40's Hacks 💀✨
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"خيرُ النّاس أنفعُهُم للنّاس" "واللهُ في عونِ العبد ما كان العبدُ في عونِ أخيه".
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Channel Posts
| 2 | ⭐️ Ranula
🔻 Sublingual salivary gland swelling due to duct ligation, commonly with Sublingual gland due to its continues secretions
🔻 at the floor of the tongue extended to the submental space & the neck
🔻bluish discoloration
مجملًا بقا كلهم بيطلعوا ant triangle عدا ال cystic hygroma فال post
لما يبقى في cholesterol crystals افكر في branchial
لو قالك حطيت التورش ولقيت translucent يبقى اكيد cystic hygroma
حاجتين بيطلعوا شمال بس ناخد بالنا
لو شمال فال midline=> Thyroglossal cyst
لو شمال فال lateral / post triangle يبقى cystic hygroma
ونركز على ال fistula لما تبقى Congenital/ acquired بتاعة branchial
قالك عيان عنده COPD يبقى نفكر في حاجة من اتنين ؛ laryngeocele - carotid body tumor
ومتنسوش تدعولي💕 | 177 |
| 3 | ⭐️ Carotid body tumor= potato tumor
🔻the most common neck paraganglioma
🔻 Hyperplasia --> tumor
🔻🚨 Chronic hypoxia ( COPD- Cyanotic heart disease - living in high altitude) stimulate Hyperplasia
🔻🚨site : carotid triangle (ant. Triangle) ,in the medial aspect of carotid bifurcation
🔻🚨 Highly vascular tumor --> biopsy is contraindicated
🔻 Supplied by External carotid ( ascending pharyngeal a.)
🔻 Slow growing
🔻 Signs :
✨ Fontaine sign ( vertically fixed )
✨salt & pepper appearance on MRI
✨ Lyre sign by angiography
أهم حتة بقا
🚨🚨D.D of carotid body tumor
✨ aneurysm:
🔻C/P: expansile pulsation, presented with emboli / stroke
🔻 Management : carotid bypass
✨Carotid body tumor :
🔻C/P:
• Pressure symptoms, can be functional causing paroxysmal hypertension & palpitation ( masked with pheochromocytoma)
•🚨transmitted pulsation
🔻 Management :
•Small tumor/ healthy young patient=> surgery
• large tumor/ elderly=> radiotherapy
✨ pheochromocytoma : differentiated from functional carotid body tumor with the presentation of the tumor site & urinary catecholamines
⭐️ branchial cyst
🔻 congenital, Due to patent (failure of obliteration) cleft between 2nd & 5th pharyngeal arches ( persistent cervical sinus)
🔻🚨 Anteromedial upper 1/3 of sternomastoid ms.
🔻🚨 Appear at age of 4-5 / 6-8 years ( NOT at birth )
🔻lined with stratified squamous epithelium originating from ectoderm
🔻🚨special characters: rich in cholesterol crystals & mucoid constitutes, Not compressible but can be partially compressible if there is a sinus tract
حوار compressible د.مينا أكد عليه ف الشرح وأكد أنها not compressible ، بس د.عمرو فالراوند ولما دورت في كذا حتة تاني قالوا أنها partial في حالة وجود sinus،فلو جت عليها سؤال إن شاء الله يبقى واضح وبردو نبقى نتأكد ساعتها
⭐️ Cystic hygroma => cavernous lymphadenoma./ Hydrocele of the neck
🔻 Multiple lobulated , large are superficial& in periphery ,small are deep
🔻due to jagular lymph sac sequesteration ( Lymphangiectasia)
🔻🚨 Partial compressible (large empty in small, small never empty)
يعني لو ضغطت عليها فالكرات الكبيرة هتفرغ جوا الصغيرة ،لكن الصغيرة مش هتلاقي مكان تفرغ فيه فعشان جزء فرغ وجزء لا سموها partial ،مهمة اتأكد عليها
🔻🚨can be in many places but commonly in the neck, Lt side, post triangle at the lower of sternomastoid
🔻🚨 Congenital commonly since birth, can be diagnosed intrauterine by using ultrasonography by 10th week gestation+ elevated alpha fetoprotein in amniotic fluid
🔻🚨contain clear fluid => transilluminates ( brilliant translucent when torch directed to it in a dark room)
🔻 investingation method of choice: MRI , Ultrasonography is useful
🔻🚨 Management :
✨ waiting ( can regress with time )
✨ Administration of sclerosing agent to cause atrophy & fibrosis of cysts
✨ surgical excision
⭐️ pharyngeal pouch ( Zenker's diverticulum)
🔻 Occur at Killian triangle between fibers of cricopharyngeus ms & thyropharyngeus ( inf. constrictor) ms
🔻🚨 Due to cricopharyngeus ms spasm
🔻 Patient common is old aged
🔻🚨 associated with dysphagia, regurgitation of undigested food & aspiration ( most serious complication)
🔻investigations:
✨swallowing barium with video fluoroscopy ( information about size)
✨ esophagoscopy ( asses mucosa to exclude SCC / carcinoma in situ)
🔻🚨 Management : according to size & patient health
✨ Small : Myotomy of cricopharyngeus
✨ Intermediate: open diverticulum/ endoscopic + Myotomy
✨ Large : Excision + Myotomy
🔻 botulinum toxin is used to decrease ms spasm => relief dysphagia
⭐️ laryngeocele
🔻 Anomaly of supraglottic larynx
🔻 dilatation of laryngeal ventricle filled with air or fluid
🔻internal type : remains within thyroid cartilage
✨managed by endoscopy
🔻 external type : protrude through thyrohyoid membrane
✨managed by open approach
🔻 Commonly seen with glassblowers & COPD
🔻🚨 compressible with sound of crepitation
🔻if infected is called : laryngopyocele | 132 |
| 4 | ✨ Surgery ✨
----- Neck swelling -----
د.مينا مكرم شرح المحاضرة دي وكان مركز على ملاحظات مهمة وقال أنه مش هيجيب الأسئلة من براها ، ف ده يعتبر تفريغ لشرح المدرج بالإضافة للملاحظات اللي اتقالت في الراوند والحاجات اللي قالها د.عمرو رئيس القسم بردو، وكالعادة أي حاجة قبلها 🚨 نعرف انها mcq بنسبة كبيرة بتنبيه من الدكتور شخصياً .
⭐️ Neck divided into 2 main triangles (ant. - post.) by sternomastoid ms ==> 🚨sternomastoid= key of the neck
⭐️ Neck triangles formed by : sternomastoid, trapezius,omohyoid, digastric ms.
⭐️ Thyroid gland is one of muscular triangle contents
-----✨Midline swelling✨-----
Can be solid or cystic
1- Solid >> soft - firm - hard
⭐️🚨L.N are the most common swelling in the neck
🔻Midline L.N : submental, suprasternal, prelaryngeal, pretracheal)
🔻 Characters of L.N swelling: site, solid & multiple
🔻 appear at any age
⭐️ Ismuth of Thyroid
🔻 movable with swallowing
🔻 Pathological swelling--> history should be taken :
Can be malignancy or
⬇️Function --> just goiter
⬆️Function --> cytotoxic
⭐️ Lipoma , hematoma ..etc
2- Cystic in Midline
🔻 Abscess:
ناخد بالنا مش اي abscess نشوفه نجري نعمله drainage لا لازم نصبر ونستنى نعرف نوعه إيه الأول وهل هو أصلًا abscess ولا مجرد cyst
⭐️ Pyogenic abscess : hotness, redness , fever
⭐️ Cold abscess = TB cervical lymphadenitis
🔻 النوع ده لو عملناله drainage هيقلب معايا الabscess ب sinus
وعمومًا ال Pyogenic - cold abscess بيطلعوا Midline/ lateral عادي ، اللي جايين بقا هما اللي بيطلعوا Midline بس فناخد بالنا عشان اتأكد على أن الsite بيبقى mcq
⭐️🚨Thyroglossal cyst
🔻 single swelling, appear at age of : childhood , commonly 8:12/15 y.
🔻Site: Midline or just Lt the midline,left to thyroid cartilage,(above/ at the level of/ below) hyoid bone.
بالمناسبة في أغلب الحالات بتبقى below hyoid
🔻 Congenital anomaly due to patency of part of Thyroglossal duct
🔻 Formed by :
✨ Outer fibrous layer rich in lymphatic tissue ==> recurrent infections are common complication
✨🚨 Lined by columnar secretory epith. endodermal in origin ==> cyst is filled with mucoid discharge
🔻🚨مهم جدًا نبقى عارفين أن الfistula بتاعتها ديمًا وأبدًا acquired ،يعني مستحيل حد يتولد بال fistula ،وبتيجي في حالتين : يا اما اتعمل drainage لل cyst أو هي نفسها ruptured عشان حصل عليها infection ، حوار أنها ديمًا acquired اتقال في المحاضرة والراوند وأي حد معدي كان بيأكد عليه ودي نقطة مهمة تفرقها عن ال fistula بتاعة ال branchial cyst اللي ممكن تبقى congenital / acquired
🔻above the fistula there is a crescentric fold of skin
🔻🚨C/P :painless not tender swelling, movable (with limit) up&down with deglutition & protrusion of the tongue by a test (fixation of the mandible)
حوار ال test قاله رئيس القسم لما دخل في الراوند ف نعرفها احتياطي ،وفي حاجة نعرفها بالمرة وخلاص وهي بصراحة متقالتش في الكلية بس سمعتها من د.وهدان أنه لما بنحط التورش على الcyst بتبان trans opaque
🔻 Investigation of choice : C.T
🔻 management/ ttt :
اول حاجة وأهم حاجة نشوف البيشنت عنده الثيرويد ولا لا
•If there is NO Thyroid gland => No incision
•If there is a Thyroid gland => sistrunk's operation
بنشيل ال cyst+ duct+ central part of hyoid لحد م نوصل foramen caecum
⭐️dermoid cyst :inclusion cyst , below the chin in infants.
مفيش حاجة غير دول بتطلع Midline ،اي حاجة تاني بتطلع lateral
-----✨Lateral swelling✨-----
Can be solid or cystic
1-solid swelling
⭐️ Most common: L.N
(Submandibular, occipital, supraclavicular L.N)
🔻🚨supraclavicular L.N = virchow L.N , its enlargement is the 1st presentation of GIT malignancy
🔻🚨D.D between submandibular L.N & submandibular salivary gland
مهمة الدكتور ركز عليها
✨ submandibular L.N :
•rolling, solid, multiple
•enlarged due to inflammation
• superficial
✨ submandibular salivary gland
• not rolling, single
• enlargement is commonly due to stones as it's the most common gland to have stones as the duct is upward as well as viscus secretions
•🚨 sensation by 2 fingers ( bidigital examination)
• +ve lemon test
⭐️ Thyroid gland ( lat. Lobe )
⭐️ Carotid body tumor | 161 |
| 5 | لو هتنزل ملخص للمحاضرات ف حابينه ازاي ؟
مع العلم 37 كانوا منزلين ساعتهم تفريغات كويسة | 500 |
| 6 | حابين لما ننزل ملاحظات الشرح وتفريغات الراوندات تبقى ازاي؟ | 469 |
| 7 | السلام عليكم ورحمة الله وبركاته
إن شاء الله تكونوا بخير وكل سنة وانتم طيبين، ربنا يجعلها بداية مرحلة سعيدة علينا كلنا 🥰
مبدئيًا في كذا حاجة عايزين ناخد رأيكم فيها ف إن شاء الله ال polls دول مش هياخدوا منكم دقيقة عشان نفهم بس حابين نمشي الفترة الجاية ازاي إن شاء الله .
ولو عندكم أي مقترحات تقدروا تبعتولنا هنكون متحمسين نسمعها ، وأخيرًا ف احنا مبسوطين إننا مكملين سوا 🥰 | 453 |
| 8 | "كيفية تشخيص حالة الوفاة🖤 | 109 |
| 9 | https://www.facebook.com/share/r/18dTGiJubj/ | 109 |
| 10 | ✨Hacks' academic index✨
⭐️ Year 1 , 2nd semester
🎀 Microbiology & Parasitology (Mid)
🎀 Microbiology final ( mind maps )
🎀 Parasitology final ( mind maps )
🎀 Pathology & pharmacology (mid)
🎀Pathology & pharmacology (final)
⭐️ Year 2
🎀CVS Mid / Final
🎀GIT Mid / Final
🎀SMU Mid / Final
🎀HIC Mid / Final / practical
🎀HEM Mid / Final +MCQs
🎀RRS Mid / Final / practical
⭐️Year 3 , 1st semester
🎀ERD Mid / Final
🎀CNS Mid / Final
For data content & much more important notes , check this please >> 40's data content
لعلكم بخير جميعاً إن شاء الله 🌷
للدفعات الأصغر خصوصًا وأي حد عمومًا ف دي كانت ملخصات عملناها على مدار فترة الأكاديمي، بتتكون تحديدًا من النقاط اللي اتركز عليها في الشرح في المدرج متضمنة الزيادات بالإضافة لتجميعات الحاجات المهمة في المنهج والأسئلة اللي الدكاترة كانوا ممكن يقولوها في الشرح وهكذا ، وكمان معظم الاسئلة اللي زمايلنا ربنا يجازيهم خير كان بيجمعوها من مصادر مهمة مختلفة والملخصات وغيرها ف هتلاقوها على الأغلب أكثر تنظيمًا بدايةً من سنة تانية وهتكون موجودة في المسدچ المجمعة لكل مديول تحت بند ( تجميعات وملاحظات وأسئلة مهمة.)
طيب بعيدًا عن المقدمة في سؤال يطرح نفسه، امتا ممكن ألجأ للملخصات دي؟ / ازاي أستفيد منها ؟
•لو انت شخص مذاكر وعايز تختصر الوقت في ليالي الامتحان عشان تلحق تحل فالملخصات اختيار مثالي للمراجعة لأنها أصلا معمولة بشكل تجميعي يساعد على الاسترجاع أكتر م كونها مفصلة زي التفريغات اللي أحياناً ممكن تبقى مصادر مذاكرة ( يعني راجع منها متخليهاش مصدر مذاكرتك الأول)
• لو في محاضرات مذاكرتهاش والامتحان خلاص مفيش وعايز المهم فيها اللي يخليك بإذن الله تحل 75-90% فالملخصات اختيار كويس بشرط متنساش تشوف أسئلة الفورماتيفز واسئلة السنين اللي فاتت.
طبعًا أغلب المحاضرات بتفضل ثابتة على مدار كام سنة كدة لكن بردو تظل الأولوية لشرح المدرج والملاحظات اللي زمايلك بيجمعوها في السنة بتاعتك .
وأخيرًا متنسوناش كلنا من دعواتكم بالخير والتيسير ، ربنا يوفقنا ويوفقكم جميعاً
"ربّنا تقبّل منّا إنّك أنت السّميعُ العليم"🌷. | 869 |
| 11 |  مسك الختام | 548 |
| 12 |  Half of the journey is to over, bringing us closer to the dream !🤍🤩 | 739 |
| 13 |  Semi seniority is getting closer and closer 🥳🤍 | 782 |
| 14 | آخر أسبوع في النيورو ،وآخر pin لآخر مسدچ فاينل هتنزل هنا في الأكاديمي
آه احنا هنروح من بعض فين 😂💖
نتمنى بجد نكون قدرنا خلال سنتين ونص فاتوا نقدم احسن حاجة عندنا تهوّن وتخفف ثقل ورهبة ليالي الامتحان :)
شكرًا لكل حد وقف جنبنا لحد م وصلنا هنا ،وشكرًا لكل حد قدم مساعدة للدفعة كلها بشكل عام ؛داتا واسئلة وزمايلنا عموماً اللي كانوا بيتواصلوا مع الدكاترة عشان يسهلوا علينا وغيرهم اللي كانوا بينزلوا ملاحظات وكل حد قدم مساعدة بأي شكل من الأشكال ، بجد ربنا يجازيكم كل خير في الدنيا والآخرة ونفضل كويسين مع بعض لحد التخرج 😂💗
متنسوناش كلنا ووالدينا من جميل دعواتكم بالبركة والخير في الدنيا والآخرة 💗
الحمد لله المسدچ رسميًا اكتملت تمامًا لو حد حابب يعملها forward
وأخيرًا وليس آخرًا :
{ربّنا تقبّل منّا إنّك أنت السميعُ العليم}
{وآخِرُ دعوىـٰهُم أنِ الحمدُ للهِ ربِّ العَالَمين} | 795 |
| 15 | +1 الارقام في محاضرة spinal cord أناتومي | 568 |
| 16 | ✨brain metabolism || biochemistry ✨
Carbohydrates
⭐️🚨main fuel of brain: glucose
⭐️ Fuel of brain during starvation : ketone bodies + amino acids
⭐️🚨 Storage form of glucose in the brain: glycogen
⭐️🚨For brain full function : constant supply O2 + glucose > deficiency of any of them more than 5 min. >> Irreversible Tissue death ( hypoglycemic coma more serious than hyperglycemic)
⭐️ glucose:
✨ By :Glycolytic - tricarboxylic acid - Krebs cycle >> ATP (energy)
✨ By : HMP pathway>> NADPH synthesis ( nucleotide synthesis)
✨ Involved in amino acids , lipids synthesis
✨ Only source of energy for ms during exercise
⭐️ Fate of glucose in :
🌬feeding state :
✨ In brain, ms, liver: glycolysis by Kreb's cycle
✨RBCs : anaerobic glycolysis by lactic acid
🌬 Storage as glycogen mainly in liver and ms ( brain store glycogen but with little amount)
🌬 Excess glucose>> Lipogenesis by liver ( TAG synthesis)
⭐️ Glucose metabolism in the brain:
✨🚨mainly by Astrocytes
✨ Nerve tissue capable of synthesis of G6P in gluconeogenic pathway ( G6P is the end product of gluconeogenesis , phosphorylation of G6P give glucose)
Amino acids
⭐️ High content of :
🚨 Glutamic acid, glutamine , aspartic acid
✨ Can be used as a source of energy during starvation.
✨🚨Glutamic acid = glutamate >> role in brain functions regulation ( NT)
Fat starvation cycle of the brain
🚨🚨🚨🚨
مهمة جداً.
⭐️ During first few days >> brain use glucose only ( from ms breakdown)
⭐️🚨 After 3 months >> use ketone bodies that decrease ms breakdown
🚨Ketone bodies:( acetone, acetoacetate, beta hydroxybuteric acid)
حفظ أسماء ketone bodies مهم على الآخر ممكن يجيب سؤال ويقول مين المخ بيستخدمه بعد ٣ اسابيع ويبقى عايز اسم واحد منهم.
Carb, protein>> 4 Kcal/g
Fat >> 9Kcal/g | 591 |
| 17 | ✨ Encephalitis | micro ✨
⭐️ Inflammation of brain parenchyma.
⭐️🚨 Commonly viral
⭐️ Most viruses cause the C/P by direct destruction of brain tissue , some cause vasculitis & demyelination after infection
⭐️C/P : flu like prodrome , High fever, severe headache, altered conscious + presentation according to affected functional area in the brain.
✨ Herpes simplex Encephalitis ( HSV 1 ,2)
⭐️ Herpes are DNA enveloped viruses with latency= periodic activation
⭐️ Infection more serious & common in immunocompromised with disseminated infection
✨ HSV 1 >> contact, latency in trigeminal ganglia, other symptoms appear above the waist
✨HSV 2 >> sexually, vertical (high risk if mother has herpes for 1st time ) , latency in sacral ganglia ,other symptoms appear below the waist & can be associated with Meningitis ( meningoencephalitis)
⭐️ HSV other symptoms:
•Gingivostomatitis & keratoconjunctivitis
• herpes labialis = cold sores = fever blisters
⭐️ Diagnosis:
🚨 Neuroimaging mainly (CT, MRI)
🚨HSV CSF PCR >>gold standard confirmatory test
🚨 IgM
⭐️ Acyclovir >> ttt & prophylaxis
⭐️ Vaccination ( live attenuated varcella )
Rabies
⭐️🚨 Acute viral disease of CNS = Neurotropent
⭐️ -ve ss RNA
⭐️ Zoonotic >> by bite / licks of infected animals
⭐️🚨C/P :
✨ Poor prognosis
✨ Start with numbness at the site of bite (localized)due to viral replication + prodrome ( fever headache malaise ..)
✨ Virus moves retrograde from PNS to CNS >> replication at DRG till brain >>acute neurological phase ( hydrophobia , photophobia, paralysis ,hallucinantion ..)
✨ Coma & death
⭐️🚨 Clinical course depends on: site of bite , number of bites , type of wounds ( deep / shallow)
⬆️⬆️🚨Fatality if : multiple deep wounds in head & neck
⭐️ clinically diagnosed by history
⭐️ viral ag in CSF or animal saliva
⭐️🚨 Pathognomonic Negri bodies post mortem brain biopsy
⭐️ttt:
✨🚨Once symptoms appeared >> No effective ttt
✨ Post exposure before symptoms:
🌬human rabies Ig ( passive immunization) + active immunization by rabies vaccine I.M 4~5 doses
ناخد بالنا هنا ومنتخدعش لو جت case وحكالك الهيستوري وقالك آه عنده تنميل بس الحمد لله لسة مش بيخاف من المياة والجو ده وأخد ال vaccine تتوقع هيخف ولا لا
لا مش هيخف عشان التنميل من علامات المرض خلاص والمفروض كان هيبقى فعال قبل م تظهر عليه أي أعراض سخونة ،صداع،تنميل | 405 |
| 18 | Spinal white matter
✨organized in 3 columns ( funiculi ) : ant, lat, post
✨ Each column contain type of tracts >> ascending sensory , descending motor, intersegmental short
Ascending sensory tracts
🎀 Gracile & cuneate tracts in the post column
✨ Formed by the afferent fibers of DRG to post column from the same side of the body , tracts for fine touch and proprioception ibsilaterally ( uncrossed tract)
✨ Gracile tract : medially , afferents from sacral , lumbar , T7 : T12 ( lower of the body)
✨ Cuneate Tract : lat to gracile , afferent from cervical & T1:T6 ( upper of the body)
✨ Both end in their nuclei in M.O >>nuclear fibers ( arcuate fibers) decussate >> medial lemniscus>> PLVNT >> primary somatosensory cortex (3,1,2)
🎀lat spinothalamic tract : in the lat column
✨🚨 Pain , temperature Contralateral
✨ Originates from fibers of DRG enter tip of post column >> dividing forming Lissauer tract >> terminate in SGR
✨ Axons of SGR cross obliquely Infront of central canal >> spinal lemniscus >>PLVNT>> primary somatosensory cortex (3,1,2)
🚨lat spinothalamic tract formed by SGR fibers
🎀ant spinothalamic tract : in the ant column
✨🚨 Crude touch Contralateral
✨ Originates from fibers of DRG >> termination in nucleus proprius >> fibers of proprius cross & ascend contralaterally to spinal lemniscus>>PLVNT >>primary somatosensory cortex (3,1,2)
🚨ant spinothalamic tract formed by nucleus proprius fibers contralaterally
Descending motor tracts
⭐️ Pyramidal or Extrapyramidal tracts
⭐️AHCs of spinal cord analog cranial motor nuclei
⭐️cranial motor nuclei : motor nuclei of all cranial nerves except 1,2,8.
Pyramidal
⭐️ Concerned with fine skilled move.
🎀Corticospinal tract
✨ Originate from Betz cells : C.C area ( 4,6+ 3,1,2)
✨Axons descend in coronal radiata >> post limb IC >>crus cerebri mid brain>> pons >> pyramidal nucleus at the ventral surface M.O
✨🚨 75% decussation at the level of lower medulla ( motor decussation)
🌷 Crossed fibers>> decend in Lat corticospinal tract>>AHCs >> fine skilled move. distal joints
🌷 Uncrossed>> descend in ant corticospinal tract>> some decussat at the level of spinal cord >> AHCs cervical & upper thoracic >> trunk ms
✨🚨 Lesion above motor decussation>> contralateral incomplet hemiplegia
✨🚨 Lesion below motor decussation>> ibsilateral incomplet hemiplegia
🎀 Corticobulbar ( cortico nuclear ) >> divided medial & lateral
⭐️ Medial : arise from area 8 , end in nuclei of CN 3,4,6 >> extraocular ms
⭐️ Lateral: area 4 , end in nuclei of : 5,7,9,10,11,12 >> ms head , neck
🚨🚨🚨 Cranial Motor nuclei supplied bilaterally by corticospinal tract EXCEPT 12 , lower 1/2 of 7 >> Unilateral contralateral supply
🎀 Extrapyramidal:
⭐️🚨 Concerned with gross, reflex movement
⭐️ Arise from subcortical motor centers ( red nucleus - tectum- vestibular nucleus..)
✨ Tectospinal tract
✨ rubrospinal tract
✨ Reticulospinal tract
✨ vestibulo spinal tract
الدكتور قال نعرفهم أسامي لا غير
(لو جاب عليهم سؤال ديتيلز هنحله من الفسيو عادي كدة كدة علينا 😔) | 281 |
| 19 | ✨ spinal cord anatomy ✨
ملاحظات وتأكيدات المدرج
Gross features
⭐️ 45 cm , 31 segments, 5 regions , occupies 2/3 of spinal canal
⭐️🚨 Start just below foramen Magnum as a continuation of M.O
⭐️ Has 2 enlargements :
• cervical >> brachial plexus
• lumbar >> lumbosacral plexus
🚨🚨🚨:
✨ Spinal cord in adults ends between L1 : L2 ( at the lower border of L1) >> lumbar puncture from L2 :L5 ( L3,L4 / L4,L5)
✨ Pia end by the level of the end of spinal cord (L1 : L2 )
✨ Arachnoid & dura >> by the level of S2.
✨🚨 Conus medullaris : lower tapering end of spinal cord
✨🚨 denticulate ligaments : Triangular lateral ligaments between ant. & Post. roots >> fixation with dura ( penetrating arachnoid)
✨🚨 Lumbar cisterna: dilation at the Subarachnoid space below Conus medullaris till S2 vertebra , contents :
•🚨 coda aquina : tail horse appearance formed of collections of Lumbo sacral coccygeal nerves
•🚨 filum terminalis : downward extension of pia from conus medullaris till back of coccyx
• CSF
Spinal cord inner structure
⭐️ Ventral root >> motor ( AHCs)
Dorsal root>> sensory (PHCs)
Trunk ( intervertebral foramina) = ventral+ dorsal fibers= mixed
⭐️ Mixed spinal N. Outside vertebral canal divides into:
⭐️🚨 ventral ramus = mixed supply of trunk, upper, lower limbs
⭐️🚨Dorsal Trunk = mixed supply back. Of the body
⭐️Mixed Sacral N. divides inside sacral canal.
⭐️🚨mode of exit :
•C1:C7 >> above corresponding vertebra
•C8 >> between C7 & T1
•Thoracolumbar >> below corresponding vertebra
•S1:4 >> divided , ventral >>ant sacral Ramus , dorsal >> post sacral Ramus
• S5+ coccygeal >> sacral hiatus
⭐️🚨 Outside white matter (myelinated nerve axons) , inside H shaped gray matter ( cell bodies )
⭐️ Gray matter nuclei:
🎀Nuclei ventral horn ( motor) >> alpha & gamma motor neurons supply 3 groups
✨medial group >>in all spinal cord , supply axial ms.
✨Lat. group >>in cervical + lumbosacral spinal cord segments,supply Limbs
✨ Central :
C3,4,5 >> Phrenic nucleus (diaphragm ms.)
C6,7 >> accessory nucleus ( trapezius & sternocleidomastoid)
🎀Nuclei dorsal horn ( sensory)
✨SGR >>top of dorsal horn,along the length >>pain & temp.
✨ nucleus proprios >> ventral to SGR along the length> Crude touch
✨ Nucleus dorsalis >> base of dorsal horn , C8:L3 >> unconscious proprioception Lower limb
✨ Visceral afferent nucleus >>lat. To nucleus dorsalis, T8:L3 >> visceral sensation
🎀Nuclei lat horn ( autonomic)
✨ Preganglionic sympathetic : thoracolumbar
✨ Preganglionic parasympathetic : S2,3,4
Blood supply
⭐️ant. Spinal a. : single a. at ant.medial fissure, arising from vertebral a. supply ant 2/3 of spinal cord
⭐️Post. Spinal a. : doubled Rt&Lt a. ,arising from vertebral a. at post.medial fissure, supply post 1/3 of spinal cord
⭐️ Radicular spinal a. : regional origin , horizontal enter vertebral canal through intervertebral foramen, supply lower 2/3 of spinal cord
⭐️🚨Arteria Radicularis magna : major blood supply of lumbar & sacral regions
🚨🚨 Upper of spinal cord mainly by spinal a ( 1ant + 2 post)
Lower of spinal cord mainly by Radicular a.
✨ Venous drainage: 6 spinal veins ( 3 ant. + 3post) anastomose and drain into :
• cranial Dural venous sinuses ( sup.)
• internal vertebral venous sinuses ( lateral)
ANS
⭐️ Sympathetic: LHCs from intermedio lateral nuclei of thoracolumbar segments (14 segment) , preganglionic leave through ant. Root of corresponding spinal n .
⭐️ Parasympathetic : spinal parasympathetic from LHCs of S2,3,4 >> supply lower of gut, U.B, genitalia
✨ Cranial parasympathetic
•3 >> EWN from tegmentum midbrain >> ciliary ganglion
• 7 >>sup. Salivatory nucleus pons >> pterygopalatine ganglion/ submandibular ganglion
• 9 >> inf. Salivatory nucleus M.O >> otic ganglion
•10 >> dorsal motor nucleus of vagus >> parasympathetic heart , thorax, viscera.
Spinal white matter | 258 |
| 20 |  +3Sensory cerebral cortex
في جزئية thalamic syndrome في المحاضرة دي كاتب هيبقى عنده sensory ataxia
هي مش أدق حاجة بالمناسبة هو قالها هنا باعتبار ال lesion هيبقى بس في PLVNT إنما الاصح أنها بتبقى mixed عشان PLVNT+ VL بيبقوا اتضربوا زي م متقال في محاضرة ١٤
لو جت في الامتحان الاحسن نسأل فيها هي تبع محاضرة ٩ ولا محاضرة ١٤ وإن شاء الله تبقى الدنيا ابسط من كدة 🙏🏻 | 363 |
