AsterionThe practical handbook of ANATOMY

Asterion

The Practical Handbook of

ANATOMY

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Asterion

The Practical Handbook of

ANATOMY

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Second
Edition

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Editors

Harishanker JS
Ajai Sasi
Avinash N

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2011-2012 Batch MBBS
Malabar Medical College
Kerala University of Health Sciences
Calicut, Kerala, India

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The Health Sciences Publisher
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The views and opinions expressed in this book are solely those of the original contributor(s)/author(s) and do not necessarily
represent those of editor(s) of the book.
All rights reserved. No part of this publication may be reproduced, stored or transmitted in any form or by any means, electronic,
mechanical, photocopying, recording or otherwise, without the prior permission in writing of the publishers.
All brand names and product names used in this book are trade names, service marks, trademarks or registered trademarks of
their respective owners. The publisher is not associated with any product or vendor mentioned in this book.
Medical knowledge and practice change constantly. This book is designed to provide accurate, authoritative information about the
subject matter in question. However, readers are advised to check the most current information available on procedures included
and check information from the manufacturer of each product to be administered, to verify the recommended dose, formula,
method and duration of administration, adverse effects and contraindications. It is the responsibility of the practitioner to take all
appropriate safety precautions. Neither the publisher nor the author(s)/editor(s) assume any liability for any injury and/or damage
to persons or property arising from or related to use of material in this book.
This book is sold on the understanding that the publisher is not engaged in providing professional medical services. If such advice
or services are required, the services of a competent medical professional should be sought.
Every effort has been made where necessary to contact holders of copyright to obtain permission to reproduce copyright material. If any have been inadvertently overlooked, the publisher will be pleased to make the necessary arrangements at the first
opportunity.
Inquiries for bulk sales may be solicited at:
Asterion—The Practical Handbook of Anatomy

First Edition: 2013
Second Edition: 2015
 

ISBN 978-93-5152-396-3
Printed at


Dedicated to
Our family and friends
for continuous suppport at all times

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“Learn to see, learn to hear, learn to feel, learn to smell, and
know that by practice alone can you become expert”
—Sir William Osler

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Foreword
I am very happy to know that the students of Malabar Medical College,

Calicut, Kerala, India, are coming out with a handbook on anatomy.
When they approached me with a different idea, Asterion—The Practical
Handbook of Anatomy, I readily welcomed that idea. The editors have
seen that the book is brief and student-friendly. This handbook covering
Histology, Osteology, Embryology, Radiology and Surface Marking will
make a quick reference for the examination going students. It will also help
them save a lot of time to concentrate on gross and applied anatomy.
I am using this opportunity to congratulate Harishanker JS, Ajai Sasi and Avinash N of 2nd
batch, all staff members of Department of Anatomy and all those students of Malabar Medical
College, Calicut, Kerala, India, who helped them to see that the book is through. I wish all the
success for this venture.

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VS Akbar Sherif MBBS MS MCh
Pediatric Surgeon
Principal, Malabar Medical College
Calicut, Kerala, India
 

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Preface to the Second Edition



It gives us immense pleasure to present before you once again the revised second edition
of Asterion. The first handout was indeed a success, which made many of the 1st MB’s to
walk through their practicals with a light heart. The response of Asterion was the biggest
encouragement for the upcoming of its modified version.
Many more modifications have been brought into this book. We have included the finer
most images. Every chapter of anatomy has been incorporated with fine details and its clinical
aspects dealt in detail. The first edition was made with a solo motto of getting every student
through the practical. But now the focus of Asterion is not just cracking the examinations, but
it will help you get into the subject. All the most probable questions have been included in the
chapter Red Alert so that you do not even miss the toughest of the questions.
Altogether Asterion is a definite solution for every examination preparing student which
can surely promise them an upper hand in their examination.


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Harishanker JS
Ajai Sasi
Avinash N


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Preface to the First Edition



Every tributary of anatomy confluent to form “Asterion”. It is the right solution for all the last
minute queries of every student just before the examination. It is an exclusive handout focusing
mainly on practical anatomy.
A need of such a book will be felt maximum as we approach our university examination, a
point of time when we get lost completely but keep staring at Histology, Radiology, Osteology,
etc with a heavy heart full of fear and anxiety. Such a fear was there indeed in our heart too,
which gave us the spark of compiling all these together, and this gave birth to our Asterion.
Asterion covers all practical aspects of anatomy comprising Histology, Embryology,
Osteology, Radiology and Surface Marking. It is only a preparatory manual for undergraduates
(UG), not a complete textbook. It is a very student-friendly concise book which will make you
so confident that you can spot the toughest of spotters with no time. It gives you the exact idea
for facing every exam—be it viva or theory at most precision, thus helping you to leave the
exam hall with a smile.
One of the marking features of Asterion is that it presents you “The Red Alert” section which
gives you the most probable theory questions from the gross anatomy section, thereby clearing
away your vague minds and promising you a sure shot at the exam.
Now everything is set. Here we present you so gladly and proudly the magical wand of
anatomy “Asterion”. So take away the wand and cast your spell on the examiner, so that
everyone of you have a magical result.

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Harishanker JS
Ajai Sasi
Avinash N

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Acknowledgments



We would take this opportunity to express our profound gratitude and deep regards to
our principal Dr VS Akbar Sherif for his exemplary guidance, monitoring and constant
encouragement throughout the course.
We also extend our sincere thanks to the Dr BS Ratna (Head, Department of Anatomy) and
all the teachers and staff of the Department of Anatomy. We are also grateful to Dr Major Hari

Bhaskar S and to all the other staff of the Department of Radiology, Malabar Medical College,
Calicut, Kerala, India.
We are heartily thankful to Shri Jitendar P Vij (Group Chairman), Mr Ankit Vij (Group
President), Mr Tarun Duneja (Director-Publishing), Mr Sunil Kumar Dogra (Production
Executive), Mr Neelambar Pant (Production Coordinator) Mr Bharat Bhushan (Typesetter),
Mr Manoj Pahuja (Graphic Designer), M/s Jaypee Brothers Medical Publishers (P) Ltd., New
Delhi, India, for their valuable guidance and support. We also note the help and continued
support of Mr PM Sebastian (Jose) Branch Manager and Mr Diffin Robin, M/s Jaypee Brothers
Medical Publishers (P) Ltd., Kochi, Kerala, India
We would like to thank Shabeeb PK, Rarimol, Midhun NL, Mekha Premachandran,
Hemanth Raj and the first batch of Malabar Medical College for their help and support. We are
also thank Mohamed Abshad for the assistance with photographs.
We are indebted to Fathima Farsana Pulikkal, Sreekiran PR, Fathima Bathool (IInd batch,
Malabar Medical College), Kavya P Valsaraj (Government Dental College, Calicut, Kerala,
India), Ashwin Ramesh, Aswin KR (KMCT Medical College, Calicut, Kerala, India) for the
immense help with illustrations.
We also thank Abhijith Varma, Aswathy BI, Shreelakshmi Pradeep, Ambili Pillai (IInd
batch, Malabar Medical College) for their help in the initial editing and valuable suggestions.
We are also grateful to Team MASK, Sonu P Alex, Aishwarya A, Anagha Manoj (IInd batch,
Malabar Medical College), Aparna J and Karthika J (IIIrd batch, Malabar Medical College) for
providing us the right resources at the right time.
We also take this opportunity to thank the all students of Malabar Medical College, Calicut,
Kerala, India, especially second batch without their support this would not have been a
complete one.
We would also like to express our deep gratitude to our parents, who has helped and
supported us throughout the entire making process. And above all without the blessing of God
Almighty this book would not have been a complete one.

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HISTOLOGY ----------------------------------------------------------------------------------- 1
Epithelia 2
Simple Squamous Epithelium 2
Simple Cuboidal Epithelium 2
Simple Columnar Epithelium 3

Ciliated Columnar Epithelium with Goblet Cells 3
Pseudostratified Columnar Epithelium 4
Transitional Epithelium 4

 

 

 

 

 

13
Bone Transverse Section 13
Bone Longitudinal Section 14
 





Bone

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Cartilage 5
Hyaline Cartilage 6
Elastic Cartilage 9
Fibrocartilage 10
Compact Bone: Transverse Section 12

 

 

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Muscle 17
Skeletal Muscle 17
Smooth Muscle 18
Cardiac Muscle 21

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Lymphoreticular System
Lymph Node 30
Palatine Tonsil 33
Spleen 34
Thymus 37

 

 

 

 







 

 

 

 

Nervous Tissue 38
Nerve Fiber 38
Spinal Ganglion 41
Sympathetic Ganglion 42

 

 



 

Oral Cavity and Structures 45
Serous Salivary Gland 45
Mucous Salivary Gland 46

 



 

Blood Vessels 22

Large Artery or Elastic Artery 22
Medium Sized Artery 25
Large Vein 26
Medium Sized Vein 29



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Contents

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Asterion—The Practical Handbook of Anatomy
 

 





Mixed Salivary Gland 49
Tongue 50

 

 

 

 

 

 

 

 

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Alimentary System 53
Esophagus 54
Stomach Fundus 54
Stomach Pylorus 57
Small Intestine 58
Duodenum 58
Jejunum 61
Ileum 62
Colon 65
Appendix 66

 

 

 

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Respiratory System
Trachea 74
Lung 77

 







 

Liver and Pancreas 69
Liver 69
Gallbladder 70
Pancreas 73

 

 

 

 

85
Thick Skin 86
Thin Skin 86

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Skin

 

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Renal System 78
Kidney 78
Ureter 81
Urinary Bladder 82

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Male Reproductive System
Testis 106
Epididymis 109
Vas Deferens 110
Prostate Gland 113


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Female Reproductive System
Mammary Gland 94
Ovary 97
Fallopian Tube 98
Uterus 101
Placenta 102
Umbilical Cord 105

 

 







 

Special Senses 89
Cornea 89
Retina 90
Optic Nerve 93



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EMBRYOLOGY ------------------------------------------------------------------------------127
General Embryology 128
Embryogenesis 128
Implantation 128
Decidua 129
Embryonic Disc and Germ Layers 129
Intraembryonic Mesoderm 130
Somites 131
Notochord 131
Neurulation 132
Neural Crest 132
Lamina Terminalis 132
Placenta 133
 

 

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Systemic Embryology 134
Pharyngeal Arches 134
Palate 135
Face 136
Upper Lip 137
Tongue 138
Thyroid Gland 138
Lungs 139
Heart Tube 139
Right Atrium 140
Interatrial Septum 140
Fallot’s Tetralogy 141
Diaphragm 142
Foregut Derivatives 142
Midgut Derivatives 142
Hindgut Derivatives 142
Esophagus 142
Stomach 142
Meckel’s Diverticulum 143
Pancreas 143
Liver and Gallbladder 144
 

 

 

 

 

 

 

 

 









 

 

 

 

 

 

 

 

 

 

 

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Central Nervous System

Spinal Cord 121
Cerebellum 122
Cerebrum 125

 









 

Endocrine System 114
Adrenal Gland 114
Thyroid Gland 117
Parathyroid Gland 117
Pituitary Gland 118

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Kidney 144
Urinary Bladder 145
Uterus 145
Uterine Tube 145
Development of Gonads (Testis and Ovaries) 146
Rectum and Anal Canal 147
Prostate 148
Amniocentesis 148
 

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RADIOLOGY --------------------------------------------------------------------------------151
Basics 152
Imaging Modalities 152
Radio-opacities 152
Plane Radiographs 153
Contrast Radiographs 153
Some Terms 155
 

 

 

 

 











 

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How to Read a Chest Radiograph (PA View) ?

 

 

 

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Plane Radiographs 160
Upper Limb 160
Thorax and Abdomen
Lower Limb 165
Head and Neck 169

 

 

 

 

 

 

 

Contrast Radiographs 171
Barium Swallow 171
Barium Meal 171
Barium Meal Follow Through 172
Barium Enema (Double Contrast) 172
Intravenous Pyelogram 173
Hysterosalpingogram 173

 

 

 

 

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Contrast Studies 156
Barium Swallow 156
Barium Meal 156
Barium Enema 156
Intravenous Pyelography (IVP) 157
Hysterosalpingography (HSG) 157



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Genetics 148
Barr Body (Sex Chromatin) 148
Chromosome Banding 148
Karyotyping 149
Nondisjunction 149
Klinefelter Syndrome 150
Turner’s Syndrome 150
Down Syndrome 150

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OSTEOLOGY --------------------------------------------------------------------------------175
Bones 176
Skull: Anterior View 176
Skull: Posterior View 176
Skull: Lateral View 177
Skull: Inferior View 177

Floor of Cranial Cavity: Posterosuperior View 178
Floor of Cranial Cavity: Superior View 179
Mandible : Anterior View 180
Mandible : Lateral View 180
Mandible : Posterior View 180
Upper Limb 181
Lower Limb 185
Thorax 191
Vertebrae 192
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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Ossification

 























Anatomical Position, Side Determination and Features
Clavicle 199
Scapula 199
Humerus 200
Radius 201

Ulna 201
Hip Bone 202
Femur 202
Tibia 203
Fibula 203
Patella 204
Vertebrae 204
205

 

 

 

 

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Contents

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SURFACE MARKING -----------------------------------------------------------------------209
Upper Limb 210
Axillary Artery 210
Brachial Artery 210
Radial Artery 210
Ulnar Artery 210
Axillary Nerve 210

Median Nerve 211
Musculocutaneous Nerve 211
Radial Nerve 211
Ulnar Nerve 211
Flexor Retinaculum 212
Extensor Retinaculum 212


5.



Medical and Legal Importance 205


 

Superficial Palmar Arch 212
Deep Palmar Arch 212
 





Asterion—The Practical Handbook of Anatomy

 

 

 

 

 

 

 

 

 

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Lower Limb 213
Femoral Artery 213
Popliteal Artery 213
Posterior Tibial Artery 213
Dorsalis Pedis Artery 213
Saphenous Opening 213
Great Saphenous Vein 213
Sciatic Nerve 214
Superior Extensor Retinaculum 214
Inferior Extensor Retinaculum 214
Flexor Retinaculum 214

 

 

 

 

 

 













 

Thorax 214
Heart 214
Arch of Aorta 215
Lungs 215
Pleural Reflection 216
Esophagus 217
Thoracic Duct 217

 

 

 

 

 

 

 

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Abdomen and Pelvis 218
Median Vertical Plane 218
Inguinal Canal 219
Stomach 219
Liver 219

Fundus of Gallbladder 220
Abdominal Aorta 220
Spleen 220
Root of Mesentry 220
Mcburney’s Point 220
Kidney 221
Ureter 221

 

 

 

 

 

 

 

 

 

Head and Neck 222
Common Carotid Artery 222
External Carotid Artery 222
Facial Artery 222
Facial Vein 222
Internal Jugular Vein 222
External Jugular Vein 223
Facial Nerve 223
Parotid Duct 223


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SPOTTERS AND DISCUSSION TOPICS--------------------------------------------------225
Spotters 226

Upper Limb  226

Lower Limb  227
Thorax 228

Abdomen and Pelvis  228

Head and Neck  229
Brain 231
Discussion Topics  231

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RED ALERT----------------------------------------------------------------------------------233
Paper 1  234

Upper Limb  234

Lower Limb  234
Thorax 235

General Histology  235

General Embryology  236

General Anatomy  236
Paper 2  236

Head and Neck  236
Neuroanatomy 237

Abdomen and Pelvis  238
Histology 238

Systemic Embryology  239
Important Diagrams  240



Index-------------------------------------------------------------------------------------------243


C H A P T E R

Histology

1


Epithelia
SIMPLE SQUAMOUS EPITHELIUM

Simple squamous
epithelium
Basement
membrane

Blood vessels

Connective tissue

SIMPLE CUBOIDAL EPITHELIUM

Simple cuboidal
epithelium
Basement
membrane

Blood vessels

Connective tissue


SIMPLE COLUMNAR EPITHELIUM

Histology

Simple columnar
epithelium

Basement

membrane

Blood vessels

Connective tissue

CILIATED COLUMNAR EPITHELIUM WITH GOBLET CELLS

Goblet cells

Ciliated simple
columnar epithelium

Basement
membrane
Connective tissue

3


Asterion—The Practical Handbook
of Anatomy
4PSEUDOSTRATIFIED
COLUMNAR
EPITHELIUM

Pseudostratified
ciliated columnar
epithelium
Basement

membrane
Blood vessels

Connective tissue

TRANSITIONAL EPITHELIUM

Transitional
epithelium
Basement
membrane

Blood vessels

Connective tissue