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The superficial lymphatics drain to the hepatic lymph nodes scattered along the hepatic vessels and ducts in the lesser omentum. In some cases, the abnormal arch, after passing over the root of the right lung, passes posterior to the esophagus to reach its usual position on the left side. The parotid glands are located lateral and posterior to the rami of the mandible and masseter muscles, within unyielding fibrous sheaths. It can be entered here by a needle or catheter (see "Internal Jugular Vein Puncture"). Branchial Sinuses and Cysts When the embryonic cervical sinus fails to disappear, it may retain its connection with the lateral surface of the neck by a branchial sinus, a narrow canal. A detached retina usually results from seepage of fluid between the neural and pigment cell layers of the retina, perhaps days or even weeks after trauma to the eye. The cornea is the transparent part of the fibrous layer covering the anterior one sixth of the eyeball. Although the lateral wall of the orbit is nearly as long as the medial wall, because it extends laterally and anteriorly, it does not reach as far anteriorly as the medial wall does, which occupies essentially a sagittal plane. The facial artery lies deep to the zygomaticus major and levator labii superioris muscles. This may serve as an impediment to reconstitution of normal white matter in the periventricular region. The adult uterus is usually anteverted (tipped anterosuperiorly relative to the axis of the vagina) and anteflexed (flexed or bent anteriorly relative to the cervix, creating the angle of flexion) so that its mass lies over the bladder. The parasympathetic fibers in the nerves to the jejunum and ileum derive from the posterior vagal trunks. Cystic remnants of the thyroglossal duct may be differentiated from an undescended thyroid by radioisotope scanning. These muscles have their fleshy bellies in the lateral compartment but are tendinous as they exit the compartment within the common synovial sheath deep to the superior fibular retinaculum. The semicircular ducts open into the utricle through five openings, reflective of the way the surrounding semicircular canals open into the vestibule. The degree of prominence of the gluteal fold changes in certain abnormal conditions, such as atrophy of the gluteus maximus. The nerve supply of the anal canal inferior to the pectinate line is somatic innervation derived from the inferior anal (rectal) nerves, branches of the pudendal nerve. Occasionally, a superficial plantar arch is formed when the superficial branch anastomoses with the lateral plantar artery or the deep plantar arch. Whether this part of the muscle compresses or dilates the prostatic urethra is a matter of some controversy. It may be involved occasionally in poliomyelitis ("polio," a viral infantile disease) and generalized polyneuropathy, a disease affecting several peripheral nerves. Costal part: consisting of wide muscular slips that attach to the internal surfaces of the inferior six costal cartilages and their adjoining ribs on each side; the costal parts form the right and left domes. Extrapleural Access Intrathoracic Surgical Fixation makes it difficult to appreciate in the embalmed cadaver, but in surgery, the relatively loose nature of the thin endothoracic fascia provides a natural cleavage plane, allowing the surgeon to separate the costal parietal pleura lining the lung cavity from the thoracic wall. A transverse slice through the bed of the parotid gland demonstrates the relationship of the gland to the surrounding structures. The femoral sheath is formed by an inferior prolongation of transversalis and iliopsoas fascia from the abdomen. From here, the lymph traverses a variable number of paratracheal nodes and enters the bronchomediastinal trunks. Endocrine secretion from the thyroid gland is hormonally regulated by the pituitary gland. Acting together, the parts of the levator ani elevate the pelvic floor after their relaxation and the consequent descent of the pelvic diaphragm that occurs during urination and defecation. Sialography of Submandibular Ducts the submandibular salivary glands may be examined radiographically after injection of a contrast medium into their ducts. One or two other small incisions ("portals") are required for surgical (instrument) access to the appendix and related vessels. Sequential stages of a deep dissection of the sole of the right foot showing the attachments of the ligaments and the tendons of the long evertor and invertor muscles.

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Ascending (fourth) part: short (5 cm) and begins at the left of the L3 vertebra and rises superiorly as far as the superior border of the L2 vertebra. Within the right and left livers, the simultaneous secondary branchings of the hepatic portal vein and hepatic artery supply the medial and lateral divisions of the right and left liver, with three of the four secondary branches undergoing further (tertiary) branchings to supply independently seven of the eight hepatic segments. Localization of regions mediating the Cushing response in the central nervous system of the cat. Superiorly and posteriorly, a thin membrane, part of the fibrous skeleton of the heart. Feasibility of cell therapy in multiple sclerosis: a systematic review of 83 studies. Each cranial nerve division supplies skin and mucous membranes and sends a branch to the dura of the anterior and middle cranial fossae. It contains the metatarsals, the dorsal and plantar interosseous muscles, and the deep plantar and metatarsal vessels. This view of the interior of the base of the cranium shows the temporal bone and the location of the bony 2199 labyrinth. The overlying leptomeninges are frequently thickened and brownish, owing to previous haemorrhage, and the surrounding brain parenchyma atrophic and discoloured. Cirrhosis of Liver the liver is the primary site for detoxification of substances absorbed by the gastrointestinal tract; thus, it is vulnerable to cellular damage and consequent 1196 scarring, accompanied by regenerative nodules. As they enter the femoral triangle, the names of the vessels change from external iliac to femoral. The calcaneal tendon is struck briskly with a reflex hammer just proximal to the calcaneus. The cartilages of the nose are retracted inferiorly to expose the sesamoid cartilages. Deep arteries of the penis pierce the crura proximally and run distally near the center of the corpora cavernosa, supplying the erectile tissue in these structures. Furthermore, because of their proximity and confinement within the popliteal fossa, an injury of the artery and vein may result in an arteriovenous fistula (communication between an artery and a vein). Movements Inversion and eversion of foot Blood Supply Posterior Ubial and fibular arteries Nerve Supply Talocalcaneonavicular Synovial joint; talonavicular part is ball and socket type Joint capsule incompletely encloses joint. Seminal glands, ejaculatory ducts, and prostate: Obliquely placed seminal glands converge at the base of the bladder, where each of their ducts merges with the ipsilateral ductus deferens to form an ejaculatory duct. As stomach cancer becomes more advanced, the lymphogenous dissemination of malignant cells involves the celiac lymph nodes, to which all gastric nodes drain. The sigmoid colon extends from the iliac fossa to the third sacral (S3) vertebra, where it joins the rectum. Infratentorial expanding lesions Hydrocephalus, with enlargement of both lateral ventricles and the third ventricle, is the most common abnormality associated with expanding lesions in the posterior cranial fossa, whether they be in the fourth ventricle, within or outside the cerebellum. At later stages, the intima is markedly thickened and the internal elastic lamina and the media largely destroyed, and the media and adventitia may become fibrotic and thickened, with blurring of their interface. Sounds received by a small external microphone are transmitted to an implanted receiver that sends electrical impulses to the cochlea, stimulating the cochlear nerve. This is the strongest and thickest of the four walls, which is important because it is most exposed and vulnerable to direct trauma. People with this type of hearing loss often speak with a soft voice because, to them, their own voices sound louder than background sounds. The liver has a convex diaphragmatic surface (anterior, superior, and some posterior) and a relatively flat or even concave visceral surface (posteroinferior), which are separated anteriorly by its sharp inferior border that follows the right costal margin inferior to the diaphragm. The menisci must be able to migrate on the tibial plateau as the points of contact between femur and tibia change. Calcaneal Bursitis Calcaneal bursitis (retro-Achilles bursitis) results from inflammation of the deep bursa of the calcaneal tendon, located between the calcaneal tendon and the superior part of the posterior surface of the calcaneus. Some lymph also passes to the deep inguinal lymph nodes, located under the deep fascia on the medial aspect of the femoral vein. Although these vestigial structures are mostly of embryological and morphological interest, they occasionally accumulate fluid and form cysts. Some vascular surgeons refer to this 1645 part of the femoral artery as the common femoral artery and to its continuation distally as the superficial femoral artery.

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The nerve fibers conveyed are from the sensory spinal ganglion of spinal nerve C2 and are not hypoglossal fibers. A prominent intermediate ridge, the pectineal line, extends from the central part of the linea aspera to the base of the lesser trochanter. The laryngeal inlet is bounded (1) anteriorly by the free curved edge of the epiglottis; (2) posteriorly by the arytenoid cartilages, the corniculate cartilages that cap them, and the interarytenoid fold that unites them; and (3) on each side by the aryepiglottic fold that contains the superior end of the cuneiform cartilage. The prostatic venous plexus is continuous superiorly with the vesical venous plexus and communicates posteriorly with the internal vertebral venous plexus. The common initial symptom of the injury is hip discomfort that may be referred to the knee. Metatarsophalangeal Condyloid synovial joint Heads of metata rsal bones articulate with bases of proximal phalanges. To observe this upward movement, the physician has the patient place her hands on her hips and press while pulling her elbows forward to tense her pectoral muscles. Internal features of the cranial base reflect the major formations of the brain that rest on it. Visceral referred pain is transmitted by visceral afferent fibers accompanying sympathetic fibers and is typically referred to somatic structures or areas such as a limb having afferent fibers with cell bodies in the same spinal ganglion and central processes that enter the spinal cord through the same posterior roots (Naftel, 2013). The perpendicular plate of the palatine bone is broken through to expose the palatine nerves and arteries descending from the pterygopalatine fossa in the palatine canal. The majority of the thoracic cavity is occupied by the lungs, which provide for the exchange of oxygen and carbon dioxide between the air and blood. This dissection exposes the pericardial sac posterior to the body of the sternum from just superior to the sternal angle to the level of the xiphisternal joint. The dorsal digital veins drain into three dorsal metacarpal veins, which unite to form a dorsal venous network. Generally, if its lower edge can be detected when palpating below the left costal margin at the end of inspiration. However, the articular surfaces on the tubercles of the superior 6 ribs are convex and fit into concavities on the transverse processes. The elastic vocal ligaments extend from the junction of the laminae of the thyroid cartilage anteriorly to the vocal process of the arytenoid cartilage posteriorly. At birth, the three primary bones are joined by hyaline cartilage; in children, they are incompletely ossified. This fascia blends with the periosteum of the cranial base and defines the limits of the pharyngeal wall in its superior part. The nerve supply derives partly from the ovarian plexus, descending with the ovarian vessels, and partly from the uterine (pelvic) plexus. The tough, outer fibrous pericardium stabilizes the 844 heart and helps prevent it from overdilating. Treatment of Dupuytren contracture usually involves surgical excision of all fibrotic parts of the palmar fascia to free the fingers (Salter, 1999). Its posterior and lateral walls are formed by the middle and inferior pharyngeal constrictor muscles. In other cases, 910 thrombokinase is injected through the catheter; this enzyme dissolves the blood clot. A localized collection of blood forms between the perichondrium and auricular cartilage, causing distortion of the contours of the auricle. The distal end of the ampulla opens into the duodenum through the major duodenal papilla. The veins of the face and scalp generally accompany arteries, providing a primarily superficial venous drainage. All visceral afferent fibers conducting reflexive sensation (information that does not reach consciousness) travel with parasympathetic fibers.

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This special type of radiograph (sialogram) demonstrates the salivary ducts and some secretory units. The face includes openings and passageways, with lubricating glands and valves (seals) to close some of them, the masticatory (chewing) devices, and the orbits that house the visual apparatus. The synovial membrane extends superiorly between the radius and ulna to form the sacciform recess of the distal radio-ulnar joint. The superficial branches of the plexus that initially pass posteriorly are cutaneous (sensory) branches. The subcutaneous tissue is loose deep to the dorsal skin; therefore, edema (swelling) is most marked over this surface, especially anterior to and around the medial malleolus. Its nourishment is derived from the capillary beds at its periphery, the aqueous humor, and lacrimal fluid. These malformations are more common in males than in females and are often associated with other skeletal anomalies. If the median nerve is severed in the forearm or at the wrist, the thumb cannot be opposed. Because these enlarged nodes are located in subcutaneous tissue, they are usually easy to palpate. There are four palatine arteries, two on the hard palate (greater palatine and the terminal branch of posterior nasal septal/sphenopalatine artery) and two on the soft palate (lesser palatine and ascending palatine). Air introduced into the cardiac chambers during open-heart surgery can embolize to the brain. The attachments of the perineal fascia determine the direction of flow of the extravasated urine. By the end of the 10th week of development, the gut is much longer than the body that contains it. In this superficial dissection, most of the zygomatic arch and attached masseter, the coronoid process and adjacent parts of the ramus 2092 of the mandible, and the inferior half of the temporal muscle have been removed. Most of these hemorrhages result from rupture of a saccular aneurysm (sac-like dilation on the side of an artery), such 1993 as an aneurysm of the internal carotid artery (see the clinical box "Strokes"). The main arteries supplying the bladder are branches of the internal iliac arteries (see Table 6. The brain lacks significant energy reserves and requires a continuous supply of well-oxygenated blood. Over the 9 months of pregnancy, the gravid uterus expands greatly to accommodate the fetus, becoming larger and increasingly thin walled. This view demonstrates the disposition of the deep plantarflexor tendons in the sole of the foot. Coronal and transverse sections of female (A, B) and male (C, D) pelves demonstrating the parietal and visceral pelvic fascia and the endopelvic fascia between them, with its ligamentous and loose areolar components. The ovarian vessels, lymphatics, and nerves cross the pelvic brim, passing to and from the superolateral aspect of the ovary within a peritoneal fold, the suspensory ligament of the ovary, which becomes continuous with the mesovarium of the broad ligament. As described by Oelrich (1980), however, the urethral sphincter muscle is not a flat, planar structure, and the only "superior fascia" is the intrinsic fascia of the external urethral sphincter muscle. Inferior to the root of the lung, this continuity between parietal and visceral pleura forms the pulmonary ligament, extending between the lung and the mediastinum, immediately anterior to the esophagus. Avulsion fractures of the hip bone may occur during sports that require sudden acceleration or deceleration forces, such as sprinting or kicking in football, soccer, hurdle jumping, basketball, and martial arts. The five rami unite to form the three trunks of the brachial plexus, which descend inferolaterally through the lateral cervical region. The intrinsic pathway originates with mitochondrial release of cytochrome c and subsequent stimulation of caspase-3 whereas the extrinsic pathway is initiated by the activation of cell surface death receptors, which belong to the tumour necrosis factor superfamily, by Fas ligand, resulting in the stimulation of caspase-8. It usually communicates with the cavity of the glenohumeral joint through an opening in the fibrous layer of the joint capsule.

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The veins of the tongue are the dorsal lingual veins, which accompany the lingual artery. Most of the inferior recess of the bursa becomes sealed off from the main part posterior to the stomach after adhesion of the anterior and posterior layers of the greater omentum. Foramen spinosum (spinous foramen): Located posterolateral to the foramen ovale and opens into the infratemporal fossa in relationship to the spine of the sphenoid. However, rather than producing either hip extension or knee flexion per se during normal walking, the hamstrings demonstrate most activity when they are eccentrically contracting, resisting (decelerating) hip flexion and knee extension during terminal swing (between midswing and heel strike). Muscles of the posterior compartment produce plantarflexion at the ankle, inversion at the subtalar and transverse tarsal joints, and flexion of the toes. In both sexes, the fatty layer of subcutaneous tissue of the perineum is continuous posteriorly with the ischio-anal fat pad in the anal region. Characteristics of this disorder are sustained turning, tilting, flexing, or extending of the neck. Stones that descend the length of the ureter cause pain described as migrating "from loin to groin" (from the lateral abdominal to inguinal regions). Although not evident anatomically, their existence is most evident through clinical manifestations. Various developmentally regulated genes that are important in normal brain development and the evolution of neoplasia. When the thigh is flexed, the inferior border of the gluteus maximus moves superiorly, leaving the ischial tuberosity subcutaneous. In the absence of recent bleeding, a site of previous haemorrhage is often marked by orange-brown discolouration of the pial surface and arachnoid. A line joining these dimples, often more visible in women than in men, passes through the S2 spinous process, indicating the level of the lowest limit of the dural sac. The lateral intermuscular septum is especially strong; the other two septa are relatively weak. Structurally, the anatomical definition is logical because the anatomical subtalar joint is a discrete joint, having its own joint capsule and articular cavity. The subcostal nerves (anterior rami of T12) arise in the thorax, pass posterior to the lateral arcuate ligaments into the abdomen, and run inferolaterally on the anterior surface of the quadratus lumborum. There are two focal enhancing lesions, which disappeared with antibiotic therapy, but recurrences similarly responsive to antibiotics occurred three times in different locations. This tiny, flat, plaque-like, subdural-based lesion, seen on a whole mount section, was found in an older woman with multiple sclerosis and was too small to be responsible for any of her symptomatology. The facial artery crosses the mandible, buccinator, and maxilla as it courses over the face to the medial angle (canthus) of the eye, where the superior and inferior eyelids meet. The middle genicular branches of the popliteal artery penetrate the fibrous layer of the joint capsule and supply the cruciate ligaments, synovial membrane, and peripheral margins of the menisci. The retropharyngeal space permits movement of the pharynx, esophagus, larynx, and trachea relative to the vertebral column during swallowing. The facial and lingual arteries in this person arise by a common trunk that passes deep to the stylohyoid and digastric muscles to enter the submandibular triangle. It is especially thick in the paravertebral gutters of the lumbar region, comprising the paranephric fat (pararenal fat body). The attachment of the diaphragm to the overlying obturator fascia divides the obturator internus muscles into a superior pelvic portion and an inferior perineal portion. The mediastinum can also be explored and biopsies taken through an anterior thoracotomy (removing part of a costal cartilage; see the Clinical Box "Thoracotomy, Intercostal Space Incisions, and Rib Excision," earlier in this chapter). Lymph drains to the submental, submandibular, and superior and inferior deep cervical lymph nodes, including the jugulodigastric and jugulo-omohyoid nodes. These trunks usually terminate on each side at the venous angles (junctions of the subclavian and internal jugular veins); however, the right bronchomediastinal trunk may first merge with other lymphatic trunks, converging here to form the short right lymphatic duct. Medial inguinal fossae between the medial and the lateral umbilical folds, areas also commonly called inguinal triangles (Hesselbach triangles), which are potential sites for the less common direct inguinal hernias. In approximately 12% of people in whom the common fibular division of the sciatic nerve passes through the piriformis. The veins from the proximal two parts of the urethra drain into the prostatic venous plexus. The pudendal nerve is the main nerve of the perineum and the chief sensory nerve of the external genitalia. Endothelial hyperplasia may be prominent, and sometimes the blood vessel wall is necrotic, whereas the surrounding parenchyma may seem nearly normal.

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Alcoholic cirrhosis, the most common of many causes of portal hypertension, is characterized by hepatomegaly and a "hobnail" appearance of the liver surface. Inferolateral to the clavicular notch, the costal cartilage of the 1st rib is tightly attached to the lateral border of the manubrium-the synchondrosis of the first rib. Damage to this nerve results in altered sensation to the ipsilateral side of the tongue. The popliteus is a thin, triangular muscle that forms the inferior part of the floor of the popliteal fossa. Anteriorly: the hepatoduodenal ligament (free edge of lesser omentum), containing the hepatic portal vein, hepatic artery, and bile duct. Enlarged arachnoid granulations (pacchionian bodies) may erode bone, forming pits called granular foveolae in the calvaria. When the 711 epiphysis is placed in its normal position during reduction, the prognosis for normal bone growth is good. Thus, it is common when entering the abdominal cavity, in either dissection or surgery, to find the omentum markedly displaced from the "normal" position in which it is almost always depicted in anatomical illustrations. The inferior end of the radius moves around the relatively fixed end of the ulna during supination and pronation of the hand. The right and left superior and inferior thyroid arteries anastomose extensively within the gland, ensuring its supply while providing potential collateral circulation between the subclavian and external carotid arteries. The skin of the superior and anterior walls of the external acoustic meatus and the supero-anterior two thirds of the external surface of the tympanic membrane are supplied mainly by the auriculotemporal nerve. The infratemporal fossa is an irregular space inferior and deep to the zygomatic arch and mandible and posterior to the maxilla. The dorsal nerve of the clitoris supplies deep perineal muscles and sensation to the clitoris (see the Clinical Box "Pudendal and Ilio-Inguinal Nerve Blocks"). The orientation drawing (left) indicates the plane of the coronal section that intersects the carotid canal (right). The circular muscle is poorly developed around the orifice; therefore, the valve is unlikely to have any sphincteric action that controls passage of the intestinal contents from the ileum into the cecum. The arch of aorta curves posteriorly on the left side of the trachea and esophagus. The ridge and the balanced pull of the vastus muscles keeps the patella centered in the intercondylar groove of the femur as it provides mechanical advantage to the quadriceps femoris in extending the leg at the knee. At birth, the uterus is relatively large and has adult proportions (body to cervical ratio = 2:1) due to the prepartum (before childbirth) influence of the maternal hormones. Lymph vessels and lymph nodes: Lymphatic drainage from the abdominal viscera courses retrograde along the ramifications of the three unpaired visceral branches of the abdominal aorta. Some lymphatic vessels may drain into the brachiocephalic lymph nodes or the 2295 thoracic duct. The gluteal muscles, overlying the pelvic girdle, constitute the bulk of this region. Neural activity triggers neuronal oxidative metabolism followed by astrocytic glycolysis. Epicardium, a thin external layer (mesothelium) formed by the visceral layer of serous pericardium. Corneal Abrasions and Lacerations Foreign objects such as sand or metal filings (particles) produce corneal abrasions that cause sudden, stabbing pain in the eyeball and tears. The edge of each cusp is thickened in the region of contact, forming the lunule; the apex of the angulated free edge is thickened further as the nodule. Within a few days after birth, the shape of the neonatal cranium returns to normal. It then runs to the dorsum of the penis, where it runs lateral to the dorsal artery.

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At the thoracic and superior lumbar levels, the sympathetic trunk is attached to intercostal nerves by paired (white and gray) rami communicantes. The invertors and evertors of the foot are principal stabilizers of the foot during the stance phase. The retromandibular vein runs posterior to the ramus of the mandible within the substance of the parotid gland, superficial to the external carotid artery and deep to the facial nerve. Calcaneal tendon rupture is probably the most severe acute muscular problem of the leg. Thus, the membrane and ligaments strongly resist the downward pull placed on the fibula by eight of the nine muscles attached to it. These fibers constitute the thyro-epiglottic muscle, which widens the laryngeal inlet. The external urethral sphincter and deep transverse perineal muscle span the region of the urogenital hiatus, which is closed inferiorly by the perineal membrane extending between the ischiopubic rami. At these sites the basal lamina under the damaged or regenerated endothelial cells becomes thickened or reduplicated. They cover the intervals between the laminae of adjacent vertebrae, thereby preventing sharp objects such as a knife from entering the vertebral canal and injuring the spinal cord. The tubercles of the C1 vertebra can be palpated by deep pressure posteroinferior to the tips of the mastoid processes. Pain in Pararenal Region the close relationship of the kidneys to the psoas major muscles explains why 1233 extension of the hip joints may increase pain resulting from inflammation in the pararenal areas. The cervicodorsal trunk (transverse cervical artery) and suprascapular artery occasionally arise directly (or via a common trunk) from the second or third parts of the subclavian artery instead of directly from the thyrocervical trunk via a common trunk, as shown here, or independently. Clubfoot (Talipes Equinovarus) Clubfoot refers to a foot that is twisted out of position. Therefore, the inserting tendons of the oblique muscles lie in the same oblique vertical plane. Episiotomy During vaginal surgery and labor, an episiotomy (surgical incision of the perineum and inferoposterior vaginal wall) may be made to enlarge the vaginal orifice, with the intention of decreasing excessive traumatic tearing of the perineum and uncontrolled jagged tears of the perineal muscles. Coxa vara causes a mild shortening of the lower limb and limits passive abduction of the hip. An ileostomy is then constructed to establish a stoma, an artificial opening of the ileum through the skin of the anterolateral abdominal wall. Scalp Infections the loose connective tissue layer (layer four) of the scalp is the danger area of the scalp because pus or blood spreads easily in it. The modiolus contains canals for blood vessels and for distribution of the branches of the cochlear nerve. In approximately 4% of people, however, the gallbladder is suspended from the liver by a short mesentery, increasing its mobility. Disposition of Uterus Normally, the uterus is anteverted and anteflexed, so that the body of the uterus rests upon the empty bladder, one of several means by which passive support for the uterus may be provided. The occurrence of aneurysms in polycystic kidney disease and other genetic diseases is related to a combination of hypertension, and defects in proteins of the perivascular matrix or the cytoskeleton of the vessel wall. The posterior (plantarflexor or flexor) compartment, containing seven muscles, is subdivided by an intracompartmental transverse intermuscular septum into a superficial group of three (two of which are commonly tendinous/aponeurotic at this level) and a deep group of four. Flow chart demonstrating long (extrinsic) and short (intrisic) reflexes involving the enteric nervous system. They may occur in both deciduous and permanent dentitions, but more commonly occur in the latter. Laterally, the head of the fibula is readily located by following the tendon of the biceps femoris inferiorly. Efferent lymphatic vessels from these nodes join the right lymphatic and thoracic ducts. The cystic artery usually arises from the right hepatic artery in the cystohepatic triangle (of Calot), bounded by the cystic duct, common hepatic duct, and visceral surface of the right liver. In this deep dissection of the root of the neck and superior mediastinum, the thymus has been removed. In the male, only the inferior part of the muscle forms an encircling investment (a true sphincter) for the intermediate part of the urethra inferior to the prostate. Inflammation and swelling of the mucous membrane lining the tympanic cavity may cause partial or complete blockage of the pharyngotympanic tube.

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Next, another capillary plexus is formed in the intermediate zone between the subventricular precursor cell zone and the cortical plate. Medial to the pelvic portions of the obturator internus muscles are the obturator nerves and vessels and other branches of the internal iliac vessels. The superior rectal artery supplies the anal canal superior to the pectinate line. The clavicle forms a strut (extension) that holds the scapula, hence the glenohumeral (shoulder) joint, away from the thorax so it can move freely. The nerve supply to the cecum and appendix derives from the sympathetic and parasympathetic nerves from the superior mesenteric plexus. The amyloid in blood vessels of the cortical grey matter and leptomeninges is quite obvious on Congo red staining. The branches of the intercostal nerves pass through the pectoral fascia covering the pectoralis major to reach overlying subcutaneous tissue and skin of the breast. The cellular material is then placed in a preservative liquid for microscopic examination. The tibial nerve and posterior tibial and fibular vessels supply both parts of the posterior compartment but run in the deep subcompartment deep (anterior) to the transverse intermuscular septum. The inferior epigastric artery arises from the external iliac artery just superior to the inguinal ligament. The vestibule features the oval window on its lateral wall, occupied by the base of the stapes. These nerve networks contain parasympathetic, sympathetic, and visceral afferent fibers. Immunohistochemical differences between neurofilaments in perikarya, dendrites and axons. Placing a gloved finger in the vagina can help direct the insertion of a catheter through the urethra into the bladder. The artificial knee joint consists of plastic and metal components that are cemented to the femoral and tibial bone ends after removal of the defective areas. It passes posteriorly in a nearly horizontal plane; its lateral fibers attach to the coccyx and its medial fibers merge with those of the contralateral muscle to form a fibrous raphe or tendinous plate, part of the anococcygeal body or ligament between the anus and coccyx (often referred to clinically as the "levator plate"). The duodenum, pancreas, and spleen and their blood supply are revealed by removal of the stomach, transverse colon, and peritoneum. Pneumothorax, Hemothorax Hydrothorax, and Entry of air into the pleural cavity (pneumothorax), resulting from a penetrating wound of the parietal pleura from a bullet, for example, or from rupture of a pulmonary lesion into the pleural cavity (bronchopulmonary fistula), results in collapse of the lung. The joint capsule is weak anteriorly and posteriorly but is strengthened on each side by collateral ligaments. The finger-like processes of the fimbriated end of the infundibulum (fimbriae) spread over the medial surface of the ovary; one large ovarian fimbria is attached to the superior 1414 pole of the ovary. Compartments of retro-inguinal space and structures traversing them to enter femoral triangle. It is said to enable the swinging limbs to clear the wide female pelvis when walking. Coverings corresponding to those of the spermatic cord are indistinct along the round ligament. Atrophy or inadvertent surgical removal of all the parathyroid glands results in tetany, a severe neurologic syndrome characterized by muscle twitches and cramps. In some people, several posterior ethmoidal cells invade the sphenoid, giving rise to multiple sphenoidal sinuses that open separately into the sphenoethmoidal recess. Variations of Thoracic Duct Variations of the thoracic duct are common because the superior part of the duct represents the original left member of a pair of lymphatic vessels in the embryo. Rapid growth of the face during infancy and early childhood coincides with the eruption of deciduous teeth.