Transcript m5zn_d01ef14957890c5

Correction of this slide
Identify Y & mention three differences
between that of opposite side.
Y: Right bronchus
Mention segmentation of X & Y
Y: Right bronchus
X: Lt bronchus
Also segmentation of lobes
Bronchopulmonary segmentation
Segmentation of the right bronchus:
Right bronchus usually gives its superior lobar branch which passes
separately into the hilum of the right lung. The right bronchus then
enters into the hilum where it terminates by dividing into middle and
inferior lobar branches.
1- superior lobar bronchus: divides into three segmental branches to
the three segments of the superior lobe:
1- Apical segmental bronchus.
2- Posterior segmental bronchus.
3- Anterior segmental bronchus.
2- Middle lobar bronchus: arise 2 cm below the superior lobar bronchus from
the front of the right bronchus and passes anterolaterally to the middle lobe
where it divides into two segmental branches to the
two segments of the middle lobe:
1- medial segment bronchus
2- Lateral segmental bronchus
3- Inferior lobar bronchus:
It is a continuation of the right bronchus beyond the middle lobar bronchus. It
gives a superior segmental bronchus to the upper part of the inferior lobe, then
divided into anterior, posterior, lateral and medial basal segmental branches. So
its branches are:
1- superior apical segmental bronchus.
2- anterior basal segmental bronchus.
3- Posterior basal segmental bronchus.
4- lateral basal segmental bronchus.
5- Medial basal segmental bronchus.
Segmentation of the left bronchus
It is divided after passing through the hilum of the left lung into:
1- superior lobar which divides into two:
A) Superior division : gives three segmental bronchi as those of the right
superior lobar:
1- Apical segmental bronchus.
2- Posterior segmental bronchus.
3- Anterior segmental bronchus.
Identify A , its root value & its branches
Femoral nerve (dorsal divisions of the
ventral rami of (L2, 3, 4).
branches before division
1- Nerve to iliacus 2- Nerve to pectineus
II- Anterior division:
Medial & intermediate cutaneous nerve
of the thigh
3- muscular branch to Sartorius.
II- branches of the posterior division :
1- Muscular branches to pubic part of
adductor magnus and obturator exernus.
2- Genicular branch to knee
Identify A , its root value & its muscular
A
branches
Femoral nerve (dorsal divisions of the ventral
rami of (L2, 3, 4).
1- Nerve to iliacus
From main trunk
2- Nerve to pectineus
3- Nerve to Sartorius (from anterior division)
4- Muscular branches to pubic part of adductor
magnus and obturator externus (from posterior
division).
Identify A , its root value & its branches
Obturator nerve
ventral divisions of the ventral rami of (L2, 3, 4).
Branches of the anterior division:
1- Articular branch to the hip joint.
2- Muscular branches to: adductore longus, brevis
& gracilis.
3-Cutaneous branch to Skin of the middle third of
the medial aspect of thigh.
II- branches of the posterior division :
1- Muscular branches to pubic part of adductor
magnus and obturator exernus.
2- Genicular branch to knee
A
-Identify A, mention its root value,
termination & 4 muscles supplied.
-A: sciatic nerve
-Its root value:
A
ventral rami of (L4,5 S1, 2, 3).
-In the middle of thigh, it divides into its
two terminal branches
1- Medial tibial
2- Common peroneal nerves
It gives motor branches to biceps femoris,
semitendinosus & semimembranosus and
ischial part of adductor magnus
Injury of the sciatic nerve:
Commonly occur due to fractures in the middle of the shaft of the femur.
An injury of the sciatic nerve results in:
1- Paralysis of the hamstring muscles when injuries in the gluteal region. But
when injured in the middle of the thigh the hamstring escaped from paralysis as
they receives innervation high up in the thigh. Paralysis of the hamstring leads
to weakness of the flexion of the knee as some flexion can be done by sartorius
& gracilis.
2- Complete paralysis of all muscles of the foot & leg leading to a condition of
flail foot as there is a foot drop resulting from the effect of the gravity.
3- Loss of cutaneous sensation on the leg & foot except the area supplied by
saphenous nerve (medial aspect of the leg & medial border of the foot to the
root of the big toe).
Identify B, mention its reoot value & four branches
in popliteal fossa.
B:(Tibial nerve (medial popliteal)
Its root value: as sciatic (L45, S123)
I- sural nerve
II- Muscular branches to:
1- Medial & Lateral heads of Gastrocnemius.
2- Plantaris
3- Popliteus
4- Superficial part of the soleus
C
B
III- Articular branches: to knee joints
Superior, inferior & middle genicular nerve.
A
Level of termination A & its continuation
Still tibial nerve
As it doesn't pass distal border of popliteus
muscle
At Distal border of popliteus it continues as
Posterior Tibial nerve
Identify C, mention its root value & level of Its
termination & its terminal branches and effect of its
injury
C: Common peroneal (Lateral popliteal)
(L4,5S12) it supplies biceps.
Lateral ton neck of fibula divides into
1- Deep peroneal (anterior tibial)
2- Superficial peroneal (Musculocutaneous) nerve.
Its injury lead to Foot drop
C
B
As a result of Paralysis of the muscles of the anterior
& lateral compartment of the leg. This leads to
paralysis of the dorsiflexor & evertor of the foot.
Identify B: (tibialial nerve)
B
Identify D mention its termination & four
muscular branches
D: Posterior tibial
D
Muscular branches: deep part of soleus,
tibialis posterior, Flexor digitorum longus,
flexor hallucislongus.
Branches of posterior tibial nerve
1- Muscular branches: deep part of soleus, tibialis posterior, Flexor digitorum longus,
flexor hallucis longus & tibialis posterior muscles.
2- Medial Calcanean nerves: to supply the skin of the heel & medial and
posterior part of the sole.
3- Vascular branches: sympathetic twings to the posterior tibial artery.
4- Articular branch: to the ankle.
5- Terminal branches: Medial & Lateral planter nerves.
X= femoral nerve
Mention its Root value and
Three of the muscles supplied by it
(muscular branches)?
Root value = dorsal division of L2,3,4
Muscles supplied: Before division nerve to
pectineus, & nerve to iliacus
Anterior dividion : sartorius
Posterior division : separate nerve for each
head of quadriceps
X
X= sciatic nerve
Mention its Root value, Its terminal branches and
Three of the muscles supplied by it?
Root value = L4,5 S1, 2& 3
Terminal Branches
tibial nerve and common fibular nerve ( in the
middle of the bacK of the thigh)
Its muscular branches: to semitendinosus ,
semimembranosus, bicpes femoris & ischial part
of adductor magnus
X
X= sciatic nerve
Y= tibial nerve
Z= common fibular nerve
X
Z
Y
X: tibial nerve in popliteal fossa
Y: Common peroneal nerve
X
Y
Identify A, its origin, its muscular branches.
Anterior tibial nerve
Deep branch of common peroneal
B
Its root value: L4,5 S1,2
Its muscular branch
Tibialis anterior
Extensor hallucis longus,
Extensor digitorum longus & Peroneus tertius.
Identify B, its origin, its muscular branches
Musculocutaaneous (superficial peroneal) nerve
Supplies peroneus longus & brevis.
A