Correction of this slide

Identify Y & mention three differences

between that of opposite side.

Y: Right bronchus

Mention segmentation of X & Y

Y: Right bronchus

X: Lt bronchus

Also segmentation of lobes

Bronchopulmonary segmentation

Segmentation of the right bronchus:

Right bronchus usually gives its superior lobar branch which passes

separately into the hilum of the right lung. The right bronchus then

enters into the hilum where it terminates by dividing into middle and

inferior lobar branches.

1- superior lobar bronchus: divides into three segmental branches to

the three segments of the superior lobe:

1- Apical segmental bronchus.

2- Posterior segmental bronchus.

3- Anterior segmental bronchus.

2- Middle lobar bronchus: arise 2 cm below the superior lobar bronchus from

the front of the right bronchus and passes anterolaterally to the middle lobe

where it divides into two segmental branches to the

two segments of the middle lobe:

1- medial segment bronchus 2- Lateral segmental bronchus

3- Inferior lobar bronchus:

It is a continuation of the right bronchus beyond the middle lobar bronchus. It

gives a superior segmental bronchus to the upper part of the inferior lobe, then

divided into anterior, posterior, lateral and medial basal segmental branches. So

its branches are:

1- superior apical segmental bronchus.

2- anterior basal segmental bronchus.

3- Posterior basal segmental bronchus.

4- lateral basal segmental bronchus.

5- Medial basal segmental bronchus.

Segmentation of the left bronchus

It is divided after passing through the hilum of the left lung into:

1- superior lobar which divides into two:

A) Superior division : gives three segmental bronchi as those of the right

superior lobar:

1- Apical segmental bronchus.

2- Posterior segmental bronchus.

3- Anterior segmental bronchus.

A

Identify A , its root value & its branches

Femoral nerve (dorsal divisions of the

ventral rami of (L2, 3, 4).

branches before division

1- Nerve to iliacus 2- Nerve to pectineus

II- Anterior division:

Medial & intermediate cutaneous nerve

of the thigh

3- muscular branch to Sartorius.

II- branches of the posterior division :

1- Muscular branches to pubic part of

adductor magnus and obturator exernus.

2- Genicular branch to knee

A

Identify A , its root value & its muscular

branches

Femoral nerve (dorsal divisions of the ventral

rami of (L2, 3, 4).

1- Nerve to iliacus

2- Nerve to pectineus

3- Nerve to Sartorius (from anterior division)

4- Muscular branches to pubic part of adductor

magnus and obturator externus (from posterior

division).

From main trunk

A

Identify A , its root value & its branches

Obturator nerve

ventral divisions of the ventral rami of (L2, 3, 4).

Branches of the anterior division:

1- Articular branch to the hip joint.

2- Muscular branches to: adductore longus, brevis

& gracilis.

3-Cutaneous branch to Skin of the middle third of

the medial aspect of thigh.

II- branches of the posterior division :

1- Muscular branches to pubic part of adductor

magnus and obturator exernus.

2- Genicular branch to knee

A

-Identify A, mention its root value,

termination & 4 muscles supplied.

-A: sciatic nerve

-Its root value:

ventral rami of (L4,5 S1, 2, 3).

-In the middle of thigh, it divides into its

two terminal branches

1- Medial tibial

2- Common peroneal nerves

It gives motor branches to biceps femoris,

semitendinosus & semimembranosus and

ischial part of adductor magnus

Injury of the sciatic nerve:

Commonly occur due to fractures in the middle of the shaft of the femur.

An injury of the sciatic nerve results in:

1- Paralysis of the hamstring muscles when injuries in the gluteal region. But

when injured in the middle of the thigh the hamstring escaped from paralysis as

they receives innervation high up in the thigh. Paralysis of the hamstring leads

to weakness of the flexion of the knee as some flexion can be done by sartorius

& gracilis.

2- Complete paralysis of all muscles of the foot & leg leading to a condition of

flail foot as there is a foot drop resulting from the effect of the gravity.

3- Loss of cutaneous sensation on the leg & foot except the area supplied by

saphenous nerve (medial aspect of the leg & medial border of the foot to the

root of the big toe).

C B

Identify B, mention its reoot value & four branches

in popliteal fossa.

B:(Tibial nerve (medial popliteal)

Its root value: as sciatic (L45, S123)

I- sural nerve

II- Muscular branches to:

1- Medial & Lateral heads of Gastrocnemius.

2- Plantaris 3- Popliteus

4- Superficial part of the soleus

III- Articular branches: to knee joints

Superior, inferior & middle genicular nerve.

A Level of termination A & its continuation

Still tibial nerve

As it doesn't pass distal border of popliteus

muscle

At Distal border of popliteus it continues as

Posterior Tibial nerve

C B

Identify C, mention its root value & level of Its

termination & its terminal branches and effect of its

injury

C: Common peroneal (Lateral popliteal)

(L4,5S12) it supplies biceps.

Lateral ton neck of fibula divides into

1- Deep peroneal (anterior tibial)

2- Superficial peroneal (Musculocutaneous) nerve.

Its injury lead to Foot drop

As a result of Paralysis of the muscles of the anterior

& lateral compartment of the leg. This leads to

paralysis of the dorsiflexor & evertor of the foot.

B

D

Identify B: (tibialial nerve)

Identify D mention its termination & four

muscular branches

D: Posterior tibial

Muscular branches: deep part of soleus,

tibialis posterior, Flexor digitorum longus,

flexor hallucislongus.

Branches of posterior tibial nerve

1- Muscular branches: deep part of soleus, tibialis posterior, Flexor digitorum longus,

flexor hallucis longus & tibialis posterior muscles.

2- Medial Calcanean nerves: to supply the skin of the heel & medial and

posterior part of the sole.

3- Vascular branches: sympathetic twings to the posterior tibial artery.

4- Articular branch: to the ankle.

5- Terminal branches: Medial & Lateral planter nerves.

X= femoral nerve

X

Mention its Root value and

Three of the muscles supplied by it

(muscular branches)?

Root value = dorsal division of L2,3,4

Muscles supplied: Before division nerve to

pectineus, & nerve to iliacus

Anterior dividion : sartorius

Posterior division : separate nerve for each

head of quadriceps

X= sciatic nerve Mention its Root value, Its terminal branches and

Three of the muscles supplied by it?

Root value = L4,5 S1, 2& 3

Terminal Branches

tibial nerve and common fibular nerve ( in the

middle of the bacK of the thigh)

Its muscular branches: to semitendinosus ,

semimembranosus, bicpes femoris & ischial part

of adductor magnus

X

X= sciatic nerve Y= tibial nerve Z= common fibular nerve

X

Z

Y

X

Y

X: tibial nerve in popliteal fossa

Y: Common peroneal nerve

A

Identify A, its origin, its muscular branches.

Anterior tibial nerve

Deep branch of common peroneal

Its root value: L4,5 S1,2

Its muscular branch

Tibialis anterior

Extensor hallucis longus,

Extensor digitorum longus & Peroneus tertius.

Identify B, its origin, its muscular branches

Musculocutaaneous (superficial peroneal) nerve

Supplies peroneus longus & brevis.

B