The ascending pharyngeal artery, the smallest branch of the external carotid artery, is a long, slender vessel, deeply seated in the neck, beneath the other branches of the external carotid and under the stylopharyngeus.
origin: a branch of the external carotid artery
Asplenia refers to absence of the spleen thereby leading to deficient splenic function.
Seen in 3% of neonates with structural heart disease and in 30% of patients who die from cardiac malposition. The male-to-female ratio is 2:1.
Asplenia can be classified into two t...
The asterion is the junction on the side of the posteroinferior calvarium where three sutures meet:
It is located at the posterior end of the parietotemporal suture, whereas the pterion is located at the anterior end.
It is one of...
Asymmetrically large jugular bulbs are entirely normal and asymptomatic; its only significance is to distinguish it from pathology.
The size of the jugular bulbs is variable, with the right side being significantly larger than the left in two-thirds of people.
A normal but large bulb will have...
Asymmetric pneumatisation of petrous apex results in asymmetric fatty bone marrow within the petrous apex. It is a common incidental finding on brain and skull base MRI.
Asymmetric pneumatisation of the petrous apex results in the presence of bon...
The atlanto-axial articulation is a complex of three synovial joints, which join the atlas (C1) to the axis (C2).
paired lateral atlanto-axial joints: classified as planar-type joint between the lateral masses of C1 and C2, though somewhat more complex in shape wit...
The atlanto-occipital articulation is comprised of a pair of condyloid synovial joints that connect the occiput (C0) to the first cervical vertebra (atlas/C1).
Each joint is comprised of two concave articular surfaces on the superior aspect of the lateral mass of a...
Atlanto-occipital assimilation is the fusion of the atlas (C1) to the occiput and is one of the transitional vertebrae.
Atlanto-occipital assimilation occurs in approximately 0.5% (range 0.25-1%) of the population 2-4.
Atlanto-occipital is typically asymp...
The atlas is the first cervical vertebra, commonly called C1. It is an atypical cervical vertebra with unique features. It articulates with the dens of the axis and the occiput, respectively allowing rotation of the head, and flexion, extension and lateral flexion of the head. Unlike the rest o...
Of the cervical vertebrae, the atlas (C1), axis (C2) and vertebra prominens (C7) are considered atypical cervical vertebrae.
The atlas (C1) lacks a body or spinous process. It has an anterior and posterior arches with lateral masses. Its superior articular surfaces articulate with the occiput a...
Of the five lumbar vertebrae, L5 is considered atypical due to its shape. The remaining lumbar vertebrae are largely typical.
For a basic anatomic description of the structure a generic vertebra, see vertebrae.
Owing to their features, the first, eleventh and twelfth ribs are considered atypical ribs.
Of all ribs, the first is the strongest, broadest and most curved. Ribs eleven and twelve are unique, among other reasons, by not being attached to the sternum.
T1 and T9 to T12 are considered atypical vertebrae. T1 bears some resemblance to low cervical vertebrae. T9 has no inferior demifacet. T10 often, but not always, shares features with T11 and T12.
For a basic anatomic description of the structure a generic vertebra, see vertebrae.
The auriculotemporal nerve is a sensory branch of the posterior division of the mandibular division of the trigeminal nerve.
The auriculotemporal nerve divides posteriorly from the posterior division of the mandibular division before dividing into two roots separate to encircle t...
The avascular plane of Brodel is the section of renal parenchyma between 2/3 anterior and 1/3 posterior kidney on the cross-section that is relatively avascular. The reason for its relative avascularity is that it represents the plane where the anterior and posterior segmental renal artery branc...
The axial skeleton is the central portion of the bony skeleton comprising the head, neck and trunk (80 bones in total). It has many functions including housing and protecting the central nervous system as well as the organs of the chest, abdomen and pelvis. It enables movement and supports the u...
The axilla is a space located between the upper limb and the neck and thorax, which permits the passage of the major neurovascular structures.
The axilla is pyramidal in shape with its apex opening superiorly into the base of the neck between the subclavius muscle, first rib and ...
The axillary artery represents the continuation of the subclavian artery and is a major artery of the upper limb.
origin: continuation of the subclavian artery as it passes under the midpoint of the clavicle on the outer edge of the first rib
termination: continues as the brachial ar...
Useful mnemonics to remember the branches of the axillary artery are:
S AL SAP
Screw the lawyer, save a patient!
S AL SAP
S: superior thoracic artery (from 1st part)
A: acromiothoracic (thoracoacromial) artery (from 2nd part)
L: lateral thoracic artery (from 2nd part)
The axillary nerve is one of five terminal branches of the brachial plexus, supplying motor and sensory branches to the shoulder.
origin: posterior cord of the brachial plexus
course: passes out of axilla through the quadrangular space to the upper arm
major branches: superior later...
Axillary lymph nodes (LN) are in the axilla and receive lymph from vessels that drain the arm, the walls of the thorax, the breast and the upper walls of the abdomen.
There are five axillary lymph node groups, namely the lateral (humeral), anterior (pectoral), posterior (subscapu...
The axillary vein is one of the major veins of the upper limb. It is formed by the union of the paired brachial veins and the basilic vein and contributes to the drainage of the axilla, arm and superolateral chest wall.
origin: formed by the union of the paired brachial veins and the b...
The axis is the second cervical vertebra, commonly called C2. It is an atypical cervical vertebra with unique features and important relations that make it easily recognisable. Its most prominent feature is the odontoid process, which is embryologically the body of the atlas (C1) 1,2. It plays a...
The azygo-oesophageal recess (AER) is a prevertebral space formed by the interface of the posteromedial segments of the right lower lobe and the azygos vein and oesophagus 1-3. The AER extends from the azygos arch to the aortic hiatus and has the following borders 1, 2:
An azygos anterior cerebral artery is uncommon to rare variant of the circle of Willis where the two A1 segments of the anterior cerebral artery (ACA) join to form a single trunk. As a result, there is no anterior communicating artery. This organisation is similar to that seen in lower primates ...
Azygos continuation of the inferior vena cava (also known as absence of the hepatic segment of the IVC with azygos continuation) is an uncommon vascular anomaly and is a cause of a dilated azygos vein.
Azygous continuation of the IVC has a prevalence ~1.5% (range 0.2-3%) 1.
An azygos lobe is created when a laterally displaced azygos vein creates a deep pleural fissure into the apical segment of the right upper lobe during embryological development. It is a normal anatomic variant of the right upper lobe due to invagination of the azygos vein and pleura during in th...
The azygos vein is a unilateral vessel that ascends in the thorax to the right side of the vertebral column, carrying deoxygenated blood from the posterior chest and abdominal walls. It forms part of the azygos venous system.
The azygos vein is formed by the union of the...
The azygos (venous) system is a collective term given to the H-shaped configuration of the azygos, hemiazygos, accessory hemiazygos veins and left superior intercostal vein.
It is responsible for draining the thoracic wall and upper lumbar region via the lumbar veins and posterior intercostal v...
A ball and socket ankle joint is a variant affecting the ankle where there is a rounded or spherical configuration to the talar dome with the corresponding concavity of the tibial plafond. The distal fibula may or may not be involved.
The aetiology has been debated with two theories ...
Ball and socket joints are a type of synovial joint where the spheroid articular surface of one bone sits within a cup-like depression of another bone.
The ball and socket configuration allows for movement with 3 degrees of freedom, which is more than any other type of synovial joint...
The band of Giacomini, also known as the tail of the dentate gyrus is the anteromedial continuation of the dentate gyrus, which in turn is part of the hippocampal formation, along with the hippocampus, subicular complex and entorhinal cortex. It is an important anatomical landmark of the inferio...
The Bartholin's glands (or greater vestibular glands) are paired pea-sized structures lying on either side of the vaginal opening and are homologous to the bulbourethral (Cowper's) glands in the male
These glands are described as less than 1 cm in diameter and found behind the po...
The basal ganglia are a group of nuclei in the deep white matter of the brain that is interconnected with the cerebral cortex, thalami and brainstem.
In a strict anatomical sense, it contains three paired nuclei that together comprise the corpus striatum:
The basal nucleus of Meynert, also known as the nucleus basalis of Meynert, is formed by a group of cells that lies in the substantia innominata. It is rich in acetylcholine and its degeneration has been correlated to Alzheimer disease. It lies anterior to the anterior commissure.
The basal plate is a synonym for the maternal side of the placenta. The fetal side of the placenta is termed the chorionic plate.
Some pathologies and processes are localized to the basal plate, and evaluation of the basal plate is a part of placental grading.
The basal veins, also known as the veins of Rosenthal, are paired, paramedian veins which originate on the medial surface of the temporal lobe and run posteriorly and medially. It passes lateral to the midbrain through the ambient cistern to drain into the vein of Galen with the internal cerebra...
The base of the skull (or skull base) forms the floor of the cranial cavity and separates the brain from the structures of the neck and face.
The base of the skull is a bony diaphragm composed of a number of bones including (from anterior to posterior):
Basilar artery fenestration (or more simply, basilar fenestration) is the most common intracranial arterial fenestration. It refers to duplication of a portion of the artery. Its reported prevalence is highly variable depending on the technique used:
~0.5% (0.3-0.6%) at angiography (presumably ...
The basilar venous plexus lies between the endosteal and visceral layers of the dura on the inner surface of the clivus. It connects the:
inferior petrosal sinuses
superior petrosal sinuses
internal vertebral venous plexus
marginal sinus (around the...
The basilic vein, along with the cephalic vein, is one of the primary superficial veins that drain the upper limb 1. It courses through both the forearm and arm, and contributes to the formation of the axillary vein.
origin: ulnar aspect of the superficial venous network of the dorsum ...
The basion is the median (midline) point of the anterior margin of the foramen magnum. The apical ligament attaches to it.
It is one of the skull landmarks, craniometric points for radiological or anthropological skull measurement.
Various lines and measurements using the ...
Batson venous plexus (or Batson veins) is a network of veins with no valves that connect deep pelvic veins draining the bladder, prostate, and rectum to the internal vertebral venous plexus 1. These veins are important because they are believed to provide a route for spread of pelvic cancer meta...
Beaver tail liver, also known as a sliver of liver, is a variant of hepatic morphology where an elongated left liver lobe extends laterally to contact and often surround the spleen. It is more common in females. The parenchyma is normal and thereby has the same risks of hepatic pathology as the ...
Betz cells are pyramidal cell neurons located within the fifth layer of the primary motor cortex. They are some of the largest in the central nervous system, sometimes reaching 100 µm in diameter and send their axons down the corticospinal tracts to the anterior horn cells of the spinal cord.
The biceps brachii muscle (also known simply as biceps) is a two-headed muscle in the anterior compartment of the arm that flexes at the elbow and supinates the forearm.
short head: coracoid process of the scapula
long head: supraglenoid tubercle of the scapula
The biceps femoris is one of the large muscles in the posterior compartment of the thigh and a component of the hamstrings. It has a long and a short head, each with different functions and innervation.
long head: tuberosity of the ischium
short head: linea aspera on the poste...
Biceps pulley refers to a complex capsuloligamentous structure which provides stability and hold the long head of biceps tendon within the bicipital groove. It comprises of the coracohumeral ligament, superior glenohumeral ligament, and distal attachment of the subscapularis tendon.
The bicipitoradial bursa is located between the distal biceps brachii tendon and the tuberosity of the radius. The bursa partially or completely wraps around the biceps tendon. It ensures frictionless motion between the biceps tendon and the proximal radius during pronation and supination of the...
Bicuspid aortic valve (BAV) refers to a spectrum of deformed aortic valves with two functional leaflets or cusps which are often unequal in size.
They are most often congenital while an acquired bicuspid valve occurs when there is fibrous fusion between the right and left cusps of a pre-existin...
The median nerve may divide into two nerve bundles in
the distal forearm and appear as a bifid median nerve in the carpal tunnel. It has an incidence of ~3%.
The median nerve usually divides into two or three branches after exiting the distal edge of the transverse carpal ligament that covers...
A bifid ureter, or ureter fissus, is an example of incomplete duplication of a duplex collecting system.
Present in ~5% (range 1-10%) of the population 1-2.
A bifid ureter is formed when there is a duplex kidney (separate pelvicalyceal collecting systems) drain i...
The bifurcate ligament arises from the calcaneus as a single band and divides into calcaneocuboid (lateral) and calcaneonavicular (medial) parts forming a Y-shape.
Various channels that collect bile from the hepatic parenchyma and transport it to the duodenum constitute the biliary tree.
By convention the biliary tree is divided into intra- and extra-hepatic bile ducts 1. There is significant variation in the biliary tree with the classical...
Bill bar is a landmark that divides the superior compartment of the internal acoustic meatus into an anterior and posterior compartment. Anterior to Bill's bar, in the anterior superior quadrant, are the facial nerve (CN VII) and nervus intermedius, and posterior to it in the posterior superior ...
Bilobed testis, also known as incomplete unilateral polyorchidism, is a very rare variant in children.
The exact aetiology is unknown but is thought be a form of incomplete polyorchidism. It has been proposed that bilobed testis results from incomplete division of the urogenital ridg...
A bipartite patella (two-part patella) is a patella with an unfused accessory ossification center at the superolateral aspect.
The superolateral accessory ossification center of the patella is usually present by 12 years of age and may persist into adult life. Prevalence of a bipa...
A bipartite scaphoid is a rare example of a divided carpus. There is controversy whether this condition is congenital (i.e. normal variant) or post-traumatic. Bipartite scaphoids may be unilateral or bilateral.
Diagnostic criteria have been proposed 3:
no history of traumatic injury
Block vertebra is a type of vertebral anomaly where there is a failure of separation of two or more adjacent vertebral bodies.
In a block vertebra, there is partial or complete fusion of adjacent vertebral bodies.
there is a frequent association with hemivertebrae/abse...
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 IV contrast media in CT and MR imaging.
The BBB is formed by a combination of e...
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 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 recognise as the presence of protruding calcified choroid tissue in the fourt...
The body of the sphenoid bone is the midline cubical portion of the sphenoid bone, hollowed by the sphenoid air sinuses.
The body has superior, inferior, anterior, posterior, and lateral surfaces.
The superior surface features:
ethmoidal spine: prominent spine that articulates...
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:
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
Bones of the foot
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
Bones of the...
There are many types of bone within the body:
long bones (longer than they are wide)
short bones (not long 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 ...
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...
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...
The skeleton is the complete set of bones that make up a human. There are 206 bones in total which can be divided into:
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 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 (19...
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. ...
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...
The brachial artery is the main supply of arterial blood to the arm, forearm and hand.
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...
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 t...
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.
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.
origin: union of the ulnar and radial veins in the cubital fossa1
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.
The BCT is the first of the three main branches of the aortic arch, which originates from the upward convexity. It measures 4...
Brachiocephalic veins (BCV) drain the head, neck, upper limbs and part of the thorax and mediastinum.
In the root of the neck, the internal jugular and subclavian veins unite to form the brachiocephalic veins posterior to the medial ends of the clavicles.
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 ...
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 development occurs from the three vesicles of the embryo's neural tube.
By approximately 4.5 to 5 menstrual weeks, the primitive neural plate has developed. The neural plate then divides into the neural crest and...
The brainstem is the most caudal part of the brain. It adjoins, is structurally continuous with the spinal cord and consists of the:
pons (part of the metencephalon)
medulla oblongata (myelencephalon)
The brainstem provides the main motor and sensory innervation to t...
The brainstem nuclei are the nuclei in the brainstem. These include:
the cranial nerve nuclei
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.
A VIP'S COMMA
A: anterior choroidal artery (C7)
V: Vidian artery (C2)
I: inferolateral trunk (C4)
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
D: deep auricular artery
A: anterior tympanic artery
M: middle meningeal artery
I: inferior alveolar artery
A: accessory meningeal ar...
Useful mnemonics to remember the four branches of the thoracoacromial artery are:
CAlifornia Police Department
Cadavers Are Dead People
B: breast (pectoral)
CAlifornia Police Department
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.
The breast has an inhomogeneous structure which is predominantly composed of adipose tissue and glandular tissue. In additi...
Breast hypoplasia is a condition which is characterised by underdevelopment of the breast. Breast hypoplasia can be congenital or acquired.
congenital adrenal hyperplasia
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...
The broad ligament(s) are the lateral folds of the parietal peritoneum which reflect over the upper genital tract.
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, mesovari...
Broca's area (Brodmann area 44) is an area of the lateral frontal lobe in the dominant hemisphere concerned with the production of speech.
Broca's area is located in the posterior inferior frontal gyrus (pars opercularis and pars triangularis) of the dominant hemisphere, anterior...