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Blood-brain barrier

The blood-brain barrier (BBB) forms a physical resistance to the passage of lipophobic substances from cerebral capillaries into the brain and is a key reason why there is no CSF enhancement following intravenous contrast media in CT and MR imaging. Gross anatomy The BBB is formed by a combina...

Blood supply of the meninges

The blood supply of the meninges generally concerns the blood supply of the outer layer of dura mater rather than the inner layer of dura mater, arachnoid or pia mater which do not require a large blood supply. There are several arteries that supply the dura in the anterior, middle, and posterio...

Bochdalek's flower basket

Bochdalek's flower basket is the eponymous name for the incidental finding of protrusion of the choroid plexus through the foramina of Luschka. This is a relatively common finding. It is an important normal variant to recognize as the presence of protruding calcified choroid tissue in the fourt...

Body of sphenoid

The body of the sphenoid bone is the midline cubical portion of the sphenoid bone, hollowed by the sphenoid air sinuses. Gross anatomy The body has superior, inferior, anterior, posterior, and lateral surfaces. The superior surface features: ethmoidal spine: prominent spine that articulates...

Bone macroscopic structure

Bone macroscopic structure allows a bone to be divided into regions based on position or morphology. This is important for a number of reasons including how growth may be affected by injury. Bones can be separated into: diaphysis metaphysis metaepiphysis metadiaphysis epiphysis physis ap...

Bones of the lower limb

The bones in the lower limb can be divided into those within the thigh and leg (4) and those within the foot (26). Bones of the thigh and leg femur patella tibia fibula Bones of the foot calcaneus talus navicular medial cuneiform intermediate cuneiform lateral cuneiform cuboid meta...

Bones of the upper limb

The bones in the upper limb can be divided into those within the arm and pectoral girdle (3), forearm (2) and wrist and hand (27). There are also a number of accessory ossicles, predominantly occurring at the wrist. Bones of the arm and pectoral girdle clavicle scapula humerus Bones of the...

Bones types

There are many types of bone within the body: long bones (longer than they are wide) short bones (not long bones) flat bones sesamoid bones (for within a tendon) irregular bones (don't fit into a category) The majority of the bones of the appendicular skeleton are long bones. However, the ...

Bony orbit

The bony orbit refers to the bones that constitute the margins of the orbits, that is the roof, medial and lateral walls and floor. The orbital margin or rim refers to the anterior circular margin of the orbit. The orbital apex refers to the posterior confluence of the orbit, where the optic can...

Bony pelvis

The bony pelvis is formed by the sacrum and coccyx and a pair of hip bones (os coxae or innominate bones), comprising the ischium, pubis and ilium and are part of the appendicular skeleton. Its primary function is the transmission of forces from the axial skeleton to the lower limbs as well as...

Bony skeleton

The skeleton is the complete set of bones that make up a human. There are 206 bones in total which can be divided into: axial skeleton appendicular skeleton

Bony trabeculae of proximal femur

The proximal femur has four major groups of trabeculae, distributing the compressive and tensile forces from the femoral head into the femoral diaphysis through the femoral neck. Together these trabeculae create the Ward triangle. The individual trabecular groups include: principal compressive ...

Bouthillier classification of internal carotid artery segments

Bouthillier et al. described (in 1996) 1 a seven segment internal carotid artery (ICA) classification system. It remains the most widely used system for describing ICA segments at the time of writing (mid-2016). There are a few other classifications systems including those proposed by Fisher (1...

Bovine arch

Bovine arch is the most common variant of the aortic arch and occurs when the brachiocephalic (innominate) artery shares a common origin with the left common carotid artery. A bovine arch is apparent in ~15% (range 8-25%) of the population and is more common in individuals of African descent. ...

Boyden classification of bronchi

The Boyden classification of bronchi refers to the standard nomenclature used to describe bronchopulmonary segmental anatomy. Each lung has 10 segments, however on the left, the first two segments share a common trunk and are hence B1/2. Also given the shared trunk on the left of the lower lobe...

Brachial artery

The brachial artery is the main supply of arterial blood to the arm, forearm and hand. Summary origin: continuation of the axillary artery distal to teres major location: medial upper arm supply: muscles of the arm, forearm and hand main branches: profunda brachii terminal branches: radia...

Brachialis

The brachialis muscle (brachialis) is one of the three muscles of the anterior compartment of the arm. It is only involved in flexion at the elbow and therefore the strongest flexor at the elbow, compared with the biceps brachii which is also involved in supination because of its insertion on th...

Brachial plexus

The brachial plexus is a complex neural network formed by lower cervical and upper thoracic ventral nerve roots which supplies motor and sensory innervation to the upper limb and pectoral girdle. It is located in the neck extending into the axilla posterior to the clavicle. Summary origin: ven...

Brachial vein

The brachial vein is a component of the deep venous system of the upper limb. After forming from the radial and ulnar veins1, the brachial vein travels from the cubital fossa superiorly to become the axillary vein. Summary origin: union of the ulnar and radial veins in the cubital fossa1 loca...

Brachiocephalic trunk

The brachiocephalic trunk (BCT) is a major vessel that supplies the head, neck and right arm. The BCT has previously been known as the innominate artery. Gross anatomy The BCT is the first of the three main branches of the aortic arch, which originates from the upward convexity. It measures 4...

Brachiocephalic vein

Brachiocephalic veins (BCV), previously the innominate veins are large paired valveless asymmetric veins that drain the head, neck, upper limbs and part of the thorax and mediastinum. Gross anatomy Origin In the root of the neck, the internal jugular and subclavian veins unite to form the bra...

Brachioradialis

Brachioradialis is a flexor at the elbow and works with biceps brachii and brachialis. Is it located in the superficial layer of the posterior compartment of the forearm and is particularly useful in elbow stabilisation. Despite the bulk of the muscle being visible from the anterior surface of ...

Bracket sign (pars marginalis)

The bracket sign of the pars marginalis, also known as the pars bracket sign, refers to the appearances of the superior most extent of the pars marginalis of the cingulate sulcus on axial imaging. It forms two roughly symmetric brackets, open anteriorly. The next sulcus anteriorly is the central...

Brain

The brain is the vital neurological organ composed of: cerebrum diencephalon brainstem midbrain pons medulla cerebellum The brain is housed in the skull and bathed in cerebrospinal fluid. It is continuous with the cervical spinal cord at the cervicomedullary junction.

Brain development

Brain development occurs from the three vesicles of the embryo's neural tube. prosencephalon/forebrain mesencephalon/midbrain rhombencephalon/hindbrain By approximately 4.5 to 5 menstrual weeks, the primitive neural plate has developed. The neural plate then divides into the neural crest and...

Brainstem

The brainstem is the most caudal part of the brain. It adjoins, is structurally continuous with the spinal cord and consists of the: midbrain (mesencephalon) pons (part of the metencephalon) medulla oblongata (myelencephalon) The brainstem provides the main motor and sensory innervation to t...

Brainstem nuclei

The brainstem nuclei are the nuclei in the brainstem. These include: the cranial nerve nuclei red nucleus substantia nigra

Branches of internal carotid artery (mnemonic)

Useful mnemonics to remember the branches of the internal carotid artery is: A VIP'S COMMA Calming voices make intra operative surgery pleasurable and almost memorable. Mnemonics A VIP'S COMMA A: anterior choroidal artery (C7) V: Vidian artery (C2) I: inferolateral trunk (C4) P: posteri...

Branches of internal iliac artery (mnemonic)

A useful mnemonic to remember the branches of the internal iliac artery is: I Love Going Places In My Very Own Underwear! Mnemonic I: iliolumbar artery L: lateral sacral artery G: gluteal (superior and inferior) arteries P: (internal) pudendal artery I: inferior vesical (vaginal in female...

Branches of maxillary artery (mnemonic)

A mnemonic for remembering the branches of the maxillary artery is: DAM I AM Piss Drunk But Stupid Drunk I Prefer, Must Phone Alcoholics Anonymous Mnemonic D: deep auricular artery A: anterior tympanic artery M: middle meningeal artery I: inferior alveolar artery A: accessory meningeal ar...

Branches of ophthalmic artery (mnemonic)

A useful mnemonic to remember the branches of the ophthalmic artery is: DR MCLESSI Mnemonic D: dorsal nasal artery R: (central) retinal artery M: muscular artery C: ciliary arteries (long, short and anterior) L: lacrimal artery E: ethmoidal arteries (anterior and posterior) S: supraorbi...

Branches of the anterior division of the internal iliac artery (mnemonic)

Mnemonics to remember the branches of the anterior division of the internal iliac artery are: SOI VU MR PIG (it can be remembered as SO fourth (IV) U MR PIG) Oranges Under Some Ice Might Peel Instantly Mnemonics SOI VU MR PIG S: superior vesical artery O: obturator artery IV: inferior ves...

Branches of the thoracoacromial artery (mnemonic)

Useful mnemonics to remember the four branches of the thoracoacromial artery are: ABCD CAlifornia Police Department Cadavers Are Dead People PACkeD Mnemonics ABCD A: acromial B: breast (pectoral) C: clavicular D: deltoid CAlifornia Police Department C: clavicular A: acromial P: pe...

Breast

The breast is an apocrine gland seen in both males and females. However, in females it has a specific function which is the production of milk. Gross anatomy Composition The breast has an inhomogeneous structure which is predominantly composed of adipose tissue and glandular tissue. In additi...

Breast hypoplasia

Breast hypoplasia is a condition which is characterized by underdevelopment of the breast. Breast hypoplasia can be congenital or acquired. Pathology Congenital hypoplasia Associations include: ulnar-mammary syndrome Poland syndrome Turner syndrome congenital adrenal hyperplasia Acquired...

Bregma

The bregma is the midline bony landmark where the coronal and sagittal sutures meet, between the frontal and two parietal bones. It is the anterior fontanelle in the neonate and closes in the second 2 (typically around 18 months after birth). It is one of the skull landmarks, craniometric poin...

Bridging bronchus

A bridging bronchus is a rare congenital bronchial anomaly where there is an anomalous bronchus to the right lung arising from the left main bronchus. It has a high association with right upper lobe bronchus (pig bronchus) and congenital cardiac and vascular malformations, particularly a left pu...

Broad ligament

The broad ligament is the lateral folds of the parietal peritoneum which reflect over the upper genital tract. Gross anatomy The broad ligament extends from the lateral aspect of the uterus to the lateral pelvic wall and can be divided into three main components - the mesosalpinx, mesovarium a...

Broad ligament contents (mnemonic)

A mnemonic for the contents of the broad ligament is: BROAD Mnemonic B: bundle (ovarian neurovascular bundle) R: round ligament O: ovarian ligament A: artifacts (vestigial structures) D: duct (oviduct)

Broca's area

Broca's area (Brodmann area 44) is an area of the lateral frontal lobe in the dominant hemisphere concerned with the production of speech. Gross anatomy Broca's area is located in the posterior inferior frontal gyrus (pars opercularis and pars triangularis) of the dominant hemisphere, anterior...

Brodmann areas

Brodmann areas are a system to divide the cerebral cortex according to cytoarchitectural organization, and are, despite controversy, still very widely used as a standardized nomenclature which is superimposed on the somewhat variable gyral and sulcal anatomy. The classification relies on the f...

Bronchial artery

The bronchial arteries are the major supply of high-pressure oxygenated blood to the supporting structures of the lung, including the pulmonary arteries, yet they are responsible for only 1% of the lung blood flow overall. Bronchial artery anatomy is variable, most commonly classified according...

Bronchial vein

The bronchial veins are counterparts to the bronchial arteries and drain the bronchi, hilar structures and the mid-portion of the esophagus. Gross anatomy There is typically a single bronchial vein at each hilum, formed from the superficial bronchial veins with deep bronchial veins draining in...

Bronchioles

Bronchioles are the branches of the tracheobronchial tree that by definition, are lacking in submucosal hyaline cartilage. Gross anatomy The bronchioles typically begin beyond the tertiary segmental bronchi and are described as conducting, terminal or respiratory bronchioles. Following the te...

Bronchopulmonary segmental anatomy

Bronchopulmonary segmental anatomy describes the division of the lungs into segments based on the tertiary or segmental bronchi. Gross anatomy The trachea divides at the carina forming the left and right main stem bronchi which enter the lung substance to divide further. This initial division ...

Bronchopulmonary segments (mnemonic)

Mnemonics to remember the bronchopulmonary segments are: A PALM Seed Makes Another Little Palm (right lung) ASIA ALPS (left lung) Mnemonics 'A PALM Seed Makes Another Little Palm' right upper lobe A: apical segment P: posterior segment A: anterior segment middle lobe L: lateral segment...

Bronchus intermedius

The bronchus intermedius is one of the two bronchi which the right main bronchus bifurcates into, the other being the right upper lobe bronchus. Gross anatomy The bronchus intermedius runs distal to the right upper lobe bifurcation and follows the trajectory of the right main bronchus 1. Its m...

Brown adipose tissue

Brown adipose tissue (BAT) is one of two types of adipose tissue (the other one being white fat) important for producing thermal energy (heat, non-shivering thermogenesis) especially in the newborn. It constitutes ~5% of body mass in the newborn and tends to disappear in adulthood. It is importa...

Buccal nerve

The buccal nerve is the only purely sensory branch of the anterior division of the mandibular division of the trigeminal nerve. It is not to be confused with the buccal branch of the facial nerve. Gross anatomy The buccal nerve divides off the anterior division and passes with the paired nerve...

Buccal space

The buccal space, also known as the buccinator space, is one of the seven suprahyoid deep compartments of the head and neck. Gross anatomy The buccal spaces are paired fat contained spaces on each side of the face forming cheeks. Each space is enveloped by the superficial (investing) layer of...

Buccinator artery

The buccinator artery is a small branch from the second part of the maxillary artery. It runs obliquely forward, between the medial pterygoid and the insertion of the temporalis, to the outer surface of the buccinator, to which it is distributed, anastomosing with branches of the facial artery a...

Buford complex

Buford complex is a congenital glenoid labrum variant where the anterosuperior labrum is absent in the 1-3 o'clock position and the middle glenohumeral ligament is thickened (cord-like) and originates directly from the superior labrum at the base of the biceps tendon and crosses the subscapulari...

Bulbospongiosus muscle

The bulbospongiosus is a muscle found in the superficial perineal pouch which covers the bulb of the penis in males and the bulb of the vestibule in females. Summary origin: median raphe and perineal body insertion: dorsum of penis/clitoris, perineal membrane innervation: pudendal nerve blo...

Bulbourethral glands

The bulbourethral glands or Cowper glands are paired small pea-sized glands of the male reproductive tract, analogous to the female Bartholin glands. Gross anatomy The bulbourethral glands are located in the deep perineal pouch posterolateral to the membranous portion of the male urethra and c...

Bulla lamella

The bulla lamella is a structure that, when intact, forms the posterior boundary of the frontal recess. When pneumatised, it forms the ethmoid bulla. Gross anatomy It is frequently incomplete and often does not reach the roof of the ethmoid at the skull base. Under these circumstances, the fro...

Bursa

Bursae are small fluid-filled sacs lined by synovial membrane with an inner capillary layer of synovial fluid. It provides a cushion between bones and tendons and/or muscles around a joint. This helps to reduce friction between the bones and allows free movement. They may or may not communicate ...

Butterfly vertebra

Butterfly vertebra is a type of vertebral anomaly that results from the failure of fusion of the lateral halves of the vertebral body because of persistent notochordal tissue between them. Pathology Associations an anterior spina bifida, with or without an anterior meningocele can be part of...

C7 vertebra

C7, also known as the vertebra prominens, is the seventh cervical vertebra and looks like vertebra C3-C6, but has some distinct features making it one of the atypical vertebrae. The name vertebra prominens arises from its long spinous process, which is easily palpable. Gross anatomy C7 posses...

Cecum

The cecum is the first part of the large bowel and lies in the right lower quadrant of the abdomen. Gross anatomy Blind-ending sac of bowel that lies below the ileocecal valve, above which the large intestine continues as the ascending colon. The cecum measures 6 cm in length and can have a m...

Calcaneal inclination angle

The calcaneal inclination angle (also known as the calcaneal pitch) is drawn on a weightbearing lateral foot radiograph between the calcaneal inclination axis and the supporting horizontal surface. It is a measurement that reflects the height of the foot framework, but is affected by abnormal p...

Calcaneal tendon

The calcaneal tendon, commonly known as the Achilles tendon, is the strongest and largest tendon of the human body. It is also one of the commonest tendons to become injured due to its high biomechanical load but poor vascularity 2. Gross anatomy The calcaneal tendon forms by the merging of fi...

Calcaneal vascular remnant

Calcaneal vascular remnant is a benign finding that may be seen on MRI of ankle and can be misinterpreted as an alarming bone lesion. It is typically located at the insertion site of sinus tarsi ligaments (cervical and interosseous ligaments). The focus of signal alteration is believed to be pr...

Calcaneofibular ligament

The calcaneofibular ligament (CFL) is the middle ligament of the lateral collateral ligament complex of the ankle and stabilises both the ankle and subtalar joints. Gross anatomy The CFL is an extracapsular round cord measuring 20-25 mm long x 6-8 mm width. Its origin is distal to the anterior...

Calcaneonavicular coalition

Calcaneonavicular coalition is one of the two most common subtypes of tarsal coalition, the other being talocalcaneal coalition. As with any coalition it may be osseous (synostosis), cartilaginous (synchondrosis) or fibrous (syndesmosis). Radiographic features This type of coalition is more ea...

Calcaneus

The calcaneus, also referred to as the calcaneum, is the largest tarsal bone and the major bone in the hindfoot. It articulates with the talus superiorly and the cuboid anteriorly and shares a joint space with the talonavicular joint, appropriately called the talocalcaneonavicular joint. The cal...

Calcar femorale

The calcar femorale is a normal ridge of dense bone that originates from the postero-medial endosteal surface of the proximal femoral shaft, near the lesser trochanter. It is vertical in orientation, and the ridge projects laterally toward the greater trochanter. This ridge of bone provides mech...

Calcarine artery

The calcarine artery, named according to its course in the calcarine fissure, is a branch of the posterior cerebral artery, usually from the P3 segment. It may also arise from the parieto-occipital artery or posterior temporal branches. It courses deep in the fissure, giving branches both to th...

Calcarine fissure

The calcarine fissure, or calcarine sulcus, is located on the medial surface of the occipital lobe and divides the visual cortex (a.k.a. calcarine cortex) into two. The fissure is variable in course (figure 1), but is generally oriented horizontally, anteriorly joining the parieto-occipital fi...

Callosal sulcus

The callosal sulcus is a sulcus of the brain, located on the medial side of each cerebral hemisphere, deep within the medial longitudinal fissure. Gross anatomy The callosal sulcus runs posteriorly from the genu to the splenium of the corpus callosum. It separates the cingulate gyrus dorsally...

Callosomarginal artery

The callosomarginal artery, also known as median artery of corpus callosum, is the largest branch of the pericallosal artery. It courses within or posterior to the cingulate sulcus, in parallel orientation to the pericallosal artery. It divides to give two or more cortical branches to supply the...

Callososeptal interface

The callososeptal interface is located on the inferior surface of the corpus callosum, where the septum pellucidum abuts it. It came to radiological attention when T2 hyperintense lesions affecting this region were believed to be specific for multiple sclerosis. This has, as is usually the cas...

Calot triangle

Calot triangle is a small (potential) triangular space at the porta hepatis of surgical importance as it is dissected during cholecystectomy. Its contents, the cystic artery and cystic duct must be identified before ligation and division to avoid damaging them during the operation. Gross anatom...

Canal of Nuck

The canal of Nuck is an abnormal patent pouch of parietal peritoneum extending anteriorly from the round ligament of the uterus into the labia majora through the inguinal ring into the inguinal canal. Incomplete obliteration of this canal is known as a patent processus vaginalis and can result i...

Canals of Lambert

The canals of Lambert are microscopic collateral airways between the distal bronchiolar tree and adjacent alveoli. They are poorly formed in children, and along with poorly formed pores of Kohn, are thought to be responsible for the high frequency of round pneumonia in that age group.

Cantlie's line

Cantlie's line is a vertical plane that divides the liver into left and right lobes creating the principal plane used for hepatectomy. It extends from the inferior vena cava posteriorly to the middle of the gallbladder fossa anteriorly. It contains the middle hepatic vein which divides the live...

Capitate

The capitate, also known as the os magnum, is the largest of the carpal bones and sits at the center of the distal carpal row. A distinctive head shaped bone, it has a protected position in the carpus. Gross anatomy Osteology The capitate sits in a proximo-distal direction with a waist that...

Capito-hamate coalition

Capito-hamate coalition is the second most common type of carpal coalition and represents congenital fusion of the capitate and the hamate. It represents ~5% of all carpal fusions 1 and is associated with Apert syndrome 2.

Cardiac bronchus

A cardiac bronchus is a rare anatomic variant of the tracheobronchial tree, arising from the medial aspect of the bronchus intermedius. Epidemiology This anomaly is rare and is reported in ~0.3% (range 0.09-0.5%) of individuals 3-5. There may be a predilection for males. Clinical presentatio...

Cardiac fibrous skeleton

The fibrous skeleton of the heart is a complex set of collagenous rings that connect annuli of all four cardiac valves. Between the four annuli are two trigones (right and left) and the membranous portions of the interatrial, interventricular, and atrioventricular septa. The annuli of the two se...

Cardiac plexus

The cardiac plexus is a plexus of nerves situated at the base of the heart. It is formed by cardiac branches derived from both the sympathetic and parasympathetic nervous systems. Gross anatomy Sympathetic cardiac nerves are derived from T1 to T4 segments and partly from the T5 segment of the ...

Cardiac valves

The four cardiac valves direct the flow of blood through the heart during the cardiac cycle. Gross anatomy The heart valves are located in the cardiac fibrous skeleton: two are atrioventricular (AV) valves: the right-sided tricuspid valve and left-sided mitral (bicuspid) valve open during di...

Carina

The carina is the sagittally-oriented cartilaginous ridge at the bifurcation of the trachea and is an important reference point in chest imaging. Gross anatomy The carina represents the inferior termination of the trachea into the right and left main bronchi. The carina usually sits at the le...

Caroticotympanic artery

The caroticotympanic branch (tympanic branch) is a small branch from the C2 segment of the internal carotid artery. It is a vestigial remnant of the hyoid artery. It passes posterolaterally into the middle ear cavity and anastomoses with the inferior tympanic artery (a branch of the external ca...

Carotid bifurcation

The carotid bifurcation is the point at which the common carotid artery terminates. As it does so, it forms the internal and external carotid arteries which go on to supply the head and neck. It is closely related anatomically to the carotid body, a small group of chemoreceptors and supporting ...

Carotid body

The carotid body is located within the neck, and in close proximity to the carotid bifurcation. It is composed of a number of chemoreceptor cells and supporting matrix and detects changes in the composition of blood in the common carotid as it forms the internal and external carotid arteries. I...

Carotid canal

The carotid canal is a passage within the petrous temporal bone and transmits the internal carotid artery and sympathetic plexus. Its inferior opening is called the carotid foramen and is situated anteriorly to the jugular fossa and medially to the carotid plate. The carotid canal is initially d...

Carotid cave

The carotid cave is a potential dural space formed by the redundant distal dural ring on the medial aspect of the clinoid segment of the internal carotid artery (ICA). It has been reported to be present in ~80% of cadaveric specimens 3. Gross anatomy The clinoid segment of the ICA is bounded b...

Carotid plate

The carotid plate, also known as the tympanic plate, is a thin (0.5 mm) bony plate that separates the carotid canal from the middle ear cavity. Gross anatomy The caroticotympanic artery perforates the carotid plate normally. Related pathology Disruption or dehiscence of the carotid plate may...

Carotid space

The carotid space (also known as the post-styloid parapharyngeal space) is one of the seven deep compartments of the head and neck. Gross anatomy The carotid space is a roughly cylindrical space that extends from the skull base through to the aortic arch. It is circumscribed by all three laye...

Carotid triangle

The carotid triangle is one of the paired triangles in the anterior triangle of the neck. The triangles of the neck are surgically focused, first described from early dissection-based anatomical studies which predated cross-sectional anatomical description based on imaging (see deep spaces of th...

Carotid tubercle

The carotid tubercle is a commonly used term referring to the paired anterior tubercles of the transverse processes of the sixth cervical vertebrae 1. The carotid tubercle serves as an important landmark with respect to performing regional anesthesia such as a brachial plexus and cervical plexus...

Carpal bones

The carpal bones are the eight bones of the wrist that form the articulation of the forearm with the hand. They can be divided in two rows: proximal row scaphoid lunate triquetrum pisiform distal row trapezium trapezoid capitate hamate The names and order of these bones can be rememb...

Carpal bones (mnemonic)

Mnemonics of the carpal bones are numerous and useful for memorising the order and location of the bones. They usually describe the position of the carpal bones from lateral to medial in the proximal row and then the distal row: Sam Likes To Push The Toy Car Hard She Looks Too Pretty Try To Ca...

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