- Hepatic veins & Portal veins
- Hepatic vein & biliary ducts
- Portal vein & Biliary ducts
- Portal vein & Hepatic artery
- Segment I & IVa
- Segment I & IVB
- Segment II & III
- Segment I & II
- Segment V
- Segment III
- Segment VI
- Segment VII
- V , VI , VII , VIII Segments
- IV , V , VI , VII , VIII Segments
- I , II, V , VI , VII
- III , IV , V, VI
Q5] Aprroximately what % of total blood supply comes from hepatic artery….
- < 10%
Q6] False about Hepatic Duct… [ AIIMS MAY 2009]
- Left hepatic duct formed in umblical fissure
- Caudate lobe is drained only by left hepatic duct
- Right anterior hepatic duct formed by V & VIII Segments
- Left hepatic duct crosses IV segment
Q7] Most common variant of normal anatomy of hepatic artery….
- division into right and left hepatic artery after giving off gastroduodenal artery
- division into right and left hepatic artery before giving off gastroduodenal artery
- replaced right hepatic artery ie origin of right hepatic artery from superior mesentric artery
- replaced left hepatic artery ie origin of right hepatic artery from superior mesentric artery
- kidney > liver > skeltal muscle > brain
- liver > kidney > skeltal muscle > brain
- skeltal muscle > brain > kidney > liver
- liver > skeltal muscle > brain > kidney
Q9] True about common bile duct all except…[AI 2000]
- Opens 10 cm distal to pylorus
- lies anterior to IVC
- Portal vein lies posterior to it
- usually opens into duodenum separate from the main pancreatic duct
- Right anterior hepatic duct is formed from segments V & VIII
- Right posterior hepatic duct is formed from segments V & VIII
- left anterior hepatic duct drains segment III , IV
- left posterior hepatic duct drains segment II
ALTERNATIVELY U CAN ANSWER THESE Q IN QUIZZ FORMAT BY CHOOSING OPTIONS AT FOLLOWING LINK http://pguploads.polldaddy.com/s/liver-anatomy-10-q
Answers (Highlighted and star marked )
Q1] Which of the following statements is not true about lumbar hernia….
[a] Lumbar hernia is congenital in 20% cases and congenital lumbar hernia are usually bilateral.
[b] Herniation is more common through superior lumber triangle and more commonly occurs in left side as compared to right.
[c] Lumbar hernia tend to increase in size and should be repaired whenever found.
[d] Howship -Romberg sign is positive in lumbar hernias.
[e] In erect posture presence of reducible and often tympanitic mass in flank usually makes the diagonosis.
ANS [D] Howship -romberg sign : pain abdomen extends down the medial aspect of thigh with abduction, extension or internal rotation of thigh. This is most specific clinical finding of a OBTURATOR HERNIA
SEE THE FIGURE BELOW
Ref CSDT pg no 794 / 11 ed.
Q1] Rotator cuff/ musculotendinous cuff of shoulder is a fibrous sheath formed by four flattened tendons which blend with capsule of shoulder joint and enforces it. Which of the following statements is false about rotator cuff….
A] All four muscle arise from scapula and are inserted into tuberosity of humerous.
B] All four muscle do external rotation of arm.
C] Rotaror cuff gives strength to capsule of shoulder joint all around except inferiorly.
D] Rotator interval is space between supraspinatous and subscapularis.
ANS [B] SEE THE TABLE BELOW
Q2] Which part of rotator cuff is in greatest tension during overhead abduction and hence is most commonly affected tendon in rotator cuff tendinitis/tear…
C] TERES MINOR
ANS [A] SEE FIGURE BELOW
Q3] All of following specificaly indicate complete rotator cuff tear in a patient presenting with shoulder pain except….
A] Neer impingement sign positive
B] JOBES test positive
C] Contrast flooding subacromial bursa when injected into glenohumeral joint during arthrography.
D] Hyperintense signals on T2 MRI that extends throughout tendon.
E] Diffusely hypoechoic tendon on USG.
ANS: [A] , [B], [E]
[A] = NEER IMPINGEMENT SIGN IS +VE in any cause of anterosuperior impingement as in subacromial bursitis or partial tendon tear.
[B] JOBES TEST can be +ve in partial tears also.
[E] normally tendon is echoic structure whereas fluid is hypoechoic so diffusely hypoechoic tendon denotes tendinitis and not tear.
NOTE : ON T2 WATER IS HYPERINTENSE IE WHITE SO TENDON TEAR APPEAR AS HYPERINTENSE SIGNAL.
SEE FIGURE BELOW:
NOTE POINTS: 1] LIFT OFF TEST IS DONE TO ASCESS ISOLATED SUBSCAPULARIS TEAR= “FORGOTTEN TENDON” [AI 2010]
2] SHOULDER JOINT CAPSULE HAS 2 OPENINGS ONE FOR LONG HEAD OF BICEPS AND BY OTHER IT COMMUNICATES WITH SUBSCAPULAR BURSA.
3] THOUGH JOINT CAPSULE IS LEAST REINFORCED INFERIORLY ,MOST COMMON TYPE OF SHOULDER DISLOCATION IS ANTERIOR OF SUBCORACOID TYPE.
4]In subacromial bursitis pressure over deltoid below acromian in adducted arm produces pain but this pain dissapears when same test is repeated in abducted position . This sign is clled as DAWBARNS SIGN.
References . CODT 3ed page 191.  BDC vol 1 page 79 4th ed  campbells orthopedics 11th ed page 2607  @medscape
Hyoid bone is present at level of base of mandible & C3 vertebra . It is kept suspended at this level by muscle and ligament attachment.
DEVELOPMENT : SEE FIGURE BELOW
OSSIFICATION: It ossifies from 6 centres [ 2 primary centre for each greater cornu + 2 secondary centre for each lesser cornu + 2 secondary for body].
MUSCLE ATTACHMENT :
[A] BODY ;1.anterior surface = geniohyoid + myelohyoid+ hyoglossus(also from greater cornu)
2. upper border = genioglossi & thyrohyoid membrane.
3. lower border = 3 strap muscle = sternohyoid , thyrohyoid( some par extend to greater cornu) ,omohyoid ( note that sternothyroid is also a strap muscle but as the name suggests it is not attached to hyoid)
[B] GREATER CORNU = Thyrohyoid memb (also on body) +digastric pulley + stylohyoid muscle+ thyrohyoid muscle ( also on body)
so hyoglossus originates from body + greater cornua (q)
[C] LESSER CORNU = stylohyoid ligament ( note that stylohyoid muscle originate from greater cornua)
note: Middle constrictor originate from lesser cornua + greater cornua.
NERVE SUPPLY OF STRAP MUSCLE :see the figure below
1. superior belly of omohyoid= by superior root ie descending branch of hypoglossal nerve fibres of which are derived from C1 ventral ramus.
2. sternohyoid + sternothyroid+ inferior belly of omohyoid = ANSA CERVICALIS.
3 NOTE THAT thyrohyoid is not supplied by ansa cevicalis , it alongwith geniohyoid is supplied by C1 through hypoglossal nerve.
Note : hyoid fracture is most likely to occur in THROTTLING > STRANGULATION> HANGING.
REF: bdc 3rd ed page 30, Langman embryology 10ed page 261
diagram : sujeet kumar