Footsteps towards Mbbs and Higher in Md Ophthalmology

By Dr Rabindranath Dikshit

The author of this book on ophthalmology is Dr. Rabindranath Dikshit, a highly experienced medical professional with a diverse background. Dr. Dikshit holds an MBBS and a Diploma in Industrial Health and has served as a Medical Superintendent and Specialist MO in Occupational Health in the Republic of Seychelles. His extensive experience includes roles such as trauma and emergency care in charge, food handlers medical, and operational research. He has also been a faculty member at various institutions and has presented research papers at international conferences. The book draws from his original notes, "Parsons Diseases of Eye," as well as textbooks on basic medical sciences and images from the internet, reflecting his comprehensive understanding of the subject

• Language: English
• Publisher: Blue Rose Publishers
• Release date: Jan 22, 2024

Book preview

BASIC MEDICAL SCIENCE

ANATOMY

a. Flat foot - 1. Lowering of Medial longitudinal arch 2. Incoordination of muscular tone **arch 2. Incoordination of muscular tone

1. Ossification –

a. Growth of bones occurs from epiphysis cartilage

b. Flat bones ossify from mesoderm

c. Clavicle from membrane

d. Spondylolisthesis - spine lamina of lumbar vertebra which is ossified with inferior articular surface at L4 L5

e. Common Fracture of Face - Nasal and mandible, Mandible at the site of canine tooth.

f. Fracture of Clavicle- Coraco- Clavicular ligament pulls down the clavicle. The injury is an indirect violence.

g. Ossification of clavicle-Two primary centres: the shaft in intrauterine life, Secondary ossification in 15-17 years of age.

h. Humerus - Upper epiphysis joins shaft at 20th year

i. Scaphoid is a bone of wrist joint- It fractures commonly, lunate-Gets fracture and is dislocated.

j. Muscles of Mastication - Masseter, Lateral and medial pterygoid, Temporalis. Nerve: Mandibular branch of Trigeminal

k. Foot- Median plantar nerve compression- by Adductor Hallucis & Flexor Digitorum Brevis muscle of foot

1. Flexor digitorum Accesorius - Supplied by Lateral plantar nerve

2. Lumbrical 1st by Medial plantar 2nd 3rd and 4th Lumbricals are supplied by Lateral plantar nerve.

3. Flexor Hallucis Brevis by medial Plantar nerve

4. Adductor Hallucis by Lateral Plantar nerve

5. Flexor digiti minimi brevis by lateral plantar

6. Interossei - supplied by lateral plantar nerve

7. Abductor digiti minimi by lateral plantar nerve

Hand-Median nerve supplies-Pronater teres, flexor carpi radialis, palmaris longus, flexor digitorum superficialis, flexor digitorum profundus, pronater quadratus, abductor flexor and opponens pollicis, and 1st, and 2nd lumbricals.

a. Dorsal interossei - Abducts fingers

b. Palmar interossei - Adducts the fingers.

c. Lumbricals- Flexthe fingers at meta carpo phalangeal joints, they can extend the inter phalangeal joints.

Ulnar nerve supplies - Flexor pollicis Brevis, Abductor pollicis, 3rd 4th Lumbricals and all interossei

Cutaneous - Full dorsum and ventral aspect of little finger extending to hand laterally and half of dorsum and ventral part of ring finger extending to the palm and hand

Radial nerve - Supplies, Triceps, Anconeus, Bracheoradialis, Extensor longus and brevis, supinator

Cutaneous branch - Dorsal part of thenamus(Thenar Muscle), laterally

Axillary nerve or circumflex nerve - supplies Deltoid, Teres minor and shoulder joint.

Biceps Brachii – is supplied byMUsculocutaneus Nerve

Brachialis - is supplied Musculocutaneus nerve and radial nerve

Cutaneus Supply of Face - By 5th cranial nerve or Trigeminal nerve,

Thigh Cutaneus supply -

a. L1 (Ilioinguinal) Adjacent to Scrotum and labium

b. L1-2 (Genito-Femoral) from Inguinal ligament in a conical way supplies to the median area of the thigh, about to 2 to 3-inch downwards

c. L2-3 (lateral Femoral) Whole of the thigh laterally and posteriorly,

d. L2-3 (anterior Femoral) Medial Aspect of thigh,

e. S1-3 (Post Femoral) Posterior aspect of thigh centrally

Leg – a.L4-S2 (common Peroneal) - upper 1/3rd of leg laterally. b.L3-4 Whole of leg medially and posteriorly, c.L4S1 Lower 2/3rd leg anteriorly and medially d.L45 Deep peroneal, half of great and 2ndtoe, anteriorly

BONE JOINT

a. Orbit

1. Roof - Medially frontal sinus, laterally lacrimal gland

a. Optic canal mor foramen communicates with middle cranial fossa

b. it transmits optic nerve and optic artery.

2. Medial wall - Lacrimal groove contains lacrimal sac, ethmoidal sinus. Body of sphenoid, lacrimal bone orbital plate of ethmoidal bone, palatine bone.

3. Inferior wall - Zygomatic bone and maxilla and palatine bone. It is the roof of maxillary sinus.

Inferior orbital fissure transmits maxillary nerve and anterior part of inferior orbital fissure transmits optic vein to join with Pterygoid plexus

4. Lateral wall is bounded by

a. Greater wing of sphenoid

b. Zygomatic bone

c. Orbital plate of frontal bone

d. Orbital surface of maxilla

Lateral wall has superior orbital fissure which communicates with middle cranial fossa, oculomotor nerve, trochlear, Abducent nerve and ophthalmic vein

Apex of orbit is the medial end of superior orbital fissure

MARGIN OF ORBIT

1. Superior orbital margin is formed by frontal bone

2. Lateral margin of orbit is formed by frontal process of zygomatic bone and zygomatic process of frontal bone.

3. Infra orbital margin is zygomatic bone and maxilla

4. Medial margin of Orbit is frontal bone and lacrimal crest of maxilla.

b. Femur - OSSIFICATION-Epiphyseal cartilage at lower end of femur, x scapular

g. Nerve supply of Elbow joint –

1. Radial. 2. Musculocutaneus.

h. Flexor of Hip - Psoas major and Iliacus.

i. Extensor of Hip - Gluteus maximus.

j. Abductor of Hip - Gluteus medius, Gluteus minimus.

k. Adductor of Hip - Abdutor longus, brevis and magnus

l. Popliteus is unlocker of knee joint-Injury causes medial meniscus tear, more

Nerve supply Hip and thigh-

a. Tensor fascia lata – superior gluteal nerve, Sartorius (longest Muscle) by Femoral nerve

b. Quadriceps femoris – extensor of thigh

c. Femoral nerve supplies-Vastus Medialis, Vastus Intermedius, Vastus Lateralis

d. Gracilis, Obturator externus, obturator internus, adductor longus and adductor magnus, adductor brevis, Obturator externus are supplied by obturator nerve. Obturator internus is supplied by obturator internus nerve.

e. Obturator magnus is supplied by sciatic and obturator nerve.

f. Pectineus - Is supplied by femoral and accessory obturator nerve.

g. Gluteus maximus is supplied by inferior gluteal nerve ILIACUS by Femoral Nerve PSOAS MAJOR by Lumbar nerve L123 GLUTEUS MEDIUS and GLUTEUS MINIMUS by Superior Gluteal nerve, PIRIFORMIS by L5, S1 S2

h. Lateral Rotator of thigh-Obturator externus, Gemellus Superior, Gemellus Inferior, Piriformis, Quadratus femoris.

i. Hamstrings muscles - Flexor of knee-

a. Biceps Femoris, long head supplied by sciatic nerve, short head by common peroneal nerve

b. Semimembranosus by Sciatic nerve

c. Semitendinosus Sciatic nerve

j. Quadriceps Femoris, Extensor Muscles of Leg – 1.Rectus femoris 2. Vastus medialis. 3.Vastus lateralis-by L2, 3, 4 nerves 4. Vastus intermedius

k. 1. Anterior crural muscles - Tibialis anterior, Extensor digitorum, Extensor Hallucis longus, peroneus tertius- supplied by Deep peroneal nerve

2. Lateral Crural Muscles - Peroneus longus and Brevis, supplied by superficial peroneal nerve

3. Posterior crural muscle - action Plantar flexor - Gastrocnemius, soleus, Plantaris - all by tibial nerve or medial popliteal nerve

4. Popliteus, Flexor Hallucis longus, Flexor digitorum longus and tibialis posterior - all supplied by Tibial nerve

MUSCLES OF CHEST (TRUNK)

a. Pectoralis major - Adductor and medial rotator of humerus, Nerve-Lateral and medial pectoral nerve-C7&8 T1

b. Serratus anterior- Long thoracic nerve- Nerve of BELLC 5, 6, 7, Action-Pushing, Punching movement of arm, Paralysis- causes winging of scapula

c. Latissimus Dorsi -Nerve- Thoraco dorsal nerve, C 6,7,8, Action-Adduction, extention and medial rotation of humerus

d. Rhomboids major and minor, Nerve- Dorsal scapular C 4, 5, Action- Retractor of scapula towards spine

e. Levator Scapulae Nerve - C3, 4 Action- Elevator if scapula and rotator of scapula

HEART

Paracentesis of pericardium or Pericardiocentesis - an emergency treatment in CARDIAC TEMPONADO. A condition fluid in pericardium, does not give heart space to beat. The situations arise in case of

a. Advanced cancer,

b. Heart attack when the heart muscles give way

c. Tuberculosis, d Other inflammatory conditions of pericardium, called pericarditis. Sites of Operation - 1. Parasternal 2. Sub Sternal

d. Apical - from lateral side of chest

1. Right atrio ventricular valve is Tricuspid Valve

2. Pulmonary valve - 3 Cusps, Anterior, Posterior and Septal

3. Left atrio ventricular opening- A mitral opening having two cusps of valves triangular in size

4. Aortic valve-Three semilunar valve, two posterior and one anterior

5. Apex beat-Half inch medial to mid clavicular line in 5th interspace

6. SA Node- In right atrium in front of opening of superior venacava

7. A V node in arterial septum near coronary sinus.

8. Ductus Arteriosus- is connected with aorta (Foetal Circulation), other connections to DA-a.