 98, 2001, Ai 97 ,Pgi 99]

[B] Warthins = Superficial Parotidectomy [ Aiims 2001 , Ai 98]

[C] Adenoid Cystic = Radical Parotidectomy

[D] Mucoepidermoid Low Grade = Superficial /Total Parotidectomy

[E] Mucoepidermoid High Grade = Radical Parotidectomy

[16] Most Common Site Of Minory Salivary Gland Tumor = Oral Cavity = Hard Palate

Syphilis

Some asked questions
SYPHILIS

✅Earliest to become +-  fta
✅Tpha last
✅Rash characteristc in 2*

✅Bullae never seen in 2*

✅Tissue paper scar- tertiary

✅Saddle
Parrot
Rhagade
WIMBERGERS SIGN

-In congenital

✅Deaf
Cultton jt
Interstitial keratits
Mulberry
Higoumenaki

-Late postnatal

✅Ollenforf ? 2*
✅Pseudo chancer - 3*
✅Tabes dorsalis in neurosyphillis( my aipg que )

✅Screening - vdrl
✅Response to tt - vdrl
✅Sensitv- ftabs
✅Specific- tpi
✅Median ip - 21 days
✅Cns syphillis toc - benza penicillin

Congenial heart diseases

✅Most common symptomatic cyanotic heart disease at birth: TGV

✅Most common cyanotic heart disease: TOF
✅Most common congenital Heart defect: VSD

✅Most common valvular anomaly: BAV
✅Most common anomaly associated with COA: BAV >> PDA

✅Most common cardiac anomaly associated with turner syndrome: BAV > COA(More specific)

✅Most common cardiac defect associated with Noonan syndrome: Pulmonary stenosis

✅Most common cardiac defect associated with Down's syndrome: AVSD > VSD > ASD

✅Most consistent feature of TOF : Infundibular stenosis > Pulmonary stenosis

✅Most common valvular abnormality associated with ankylosing spondylitis:  incompetent aortic valve

✅Most common valve involved in Rheumatic heart disease: Mitral valve

✅Most common valve abnormality in acute rheumatic fever: Mitral incompetence/ Regurgitation

✅Over all most common heart valve abnormality in rheumatic heary disease: MR

✅Most common valve abnormality in chronic rheumatic heart disease: Mitral stenosis

✅Most common valve affected with carcinoid syndrome: Tricuspic Valve

Lung cancer

QuickRevision‬

Lung Cancer
Reference Fletcher 4th edition and Robbins 9th edition

1. Most frequently diagnosed cancer in the world

2. Most common cause of cancer mortality worldwide

3. Most frequent malignancy in individuals exposed to asbestos (latent period 10-30 years) particularly when coupled with smoking

4. The WHO estimates that 25% of lung cancer worldwide occurs in never smokers. This percentage is probably closer to 10% to 15% in Western countries. These cancers occur more commonly in women and most are adenocarcinomas

5. More than 90% of lung cancers develop as a direct result of exposure to tobacco smoke. Approximately 10% of smokers eventually develop lung cancer.

6. The gene known to be mutated most frequently in lung cancers is P53. P53 mutations are found in about 50% of NSCLC

7. Squamous cell carcinoma shows the highest frequency of Tp53 mutations among all histological subtypes of lung cancer

8. Small cell carcinoma shows the strongest association with smoking

9. Many smoking-associated mutations are G→T transversions that occur in known hotspots of the P53 open reading frame. These characteristic mutations can be directly attributed to bulky adducts caused by exposure to BPDE, a carcinogen in cigarette smoke.

10. RB is inactivated in 30–40% of NSCLC and in nearly all SCLC tumors.

11. Among NSCLC, RB mutations are associated with more advanced tumors, implying that RB loss occurs during later stages of tumorigenesis

12. Most common histological subtype - adenocarcinoma

13. Most common site of metastasis - brain

14. Cancers in non smokers more likely to have EGFR mutations and KRAS mutations almost never happen

15. Any histologic type of tumor may occasionally produce any one of the hormones, but tumors that produce ACTH and ADH are predominantly small cell carcinomas, whereas those that produce hypercalcemia are mostly squamous cell carcinomas.

16. Most common lung cancer to cause SVC syndrome : small cell > squamous

17. Broncheoalveolar carcinoma is now called Adenocarcinoma with Mucinous features

Orthopaedics

Points commonly asked in exam:
1. Spine is the commonest site of bone and joint tuberculosis.
2. Paradiscal is the commonest type of spinal tuberculosis.
3. Anti-tubercular chemotherapy forms the mainstay of treatment.
4. The spine is put to absolute rest by sling traction for the cervical spine and bed rest for dorsolumbar spine.
5. Pott’s paraplegia is TB spine with neurological involvement. It occurs most commonly in tuberculosis of the dorsal spine because the spinal canal is narrowest in this part.
6. The onset of paraplegia is gradual in onset in most cases but in some it is sudden.
7. Tubercular paraplegia is usually spastic to start with clonus (ankle or patellar) is the most prominent early sign.
8. Reduction of disc space is the earliest sign in the commoner, paradiscal type of tuberculosis.
9. Reduction of disc space is an important sign because in other diseases of the spine e.g., secondaries in spine, disc space is well preserved.
10. Back pain is commonest presenting symptom in Pott’s disease.
11. Stiffness is very early symptom in TB spine.
12. TB of spine is always secondary.
13. Commonest cause of early onset paraplegia is abscess

Nail changes

NAIL CHANGES IN DERMATOLOGY :

Darier’s disease – Red streak lines

Pitting of nail , longitudinal ridging & oil drop sign – Psoriasis

Cris cross black lines on nail plate known as Hutchinson nail – Malignant melanoma

Mees line -Chronic Arsenic poisoning

Lichen planus -Pterygium

Half and half nail-Chronic renal failure

Muehrcke lines – Severe Hypoalbuminemia

Points

Nitroblue tetrazolium test- screening for chronic granulomtous dis
Wangenstien invertogrm- for diagnosis of ano-rectal anomalies
Flow cytometry- gold standrd for PNH
High perf liq chromatography- sickle cel anaemia in infants
Daptomycin- used even in linezolid, streptogranin resistnt stap
Paper chromatography+ nitric acid test= for sanguinarine toxin detectn
Ivabradine- reduces HR and used in chronic
angina
Iodine, osmium tetroxide used in finger printing
Galton system- F.printing
Bertilon systm- anthropometry
Father of modrn toxicology- orfilla
Black hypostasis- opium poisoning
Hippus+ buring,tingling lips and throat- aconite
King of poison- arsenic
Vineyard sprayer lung- copper sulph toxicity
Green coloured urine- carbolic acid poisoning
(leather bottle stomach)
Strychnine poisoning- no unconciousness, acts at post synaptic glycine receptor
Cantharide poisoning- priaprism
Phosphorus poisn- phossy jaw
Cholera like diarhoea in arsenic poisoning
Viral infctd tissue- 50%glycerine
Negri bodies- rabies (hippocampus, cerebellum)
Lewy body(alpha synuclein)- in parkinson dis
NF tangle(tau protn)- in Alzheimr dis
Hirano bodies- alzheimer dis
Verrocay bodies, antoni bodies- schwannoma
C-ANCA refers to anti protienase3
P-ANCA refers to antimyeloperoxidase
Amyloidosis in haemodialysis- A-beta2 microglobulin
Muted ATTR- in familial amyld polyneuropathy
Durck granuloma- cerebral malaria
Masson fontana- stain for melanin
Masson trichrome- for collagen
Von kossa- for calcium
Elecroculogram- arden index used

Food safty 2015

Food safty 2015

Guidelines
WHO’s Five
keys to safer food offer practical
guidance to vendors and consumers
for handling and preparing food:
Key 1: Keep clean
Key 2: Separate raw and cooked food
Key 3: Cook food thoroughly
Key 4: Keep food at safe
temperatures
Key 5: Use safe water and raw
materials.

Recent advances in Pathology of Type II diabetes

Recent advances in Pathology of Type II diabetes
=====================================
1. Genes for type II diabetics that cause the insulin resistance and the beta cell failure- a gene on chromosome 2 encoding a cysteine protease, calpain –10, has been reported in some patient.
2. Several adipokines, secreted by fat cells, can affect insulin Action. 
3. Example of adipokines 
I. leptin 
II. Adiponectin 
III. TNF 
IV. Resistin 
A. Adipokines which reduce insulin resistance - a. Leptin b. Adiponectin.
B. Adipokines which increase insulin resistance – a. TNF-alpha b. Resistin 

Emperipolesis

EMPERIPOLESIS 

● presence of an intact cell within the cytoplasm of another cell. 
● defined by as, "the active penetration of one cell by another which remains intact". 
● It differs from phagocytosis :- because the engulfed cell exists within another cell and remains viable, and can exit without any physiological and morphological changes in them. 
● Etiopathogenesis of emperipolesis is uncertain. 
● seen in 
1) hematolymphoid disorders e.g. myeloproliferative disorders, nonHodgkin's lymphoma, idiopathic myelofibrosis, myelodysplastic syndrome (MDS) 

2) Rosai-Dorfman disease. 

3) Autoimmune hepatitis.

4) megakaryocytic emperipolesis is seen in ---- MDS.
5) lymphocytes within Astrocytes (emperipolesis) in multiple sclerosis plaques and brain tumors.

6) Lymphocytic- emperipolesis----CHRONIC LYMPHOCYTIC LEUKEMIA.

Liver pathology

STEATOSIS
• Accumulations of triglyceride fat droplets within hepatocytes is known as Fatty liver or Steatosis.
• Two types 
A) MICROVESICULAR 

( multiple tiny droplets not displacing nucleus)

1)Reye syndrome 
2)Acute Fatty liver of pregnancy
3)Jamaican vomiting sickness
4) Drugs—valproic acid ; tetracycline
5) Wolman disease
6) Lysosomal acid lipase deficiency
7) Early alcoholic liver disease 
8) chronic viral hepatitis

B) MACROVESICULAR

(single large droplet displacing nucleus to periphery)

1) Late alcoholic liver disease
2) Diabetes Mellitus – insulin resistance
3) lipodystrophy
4)Protein energy malnutrition ;starvation
5) dysbetalipoproteinemia
6) TPN; Jejunoileal bypass
7) Inflammatory bowel disease
8) Syndrome X (obesity; DM; hypertriglyceridemia)
9)Drugs---estrogens ; calcium Channel Blockers

Cleft lip and palate

Cleft lip results from abnormal development of medial nasal and maxillary process at time they
bulge downwards in front of and below the nasal pit.
Cleft palate results from a failure of fusion of the two palatine processes or in the case of the soft
palate, of a merging process to carry the union backwards from the site of initial fusion.
Treatment:
1. Cleft lip alone:
a. Unilateral (one side): One operation at 5-6 months.
b. Bilateral (both sides): One operation at 4-5 months.

2. Cleft palate alone:
a. Soft palate only: One operation at 6 months.
b. Soft & hard palate: Two operations. Soft palate at 6 months. Hard palate at 15-18 months.

3. Cleft lip and palate:
a. Unilateral: 2 operations. 

Cleft lip and soft palate at 5-6 months. 

Hard palate and gum pad with or without lip revision at 15-18 months.
b. Bilateral: 2 operations. 

Cleft lip and soft palate at 4-5 months. 

Hard palate and gum pad with or without lip revision at 15-18 months

Anatomy one liners

Innervations

Palatal muscles:
All muscles of soft palate supplied by vagus nerve thru pharyngeal plexus except tensor veli palati supplied by mandibular nerve

pharyngeal muscles:
All muscles of pharynx are supplied by vagus nerve except stylo pharyngeus supplied by Glossopharyngeal nerve

Larynx:
All muscles of larynx supplied by recurrent laryngeal nerve except cricothyroid supplied by external laryngeal nerve (superior LN)
Most frequently fractured bone of body: Clavicle
Most frequently dislocated carpal bone: Lunate
Most frequently fractured carpal bone:Scaphoid
Osseous structure palpated deep to "anatomical snuff box": Scaphoid
Fracture of distal radius that produces "dinner fork" appearance: Colles' fracture
Nerve injured with fracture of surgical neck of humerus: Axillary
Nerve injured with fracture of shaft of humerus: Radial
Nerve injured that results in wrist drop: Radial
Nerve injured with fracture of medial humeral epicondyle: Ulnar
Muscle that is the chief flexor and chief extensor at shoulder joint: Deltoid
Muscles innervated by axillary nerve: Deltoid and teres minor
Muscle that initiates abduction of arm: Supraspinatus
Most commonly torn tendon of rotator cuff: Supraspinatus
Two muscles that rotate scapula for full abduction of arm: Trapezius and serratus anterior
Tendon that courses through shoulder joint: Long head of biceps
Chief supinator muscle of hand: Biceps brachii
Primary (major) flexor of the forearm: Brachialis
Orientation of structures located in the cubital fossa-Lateral to Medial: Tendon biceps brachii, brachial a., median n.
Injury to what nerve causes winged scapula: Long thoracic nerve
Spinal levels of axillary nerve: C5 and C6
Spinal levels of innervation to muscles of the hand: C8 and T1
Dermatome of thumb: C6
Nerve to thenar compartment: Recurrent branch of Median
Innervation of adductor pollicis: Ulnar (deep br.)
Innervation to all interosseous muscles: Ulnar (deep br.)
Innervation to nail bed of middle finger: Median nerve
Innervation to nail bed of ring finger: Ulnar and median
Region affected by upper trunk injury of brachial plexus (C5-C6): Shoulder
Region affected by lower trunk injury of brachial plexus (C8-T1): Intrinsic hand muscles
Nerve compressed with carpal tunnel syndrome: Median
Nerve affected by cubital tunnel syndrome: Ulnar
Paralysis of which muscles results in total "claw" hand: Lumbricals
Dermatome around nipple: T4

Vertebral level at inferior angle of scapula: TV7

Structure that lies immediately posterior to manubrium: Thymus

Vertebral level associated with sternal angle: Disc between TV4-5

Rib related to oblique fissure of lung posteriorly: 2nd

Rib paralleled by horizontal fissure of right lung: 4th

Inferior extent of lung at mid-clavicular line: 6th rib

Inferior extent of pleura at mid-clavicular line: 8th rib

Inferior extent of lung at mid-axillary line: 8th rib

Inferior extent of pleura at mid-axillary line: 10th rib

Inferior extent of lung posteriorly : 10th rib

Inferior extent of pleura posteriorly: 12th rib

Innervation of costal pleura: Intercostal nerve

Innervation of mediastinal pleura: Phrenic nerve

Level where ascending aorta is continuous with arch of aorta: TV4-5

Level where arch of aorta is continuous with descending aorta: TV4-5

Effect of sympathetic nerves on lungs: Bronchodilation, Vasoconstriction

Effect of parasympathetic nerves on lungs: Bronchoconstriction, Vasodilation

Rationale for aspirated small objects to go to right primary bronchus: Wider diameter, shorter and more vertical

Needle location for therapeutic pleural tapping: Superior to 12th rib, posteriorly

Name given to portion of right ventricle prior to beginning of pulmonary trunk: conus arteriosum or infundibulum

Site for auscultation of pulmonary valve: Left 2nd interspace

Site for auscultation of aortic valve: Right 2nd interspace

Site for auscultation of tricuspid valve: Xiphisternal joint

Site for auscultation of mitral valve: Left 5th interspace, mid-clavicular line

Heart chamber with greatest sternocostal projection: Right ventricle

Chamber that forms apex of heart: Left ventricle

Major chamber that forms base of heart: Left atrium

Heart chamber that contains moderator band: Right ventricle

Ridge located between sinus venarum and right ventricle: Cristae
terminalis at the root of the SVC

Artery that determines coronary dominance: Posterior interventricular

Usual origin of SA and AV nodal arteries: Right coronary artery

Location of SA node: Cristae terminalis

Major vessel that drains the musculature of the heart: Coronary sinus

Innervation of fibrous pericardium: Phrenic nerve

Most common cause of systolic ejection murmur: Aortic stenosis

Rib associated with sternal angle: Second rib

Location of ductus arteriosus: Between left pulmonary artery and aorta

Nerve potentially injured with repair of patent ductus arteriosus: Left
recurrent laryngeal Nerve

Veins that unite to form brachiocephalic: Subclavian and internal Jugular

Veins that unite to form superior vena cava: Right and left Brachiocephalic

Termination of azygos vein: Superior vena cava

Structures that lie to right and left of thoracic duct: Azygos veins, aorta

Spinal levels of greater splanchnic nerve: T5-9

Spinal levels of lesser splanchnic nerve: T10-11

Spinal levels of least splanchnic nerve: T12

Thoracic structures that can compress the esophagus: Left bronchus, aorta and Diaphragm

Disease often associated with thymoma: Myasthenia gravis
Structure that separates pelvis from perineum: Pelvic diaphragm

Two major components of pelvic diaphragm: Levator ani and coccygeus

Two major components of levator ani: Pubococcygeus and iliococcygeus

Two muscles which close lateral pelvic wall: Obturator internus and piriformis

Means by which obturator internus exits pelvis: Lesser sciatic foramen

Means by which piriformis exits pelvis: Greater sciatic foramen

Innervation of detrusor: Pelvic splanchnics (S2-4)

Innervation of trigone
: Sympathetics (Pregang. lesser, least, lumbar splanchnic nn.)

Innervation of sphincter urethrae: Pudendal n. (S 2,3,4)

Remnants of umbilical arteries: Medial umbilical ligaments

Provides major vasculature to pelvic organs: Internal iliac

Chief artery to rectal mucosa Superior rectal

Chief artery to rectal muscular wall: Middle rectal

Most common type of pelvic inlet in females: Gynecoid

Two remnants of gubernaculum in females: Ovarian and round ligament

Ligament that contains ovarian vessels: Suspensory ligament of ovary

Cavity into which ova immediately escape the ovary: Peritoneal

Lymphatic drainage for ovary and testes: Lumbar nodes (para-aortic)

Normal position of uterus: Anterverted, anteflexed

Name given to orientation where uterus and vagina intersect at angle of 90 degrees: Anteversion

Name given to orientation where uterine body and cervix intersect at angle of 10-15 degrees: Anteflexion

Chief uterine support: Pubococcygeus

Ligament that contains uterine vessels: Lateral cervical

Structure potentially injured with hysterectomy: Ureter

Relation of ureter to uterine artery: Inferior and posterior

Structure that separates deep and superficial perineal spaces: Perineal membrane

Bony landmarks between anal and UG triangles: Ischial tuberosities

Structure forming lateral wall of ischioanal fossa: Fascia of obturator Internus

Structure that forms the pudendal canal: Fascia of obturator Internus

Structure that separates internal and external hemorrhoids: Pectinate line

Lymphatic drainage for area superior to pectinate line of anal canal: Internal iliac, inferior mesenteric nodes

Lymphatic drainage for area inferior to pectinate line of anal canal: Superficial inguinal nodes

Lymphatic drainage for glans penis: Deep inguinal nodes

Muscle which compresses the bulb of penis: Bulbospongiosus

Muscle which compresses the crus of penis: Ischiocavernosus

Nerves of erection: Pelvic splanchnic, nervi erigentes (S 2,3,4)

Muscles which meet at the perineal body: Superficial and deep perineal, bulbospongiosus, external anal sphincter, pubococcygeus

Major structure of deep perineal space: Sphincter urethrae
Exaggerated over-curvature of thoracic area of vertebral column: Kyphosis

Lateral deviation of vertebral column: Scoliosis

Major feature of cervical vertebrae: Transverse foramina

Structure which regionally determines vertebral movement: Facet joints

Vertebra located at level of iliac crest: L4

Ligament that connects internal surface of laminae of vertebrae: Ligamentum flavum

Ligament that checks hyperextension of vertebral column: Anterior longitudinal

Ligament affected by whiplash injury: Anterior longitudinal

Ligament which limits skull rotation: Alar

Defective portion of vertebra with spondylolisthesis in cervical area: Pedicle

Defective portion of vertebra with spondylolisthesis in lumbar area: Pars interarticularis, Lamina

Common direction of all superior articular facets of vertebrae: Posterior

Structure in contact with posterior surface of dens: Transverse ligament of atlas (part of cruciate)

Most commonly herniated intervertebral disc: L4-5

Most common nerve compressed with herniated intervertebral disc: L5

Spinal nerve affected by protrusion of the disc between C5/6: C6

Spinal nerve affected with herniated disc at L3/L4: L4

Thoracic intercostal space located deep to triangle of auscultation: sixth

Vertebral level of lumbar puncture: L4

Muscles which extend and side-bend the spine: Erector spinae

Muscles which extend, ROTATE, and side-bend the spine: Transversospinae

Innervation of suboccipital muscles: Suboccipital nerve (Dorsal ramus C1)

Roof of suboccipital triangle: Semispinalis capitis

Floor of suboccipital triangle: Posterior arch of atlas; posterior atlanto-occipital membrane

Major vessel within suboccipital triangle: Vertebral artery

Inferior extent of dura-arachnoid sac: SV2

Inferior extent of spinal cord: LV2

Location of internal vertebral plexus: Epidural space

Most frequently fractured bone of body : Clavicle

Most frequently dislocated carpal bone: Lunate

Most frequently fracture carpal bone: Scaphoid

Osseous structure palpated deep to “anatomical snuff box”: Scaphoid

Fracture of distal radius that produces “dinner fork” appearance: Colle’s fracture

Nerve injured with fracture of surgical neck of humerus: Axillary

Nerve injured with fracture of shaft of humerus: Radial

Nerve injured that results in wrist drop: Radial

Nerve injured with fracture of medial humeral epicondyle: Ulnar

Muscle that is the chief flexor and chief extensor at shoulder joint: Deltoid

Muscles innervated by axillary nerve: Deltoid and teres minor

Muscle that initiates abduction of arm: Supraspinatus

Most commonly torn tendon of rotator cuff: Supraspinatus

Two muscles that rotate scapula for full abduction of arm: Trapezius and serratus anterior

Tendon that courses through shoulder joint: Long head of biceps

Chief supinator muscle of hand: Biceps brachii

Primary (major) flexor of the forearm: Brachialis

Orientation of structures located in the cubital fossa-Lateral to Medial: Tendon biceps brachii, brachial a., median n.

Injury to what nerve causes winged scapula: Long thoracic nerve

Spinal levels of axillary nerve: C5 and C6

Spinal levels of innervation to muscles of the hand: C8 and T1

Dermatome of thumb: C6

Nerve to thenar compartment: Recurrent branch of Median

Innervation of adductor pollicis: Ulnar (deep br.)

Innervation to all interosseous muscles: Ulnar (deep br.)

Innervation to nail bed of middle finger: Median nerve

Innervation to nail bed of ring finger: Ulnar and median

Region affected by upper trunk injury of brachial plexus (C5-C6): Shoulder

Region affected by lower trunk injury of brachial plexus (C8-T1): Intrinsic hand muscles

Nerve compressed with carpal tunnel syndrome: Median

Nerve affected by cubital tunnel syndrome: Ulnar

Paralysis of which muscles results in total “claw” hand: Lumbricals

Boundaries of femoral triangle: Inguinal ligament, sartorius, adductor longus

Structure immediately lateral to femoral sheath: Femoral nerve

Structure immediately medial to femoral artery in femoral sheath" Femoral vein

Contents of femoral canal: Deep inguinal lymph nodes

Medial boundary of femoral ring: Lacunar ligament

Structures that course throughout entire length of adductor canal: Femoral artery and vein

Structures that course through only portion of adductor canal: Saphenous nerve, nerve to vastus medialis, descending genicular vessels

Muscle that forms floor of popliteal fossa: Popliteus

Muscle that is chief flexor at hip joint: Iliopsoas

Muscle that prevents pelvis from tilting when walking: Gluteus medius

Nerve affected when pelvis tilts to unsupported side during gait: Superior gluteal n.

Muscles which extend the thigh and flex the leg: Hamstrings

Muscle that extends leg: Quadriceps femoris

Specific muscle that holds patella in place: Vastus medialis

First portion of quadriceps femoris to atrophy with injury: Vastus medialis to femoral nerve

Last portion of quadriceps femoris to recover following injury: Vastus medialis

Muscle that unlocks knee joint: Popliteus

Muscle affected with “foot slap”: Tibialis anterior

Major spinal cord level of nerve affected causing foot slap: L4

Chief invertors of foot: Tibialis anterior and posterior

Chief evertors of foot: Fibularis longus and brevis

Ligament that checks backward displacement of femur on tibia: Anterior cruciate

Ligament laxity with positive valgus maneuver: Medial collateral

Most commonly injured ankle ligament: Anterior talofibular

Ligament stretched with “flat foot”: Plantar calcaneonavicular (spring)

Joints for movements of inversion and eversion: Subtalar and transverse Tarsal

Major artery to head of femur in adult: Medial femoral circumflex

Nerve affected with fracture of head and neck of fibula: Common fibular

Tendon affected with avulsion fracture of 5th metatarsal: Fibularis brevis

Innervation of adductor magnus: Obturator, tibial portion of Sciatic

Nerve affected with tarsal tunnel syndrome: Tibial

Embryology

Events of pregnancy
Day 0- fertilisatn
Day 4- morula
Day 5- blastocyst
Day 6- implantn starts
Day 8- bHCG start synth
Day 11- implantn completd
Day 11- uteroplacentl circulatn
Day 13- primary villi forms
Day 14- haematopoisis starts in yolk sac
Week 2 - bilaminar disc
Week 3 - gastrulatn, trilaminar disc
Day 21- fetoplacentl cirultn
Day 25- anterior neuropore closes
Day 27- posterior neuropore closes
Week 4-5 gestatnl sac
Week 5- 44 somites formd
Week 6- fetal cardiac activity by TVS
Week 7- embryonic movmnt
Week 3to8- embryo
Week 8 to 14- max risk of radiatn
Week 9- early detectn of anencephaly
Week 10- physiolog umb hernia
Week 11- thyroxine productn starts, breathing movmt begins
Week 12- urine productn starts, ADH functns
Week 10 to 12- chorionic V Samp done
Week 11 to 13- nuchal translucency checkd
Week 12 to 18- amniocentesis done
Week 18 & above- cordocentesis
Week 18- anamoly scan
Week 16- quickening starts(multi), W18(primi)
Week 20- meconium forms, keratinstn of fetal skin
Abve W20- no abortn performd
Week 20- external balotment
Week 24to 28- GDM screening
Less than week 28- extremly premature
W28 to W32- very premature
W30 to 32- maternal blood volume reach max
Week 38- lightening of pressure symptm
Above Week 42- postmature

Points from ent

CAULIFLOWER EAR---is due to Hematoma of Auricle,"

 "ENCEPHALOCELE---Herniation of Brain tissue with its Dural covering into the Nasal cavity, "-

 "EPITYMPANUM---includes--head of Malleolus , Body of Incus," 

"FITZGERALD-HALLPIKE TEST---uses Temp. at 30oC& 44oC, also called as caloric test?,"

 "LE FORT'S FRACTURE---inv's ZYGOMA, MAXILLA, & NASAL BONES,"

 "Oblique & Horizontal Fracture of nasal septum--- is called asJARJAVAL FRACTURE,"- 

"GLOBUS HYSTERICUS---lump in throat not interfering with swallowing,"- "

GROMMET INSERTION---is done in anteroinferior quadrant,"

 GELLE'S TEST---done in Otosclerosis, "Great Auricular Nr. ---supplies Skin at Angle of JAW,"

 "GLOSSOPHARYNGEAL NEURECTOMY--- Route of Approach -Tonsillectomy approach,"- Hearing impairment due to noise starts at 4000 Hz.,- 

"HEMANGIOMA---Bleeding Polyp of nose--arises from septum,"

 HYPERACUSIS---normal sound are heard as loud & painful.

 "HYPERNASALITY---caused by Cleft palate, Submucous celft, Bifed Uvula," 

HYPOPHARYNEAL CANCER---predisposing factors -Plummer Vinson's Synd., 

"INVERTED PAPILLOMA---of Rt.side of nasal cavity -TOC.=Total Maxillectomy,"- 

"INNER AUDITORY MEATUS---facial nerve is lateral to superior vestibular nerve," 

"JUVENILE PAPILLOMA---Rx-Surgical excision," 

"KERATOSIS OBURANS---is a Premalignant condition," 

KOBARK TEST---used for Minimal Caloric Stimulation, "

KARTAGENER'S SYND.---Ass.with Sinusitis, Dextrocardia, Bronchiectasis, " 

"LARYGEAL MIRROR---warmed before use by placing glass surface on Flame,"

LARYNGOFISSURE---Opening the larynx in midline," 

"LARYNGECTOMY---after laryngectomy Voice is from Oesophagus,"

 "LARYNGOCELE---Gas filled sac in neck region after VALSALVA MANOEURVE," 

"ANAESTHESIA OF LARYNX---occurs with Diptheria, Lead Poisoning, Multiple sclerosis,"- 

"LYMPH NODE METASTASIS IN NECK --- is seen in SupraGlottic Ca., Ca.of Tonsil, Papillary Ca.of thyroid, NEVER seen in Ca.of Vocal Cords, "

 "MASKING---is applied for inability to hear,"

 "MASTOID TEMPORAL BONE AIR CELL GROUPS---include Petrosae, Retrofacial, Hypotympanic, Sublabyrinthine."

 "MASTOID TIP---appears by 2yrs. of age," 

"INFERIOR MEATUS OF NOSE---NasoLacrimal duct/ Frontonasal duct opens," 

"MONOAURAL DISPLACUSIS---due to Lesions of Cochlea,"

 "MYIASIS OF NOSE---MAGGOTS OF NOSE, Rx-TOC.--CHLOROFORM Water," "

MYRINGITIS BULLOSA---caused by Virus," 

"NASAL DEPRESSED BRIDGE--- caused by Syphylis, Septal Abscess, Injury," 

CROOKED NOSE---due to Deviated Tip & Septum , "

SADDLE SHAPED NOSE---due to Destruction of na sale septum," 

"OESOPHAGUS---cervical oesophagus receives its blood supply from Inf.Thyroid Artery, "

 "BENIGN NEOPLASMS OF OESOPHAGUS---commonest --is Intramural Tumour of oesophagus "

CARCINOMA OF OESOPHAGUS---RAT TAIL APP. on Barium swallowing,"- 

"OLFCTORY AREA---Looks YELLOW in colour," "OSSICULAR RATIO = 1.3:1 ,

" "TUBERCULAR OTITIS MEDIA---Multiple perforations of T.M.,

 "ACUTE NON SUPPURATIVE OTITIS MEDIA---Retracted drumhead with a hiar-line or air bubbles on otoscopy," 

"OTOMYCOSIS---most common fugas aspergillus fumigatus," 

CSF OTORRHOEA--- fracture of petrous ridge/ petrous temporal bone,-

"PENDRED SYND.--Thyroid swelling + nerve deafness,"

 PARAPHARYNGEAL ABCESS---swelling in post. Part of middle1/3 of sternomastoid & tonsil is pused medially "

PAROSMIA---PERVERSION OF SMELL," 

"PHARYNGITIS- MEMBRANOUS---causes--streptococcal, ludwig's angina, diptheria, "-

 PHARYNGOMAXILLARY ABSCESS---medial bulge of pharynx , "

PLEOMORPHIC ADENOMA---most common tumour of parotid gland,"--- 

PNEUMATOCELE--seen in fracture of frontal sinus,----

 PROCESSUS COCHLEARIFORMIS--attaches to handle of mallues, "

RESP.ALLERGY--house dust,"--- "

RANADIER'S OPERATION---done in Petrositis,"

 CHRONIC RETROPHARYNGEAL ABSCESS--due to caries spine,- 

"SICCA RHINITIS--anterior nares inv.,", 

"RHINOLITH--- deposition of calcium around the F.B. in nose,"- 

RHINOPHYMA---hypertrophy of sebaceous gland,---

 "SINGERS NODULE---Voice abuse," 

"SCALA MEDIA ---shows endolymph,"-"

SCHIRMER'S TEST---for lacrimal secr. To test facial nerve,"-- "

SEMICIRCULAR CANALS--senses Angular movements,"---- 

"SCHWARTZ SIGN ---seen in otosclerosis,"- 

"SCHWARTZE OPERATION---done in CSOM,"- 

"SPEECH DISCRIMINATION SCORE---lowest in retrocochlear SND,"---- 

"ALPORT'S SYND.---SNHL+Hereditary nephritis,"----

 "TEMPORAL BONE---petrous part-inner ear,"--- 

"TONE DECAY TEST---done to fineout retrocochlear lesions,"--

 "TOBEY AYER TEST---Lateral sinus thrombosis,"- 

"TRACHEOSTOMY TUBE---double tube, made of Titanium silver alloy, cuffed tube is used for IPPV,

" "TROTTER'S TRIAD---seen in nasopharyngeal ca.,"- "

UMBO---most reliable landmark on otoscopy,"--- 

"VERTIGO---peripheral/ labyrinthine V. fes--unidirectional nystagmus, marked vertigo, ass.central abn.absent,"----

 "VESTIBULE---IS present in nose, larynx, pharynx,"---- 

"VESTIBULAR SCHWANOMMA---IOC--GADOLINIUM ENHANCED MRI,"---

 VIDIAN NERVE---/ NERVE OF PTERYGOID CANAL---, 

"VOCAL NODULES---present at junction of anterior 1/3 & post. 2/3, "- "

WOODRUFF'S AREA---post. End of inferior turbinate, "--

 "WALDERYER'S RING ---inner w.group of L.N.=tonsils, lingual tonsils, adenoids,"--

 "WARTHIN'S TUMOUR---Rx superior paratidectomy,"--- 

ZENKER'S DIVERTICULUM --- it's asymp. 

"AT BIRTH---following structures are of adult size--tympanic cavity, malleus, tympanic ring , except -mastoid antrum," 

"The ADDUCTION OF V.C. cannot occur while talking , but can occur with good cough --is a condition ass. With functional aphonia,"

 "SUPRAGLOTTIS--- include -aryepiglottic folds, false cords, laryngeal surface of the epiglottis,"

 "TRANSBRONCIAL BIOPSY---is thru. Fiber-optic bronchoscopy,"-

 "NORMAL RANGE OF frequency of human haering = 20-20,000 hz,"
 
"AUDIBLE SOUND FOR NORMAL HUMANHEARING = 40-45 db," 

"PROLONGED EXPOSURE TO NOISE LEVELS > 85 db can impair hearing permanently,"

 "RUPTURE OF T.M. /EAR DRUM occur at noise level > 160 db,

" "40 db COMPARED TO 20 DB is 100 TIMES,

 "RHINITIS SYNDROME---in mast cell mediator release category are categorised by sneezing , marked postnasal discharge, lacrimation,"
 
"WATER'S VIEW ( OCCIPITOMENTAL )--- provides good visualization of maxillary sinus, orbitofrontal sinus, frontal sinus," 

"CHILD WITH COMPRESSIBLE SWELLING ROOT OF NOSE---MENINGOMYELOCELE," 

"STRUCTURES PASSING between the upper border of the superior constrictor muscle & base of the skull are levator palati muscle & the cartilagineous eustachain tube," 

QUALITY OF VOICE--- not changed in total adductor palsy

 "FAMILIAL PREDISPOSITION of malignancies--- are seen in -breast, leukaemia, thyroid

 "GLOSSOPHARYNGEAL NERVE---supplies sensation to the middle ear mucous memb.,& tongue (post1/3)"

 "MICROPHONIC POTENTIALS ORIGINATING IN COCHLEA are resistant to Ischaemia,"
 
"IVORY OSTEOMA--- sen in fronto-ethmoidal region," 
"
PLICA SEMILUNARIS---is situated in Tonsillar area,"
 "
SUBMANDIBULAR GLAND SURGERY---may result in damage of 7,11,12 Cr.N.,"
 "
MICROLARYNGOSCOPY---size of lens used is 400mm.," 
"
VOCAL FREMITUS ---decreased in Emphysema , thick pleura, Pleural effusion,"
 
"common site of F.B. in lower respiratory tract is --Rt.Main Bronchus,"
 
"IMPAIRMENT OF hearing due to noise starts at ---4000 hz.,/ 4khz. 

"U-SHAPED AUDIOGRAM---CONGENITAL DEAFNESS,"

 FLAT AUDIOGRAM---SEROUS OTITIS MEDIA,

Anatomy points

RED ALERT POINTS For ANATOMY

1. Bile from quadrate and caudate lobe of liver usually drains into: Right hepatic duct
2.A fracture through the roof of maxillary sinus results in sensory loss to: Upper incisor and Canine teethQ
3.Inability to suck on a straw may indicate lesion of: VII Cranial NerveQ
4.Main pancreatic duct is derived from : Partly from the dorsal pancreatic bud and partly from the ventral pancreatic budQ
5.Labyrinthine artery is a branch of : Basilar arteryQw
6.Ophthalmic artery is a branch of : Cerebral part of ICAQ
7.Posterior communicating artery supply Crus cerebriQ
8.Ulnar nerve severed above elbow causes: Complete loss of sensation in 4th and 5th fingers, Paralysis of flexor carpi ulnaris and flexor profundusQ
9.Paralysis of T2 root causes : Reflex finger flexion test positiveQ
10.Superior vena cava syndrome due to carcinoma bronchus is treated by: external radiation- mediastitomy & chemotherapyQ
11.Short saphenous  vein  is a tributary of : Lateral marginal veinQ
12.Commonest parotid tumour : Pleomorphic adenomaQ
13.From Foramen caecum- gland derived is: ThyroidQ
14.Commonest cause of fresh  bleeding per rectum in a child is: IntussusceptionQ
15.Commonest cause of bleeding per rectum in 3rd and 4th decade is : Internal haemorrhoidsQ
16. The ventral mesogastrium of the embryonic gut develops into : Lesser omentumQ
17.Collecting tubules of the human kidney are derived from  : Ureteric BudQ
18.The origin of the Ovaries is from : Genital ridge
19.The taste sensation to the anterior 2/3rd of the tongue is subserved by : Chorda tympani nerveQ
20.Uterine artery is a branch of : Internal iliac arteryQ
21.The blood supply to the inner ear is derived from : Basilar arteryQ
22.Left testicular vein drains into : Left Renal VeinQ
23.Total bones in the body are: 206Q
24.Meckel’s diverticulum arises from : IleumQ
25.The abdominal organ most frequently injured is: SpleenQ
26.The cystic angle of Callot  includes: Liver, common bile duct , cystic duct, cystic artery , but Not HEPATIC ARTERYQ
27.Elbow is a condyloid jointQ
28.Distance between upper incisors and gastroesophageal junction : 40cmQ
29.The length of epiploic foramen is: 3cmQ
30.Ectopia cordis is associated with: Heart
31. Increased activity in Lateral hypothalamic nuclei would lead to eating.
32.Length of a mature human spermatozoon is: 50-60 micronsQ
33.Anterior interosseous nerve is a branch of: Median nerveQ
34.Gall bladder is lined by: Simple columnar epitheliumQ
35.Inferior vena caval opening of diaphragm is at the level of: 8th thoracic vertebraQ
36.Common carotid artery usually bifurcates at the level of: 4th Cervical vertebraQ
37.Cremasteric carotid arises from Inferior epigastric arteriesQ
38.Kerckring’s centre for ossification is associated with: Occipital boneQ
39.Ovum was discovered by: Von BaerQ
40.Axillary nerve and radial nerve are branches of posterior cord.
41.Superficial temporal, occipital, facial are direct branches of external carotid arteryQ
42.Proprioceptive fibres convey impulse from the : muscles, joints, semicircular canals of ears
43.The strong phagocytic cells are : Macrophages, Cell of KupfferQ
44.Flexors of the elbow are: Biceps & BrachialisQ
45.Lymphatic drainage of umbilicus includes : Groins & AxillaQ
46.Deep inguinal ring is: found in fascia transversalis, mid point between anterior superior iliac spine and pubic tubercleQ
47.Nerves to the capsule of thymus gland comes from : PhrenicQ
48.The maxillary artery is a branch of : External carotid arteryQ
49.Foramen spinosum transmitsQ: Meningeal branch of the Mandibular nerve , middle meningeal artery.
50.Father of the modern anatomy is: ANDREAS VESALIUSQ
51.Gartner’s duct is a remnant of : Wolffian ductQ
52.The vocal folds are abducted by: Posterior cricoarytenoid muscleQ

53.The miral orifice is at the level of: 4th costal cartilageQ
54.Anterior cardiac veins open into: Right atriumQ
55.Superior vena cava is formed at the level of: 1st costal cartilage.
56.The weight of the left lung of a healthy adult is approximately: 600gmsQ
57.Submucosal glands are present in: DuodenumQ
58.A rare abnormality sometimes occurs in right lung is called: Azygos lobeQ
59.Azygos vein passes through the aortic hiatus of the diaphragmQ
60. Which muscles puts the corkscrew in : Biceps brachiiQ
61.The portal vein is formed: by the superior mesenteric vein, splenic vein, at the level of 2nd lumbar vertebrQ
62.Mc-Burney’s point is located in the : Base of appendixQ
63.The contents of the superior mediastinum areQ arch of aorta, thoracic duct, right common carotid artery, but Inferior vena cava is NOT the content.
64. The supporting cells of the testes are: Cells of SertoliQ
65.Spleen is supplied by the coeliac arteryQ
66.The  foramen Rotundum transmits the : Maxillary nerveQ
67.Lateral medullary syndrome is due to involvement  of : Posterior inferior cerebeller arteryQ
68.The smallest part of male urethraQ is: Membranous.
69.The thickest nerve of the body is: Sciatic.
70.The length of external  acoustic meatus is approximately : 25mmQ
71.The length of esophagus (in inches) is: 10
72.Triceps is supplied by: Radial nerveQ
73.RisoriusQ: is the ‘Grinding muscle’.
74.A double aortic arch is due to persistent: Right 4th archQ
75.Rathke’s pouch gives rise to: Anterior pituitaryQ
76.Greater cornu of hyoid bone is developed from: 3rd pharyngeal archQ
77.The strongest ligament in the body is: Ileofemoral ligamentQ
78.Foramen of Winslow is: between greater and lesser sacQ
79.The right suprarenal vein drains into : Inferior vena cava
80.Winging of the scapula is due to injury to: Nerve supplying serratus anteriorQ
81.Pectinate line is an important landmark because it: marks a divide in nerve supply, location of change in type of epithelium, represents lymphatic and venous divideQ
82.Stylopharyngeus muscle is supplied by:  IX NerveQ
83.Temporomandibular joint is a: Condyloid jointQ
84.Increased thickness of skull bones is seen in: ThalassemiaQ
85.Broaca’s areas are: 44 and 45Q
86.Tonsil is mainly supplied by : Facial arteryQ
87.The great vein of Galen drains into the: Straight sinusQ
88.The Broaca’s areas are situated in the: Inferior frontal gyrusQ
89.The smallest cranial nerve is the: TrochlearQ
90.The Charcot’s artery is the branch of : Middle cerebralQ
91.Foramen transversarium transmits : Vertebral arteryQi
92.Output from cerebellum is solely from: Purkinje cellsQ
93.Danger area of face is so-called because of connection of facial veins to cavernous sinus through: Superior ophthalmic veinQ
94.Nasolacrimal duct drains into: Inferior meatusQ
95.The largest ganglion in the neck is : Superior ganglionQ
96.CSF  is contained in : subarachnoid spaceQ
97.Base of submental triangle is formed by : HyoidQ
98.Ridge of Passavant is found in: Superior constrictorQ
99.The rate of formation of CSF per day : 5000c.cQ
100.Medulla oblongata is also called: MyelonecephalonQ
101.Largest branch of vertebral artery is: Posterior inferior cerebellerQ
102.Andidrop effect of temperature regulation in hypothalamus is mediated  by : 5HTQ
103.Oesophagus crosses the diaphragm at the level of: T10
104.Root value of phrenic nerve is : C3-5
105.Anterior interventricular artery is a branch of : Left coronary artery
106.The coronary sulcus is occupied by the: Coronary sinusQ
107.Projecting from each Atrium of the heart is diverticulum of the : AuricleQ
108.Sequestration of lung is seen in : Posterior part of the lungQ
109.The superior most opening in the diaphragm is : Vena cavalQ
110.Lingula is a part ofQ: Left lower lobe.
111.Central tendon of Diaphragm is developed from: Septum transversumQ
112. Injury to radial nerve at wrist leads to : Sensory loss on adjacent sides of IIIrd and IV th fingers
113.Erb’s point is : C5,C6.
114.The cubital fossa is bounded by the: Brachioradialis
115.Porters tip deformity is seen in : Erb’s paralysis
116.Ulnar nerve: doesn’t pass through the carpal tunnelQ
117.Main action of quadrates femoris: Lateral rotationQ
118.At Talocalcaneal joint does inversion of foot occurQ
119.Foot drop is caused by damage to: Deep peroneal  nerveQ
120.Gluteus maximus muscle paralysis will affect the gait mostly at: Heel strikeQ
121.In walking gravity tends to tilt pelvis and trunk to the unsupported side . major factor in preventing this unwanted movement is: Gluteus medius and minimusQ
122.The main action of muscle “Gamellius “ is : Lateral rotation of thighQ
123.Muscles used in normal walk during stance and swing: GastrocnemiusQ
124.Clitoris develops from: Genital tubercleQ
125.Superior radioulnar joint is: Pivot type of jointQ
126.In Prone position Diaphragm is at the lowest level
127.The narrowest part of male urethra is the: External urethral meatusQ
128.Length of female urethra is : 4cm
129.Transpyloric plane passes through: 1st lumbar vertebraQ
130.Meckel’s diverticulum: contains all the layers of the gutQ
131.The pancreatic islets start secretion at: 3rd monthQ
132.Skin around umbilicus is supplied by: T10.
133.Pleural reflection on left mid axillary lineQ is in inter-costal space: 10
134.Abdominal aorta bifurcates at lower border of: T12Q
135.Neural tube develops from: EctodermQ
136.Pinna is formed at birthQ
137.C-cells in thyroid gland are derived from: Secondary areolaQ
138.The supporting cells of testes are : cells of SertoliQ
139.In the formation of sperm , part of the golgi apparatus gives rise to the : AcrosomeQ
140.Three mitral orifice is at the level of: 4th costal cartilageQ
141.Sympathetic supply to the heart is from : T1-T5
142.The lower angle of scapula lies at the level of : T8.
143.The highest point of iliac crest is at the level of: L3-4.
144.Lymphatic drainage of testes is to: ParaorticQ
145.Facial nerve is the nerve of : Second archQ
146.Taste sensation from the posterior 1/3rd of tongue are carried by: Glossopharyngeal  nerveQ
147.Nerve supply to platysma is : facialQ
148.The epiphysis at the tip of coracoid process isQ: Atavistic.
149.Ear lobule is made up of: Elastic cartilageQ
150.Superior mesenteric artery supplies: ColonQ
151.Portal vein is formed by union of : SMV & SVQ
152.Sphenoid  is Not a bone of quadrilateral cartilage.
153.Hypogastric nerve: is Not a content of broad ligamentQ
154.Pleura extends to 10th ribQ in mid axillary line.
155.Umbilical vein becomes: Ligamentum teresQ
156.Spermatid doesnot undergo division.
157.Floor of 4th ventricle is not formed by: inferior medullary velumQ
158.Goblet cells are Not found in stomach.
159.The first bone to ossify in body is: ClavicleQ
160.Ileoinguinal nerve : is responsible for Cremasteric Reflex
161.The posterior relation of epiploic foramen is: inferior vena cavaQ
162.The structure related to arch of aorta is : tracheal bifurcation, bifurcation  of pulmonary trunk.
163.Ureter : is related to lateral wall of Vagina
164.The narrowest part of ureter is : at the entry of bladderQ
165.Taste fibres are relayed in : Tractus solitariesQ
166.The membranous part of the interventricular septum is situated between: Right ventricle and left atriumQ
167.The structure that passes deep to the flexor retinaculum is : Tibialis posteriorQ
168.Flexor digitorum brevisQ:   is found in the first layer of the sole.
169.Foramen of Morgagni Qrefers to an opening in: The Diaphragm.
170.The Chorda tympani nerve arises from: the facial nerveQ
171.Thoracic duct terminates into the left brachiocephalic vein at the junction of: Internal jugular vein and brachicephalic veinQ
172.The stapes is a derivative of: 2nd arch.
173.Uvula seen in bladder is: Median lobe of prostateQ
174.Mitochondria of a sperm is seen in: BodyQ
175.Nucleus was launched in: NotochordQ
176.The lung  disease associated with mesothelioma is : AsbestosisQ
177.Superior relation of uncinate process : EthmoidQ
178.Posterior communicating artery supplies crus cerebri.
179.Foramen spinosum transmitsQ: meningeal branch of the mandibular nerve , middle meningeal artery.
180.The lower angle of scapula lies at the level of: T8.
181.Superior  radioulnar joint is : Pelvic ureteric junctionQ
182.Short saphenous vein is a tributary of: Lateral marginal veinQ
183.Meckel’s diverticulum arises from : IleumQ
184.The length of epiploic foramen is 3cm.
185.Kerckring’s centre for ossification is associated with: Occipital boneQ
186.Genu of internal capsule has: sensory fibres from thalamus to brainQ
187.Vital point is found in : medulla oblongataQ
188.Drainage of CSF from lateral to third ventricle is through: Foramen of MunroQ
189.Earliest sign seen in acoustic neuroma is: Reduced corneal reflexQ
190.Lateral boundary of cubital fossa is formed by: brachioradialisQ
191.Paralysis of opponens muscle leads to loss of : Pinching thumbQ
192.Geniculate bodies is not a part of epithalamus.
193.Nucleus in brain common to IX, X, & XI Cranial nerves : Nucleus AmbiguousQ
194.Corticonuclear fibres does not pass through post. Limb of internal capsule.
195.Dorsal nucleus of vagus  belong to the general visceral efferent columnQ
196.Closure of neural tube begins at : CephalicQ
197.Delphic nodes are : PretrachealQ
198.Primary defect in structure is known as : MalformationQ
199.PectineusQ is not a composite muscle.
200.Femoral nerve : escapes entrapment syndromeQ
201.CSF pressure depends primarily on: Rate of CSF absorptionQ
202.Fascia around nerve bundle of branchial plexus is derived from: Prevertebral fascia.
203.Spleen projects into Greater sac of peritoneal cavity.
204.Serratus anterior doesnot form a boundary of the triangle of auscultationQ
205.Facial angle Q is a rough index degree of development of: Brain.
206.The last tributary of the azygous vein is: Right Bronchial VeinQ
207.Von Brun’s nest is seen in : Normal UrotheliumQ
208.Ureteric peristalsis is due to intact supply of: both sympathetic and parasympathetic.
209.Ureter develops from: mesonephric ductQ
210.Preaortic is the terminal groupQ of lymph node for colon.
211.Sphincter of Oddi Qconsists of: 3 sphinters.
212.Aortic hiatusQ contains : Azygous vein and thoracic duct.
213.VIII Cranial nerve affects: EquillibriumQ
214.Aureback and Meissner plexus are derived from : Neural crestQ
215.Ureter is Not Felt with per rectal examination.
216.Cranial nerve parasympathetic is not supplied by: TrochlearQ
217.Lymphatics is the most medial in the femoral triangle.
218.Deep peroneal  nerve provides sensory innervation to : 1st web spaceQ
219.Psoas : is a flexor of hip.
220.Friction:  is not a type of epiphysis.
221.Clavipectoral fascia Qis not pierced by: Medial pectoral nerve.
222.Epiplocele contains : OmentumQ
223.During ejaculation sperm is released from : EpididymisQ
224.Prostate containsQ: Glandular tissue covered with transmitted epithelium.
225.Myelination in CNS is done by: OligodendrocytesQ
226.Superficial palmer arch is related to : Distal end of fully extended thumbQ
227.Lower one fourth of vagina is formed by : Urogenital sinusQ
228.Craniosacral neresQ contain : Parasympathetic preganglionic fibres.
229.Subcutaneous muscle is : Palmaris longusQ
230.First costochondral  is not fibrous jointsQ
231.Incudomalleolar joint is a : Saddle jointQ
232.Midgut is supplied by: Superior mesenteric arteryQ
233.Magendie foramenQ , drains CSF from 4th ventricle and exits from it.
234.Upper 1/3rd of Vagina is derived from : Mullerian ductQ
235.Protractor or muscle of Scapula : Serratus interiorQ
236.Unlocker of knee : PopliteusQ
237.Tendon to obturator externus is not entering lesser sciatic foramen.
238.Atavistic epiphysis is found in : Coracoid processQ
239.Parasympathetic nerve supply to parotid salivary gland by : Otic ganglionQ
240.Medial border of Hasselbach’s triangle: Lateral border of rectusQ
241.Pain from external haemorrhoids is carried by: Pudendal nerveQ
242.Reffered otalgiaQ from base of tongue or Oropharynx is by : IX nerve.
243.Nerve supply of angle of mouth : C2.3.
244.Spina ventosa is due to : Infection .
245.Great auricular nerve originates from : C2.3.
246.Appendix of testisQ arise from : Paramesonephric duct.
247.Klumpke’s paralysis is injury to : C8,T1.
248.Haemoperitoneum  doesnot occurs in : Perforation of colon.
249.Hypercalcemia : is not the complication of Total thyroidectomy .
250.Meckel’s diverticulum: doesnot always contains gastric mucosa.
251.Superior cerebeller artery : doesnot supply Medulla.
252.Ascending cervical artery : doesnot passes throughQ Foramen magnum.
253.Decidua parietalis : is not the part of Placenta.
254.Tibialis posterior is not inserted in : TalusQ
255.The distal row of carpal bone doesnot includes : LunateQ
256.Gluteus maximus : is not abductor of Hip joint.
257.Naso;acrimal duct : doesnot drain into middle meatus of NoseQ
258.Anterior cardiac vein : doesnot drain into coronary sinusQ
259.Ulnar nerve: doesnot pass through the carpal tunnelQ
260.Right Phrenic nerve  : doesnot pass through aortic opening in DiaphragmQ
261.Internal pudental vessel : doesnot pass through lesser sciatic foramenQ
262.Ilio inguinal nerve : doesnot passes through deep inguinal ringQ
263.Posterior wall of inguinal canal is not formed by: Internal obliqueQ
264.Collagen is not found in: FibroblastsQ
265.Inferior gluteal vessels : doesnot passes through lesser sciatic foramenQ
266.Cell division: doesnot produces haploid number of chromosomes.
267. Prostatic utricle : is not derived from mesonephric ductQ
268.Ophthalmic nerve : doesnot pass through optic nerveQ
269.Sphenoid sinus: is not at risk in anterior cranial fossa fractureQ
270.Right  gastric artery : is not the branchQ of coeliac trunk.
271. The tributaries of the inferior vena cava does not include: Left gonadal veinQ
272.Right bronchus : does not press over the oesophagusQ
273.Cranial part of accessory nerve doesnot supplies : Tensor veli palatiQ
274.Elevation of scapula is not caused by : Latisimus dorsi
275.Inferior cerebellar peduncle  does not have : Pontocerebeller tractQ
276.Posterior auricular artery: is not arterial supply of sternocleidomastoid muscle.
277.Buccinator muscle is not pierced by: Buccal branch of facial nerveQ
278.Bipolar cells : are not present in cerebral cortex.
279.Urothelium : doesnot lines Collecting duct.
280.Tredelenburg test is not positive due to injury to : Superior gluteal Q
281.Deltoid ligament is not attached to : Medial cuneiformQ
282.Choroid plexus :  is not a pain sensitive structure of BrainQ
283.Retraction of scapula is not achieved by : Levatot scapulaQ
284.Pubovaginalis : is not the content of vaginal sphincterQ
285.Tibial nerve: cannot involved in an injury to the head of the Fibula.
286.4th part of Duodenum : is not a boundary of Epiploic foramen.
287.Fibrocartilage is not present in : Pinna.
288.Thyroid: is not a elastic cartilage.
289.Caudate: is not a cerebellum nuclei.
290.Corticospinal : is not a afferent fibres from thalamus.
291.The Sphenopalatine foramen is not formed by : Vomer
292.Denonvilliers fascia : doesn’t seperates prostate and urinary bladder
293.Interfoveolar ligament forms lateral two third of anterior wall: is incorrect about relation of Inguinal canal

National Programme for Control of Blindness

National Programme for Control of Blindness

National Programme for Control of Blindness was launched in the year 1976 as a 100% Centrally Sponsored scheme with the goal to reduce the prevalence of blindness from 1.4% to 0.3%. As per Survey in 2001-02, prevalence of blindness is estimated to be 1.1%. Rapid Survey on Avoidable Blindness conducted under NPCB during 2006-07 showed reduction in the prevalence of blindness from 1.1% (2001-02) to 1% (2006-07). Various activities/initiatives undertaken during the Five Year Plans under NPCB are targeted towards achieving the goal of reducing the prevalence of blindness to 0.3% by the year 2020. 

Main causes of blindness are as follows: - Cataract (62.6%) Refractive Error (19.70%) Corneal Blindness (0.90%), Glaucoma (5.80%), Surgical Complication (1.20%) Posterior Capsular Opacification (0.90%) Posterior Segment Disorder (4.70%), Others (4.19%) Estimated National Prevalence of Childhood Blindness /Low Vision is 0.80 per thousand

Goals & Objectives of NPCB in the XII Plan

· To reduce the backlog of blindness through identification and treatment of blind at primary, secondary and tertiary levels based on assessment of the overall burden of visual impairment in the country.
· Develop and strengthen the strategy of NPCB for “Eye Health” and prevention of visual impairment; through provision of comprehensive eye care services and quality service delivery.
· Strengthening and upgradation of RIOs to become centre of excellence in various sub-specialities of ophthalmology
· Strengthening the existing and developing additional human resources and infrastructure facilities for providing high quality comprehensive Eye Care in all Districts of the country;
· To enhance community awareness on eye care and lay stress on preventive measures; 
· Increase and expand research for prevention of blindness and visual impairment
· To secure participation of Voluntary Organizations/Private Practitioners in eye Care

BLOOD- BANKING

BLOOD- BANKING

SAGM additive solution provides
optimum red Cell viability

1) Sodium Chloride provides isotonicity
2) Adenine maintains ATP for red cell viability
3) Glucose supports red cell metabolism
4) Mannitol helps reduce red cell lysis

• Shelf life (whole blood / red cells ) in :

1) ACD( acidified citrate dextrose) = 21 days
(> 70% transfused cells viable after 24 hours)
2) CPD( Citrate phosphate dextrose) = 28 days
3) Citrate Phosphate Dextrose Adenine (CPDA) = 35 days
4) SAGM ( Saline Adenine Glucose Mannitol)= 42 days
• Whole blood:
Storage temp.= 2-6 0c
1 unit raises Hb by ---1gm/dl and haematocrit by 3%.

After collection from donor ,blood should be processed for component separation within 6 hrs
• Storage and duration
1) Whole blood / packed red cells--- 2-6 0c for 42 days
2) Platelets----22-24 0c for 3 days with continuous agitation
3) Fresh frozen plasma---below -25 0c for 1 year
4) Cryoprecipitate------ below -25 0c for 1 year
• Transfusion protocols:
Transfusion should commence within 30 minutes of removing blood bag from refrigerator of blood bag.
(after that it will increase risk of bacterial contamination)

1) Whole blood /packed rbc --transfusion must be completed within 4 hrs.
2) Platelet and FFP----within 20 minutes.
Transfusion set should have standard filter of 170 micron meter pore size
Usual needle size =18-19 gauge
Not necessary to warm blood before transfusion
Patient should be monitored during 1st 15 minutes, following this every hour, at the end and after 4 hrs after end of transfusion.

Dermatology signs

Eponymous signs in dermatology - Albright's dimple sign

This is seen in Albright's hereditary osteodystrophy in which there is presence of a dimple over the knuckle of the typically affected fourth metacarpal and can be enhanced by clenching of the fist.[3,4]

Antenna sign

It is seen in keratosis pilaris in which individual follicles show a long strand of keratin glinting when examined in tangentially incident light.[5]

Asboe-Hansen sign (Blister spread sign)

Gustav Asboe Hansen first described it in 1960, when he demonstrated enlargement of bulla by applying finger pressure to small, intact, and tense bulla in patients with pemphigus and bullous pemphigoid.[6] In the traditional bulla spread sign, pressure is applied to the blister from one side, whereas in eliciting Asboe-Hansen sign pressure is applied at the center of the blister and perpendicular to the surface due to smaller size of the lesion.

Auspitz sign

It is a celebrated sign of dermatology named after Heinrich Auspitz, described in psoriasis, where there is pinpoint bleeding on removal of scales from the lesions of psoriasis. The test by which Auspitz sign is elicited is called as Grattage test. Other dermatoses where Auspitz sign can be positive is Darier's disease and actinic keratosis.[7]

Barnett's sign (scleroderma neck sign)

It is ridging and tightening of the skin of the neck on extending the head with a visible and palpable tight band over platysma in the hyperextended neck.[8,9]

Branham's sign (Nicoladoni sign)

It is to be elicited in cases of arterio-venous fistula where there is slowing of the heart rate in response to (manual) compression.[10]

“Breakfast, lunch, and dinner” sign

The bites of bed bugs (Cimex lectularius) usually follow a linear pathway in a group of three to five blood meals and are often referred to as “Breakfast, lunch, and dinner” or “Breakfast, lunch, and supper” sign.[11]

Buschke-Ollendorff sign

This is a sign to be elicited in case of secondary syphilis and cutaneous vasculitis, where there is deep dermal tenderness on pressing the lesion (e.g., papular lesions of syphilis) with a pinhead.[12]

Butterfly sign

This refers to sparing of the mid scapular region in patients having prurigo nodularis with neurodermatitis as they are unable to reach the region for scratching.[13]

Buttonhole sign

In type 1 neurofibromatosis (Von-Recklinghausen's disease), neurofibromas can be invaginated with the tip of index finger back into the subcutis and again reappear after release of pressure.[14] Other condition where one can find positive buttonhole sign are anetoderma and dermatofibroma.

Carpet tack sign (Tin tack sign, Cat tongue sign)

When the adherent scale is removed from the lesions of discoid lupus erythematosus, the undersurface of the scale shows horny plugs that have occupied patulous hair follicles. This sign is also seen in seborrheic dermatitis.[7]

Chagas–Mazza–Romaña's sign

In about eighty percent of cases of Chagas’ disease (American trypanosomiasis), conjunctiva is the portal of entry for Trypanosoma Cruzi. Unilateral swelling of eyelids and orbit after conjunctival inoculation is called as eye-sign or Chagas–Mazza–Romaña's sign or Romaña's sign.[15]

Coral bead sign

Papules seen around the nail fold in multicentric reticulohistiocytosis are called as coral bead sign.[16]

Coudability sign

It was first described by Shuster in cases of alopecia areata in 1984. Coudability sign is normal-looking hairs tapered at the proximal end in the perilesional hair-bearing scalp and can easily be made to kink when bent or pushed inward.[17]

Crowe's sign

Axillary freckling seen in type I neurofibromatosis is known as Crowe's sign.[18] (See also Patrick Yesudian sign)

Cullen's sign

Periumbilical ecchymosis in cases of acute hemorrhagic pancreatitis and ruptured ectopic pregnancy is termed Cullen's sign. Similar changes in the flank is called as Grey-Turner sign.[19]

Deck-chair sign

It was classically described in Papulo-erythroderma of Ofuji, wherein there is flat-topped red papules that become generalized erythrodermic p