Anatomy books

Wednesday, February 28, 2024

Clinical questions : scalp Why do scalp wounds bleed profusely?

 To help you recall the layers of the scalp, which are Skin, Dense Connective Tissue, Epicranial Aponeurosis, Loose Areolar Connective Tissue, and Periosteum, try using the acronym "SCALP."

The skin is home to many sebaceous glands and hair follicles, making it a typical location for sebaceous cysts.
The layer that joins the epidermis to the epicranial aponeurosis is called dense connective tissue. It has a dense innervation and vascularization.
The blood vessels in the layer have a strong bond with the connective tissue. This prevents them from completely constricting in the event of a laceration, which increases the risk of excessive bleeding on the scalp.
The tendon-like structure known as the epicranial apontoneurosis joins the frontalis and occipitalis muscles.

Why do scalp wounds bleed profusely?

The second layer of the scalp is composed of fibrous tissue, which adheres to the blood vessel walls on the outside. The scalp has a large blood supply. As fibrous tissue forces the blood vessel wall outward when it is cut or sliced, the blood vessels are unable to retract, resulting in extensive bleeding.

Why is the fourth layer of scalp, or loose areolar tissue, referred to as the "dangerous layer of scalp"?

Because it contains the emissary veins that connect the scalp's veins to the intracranial dural venous sinuses, the subaponeurotic loose areolar connective tissue layer is referred to as a dangerous layer of the scalp because it tends to collect blood and pus. This means that infection from this layer can easily spread along the emissary veins and enter the intracranial venous sinuses.


Tuesday, February 27, 2024

Difference between skeletal muscle and cardiac muscle : easy notes for written examination

 Skeletal muscles are voluntary muscle which attached with skeleton of body , helps in movement .

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Cardiac muscle pump blood and form myocardium of heart 

Topics 
Skeletal
Cardiac
Shape and size 
long and cylindrical 
Short, cylindrical 

Location
 skeleton muscle (muscle attached with skeleton) 
Heart, SVC, IVC

Connective tissue components 
Epimysium (cover whole muscle) , 
perimysium (cover individual muscle bundle)  
Endomysium (cover individual muscle cell) 

Endomysium
Branching
Absent
Present

Striation

Present

Present


Nucleus
Multinucleated & Peripherally placed 
Single centerally placed 
Cell to cell junctions
None
Intercalated disks containing
  1. fasciae adherents
  2. macula adherens
  3. gap junctions
Special features
Well-developed sER and T- tubules

Intercalated disks
Functions
Voluntary
Involuntary

Regeneration
Limited
None

Difference between primary and secondary cartilaginous joint

 Difference between primary and secondary cartilaginous joint 

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Cartilaginous joints : articular surfaces of two bones are connected by cartilage. 


Theses joints are formed by only hyaline cartilage or both hyaline  and fibrocartilage. 

Primary cartilaginous joint
Secondary cartilaginous joint
It is also known as Synchondroses
it is also known as symphysis
articular surfaces are connected by hyaline cartilage  
articular surfaces are covered by thin plates of hyaline cartilage which is separated by fibro-cartilage.
It is a temporary joint
It is a permanent joint
Hyaline cartilage of joint is converted into bone
thin hyaline cartilage and fibrocartilage are not converted into bone
they are not located in the median plane 
they are usually located in the  median plane
It allows no movement
It allows little movement
they make very strong joint Exmple: costochondral joint
they make relatively strong joint example : menubriosternal join

The midline anterior abdominal incision

 

The midline anterior abdominal incision

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Extension: from the xiphoid to the pubic symphysis.

Advantage or use of this incision

1.       Bloodless

2.      No muscle cut

3.      No nerves divided

4.      Less complication during incision

5.      Rapid and easy closer possible

6.      When wide exposure is required

Disadvantage / need to be careful

The upper region of the midline contains the ligamentum teres and the falciform ligament; therefore, the peritoneum should open just to the left or right of the midline to prevent damage to this structure.

Following structure cut during this incision

1.       Skin,

2.      Subcutaneous fascia and  fatty tissue,

3.        Linea alba, is formed by the union of aponeuroses (of the muscles of the anterior abdominal wall) that collectively make up the rectus sheath.

4.       Transverse fascia

5.      Extra-peritoneal fat and

6.      Peritoneum

Development of male reproductive system : lecture note

 

Development of male reproductive system

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When fertilization occurs, the genetic makeup of the male gamete (22X or 22Y) determines the sex of the developing embryo.

The process of sex differentiation is complicated and multigenic.
The most significant one is the Y chromosome gene's sex-determining region (SRY), whereas certain autosomal chromosomal genes are also involved in this process.

On the short arm of Y chromosome Yp11, the SRY gene is located. Male development is influenced by the SRY protein, whereas female development is developed in its absence.

Indifferent gonad

Up to 6 weeks of development, gonads are two longitudinal genital ridges, at the dorsal body wall of embryo which develop from intermediate mesoderm.

The genital ridge is formed by coelomic epithelium and underlying mesoderm. The coelomic epithelium forms irregular sex cords in both male and female embryos, and it is not possible to distinguish between male and female gonads at this stage, so this stage of development is known as indifferent gonads.

By the 12-week mark, the male and female structures of the external genitalia can be differentiated.

By the 20th week, the phenotypical differentiation is complete.

Source of development of gonad

  1. Genital ridge: it is formed by the elevation of the intermediate mesoderm, which is covered by the coelomic epithelium. 
  2. Primordial germ cells

The STY gene produces a protein known as a testis-determining factor.

TDF induces the testis to secrete FGF9, which stimulates the mesonephric duct to penetrate the gonadal ridge.

The SRY gene also produces SF1, which stimulates the differentiation of sertoli and leydig cells, which produce testosterone and Mullarrian-inhibiting factor (MIF), respectively.

In the presence of TDF, testosterone, and MIF, the indifferent gonad will produce a male phenotype.

In the absence of TDF, testosterone, and MIF, the indifferent gonad will produce a female phenotype.

Sequence of development of reproductive system

Gonads > then genital duct formation > then formation of external genitalia

Development and migration of primordial germ cells originate from the epiblast, then migrate through the primitive streak to reach the endodermal cell of the yolk sac close to allantois by the 3rd week. During the 4th week of development, they pass through the dorsal mesentery of the hindgut, and by the 5th week of development, they reach near the genital ridges and start to penetrate the genital ridge by the 6th week.

If primordial germ cells have an inductive influence on the development of the gonad, if they fail to reach the genital ridges, the gonad will not develop.

 

Development of gonads

Development of testis

1.          Intermediate mesoderm forms the urogenital ridge, a longitudinal elevation at the dorsal body wall of the fetus.
The coelomic epithelium and underlying mesoderm of the urogenital ridge protifelate to form the gonadal ridge.
The coelomic epithelium forms irregular primary sex cords and incorporative primordial germ cells, which migrate from the wall of the yolk sac.
The primary sex
The development of the testis ord extends deep into the medulla to form medullary cords, which lose their connection to the surface epithelium as the thick tunica albuginea forms in between the medullary cord and coelomic epithelium.

2.       Near the hilum medullary cord break up into network of tiny cell stands that form rete testis

3.       By the 4th month of interuterine life medullary cord is continuous with rete testis

4.       The testis or medullary cord contain and primitive germ cells and sustentacular cell of  sertoli cell which derived from the surface epithelium of genital ridge.

5.       Sertoli cell secrete mullarian inhibiting factor (MIF) which degenerate mullarian duct

6.       Interstitial cell of leydig derive from mesenchyme of genital ridge which derived from intermediate mesoderm ,By the 8th week of gestation leydig cell begin to produce testosterone which influence development of genital duct and external genitalia

7.       The testis or medullary cord of testis remain solid cord until puberty , then it become canalize and known seminiferous tubule, the canal of seminiferous tubules are continuous with rete testis which inturn join with efferent ductile. The efferent ductules and other excretory part of male genital system derived from mesonephric or wolffian duct

 Relative descent of the testis

The testis originally developed within the abdomen but later descent to scrotum due to disproportionate growth of upper abdomen region away from the pelvic region

The gubernaculum testis a fibrous band extend from testis to scrotum pull the testis

The gubernaculum also pull part of peritoneum with it the processus vaginalis which obliterate later except a remnat of peritoneal sac the tunica vaginalis of the testis

12th week , testis reach inguinal region

28th week, inguinal canal

By 33rd week it reach the scrotum  

Genital duct in male

There are two genital ducts, mesonephric and paramesonephric ducts  are present in both sex at the initial period of development

In case male mesonephric duct is developed but paramesonephric duct mostly degenerate, while in case female para mesonephric duct is developed but mesonephric duct mostly degenerate

Gonads influence the development of genital duct and genitalia.

The Sertoli cell secrete mullarian inhibiting factor (MIF) which inhibit the development of paramesonephric or  mullarian duct

Interstitial cell of leydig derive from mesenchyme of genital ridge which derived from intermediate mesoderm ,

By the 8th week of gestation leydig cell begin to produce testosterone which stimulates the mesonephric ducts to form genital ducts .  Structure derived from mesonephric duct : Efferent ductules, epididymis, vas deferens, seminal vesicle and ejaculatory duct

The paramesonephric duct regress due to presence of Mullarian inhibiting factor secreted from the sertoli cell

The remnant of paramesonephric duct in male: Appendix testis , appendix epididymis,

, The remnant of mesonephric duct in male: paradidymis,

 

Development of external genitalia

Indifferent stage

In the 3rd week of development, mesenchymal cells origining in the region of the primitive streak migrate aroung the cloacal membrane to form a pair of slightly elevated cloacal folds , cranially these folds unit and form genital tubercles , caudally the folds are subdivided into urethral folds anteriorly and anal folds posteriorly .  another pair of swellings lateral to it known as genital swellings

A the end of the 6th week of development it is impossible to distinguish between two sexes.

Development of male external genitalia

Under influence of testosterone genital tubercle is elongated known as phallus which pull urethral folds forward

Phallus forms the (glans penis, corpora cavernosa and corpus spongiosum of penis )

Urethral folds form the ventral part of the penis

The genital swelling form the scrotum

Indifferent gonad : summary lecture

 

Indifferent gonad

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Up to 6 weeks of development, gonads are two longitudinal genital ridges, at the dorsal body wall of embryo which develop from intermediate mesoderm.

The genital ridge is formed by coelomic epithelium and underlying mesoderm. The coelomic epithelium forms irregular sex cords in both male and female embryos, and it is not possible to distinguish between male and female gonads at this stage, so this stage of development is known as indifferent gonads.

By the 12-week mark, the male and female structures of the external genitalia can be differentiated.

By the 20th week, the phenotypical differentiation is complete.

Source of development of gonad

  1. Genital ridge: it is formed by the elevation of the intermediate mesoderm, which is covered by the coelomic epithelium. 
  2. Primordial germ cells

The STY gene produces a protein known as a testis-determining factor.

TDF induces the testis to secrete FGF9, which stimulates the mesonephric duct to penetrate the gonadal ridge.

The SRY gene also produces SF1, which stimulates the differentiation of sertoli and leydig cells, which produce testosterone and Mullarrian-inhibiting factor (MIF), respectively.

In the presence of TDF, testosterone, and MIF, the indifferent gonad will produce a male phenotype.

In the absence of TDF, testosterone, and MIF, the indifferent gonad will produce a female phenotype.

Thursday, December 28, 2023