ANATOMY 2010/2009
PROBLEM1
Hosam ,abcess in the lat wall of left side of his nos..Q.(the only ANSWERS FROM DR AHMED GUNAID)
1-proper diagnosis:-->CAVERNOUS SINUS THROMBOSIS
2-infection spread from lat wall of nose through?OPHTALMIC VEIN
3-loss of sensation from middle part of face due to infection of:MAXILLARY NERVE
4-affected LN:submandibular LN
5-area drained ny affected LN:NOSE,CHEECK,UPPER LIP,LOWER LIP,FRONT OF SCALP.
PROBLEM2
A 56 year old man…right arm weakness&difficulty of speaking:
1- 1)artery affected-MIDDLE CEREBRAL ARTERY
2- 2) position of cortical area affected:
-motor area4-precentral gyrus of left hemisphere
-broca’s speech area-post part of inf frontal gyrus in dominant hemisphere.
3- part of internal capsule through which the fibres controlling the movement of are pass:
anterior half of POSTERIOR LIMB.
4-tract carrying the motor fibres:pyramidal tract
ESSAY QUESTIONS:
1.Relation of post limb of internal capsule:between thalamus&lentiform nucleus.
-Fibers passing through post limb of internal capsule:
| Ascending fibers | Descending fibers |
| Sup thalamic radiation | -corticospinal fibers -frontopontine fibers -frontorubral fibers/corticorubral |
2.origin&course of facial artery in face:
Origin: arise from the ant aspect of external carotid A in upper part of neck.
Course:it reach the face by piercing the deep fascia of neck at lower border of mandible.
-then it curve at antero-infero angle of masseter.
-in face,it has tourtous course upward &forward anterior to ant facial vein.
-it end at the angle of eye by becoming the angular artery(lateral nasal artery).
3.The lobes &f(x) of cerebellum:
|
| Ant lobe | Post lobe | Flocculonodular lobe |
| f(x) | Regulation of muscle tone | Coordination of movement | Concerned with equilibrium |
4.Cranial nerve nuclei in the pons:
1- trigeminal nuclei:
a) motor nucleus:its axon form the motor root of trigeminal nerve which join the mandibulat nerve
b) main sensory nucles:receive afferent touch&pressure sensation from trigeminal area fo face &scalp
send efferent fibres which cross to join the opposite trigeminal lemniscus
2- abducent nerve nuclei:
site:in the post aspect of the lower part of the pons near the floor of 4th ventricle.
-it is encircle by the fibres of facial nerve,raising a bulge called the facial colliculus
3- facial nerve nucleus:
a) motor nucleus:it efferent fibres encircle the abducent nucleus then pass anterolaterally to emerge at junction between medulla &pons.
b) Sup. Salivary nucleus:
its efferent fibres run in facial nerve as preganglionic parasympathetic fibres to relay in the spenopalatine &submandibular ganglia
3- vestibulocochlea nucleus:
a) vestibular nucleus:
b) cochlea nucleus:dorsal &ventral nuclei lying dorsal&ventral to inf cerebellar peduncle in the lower part of the pons.they receive impulse from internal ear via cochle nerve.
5.Development of thyroid gland: (from slide dr wafaa)
· the thyroid bud develops as andodermal thickening fromm floor of primitive pharynx between tuberculumm impar&copula of His of developing tougue at the midline
• Blind end of thyroid budàdilatesà descend caudally to the level of ultimobranchial body (4th pouch) which prevents its further descend in the thorax.
• The hollow distal blind endà solid flask shapedà solid crescenticà solid bilobed.
• Endodermal cells of thyroid budà thyroid follicles ( thyroxine).
• Ultimobranchial bodyà parafollicular cells ( c- cells) à calcitonin.
• Proximal part of the budà narrowà stalk attached to the tongue( thyroglossal ductà degenerate except at foramen caecum in the tongue.
Congenital anomalies of thyroid gland:
• 1- Persistant thyroglossal duct:
• a- Accessory thyroid tissue formed from remnants of the duct.
• b- Thyroglossal cyst : lies inferior to hyoid bone at the mid line of the neck ( movable with deglutition & painless).
• c- Thyroglossal fistula: formed after rupture of the cyst.
• 2- Ectopic thyroid gland:
• a- Lingual & sublingual thyroid due to incomplete descendà development inside or under the tongue.
• b- Retrosternal thyroid : due to excessive descend.
• 3- Agenesis: due to failure of growthà critinism.
• 4- superficial thyroid: It lies superficial to infrahyoid muscles.
2008-2009
Problem 1
A 56 year old man…right arm weakness&difficulty of speaking:
1.artery affected-MIDDLE CEREBRAL A
2.position of cortical area affected:
-motor area4-precentral gyrus of left hemisphere
-broca’s speech area-post paor of inf frontal gyrus in dominant hemisphere.
3- part of internal capsule through which the fibres controlling the movement of arm pass:
anterior half of POSTERIOR LIMB.
PROBLEM2
A 44 year old man fall from tree&develop a severe scalp hematoma.the superficial temporal artery continued to bleed internally because he took an anticoagulant drugs for artificial valve.
1- which arteries must be ligated?-->OCCIPITAL ARTERY
2- what is the site beginning of the ligated artery?-->ARISE FROM BACK OF THE EXTERNAL CAROTID ARTERY
3- What is the site of termination of this artery?-->POSTERIOR PART OF THE SCALP
PROBLEM 3
-65 year old patient
-underwent carotid end arterectomy due to carotid artery occlusion
-on approaching internal carotid artery,the surgeon severed a nerve embedded in the anterior wall of carotid sheath.
a)the severe nerve is?-->ANSA CERVICALIS
b)the nerve embedded in post wall of sheath?-->SYMPATHETIC TRUNK
c)what is the origin of severed nerve?-->C1,C2,C3
ESSAY QUESTIONS:
1. carotid triangle:
boundries:
-anterior border of sternomastoid muscle
-posterior belly of digastrics
-superior belly of omohyoid muscle
floor
-ant:thyrohyoid&hyoglossus muscle
-post:middle&inf constrictor of pharynx
roof:
-skin
-superficial fascia
-investing layer of deep fascia
contents:
arteries:-carotid arteries(common,iternal&external)
veins-internal jugular vein
nerves:last 3 cranail nerve(10th ,11th,12th )
2.blood supply of thyroid gland:
a) a) arterial supply:
-sup thyroid artery
-inf thyroid artery
-thyroidea ima artery
b)venous drainage:
-sup thyroid vein
-inf thyroid vein
-middle thyroid vein
3.the arteries forming the circulus arteriosus:
-internal carotid artery
-ant cerebral artery
-post cerebral artey
-ant communicating artery
-post communicating artey
4.pathway of vibration sensation from lower half of the body:GRACILE TRACT:
| 1st neuron | $dorsal root ganglia -their central process enter the spinal cord &ascend (without relay)in post column as gracile tract to reach the medulla |
| 2nd neuron | $gracile nuclei -axon of these cells curve forward &medially forming the internal arcuate fibers which cross the medulla forming sensory decussation -then thes fibers ascend in opposite side as medial lemniscus -medial lemniscus ascend to terminate in PLVN of thalamus |
| 3rd neuron | $PLVN of thalamus -axon of these cells pass post limb of internal capsule to reach postcentral gyrus. |
5.Development of tongue: (from slide dr wafaa)
1- The anterior two thirds:
Origin: The 1st Pharyngeal arch (mandibular processes)à two lateral lingual processes+ one tuberculum imparà meet à fuse à anterior 2/3 of the tongueà U shaped sulcusà mobile tongue leaving frenulum linguae.
2- The pharyngeal part (posterior third):
Origin: 2nd and 3rd pharyngeal archesà four swellings à meet à fuseà copula of Hisà posterior third of the tongue.
Musle of tongue:
— Three or four occipital myotomes migrate to enter the tongue forming muscles of the tongue.
— The occipital myotomes are supplied by the hypoglossal nerve which migrate with them to supply the tongue muscles during their development.
Congenital anomalies:
— 1- Bifid tongue: Due to incomplete fusion between the two lateral lingual swellings.
— 2- Trifid tongue: The tuberculum impar elongates& separates the lateral swellings à three parts.
— 3- Tie tongue ( ankyloglossia): due to attachment of frenulum linguae to the tip of the tongueà interfere with protrusion and speech.
— 4- Macroglossia: large tongue.
— 5- Microglossia: small tongue.
— 6- Hemiglossia: Non development of one lateral swelling.
— 7- Aglossia: no tongue.
THANK YOU, GOOD LUCK
