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Dear friend,

These very tiny parts of notes are taken form various sections form Chotiwala's Notes. It may be possible here these notes you may see in right formats please down load Amar font for Hindi/Sanskrit section. For complete notes and guidance please order today.
Best of luck
Tomorrow is yours
Yours truly,
Dr. Sanjay Kr. Singh
_{M.S. (Ay), D.Yo., I.M.S. B.H.U., Gold Medalist}

Consultant Surgeon & Oncologist

'kkjhj’kkL=

vFkZosn esa 'kjhj dks czgeiqjh, vkBpØ, ukS }kjks dh v;ks/;k uxjh dgk gSA bldks rhu vjks okyk o rhu LFkkuksa ij fVdk crk;k x;k gSA

iapegkHkwr ls cuk inkZFk 'kjhj gSA

'kjhj 'kCn Jh /kkrq ls cuk gSA Jh ¾ J;Urs

xHkkZsifuYkn us Ójhj esa rhu vfXu;ka ¼1½ KkukfXu, ¼2½ n'kZukfXu, ¼3½ dks"BkfXu crkbZ gSA

Ó` /kkrq esa bju~ izR;; ls 'kjhj 'kCn cuk gSA

;kLd us 'kjhj 'kCn dks mi'k; ¼fouk'k½ ekuk gSA

'kjhj Ik;k;Z ¾ nsg, dk;

nsg ¾ fng /kkrq esa ?k´ izR;; ls fodkl ¼Anabolic Process ½ dk Kku gksrk gSA

dk;k ¾ vfXu ¾ {k;&o`f) dk LFkku ¼ that place where Anabolic & catabolic process i.e. Metabolism occur)

fØ;k'kkjhj ds vuqlkj 7 /kkrq $ 3 nks"k $ 13 vfXu dk LFkku 'kjhj gSA

pjdkuqlkj psruk $ egkHkwr dk la;ksx 'kjhj gS

lqJqrkuqlkj 'kqØ, 'kksf.kr, lq{e'kjhj o vkRek ds la;ksx ls xHkZ curk gSA fodflr xHkZ gh 'kjhj gSA

'kkjhj ¾ pjdkuqlkj izkf.kek= 'kjhj ds foYk; esa tgka fopkj djrs gS og 'kkjhj gS

okXHkVkuqlkj 'kjhj ds tUe vkSj e`R;q dk tgak o.kZu gS og 'kjhj gSA

Anatomy = Ana + Tounein = Asunderora Part + To cut

Ókjhj dk iz;kstu izR;{k ,oa fl}kfUrd nksuks dk Kku djuk gSA

pjd o lqJr us 6 vaxks, nks gkFk, nks iSj, flj, o e/; 'kjhj dks "kMax’kjhj dgk gSA

Hkkoizdk’k us 'kjhj ds 8, flj, xzhok, gkFk, o{k, mnj, ikZ’o, i`"B, iSj esa foHkkftr fd;k gSA

nkeksnj xkSM+ 'kekZ us vfHkuo’kkjhj esa 'kjhj dk bl izdkj esa foHkktu fd;k %&

Developmental anatomy

a. Componental Anatomy

b. Embryology

General or Gross Anatomy

c. Topological Anatomy

d. Systematic or Ennmeration

Practical Anatomy

Descriptive Anatomy

e. Osteology

f. Arthology

g. Syndesmology

h. Myology

lqJqr ds vuqlkj &

ekluks ifpra dkys /keuhH;krnkrZoe~

bZ"knd`".ka foxa/ka p ok;q;ksZfueq[k u;sr~A

vkrZo jl dh mi/kkrq gSA

vkrZoog /keuh nks crkbZ xbZ gSA

vkrZo jl dh mi/kkrq gSA

vkrZo o`f) ls vaxenZ, nqcZyrk gksrh gSA

{k; ls ;ksfu esa osnuk o vle; vkrZo gksrk gSA

vkrZo pØ Ovary ds dkj.k gksrk gSA Ovary izR;sd ekl esa alternate (by ovulation) ovum NksMrk gSA Ovulation jtlzko izkjEHk gksus ls 14 osa fnu igys gksrk gSA

Ovum dk size 100 – 150 micron gksrk gSA

Weight of Ovary is 5 – 10 gm (average 7gm).

Size of Ovary is 3x2x1 cm.

Ovary lies in ovarian fossa.

Size of Testes is 5x2.5x3 cm.

Weight of testes is 10.5 – 14 gm. Testes having 250 lobules.

One spermatogonia produces 4 sperm.

Sperm embedded on free end of sertoli cell.

Vas deference is 45 cm long, 3 mm diameter and having 1 mm of lumen.

Penis is 10 cm long 4 cm broad and on errection it become 6 inch long. In testes sperm is non-motile and can’t fertilize ovum.

In epididmis store & transport the sperm which are motile and mature. Semen is secretion of Seminal vesicle, Prostrate and Coupers’ gland and 2 – 5 ml in quantity.

Leding cell secrete Testosteron which is inhibited by ICSH.

Fructoses (140 – 280 mg/100ml), Ascorbic acid, Prostgladin are secreted by Seminal vesicle.

Prostrate secretes Proteolytic enzyme, citric acid, Zn, Mg.

Semen is Alkaline (ph 7.35 -7.50)

'kqØ ds leku lqJqr us vkrZo nks"k 11 crk;s gSaA

vkrZoefi f=fHknkZs"kS & dq.kixfU/k iwfr iw; {kh.k ew= iqjh"k izdk’kelk/;a lk/;eU;ppsfrA lq0’kk0 2@5

Fertilizatin ¼xHkkZ/kku½ ¾ It occur in lateral end of fallopian tube.

Hkkoizdk’k us 'kqØ’kksf.kr dk la;ksx xHkkZ’k; esa crk;k gSA

euksokafNr larku izkfIr ds fy;s iqlaou deZ djrs gSA

iq= dh izkfIr ds fy;s iq=sf"V;KdeZ djrs gSA

iq= dh izkfIr ds fy;s iwodeZ

iq:"k ¾ ?k`r, nq/k, {khj iz/kku Hkkstu lsouA

L=h ¾ rSy enZu, mM+n iz/kku Hkkstu lsouA

lgokl dh jkf=;ka dU;k izkfIr ds fy;s 5, 7, 9, 11,

lgokl dh jkf=;ka iq= dh izkfIr ds fy;s 4, 6, 8, 10, 12

lgokl ds fy;s fu| jkf=;ka &

lqJqr

euq

okXHkV

3 o 13

4, 11, 13

3, 11

No. of chromosomes in human somatic cell is 46 (44xy or 44xx)

y chromosomes is smaller then x

Mitosis cell division produces identical daughter cell.

Steps of Mitosis:

Prophase → Metaphase → Anaphase → Telophase

Meiosis cell division complete in two stages. In 1^st stage No. of gene become Haploid and 2^nd stage just like Mitosis and at last 4 haploid cell formed.

From Oogonia only one ovum (22x) is formed and rest 3 cell absorbed and Spermatogonia produces 4 sperm (22x or 22y)

At the time of meiosis/mitosis gene translocation may occur which produces abnormalities.

Numerical autosomal abnormalities

a. Increase in number (46 = 2n, n = 23) → 3n (69), 4n (92) = Polyploidy

b. Change in number = Aneuploidy
2n + 1= Trisomy (47xxx), 2n – 1 = Monosomy (45xO → Turner Syndrome

The example of Trisomy are Doun Syndrome (21), Edward Syndrome (18), Pataer Syndrome (trisan – 13). These babies are having growth retardation and mentally defected.

Monosomy is lethal

Structural Autosomal abnormalities

c. Translocation (1) Reciporcal, (2) Balanced & Unbalanced → Produces habitual abortion

d. Rebortsamian taranslocation → Increase risk of Down Syndrome (21 attached to 14)

Sex Chromosomes abnormalities

e. Change in number → Aneuploidy

f. Change in Structure

i. Isochromosomes = Transverse division instead of longitudinal division.

ii. Ring Chromosomes = Broken end join to form ring

iii. Deletion=
Mosaicism → non disjunction at gemetogenesis and fertilization → xy/xo, xy/xxy
Chemcrism → double fertilization or fusion of two zygote

Single gene disorder (mutation) → Achondroplasia, Hemophilia, wrilizing syndrome

Polygenic inheritance → Neural tube defect, Anecephaly, Spina bifida, Hydrocephalus

Turner Syndrome (45x0) produces gonodal dysgensis

Klinefelter Syndrome:

In male (47, xxy) → Small testes and Azoospermia,

In female (47, xxx) → Normal female phenotype with ovarian dysfunction and mental retardation.

Spermatogenesis takes 64 days and 4 cycles of each 16 days.

Spermatogonia → 2 primary spematocytes (2n) → 2 secondry spermatocytes (nx or ny) → 4 spermtid (nx, nx, ny, ny,) → 4spermatozoa

Oogensis:

In 5^th month of fetal life 7 million oogonia produces form primary oogonoia and 7^th month formation of oogonia stopped.

Meiosis I start in foetal life but arrested at Prophase.

At the time of birth → 2 milliion oocytes

At the time of puberty → 40000 primodical follical remain.

From puberty till menopause under LH effect meiosis is resumed in primary oocyte and developing ovarian follicle and complete 36 – 48 hour before Ovulation.

Secondry oocytes (22x) is formed with discharge of first polar body.

Meiosis II is occur in secondry oocyte but halted in Metaphase ovum (22x). On fertilization by spermatozoa Meiosis II completed. At this time mature ovum formed and discharge of second polar body in pervitallian space.

Oogenesis is cyclic and take 10 – 50 years (Starting at fetal life till at ovulation form puberty to menopause).

Fertilization occure with in 24 hour of ovulation & 24 – 48 hour after ejaculation in vagina by sexual act.

Sex ratio = 160male/100female (Primary), 106/100 (Secondry)

In 1981, 933 female/ 1000 male,

Kerala →1032 femal/1000male, Haryana→ 870female/1000male.

At present female/ male ration……………………………….

Near time of ovulation, application of Vinegar acid in vagina produces female and Alkaline sodabicarbonate produces male.

Fertilization → 2 cell stage by cleavage (24 – 30 h after fertilization → 4 cell stage (36h) → 20 -50 cell ( covering with zonapellacida, reach in uterus at 4^th day of fertilization → blastocyst (4 – 5^th day, imbibe uterine fluid, zonapallacida degenerated, morula expand with accumulation of fluid in blastocyst, implant in endometriam → Nidation (blastocyst 200 cell, 6^th day from complete end of 10 day, 20 days of mense) → Trophoblast (divide in two → 1. cytotrophoblast & 2. syncytotrophoblast)

Trophoblast → Cytotrophoblast → Chorian → lined internally.

Trophoblast → Syncytotrophoblast → Chorion villi (finger like projection) it is following type:

Primary villi → solid layer (12 days of fertilization)

Secondary villi → with mesenchymal layer (16 days)

Tertiary villi → secondry villi with blood vessels (21days)

a. Cholion leave → uterine cavity

b. Chorian frondosium → uterin wall side (this formed Decidua 5 – 10 mm thikness

Muscle of anterior abdominal wall

Muscle	Origin	Fibre,	Insertion	Nerve supply
External oblique 1. It has three free borders, posterior, superior and inferior. inferior border forms inguinal ligament 2. It has one opening, the superficial inguinal ring 3. The intercrural fibres. bind the two limbs of the superficial inguinal ring, and are arranged at right angle to other fibres	8 fleshy slips from the lower 8 ribs. The upper 4 slips interdigitate with serratus anterior, and the lower 4 slips with latissimus dorsi.	Fibers are directed downwards, forwards and medially	A. By fteahy fibres it is inserted into the anterior2/3 of the outer lip of iliac crest. B. By a broad aponeurosis. it is inserted into xiphoid process, linea alba, pubic symphysis, pubic crest and the pectineal line of pubis.	Lower 6 thoracic nerves
Internal oblique1. The. lower free border & Conjoint tendon Arch over the inguinal canal 3. Its fibres form a part of the cremaster muscle	fleshy origin from: a. Lateral 2/3 of inguinal ligament, b. Anterior 2/3 of the intermediate area of iliac crest, and c. Thoracolumbar fascia.	Fibres are directed upward, forward and medially The lowest fibres of the. internal oblique and transverses abdominis fuse to form conjoint tendon	A. By fleshy fibres it is inserted into the lower 3 or 4 ribs and their cartilage B. By a broad aponeurosis it is inserted into 7th, 3th and 9th costal cartilages xiphoid process, linea alba, pubic crest and pectineal line of pubis.	Lower 6 thoracic and first lumber nerves.
Transversus abdominis	fleshy origin from: a. Lateral 1/3 of inguinal ligament b. Anterior 2/3 of the inner lip of iliac crest, c. Thoracolumbar fascia, d. Inner surfaces of the lower six costal cartilales; these fibres interdigitate with. diaphragm	fibres Directed transversely forwards its lowest fibre fuse with the internal oblique to form conjoint tendon	by a broad aponeurosis into xiphoid process, linea alba, pubic crest and pectineal line of pubis	Lower 6 thoracic and first lumber nerves.
Rectus abdominis 1. It is enclosed in the rectus sheath. 2. Its upper part is crossed by three tcndinous intersections.	two tendinous heads a. Lateral head from lateral part or pubic crest. b. Medial head from anterior pubic ligament. Continued	The fibres are vertical.	a. 5^th, 6^th and 7^th costal cartilages, b. Xiphoid process and costoxiphoid ligament.	Lower 6 or 7 thoracic nerves.
Cresmaster fully developed only in males	lateral and medial part a. Lateral part arises from the middle part of inguinal ligament, internal oblique and transversus abdominis. b. Medial part is vari able and may be absent. It arises from pubic tubercle and may extend to pubic crest and conjoint tendon.	Fibres are united by areolar tissue to form a sac like cremasteric fascia around the sepermatic cord and testis deep to the external external spermatic fascia	The lateral part intermediate with the medial part forming loops of varying length.	Genital branch of genitofemoral nerve (L₁)
Pyramidalis It it a small triangular, rudimentary in human beings	a. Anterior surface of the body of pubis. b. Anterior pubic ligament	Fibres are directed upwards and medially.	into linea alba.	Subcostal nerve (T₁₂)

Muscle of the posterior abdomiaal wall

Muscles	Origin	Insertion	Nerve supply
.Psoas major A fusiform muscle Psoas and iliacus are together known as ilio-psoas, 1. With iliacus, it acts as a powerful flexor of the hip joint, 2. Helps in maintaining posture at the hip. Balances trunk while sitting. 3. One psoas brings about lateral flexion of trunk on that side 4. It is a lateral rotator of hip. After fracture of the neck of femur the limb rotates laterally.	a. anterior surfaces and lower borders of transverse processes of all lumbar vertebrae. b. By 5 slips, each one of which arises from the bodies of two adjacent vertebrae and their intervertebral disc, from T₁₂ to L₅ vertebrae. c. From 4 tendinous arches extending across the constricted parts of the bodies of lumber vertebrae, between the preceding slips. Thus it is a continuous origin from lower border of T₁₂ to upper border of L₅.	the tip and medial part of the anterior surface of lesser trochanter of femur.	Branches from the roots of L₂,3 nerves some times L₄

Incubation period = 10-25 days. Eruption with in 24 hour rFkk dbZ fnu rd fudyrs jgrs gSA igys /kM+ ij fQj pgsjs ij fudyrs gS lq[kus ij nkx ughA

Complication = Pnemonitis, Myocarditis, Conrneal Lesion, Arthritis Gout, Hepatitis, Glomerunephritis.

jksekfUrdk ¼[kljk, measles½& dQ,fir ds izdksi ls jksedwiksa ds mHkkj ln`’k yky o.kZ dh fifM+dk;s, iwoZ :i & Toj, [kkalh, v:fpA lqJqr us bldk o.kZu ugh fd;kA pjd fpfdRlk v/;k; 13 esa o.kZu gSA elqfjdk gh Hksn ekuk gSA

Droplet infection of nasopharynx, secret in teenager& young adult,

Incubation period 9-17 days

Symptom = Malaise, Irratibility, High Ferver, Conjectivitis, Severe Cough, Coryza, after 3-4 day Koplic spot in mouth, blue white spot on cheek, rash = forhead – face – trunk, leucopenia <2000 lymphocyte.

Complication = Bronchitis, Broncholytic, Conjectivitis, Myocarditis, Acute Granulonepharitis, Sub acute sclorsing panencephlitis, eczema.

German measles

Incubation period – 14-21days,

Symptom = Malaise, Headache, Fernuculosis, Conjectivitis, Maculopapular Rash = forhead – face- trun – extremities,

Enlarge lymphgland = postauricular, suboccipatal

Congenital = Patent ductus arteriosus, IVSD, PS, cataract, corneal clouding, microcephaly, mental retardation, deafness.

Hkkoizdk’k us 'khryk o elqfjdk fHkUu fHkUu ekuh gSA elwfjdk tc 'khryknsoh ls vkØkUr gks tkrh gS rks mls 'khryk dgrsa gSA blds lkr Hksn gSA

¼1½ o`gr’khryk, ¼2½ dksnzo’khryk, ¼3½ ikf.klgk, ¼4½ l"kZfidk, ¼5½ jkftdk, ¼6½ cgLQksVk, ¼7½ peZtkA

'yhin & f’kykor~ infefr 'yhine~A Qhyikao, gkFkhikao, elephantiasis,

Filariasis= long lymphatics obstraction by microfilaria bancrofti or wucheria bancrofti or filaria sanguimis homimis tyHkwf;"B LFkkuksa ij vf/kd, caxky, mM+hlk, dksphu, eykckj,

okfrd, iSfrd, 'ySf"ed gksrk gSA jkf= esa jDr esa feyrk gSA

okgd & culax fatigans ePNj gksrk gSA

dQ iz/kku jksx gSA ,d o"kZ iqjkuk ,oa okfYed ds leku f’k[kj, xkaB ;qDr & vlk/;

fpfdRlk & okrt & nkgdeZ, firt & folZi ds leku, dQt & vaxqBs dh f’kjk os/ku, ikuh; {kkj, fuR;kuUn jl & 5 ls 10 jrh lqcg 'kke,

'yhinxtdsljh & 2 ls 4 jrh

Hetrazan (diethylcarbamangine citrate)

Swiss roll operation.

Important notice
Dear friend,

These very tiny parts of notes are taken form various sections form Chotiwala's Notes. For complete notes and guidance please order today.
Best of luck
Tomorrow is yours
Yours truly,
Dr. Sanjay Kr. Singh
_{M.S. (Ay), D.Yo., I.M.S. B.H.U., Gold Medalist}

Consultant Surgeon & Oncologist

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