1- Femoral artery (origin /end /branches/surgical importance)

Origin: as a continuation of the external iliac artery

End: as popliteal artery
Branches:
superficial epigastric artery
superficial circumflex iliac artery
superficial & deep external pudendal
deep femoral artery
Surgical importance:
Cannulation, lacerations, occlusion

2- external iliac vein (begin /end /branches)

Begin: as a continuation of femoral vein
End: by joining internal iliac vein forming common iliac vein
Branches:
1-inferior epigastric vein 2-deep circumflex iliac vein

3- deltoid muscle (origin/insertion /n. supply/action /surgical importance)

Origin:
1- anerior border of the lateral 1/3 of the clavicle
2- lateral border of acromion
3- crest of spin of scapula
Insertion: deltoid tuberosity of humerous
N. supply: axillary nerve (circumflex nerve)
Action: extension and lateral rotation of the arm
Paralysis of deltoid flat shoulder deformity and failure of abduction from 15 – 90 degree.

4- gastrocnemius muscle (origin /insertion/n.supply/action)

Origin:
medial head: from popliteal surface of femur
Lateral head: lateral epicondyle of femur
Insertion : tendon Achilles inserts into the posterior surface of the calcaneus
Nerve supply : medial popliteal nerve.
Action : flexion of knee and planter flexion of ankle

5- Liver (ligament/anatomical lobe)

Ligaments: falciform ligament - ligamentum teres - ligamentum venosum - triangular ligament
Anatomical lobes: -large right lobe - small left lobe
6- esophagus (length/blood supply arterial, venous)
Length: 25 cm -
1
Blood supply:
Arterial
inferior thyroidal artery - esophageal branches from (aorta & left gastric)
Venous
Upper part: inferior thyroid vein
Middle part: azygous vein
Lower part: left gastric vein to portal vein

7-ulner nerve (branches)

Branches:
branch to flexor carpi ulnaris
br to medial ½ of flexor digitorum profundus
medial 1/3 of the palm and medial 1/3 of the back of the hand
back of medial 1 ½ finger
br to adductor pollicis
bra to 3 muscle of the hypothenar eminence
br to Palmaris brevis
3rd and 4th lumbricalis
br to all interossi
palmer surface of medial 1 ½ finger
Effect of injury: At wrest
motor:
partial claw hand
guttering between metacarpal bones
wasting of hypothener eminance
+ve froment test & +ve card test
Sensory: loss of sensation over: Medial ½ of palm & medial 1 ½ finger
At elbow: as above + loss of ulnar deviation +ulnar paradox

8-sartorious muscle (origin / insertion /n supply /action)

Origin: A.S.I.S
Insertion: upper part of medial surface of tibia
N. supply: femoral nerve
Action: 1- flexion of hip and knee joint 2- abduction and lateral rotation of thigh and medial rotation
of leg

9- Parotid gland (structure within /blood supply /n supply /surgical importance)

Structure within:
1- External carotid artery 2- Facial nerve 3- Retro mandibular vein
Blood supply: 1- ECA 2- retro mandibular vein

2
Nerve supply:
sensory to : - gland: auriculo temporal nerve - skin and capsule: greater auricular nerve
Sympathetic: sympathetic chain
Parasympathetic: glossopharyngeal nerve
Surgical importance:
Parotid abscess drained through Hilton technique to avoid injury of facial nerve

10- Submandibuler gland (relations / surgical importance)

Relation
Medial: mylohyoid muscle , hyoglossus muscle /lingual and hypoglossal nerve
Lateral: mandible and facial nerve
Infero lateral: skin, superficial fascia / cervical br of facial N
Surgical importance: d
uct more liable for obstruction and inflammation
facial A should be double ligated during the operation

11- Abdominal aorta (branches)

Branches:
Single: 1- celiac trunk 2- superior mesenteric A 3-inferior mesenteric
Paired: 1- Supra renal a 2- Renal artery 3-Gonadal artery
Terminal: Rt and left common iliac and median sacral artery

12- Femoral nerve (branches and injury)

Branches:
Muscular 4 to iliacus, Sartorius, pectinus , quadriceps femoris
Cutaneous 3 intermediate and medial cutaneous nerve of the thigh
Articular 2 to hip and knee joint
Effect of injury:
Inability to extend the knee
Sensory loss of medial and intermediate compartment of the thigh and medial side of leg

13- Post. belly of digastric (origin /ins/n supply /action)

Origin :medial surface of mastoid process
Insertion: intermediate tendon connected to hyoid bone
N . supply: facial nerve
Action: elevation of hyoid bone and depression of mandible

14- common bile duct (surgical importance)

Obstruction or stricture lead to obstructive jaundice
16- Lt. gastric artery (origin /branches)
3
Origin: celiac trunk
Branches: esophageal branches - Gastric branches

15- Median nerve (origin/branches/ )

Origin :medial and lateral cord of brachial plexus C5,6,7,8, T1
Branches:
In the forearm: 1-pronator teres
2-flexor carpi radialis
3-palmaris longus
4 -flexor digitorum superfacialis
5-anterior interoseus nerve
In the hand :
1-Thener muscle except adductor policis
2-lateral 2 lumbrical muscle
Sensory : palmer cutaneous branch - digital branches

16- Popleteal artery(origin /branches /end /surgical importance)

Origin: femoral artery at adductor hiatus
End: at lower border of poplitus muscle by dividing into anterior and post tibial a.
Branches:
Muscular branches to extensor compartment of the leg
5 geniculer branches
2 terminal branches ant and post tibial
Surgical importance: Common site of peripheral artery aneurysm

17-addactor longus (origin /insertion /n supply /action)

Origin: front of body of pubis
Insertion: linea aspra
N.supply: obturator nerve
Action: adduction of hip joint

18-adductor Magnus (origin /insertion/n supply/action)

Origin:
adductor part: from conjoint ramus
Hamstring part: lower lat part of ischial tuberosity
Insertion:
adductor part: linea aspra
Hamstring part: adductor tuberosity

4
Supply: obturator nerve and sciatic nerve
Action; adduction and extension of hip joint

19- Sternomastoid muscle (origin /insertion /n supply /action)

Origin:
sternal head: manubrium sterni
Claviculer head: clavicle
Insertion: mastoid process
N.supply: spinal part of accessory N
ACTION:
2 muscle flexes the head
1 muscle bend head to same side and turn face to opposite side

20- Serratus anterior (origin/insertion /n supply /S.surgical importance)

Origin : 8 digitation from outer surface of 8 ribs
Insertion: medial border of scapula
N.supply: long thoracic nerve
Action: protraction and rotation of scapula from 90 to 180 degree
Surgical importance:
nerve should be preserved in radical mastectomy
injury lead to winging of scapula

21- Solius muscle

Origin: soleal line of tibia and upper 1/3 of back of fibula
Insertion: tendo-achillis
N.supply: medial popliteal N and tibial N
Action: planter flexion of ankle
Surgical importance: common site of D.V.T

22- Tibialis Anterior

Origin: upper 2/3 of lateral surface of tibia
Insertion: medial cuniform
N.supply: anterior tibial nerve
Action: dorsiflexion and inversion of foot

23- Quadriceps muscle

Insertion: patella by common tendon
N. supply: femoral nerve
Action: extension of knee

5
24-glutus Maximus
Origin: hip bone behind the posterior gluteal line &back of sacrum
Insertion: gluteal tuberosity &ilio -tibial tract
N.supply: inferior gluteal nerve
Action: extension of hip and rotation of thigh laterally

25-hamstring muscle
Origin: ischeal tuberosity
Insertion: upper end of tibia and fibula
N supply: sciatic nerve
Action: extension of hip &flexion of knee

26- Brachial artery(origin /end / branches)

Origin: at the lower border of teres major
End: in cubital fosa
Branches:
- profunda brachii - nutrient artery to humerous
- superior & inferior ulnar collateral arteries

27- Axillary artery (branches)

1st part: superior thoracic artery
2nd part: lateral thoracic artery & thoraco acromial artery
3rd part: 1- sub scapular -2-post circumflex humeral -3 ant circumflexes humeral

28-spleen (ligament //blood supply /relation)

Ligament: 1- gastrosplenic lig . - 2-phrenico-colic lig - 3-lieno-renal lig.
Blood supply: Splenic artery and vein
Relation:
Parietal: diaphragm
Visceral: stomach, kidney, tail of pancreas, colon

29- Thyroid cartilage (muscle attached)

1-mylohyoid M 2- cricothyroid M 3- sternothyroid M

30-stomach bed / blood supply

Stomach bed:
Left crus of diaphragm
left kidney & left supra renal gland
spleen & Splenic artery and vein
body of pancreas

6
transvers colon & transverse mesocolon
Blood supply:
Right & left gastric artery
short gastric artery
right & left gastro epiploic

31- intrnal jugular vein (origin /branches)

Origin: sigmoid sinus
Branches:
1- Inferior petrosal sinus 2- jugular lymph trunk 3- common fascial vein
4-Lingual vein 5-superior, middle thyroid veins

32- Thyroid (blood supply)

1-sup. & inf Thyroid artery
3-thyroid ima artery
4-Accessory thyroid artery
5-Superior, middle, inf thyroid veins

33-external carotid a (branches)

ascending pharyngeal A - sup. Thyroid A - lingual A - fascial A -occipital A - post auricular A -
sup.temporal artery - maxillary artery

34- Rectus abdominis (origin /inser/n supply/action)

Origin: pubic crest &symphysis pubis
Insertion: xiphoid process & 5,6,7 costal cartilage
N .supply: lower 6 thoracic nerve
Action: flexion of trunk

35- Sympathetic chain (surgical importance/part)

Surgical importance: injury oh s. chain lead to Horner’s syndrome
Parts: cervical /thoracic /abdominal /pelvic

36- Splenic artery (branches)

Origin: celiac trunk
Branches:
Pancreatic branches - Short gastric branches - Gastro-epiploic
Posterior gastric - Terminal branches

37-inguinal canal (structure passing)

1- Ilioinguinal nerve. 2- Spermatic cord in male & round ligament in female.

7
38-trapezius
N. supply: spinal root of accessory nerve
Action: retraction and elevation of shoulder &rotation of scapula from 90 to 180 degree
surgical importance: paralysis leads to shoulder drop

39-cubital fossa (contents)

1-median nerve 2- end of brachial artery 3- Biceps tendon
4-Radial nerve 5- Post interosseous nerve 6- Supratrochlear LN

40- inter crural FIBERS

Surgical importance: protection against inguinal hernia

41-anterior belly of digastric

Origin: digatric fossa of mandible
Insertion &action: like posterior belly
N.supply :mandibular nerve

42-Aortic hiatus
Level: T12 midline ,behind median arcuate ligament
Structure passing :
1- abdominal aorta 2-thoracic duct 3-azygous vein

43- oesophageal hiatus

Level: T10 1 inch to the left inside right crus of diaphragm
Structure:
1-oesophagus 2- 2 vagi nerve 3- oesophageal hernia
Surgical importance: site of sliding hernia

44- Siatic Nerve

Origin: L4,5 & S1,2,3
Branches:
A. Muscular branches to
1- biceps femoris 2-semimembranous
3-semitendinous 4-ischeal part of adductor magnus
B. 2 terminal branches