Anatomy Mnemonics

Anatomy Mnemonics

Sympathetic vs. Parasympathetic Sympathetic: "Fight or
Flight"
Parasympathetic: "Sex, Sandwiches and Sleep"

Tarsal bones of ankle "Tiger Cubs Need
MILC":
Superior, then clockwise on right foot:
Talus
Calcaneus
Navicular
Medial cuneiform
Intermediate cuneiform
Lateral cuneiform
Cuboid

Rheumatic fever: Jones 5 major criteria SPACE:
Subcutaneous nodules
Pancarditis
Arthritis
Chorea
Erythema Marginatum

Intrinsic muscles of hand (palmar surface) "All For
One And One For All":
· Thenar:
Abductor pollicis longus
Flexor pollicis brevis
Opponens pollicis
Adductor pollicis.
· Hypothenar:
Opponens digiti minimi
Flexor digiti minimi
Abductor digiti minimi

Bifurcation vertebral landmarks · A bifurcation occurs on 
4th level of each vertebral column:
C4: bifurcation of common carotid artery
T4: bifurcation of trachea
L4: bifurcation of aorta

Femoral triangle: boundaries "Femoral triangle is shaped
like a SAIL":
Sartorius
Aductor longus
Inguinal Ligament

Lingula location LingULa = Left Upper
Lobe

Grey vs. white rami communicantes WhIte = On
the Way In to the sympathetic trunk
GrEy = Exiting the sympathetic trunk

Muscles of respiration "Don't Exercise In
Quicksand":
Diaprahm
External intercostals
Internal intercostals
Quadratus

Sacral plexus: posterior components "Common Gluttons
For Punishment":
Common fibular
Gluteals (superior and inferior)
Femoral cutaneous (Posterior)
Piriformis nerve

Cervical vertebra: landmarks at each level "NoaH
Told MariaH To Try Cervical Counting":
Nose (base), Hard palate: C1
Teeth: C2
Mandible, Hyoid bone: C3
Thyroid cartilage (upper): C4
Thyroid cartilage (lower): C5
Cricoid cartilage: C6
Cricoid cartilage (just below): C7

Deltoid: proximal attachments Deltoid CLASPs:
Clavicle, Acromion and Spine of the scapula.

Musculocutaneous nerve: muscles supplied BBC:
Biceps brachii
Brachialis
Coracobrachialis

Pharynx vs. larynx Eat Phood with your Pharynx.
Sing La La La with your Larynx

Posterior mediastinum: contents DATES:
Descending aorta
Azygos and hemiazygous veins
Thoracic duct
Esophagus
Sympathetic trunk/ganglia

Supination vs. pronation Supination: palm to the Sun
Pronation: palm to the Plants.

Skull bones "STEP OF 6 "
· The 6 skull bones are:
Sphenoid
Temporal
Ethmoid
Parietal
Occipital
Frontal
· Alternatively: "STEP OFf my skull".

Balance organs: relative position of saccule vs. utricle
"Your SAC is below U":
Saccule is below the Utricle.
· Note: "sac" is slang for male genitalia, and it thus down "below".

Hand: nerve lesions DR CUMA:
Drop=Radial nerve
Claw=Ulnar nerve
Median nerve=Ape hand (or Apostol [preacher] hand)

Branches of Internal Iliac Artery "I Love Going
Places In My Very Own Underwear":
Ileolumbar
Lateral sacral
Gluteal (superior and inferior)
Pudendal (internal)
Inferior vesicle (uterine in females)
Middle rectal
Vaginal
Obturator
Umbilical

Wrist: radial side vs. ulnar side "I cut off my thumb
with a radial saw!":
The radius is on the thumb side of the arm.

Carpal bones "Sally Lowers Tim's Pants,
Then Things Can Happen":
· Proximal row lateral to medial:
Scaphoid
Lunate
Triquetrium
Pisiform
· Distal row, lateral to medial:
Trapezium
Trapezoid
Capate
Hamate

Thoracoacromial trunk: branches "Cadavers Are
Dead People":
Clavicular
Acromial
Deltoid
Pectoral

Pes anserinus: component tendons "Some God*amned
Tendon":
· From medial to lateral:
Sartorius
Gracilis
Semitendinosus

Carpal bones "Simply Learn The Parts
That The Carpus Has":
Proximal row first, then distal row:
Scaphoid
Lunate
Triquetrium
Pisiform
Trapezium
Trapezoid
Capate
Hamate

Tibia vs. fibula: sizes The Fibula is thin like a 
Flute.
The Tibia is thick like a Tuba.

Carpal Bones "Sally Likes To Play
The Tiny Chrome Harmonica":
· Proximal row lateral to medial:
Scaphoid
Lunate
Triquetrium
Pisiform
· Distal row, lateral to medial:
Trapezium
Trapezoid
Capate
Hamate

Lower limb: muscles between upper legs "There's a GAP
between upper legs when you sit without closing your knees":
Gastrocnemious
Adductors
Pectinious

Broad ligament: contents BROAD:
Bundle (ovarian neurovascular bundle)
Round ligament
Ovarian ligament
Artefacts (vestigial structures)
Duct (oviduct)

Cardiac valves: order in circuit "TRI berore you 
BI":
Tricuspid valve is located in left heart and Bicuspid valve is
located in right heart. Blood flows through the tricuspid before
bicuspid.

Diaphragm apertures: spinal levels Aortic hiatus = 
12 letters = T12
Oesophagus = 10 letters = T10
Vena cava = 8 letters = T8

Heart valves: order in circuit "First learn a Tricycle,
then learn a Bicycle":
Flow through Tricuspid first, then Bicuspid.

Lung lobes: one having lingula, lobe numbers Lingula
is on Left.
The lingula is like an atrophied lobe, so the left lung must have 2 "other"
lobes, and therefore right lung has 3 lobes.

External jugular vein: tributaries PAST:
Posterior external jugular vein
Anterior jugular vein
Suprascapular vein
Transverse cervical vein

Diaphragm apertures: spinal levels "Voice Of
America":
· In order from smallest to highest spinal number:
Vena cava: T8
Oesophagus: T10
Aorta: T12
· Note: Voice Of America (VOA) is a radio broadcast station.

Elbow joint: radius vs. ulna ends CRAzy TULips:
Capitalum = RAdius
Trochlear = ULnar

Serratus Anterior: nerve vs. blood LoNg thoracic: 
Nerve
LAteral thoracic: Artery

Elbow joint: capitulum vs. trochlea CUTER:
Capitulum: Ulnar
Trochlea: Radial

Sperm: path through male reproductive system "My boyfriend's
name is STEVE":
Seminiferous Tubules
Epididymis
Vas deferens
Ejaculatory duct

Popliteal fossa: medial to lateral arrangment "Serve
And Volley Next Ball":
Semimembranosus/ Semitendonosus
Artery
Vein
Nerve
Biceps femoris
· Lateral and medial heads of Gastrocnemius are inferior borders.

Subclavian artery branches "Very Tired Individuals
Sip Strong Coffee Served Daily":
Vertebral artery
Thyrocervical trunk
---Inferior thyroid
---Superficial cervical
---Suprascapular
Costocervical
---Superior intercostal
---Deep cervical

Internal pudendal branches "I Pee Pee
But Don't Dump!":
Inferior rectal
Posterior scrotal (or labial)
Perineal
Bulb
Deep artery
Dorsal artery

Horner's syndrome: components PAM:
Ptosis
Anhydrosis
Miosis

Erector spinae muscles: order Spinalis is on the 
spine (most medial).
Iliocostalis is on the ribs (most lateral).
And it's a Long (Longissimus) way between the spine and the ribs!

Hand fractures: Colle's vs. Smith's Colle's fracture:
arm in fall position makes a 'C' shape.
Smith's fracture: arm in fall position makes a 'S' shape.

Femoral triangle: boundaries "So I May
Always Love Sally":
Superiorly: Inguinal ligament
Medially: Adductor longus
Laterally: Sartorius

Arm fractures: nerves affected by humerus fracture location
ARM fracture:
· From superior to inferior:
Axillary: head of humerus
Radial: mid shaft
Median: supracondular

Extraocular muscles: movements "ObliqLiques cause 
lateral rotation of eyeball":
· Obliques cause lateral, all other rectii are medial rotators of the eyeball.
Action of the obliques is opposite to their names.
Action of the rectii is rightly fitting to their names.
Both superiors cause intorsion and both inferiors cause extorsion.

Cruciate ligaments: insertions PAMS APPLES:
Posterior [passes] Anterior [inserts] Medially.
Anterior [passes] Posteriorly [inserts] Laterally.

Tibia: muscles of pes anserinus (the muscles attached to tibia's
medial side) "A Girl between Two Sargeants":
Gracilus is between
Sartorius and
Semitendonosus

Erector spinae muscles "I Like Standing":
· From lateral to medial
Illiocostalis
Longissimus
Spinalis

Lower limb peripheral nerve injurys "Drop into a 
DEeP PIT and shuffle your way out":
Foot Drop results from Dorsiflexors and Evertors paralysis,
due to common Peroneal nerve lesion.
Plantarflexion and Inversion impairment due to Tibial nerve
lesion, results in a shuffling gait.

Genu valgum vs. genu vargum Genu valGUM (knock-knee):
knees are GUMmed together.
· Varum (bowleg) is the other by default, or Far rhymes with Var,
so knees are far apart.

Carpel bones "So Long To Pinky,
Here Comes The Thumb":
· Proximal row, lateral-to-medial, then distal row, medial-to-medial:
Scaphoid
Lunate
Triquetrium
Pisiform
Hamate
Capate
Trapezoid
Trapezium

Supination vs. pronation "SOUPination": Supination is
to turn your arm palm up, as if you are holding a bowl of soup.
"POUR-nation": Pronation is to turn your arm with the palm down, as if
you are pouring out whatever is your bowl.
· Alternatively, Pronation donation: Pronation is palm facing
downward, as if making a donation.

Mediastinums: posterior mediastinum structures There are 4
birds:
The esophaGOOSE (esophagus)
The vaGOOSE nerve
The azyGOOSE vein
The thoracic DUCK (duct)

Thigh: innervation by compartment "MAP OF Sciatic":
Medial compartment: Obturator
Anterior compartment: Femoral
Posterior compartment: Sciatic
· So all the thigh muscles in that compartment get innervated by that nerve.

Femoral artery deep branches "Put My Leg
Down Please":
Profundus femoris (deep femoral artery)
Medial circumflex femoral artery
Lateral circumflex femoral artery
Descending genicular arteries
Perforating arteries

Carpal bones (multangular names) "Never Lower
Tillie's Pants. Mother May Come Home.":
Navicular
Lunate
Triquetrium
Pisiform
greater Multangular (trapezium)
lesser Multangular (trapezoid)
Capitate
Hamate

External carotid artery branches "Suzy Always
Lays Flat On Pillows Making Sex Terrific":
Superior thyroid
Ascending pharyngeal
Lingual
Facial
Occipital
Posterior auricular
Maxillary
Superificial Temporal

Horner's syndrome: components "HORNy PAM"
· Horner's is:
Ptosis
Anhidrosis
Miosis
· Extra details with HORNY PAMELa:
Ptosis
Anhidrosis
Miosis
Enophthalmos
Loss of ciliospinal reflex

Coelic trunk: branches Left Hand Side (LHS):
Left gastric artery
Hepatic artery
Splenic artery

Biceps brachii muscle: origins "You walk shorter to a
street corner. You ride longer on a superhighway.":
· Short head originates from coracoid process.
· Long head originates from the supraglenoid cavity.

Heart valve sequence "Try Pulling My Aorta":
Tricuspid
Pulmonary
Mitral
Aorta

Bell's palsy: symptoms BELL'S Palsy:
Blink reflex abnormal
Earache
Lacrimation [deficient, excess]
Loss of taste
Sudden onset
Palsy of VII nerve muscles
· All symptoms are unilateral.

Superior mediastinum: contents PVT Left BATTLE:
Phrenic nerve
Vagus nerve
Thoracic duct
Left recurrent laryngeal nerve (not the right)
Brachiocephalic veins
Aortic arch (and its 3 branches)
Thymus
Trachea
Lymph nodes
Esophagus

Inguinal canal: walls "MALT: 2M, 2A, 2L,
2T":
· Starting from superior, moving around in order to posterior:
Superior wall (roof): 2 Muscles:
· internal oblique Muscle
· transverse abdominus Muscle
Anterior wall: 2 Aponeuroses:
· Aponeurosis of external oblique
· Aponeurosis of internal oblique
Lower wall (floor): 2 Ligaments:
· inguinal Ligament
· lacunar Ligament
Posterior wall: 2Ts:
· Transversalis fascia
· conjoint Tendon

Scalp: nerve supply GLASS:
Greater occipital/ Greater auricular
Lesser occipital
Auriculotemporal
Supratrochlear
Supraorbital

Tarsal bones "Tall Californian Navy 
Medcial Interns Lay Cuties":
· In order (right foot, superior to inferior, medial to lateral):
Talus
Calcanous
Navicular
Medial cuneiform
Intermediate cuneiform
Lateral cuneifrom
Cuboid

Eye rotation by oblique muscles "I Love S&M":
Inferior oblique: Lateral eye rotation.
Superior oblique: Medial eye rotation.

External carotid artery branches "She Lay Flaccid
As Olaf's Penis Slipped In":
· From caudal to cephalad:
Superior thyroid
Lingual
Facial
Ascending pharyngeal
Occipital
Posterior auricular
Superficial temporal
(Internal) maxillary

Brachial artery is medial to biceps tendon "BAMBI":
Brachial Artery is Medial to Biceps In elbow.

Retroperitoneal organs (major) "AC/DC Rocker
Kids Party Down":
Ascending Colon
Descending Colon
Rectum
Kidneys
Pancreas
Duodenum

Ossification ages "Every Potential Anatomist
Should Know When"
· When they ossify, in order of increasing year:
Elbow: 16 years
Pelvis, Ankle: 17 years
Shoulder, Knee: 18 years
Wrist: 19 years

Foramen ovale contents OVALE:
Otic ganglion (just inferior)
V3 cranial nerve
Accessory meningeal artery
Lesser petrosal nerve
Emissary veins

Carpal tunnel syndrome: causes TRAMP:
Trauma (occupational)
Rheumatiod arthritis
Acromegaly
Myxoedema
Pregnancy
· Alternatively: ARMPIT to include Idiopathic.

Bronchopulmonary segments of the left lung "Astute 
Anatomists Share Inside Secrets About Lungs":
Apicoposterior (S1+2)
Anterior (S3)
Superior (S4)
Inferior (S5)
Superior (S6)
Anteromedial basal (S7+8)
Lateral basal (S9)

Vagal nerve: path into thorax Vagus nerve, unlike phrenic,
continues through diaphragm with esophagus--it is "Not Left Behind":
· The left vagus is anterior, right is posterior [behind].

Atrioventricular valves "LAB RAT":
Left Atrium: Bicuspid
Right Atrium: Tricuspid

Cubital fossa contents MBBR:
· From medial to lateral:
Median nerve
Brachial artery
Biceps tendon
Radial nerve

Muscles: potentially absent ones · Muscles which may be
absent but may be important:
5 P's:
Palmaris longus [upper limb]
Plantaris [lower limb]
Peroneus tertius [lower limb]
Pyramidalis [anterior abdominal wall]
Psoas minor [posterior abdominal wall]

Brachial plexus: numbers of each section · It is the same
backwards and forwards:
5-3-2-3-5:
5 Rami
3 Trunks
2 Divisions
3 Cords
5 Terminal nerves

Carpal bones "These Things Can Happen.
Sensible Lovers Take Precautions":
· Distal to proximal:
Trapezium
Trapezoid
Capitate
Hamate
Scaphoid
Lunate
Triquetrum
Pisiform

Umbilical ligaments: contents IOU:
· From lateral to medial:
lateral umbilical ligament: Inferior epigastric vessels
medial unbilical ligament: Obliterated umbilical artery
median umbilical ligament: Urachus

Vetebrae subtypes "Certain Doctors Luv
Saddling Coeds":
· From superior to inferior:
Cervical
Dorsal
Lumbar
Sacrum
Coccyx

Leg: anterior muscles of leg "The Hospitals 
Are Not Dirty Places":
T: Tibialis anterior
H: extensor Hallucis longus
A: anterior tibial Artery
N: deep fibular Nerve
D: extensor Digitorum longus
P: Peronius tertius [aka fibularis tertius]

Tarsal bones "Traverse City (is) Noted
(for) MIchigan's Lovely Cherries":
Talus
Calcaneus
(new row)
Navicular
(new row)
Medial Intermediate cuneiforms
Lateral cuneiform
Cuboid

Ear: bones of inner ear Take a Hammer: Malleus
Hit an Indian Elephant: Incus
It puts its foot in a stirrup: Stapes
· Describes the shape, and relative position (from out to in) of the inner ear
bones.
· Alternatively: "Mailing Includes Stamps".

Bowel components "Dublin Sisters Ceramic
Red Colored Jewelry Apparently Illegal":
· 2-4 letters of each component:
Duodenum
Sigmoid
Cecum
Rectum
Colon
Jejunum
Appendix
Ileum

Tarsal tunnel: contents "Tiny Dogs Are
Not Hunters":
· From superior to inferior:
T: Tibialis posterior
F: flexor Digitorum longus
A: posterior tibial Artery
N: tibial Nerve
H: flexor Hallucis longus

Radial nerve: muscles innervated "Try A Big
Chocolate Chip Sundae, Double Dip Cherries
And Peanuts Preferably Included":
· In order of their innervation, proximal to distal:
Triceps
Anconeus
Brachioradialis
ext. Carpi radialis longus
ext. Carpi radialis brevis
Supinator
ext. Digitorum
ext.Digiti minimi
ext. Carpi ulnaris
Abductor poll. longus
ext. Poll. brevis
ext. P poll. longus
ext. Indicis
· For the neighboring words that start with the same letter (eg: chocolate and
chip), notice that the longer word in the mnemonic, corresponds to the
longer of the two muscle names (ex: ext. carpi radialis longus and ext.
carpi radialis brevis)

Thoracoacromial artery branches ABCD:
Acromial
Breast (pectoral)
Clavicular
Deltoid

Axillary artery branches "Screw The Lawyer
Save A Patient":
Superior thoracic
Thoracoacromiol
Lateral thoracic
Subscapular
Anterior circumflex humeral
Posterior circumflex humeral
Alternatively: "Some Times Life Seems A Pain".

Scrotum layers "Some Days Eddie Can
Irritate People Very Thourougly":
Skin
Dartos layer
External spermatic fascia
Cremaster muscle
Internal spermatic fascia
Parietal tunica vaginalis
Visceral tunica vaginalis
Tunica albuginea

External carotid artery branches "Sally Ate 
Lots Of Fresh Produce March Through September":
Superior thyroid
Ascending laryngeal
Lingual
Occipital (O before F is an extremely common variation)
Facial
Posterior auricular
Maxillary
Transverse facial
Superficial temporal

Ankle: anterior compartment of leg contents "The Hamptons
Are Never Dull Parties":
· From medial malleolus:
Tibialis anterior tendon
(Extensor) Hallacus longus
Artery (anterior tibial)
Nerve (deep peroneal)
(Extensor) Digitorum
Peroneus tertius

Cubital fossa contents "Really Need Booze
To Be At My Nicest":
· From lateral to medial:
Radial Nerve
Biceps Tendon
Brachial Artery
Median Nerve

Cricoarytenoids: abductor vs. adductor When aliens abduct
you, they Probe you.
Posterior cricoarytenoids abduct. Lateral therefore is adduct by
default.

Ansa cervicalis nerves "GHost THought SOmeone
STupid SHot Irene":
Geniohyoid
Thyrohyoid
Superior Omohyoid
Sternothyroid
Sternohyoid
Inferior omohyoid

Bronchopulmonary segments of right lung "A PALM Seed
Makes Another Little Palm":
· In order from superior to inferior:
Apical
Posterior
Anterior
Lateral
Medial
Superior
Medial basal
Anterior basal
Lateral basal
Posterior basal

Psoas major: innervation If you hit L2, 3, 4
Psoas gets sore!

Inferior vena cava tributaries "I Like To
Rise So High":
Illiacs
Lumbar
Testicular
Renal
Suprarenal
Hepatic vein.
· Think of the IVC wanting to rise high up to the heart.

Cavernous sinus contents O TOM CAT:
O TOM are lateral wall components, in order from superior to inferior.
CA are the components within the sinus, from medial to lateral. CA ends at the
level of T from O TOM.
· See diagram.
Occulomotor nerve (III)
Trochlear nerve (IV)
Ophthalmic nerve (V1)
Maxillary nerve (V2)
Carotid artery
Abducent nerve (VI)
T: When written, connects to the T of OTOM.

Cranial bones "Fraternity Parties Occasionally
Teach Spam Etiquette":
· The first two letters of each bone:
Frontal
Parietal
Occipital
Temporal
Sphenoid
Ethmoid

Superior mediastinum contents "BATS & TENT":
Brachiocephalic veins
Arch of aorta
Thymus
Superior vena cava
Trachea
Esophagus
Nerves (vagus & phrenic)
Thoracic duct

Femoral triangle: contents NAVY:
· In order from lateral to medial:
Nerve
Artery
Vein
Y of the groin
· Alternatively: Y = Y-fronts [male underwear].

Carpal bones "The boat sailed to the moon with
3 pEas in a rOw, at the wheel was Captain Hook":
· Carpal bones in order of occurrence:
Boat is scaphoid. Moon is lunate. 3 is triquetrum. Peas is pisiform (stressing
the E sound for trapezium). Row is trapezoid (stressing the O for trapezOid).
Captain is capitate. Hook is hamate (hamate has the hook).

Internal iliac artery: anterior branches What Bill admitted
to Hilary: "I Milked Our Insatiable Intern's
Udders Under the Desk":
Inferior gluteal
Middle rectal
Obturator
Inferior vesical artery
Internal pudendal artery
Umbilical
U/D=Uterine artery (female)/ Deferential artery
(male)

Facial nerve: branches after Stylomastoid foramen "Ten
Zulus Buggered My Cat (Painfully)":
· From superior to inferior:
Temporal branch
Zygomatic branch
Buccal branch
Mandibular branch
Cervical branch
(Posterior auricular nerve)
· Alternatively: "PAssing Through Zanzibar By Motor
Car" (PA for Posterior Auricular).

Sperm pathway through male reproductive tract "STaRT
DEEP--VD!":
· Sperm duct system progression, from smallest to largest:
ST: Seminiferous Tubules
RT: Rete Testes
DE: Ductus Efferentes
EP: Epididymis
VD: Vas Deferens

Horner's syndrome components SPAM:
Sunken eyeballs/ Symphathetic plexus (cervical) affected
Ptosis
Anhydrosis
Miosis

Spermatic cord contents "Piles Don't Contribute
To A Good Sex Life":
Pampiniform plexus
Ductus deferens
Cremasteric artery
Testicular artery
Artery of the ductus deferens
Genital branch of the genitofemoral nerve
Sympathetic nerve fibers
Lymphatic vessels

Maxillary artery branches "DAM I AM Piss Drunk
But Stupid Drunk I Prefer, Must Phone
Alcoholics Anonymous":
Deep auricular
Anterior tympanic
Middle meningeal
Inferior alveolar
Accessory meningeal
Masseteric
Pterygoid
Deep temporal
Buccal
Sphenopalatine
Descending palatine
Infraorbital
Posterior superior alveolar
Middle superior alveolar
Pharyngeal
Anterior superior alveolar
Artery of the pterygoid canal

Femoral hernia: epidemiology FEMoral hernias are more
common in FEMales.

Superior orbital fissure: structures passing through "Live
Free To See Absolutely No Insult":
Lacrimal nerve
Frontal nerve
Trochlear nerve
Superior branch of oculomotor nerve
Abducent nerve
Nasociliary nerve
Inferior branch of oculomotor nerve

V3: sensory branches "Buccaneers Are Inferior
Linguists":
Buccal
Auriculotemporal
Inferior alveolar
Lingual

External carotid artery branches "So Long For
Acting Old Parenting Means Stability":
Superior thyroid
Lingual
Facial
Ascending pharyngeal
Occiptal
Posterior auricular
Maxillary
Superficial temporal

Spinal cord: length in vertebral column SCULL:
Spinal Cord Until L2 (LL).

Carotid sheath contents "I See 10 CC's in the IV":
I See (I.C.) = Internal Carotid artery
10 = CN 10 (Vagus nerve)
CC = Common Carotid artery
IV = Internal Jugular Vein

Obturator canal: relations of structures "Who's flying in
the top of Obturator canal? Obviously Not A Vein!":
Obturator
Nerve
Artery
Vein

Lacrimal nerve course "Lacrimal's story of 8 L's":
Lacrimal nerve runs on Lateral wall of orbit above Lateral
rectus, then Lets communicating branch join in, then supplies Lacrimal
gland, then Leaves it and supplies Lateral upper eye Lid!

Internal iliac artery: posterior branch PILS:
Posterior branch
Iliolumbar
Lateral sacral
Superior gluteal

Facial nerve branches "Two Zombies Buggered
My Cat":
· From superior to inferior:
Temporal branch
Zygomatic branch
Buccal branch
Mandibular branch
Cervical branch
· Alternatively: "Two Zulus Bit My Cat".
· Alternatively: "Two Zebras Bit My Coccyx".
· Alternatively: "To Zanzibar By Motor Car".
· Alternatively: "Tall Zulus Bear Many Children"
· Alternatively: "Tell Ziggy Bob Marley Called".

External carotid artery branches StApLE OPIS:
Superior thyroid
Ascending pharyngeal
Lingual
External maxillary (facial)
Occipital
Posterior auricular
Internal maxillary
Superficial temporal

Bronchi: which is more vertical "Right on Red":
Many places allow making a right hand turn at a red light, if you
first come to a complete stop.
A child swallowing a red penny is more likely to get it stopped
down the right bronchus, since it is more vertical.

Hip: lateral rotators "Play Golf Or 
Go On Quaaludes":
· From top to bottom:
Piriformis
Gemellus superior
Obturator internus
Gemellus inferior
Obturator externus
Quadratus femoris
· Alternatively: "P-GO-GO-Q".

Cartilage derivatives of 1st pharyngeal arch (mandibular) "I'M
A Super Sexy Guy" (or Girl):
Incus
Malleus
Anterior ligament of malleus
Spine of sphenoid
Sphenomandibular ligament
Genial tubercle of mandible

Axillary artery branches "Suzy Thompkins Loves
Sex, Alcohol, and Pot":
· From proximal to distal:
Superior thoracic
Thoracacromial
Lateral thoracic
Subscapular
Anterior circumflex humeral
Posterior circumflex humeral

Brachial artery: recurrent and collateral branches "I
Am Pretty Sexy"
Inferior ulnar collateral artery goes with Anterior ulnar
recurrent artery.
Posterior ulnar recurrent artery goes with Superior ulnar
collateral artery.
· Alternatively: "I Am Pretty Smart".

Cubital fossa contents "My Bottoms Turned
Red":
· From medial to lateral:
Median nerve
Brachial artery
Tendon of biceps
Radial nerve

Lumbar plexus "I, I Get Laid 
On Fridays":
Iliohypogastric [L1]
Ilioinguinal [L1]
Genitofemoral [L1, L2]
Lateral femoral cutaneous [L2, L3]
Obtruator [L2, L3, L4]
Femoral [L2, L3, L4]
· Alternatively: "I twice Get Laid On Fridays".
· Alternatively: "Interested In Getting Laid On
Fridays?"

Intrinsic muscles of hand (palmar surface) "A OF A OF A":
· Thenar, lateral to medial:
Abductor pollicis longus
Opponens pollicis
Flexor pollicis brevis
Adductor pollicis.
· Hypothenar, lateral to medial:
Opponens digiti minimi
Flexor digiti minimi
Abductor digiti minimi

Orbit: bones of medial wall "My Little Eye
Sits in the orbit":
Maxilla (frontal process)
Lacrimal
Ethmoid
Sphenoid (body)

Hip: lateral rotators "Piece Goods Often
Go On Quilts":
Piriformis
Gemellus superior
Obturator internus
Gemellus inferior
Obturator externus
Quadratus femoris

Erector spinae muscles "I Love Sex":
· From lateral to medial:
Iliocostalis
Longissimus
Spinalis
· Alternatively: "I Long for Spinach"
· "Sex" helps you think of "Erector", but "Long" and "Spinach" help you remember
the muscles' names.

Thoracoacromial artery branches "CAlifornia Police
Department":
Clavicular
Acromial
Pectoral
Deltoid

Axillary artery branches "Send The Lord
to Say A Prayer":
· From proximal to distal:
Superior thoracic
Thoracacromial
Lateral thoracic
Subscapular
Anterior circumflex humeral
Posterior circumflex humeral

Scrotum layers "Some Damn Englishman 
Called It The Testis":
· From superficial to deep:
Skin
Dartos
External spermatic fascia
Cremaster
Internal spermatic fascia
Tunica vaginalis
Testis

Internal jugular vein: tributaries "Medical Schools
Let Confident People In":
· From inferior to superior:
Middle thyroid
Superior thyroid
Lingual
Common facial
Pharyngeal
Inferior petrosal sinus

Retroperitoneal structures list SAD PUCKER:
Suprarenal glands
Aorta & IVC
Duodenum (half)
Pancreas
Ureters
Colon (ascending & descending)
Kidneys
Esophagus (anterior & left covered)
Rectum

Portal-systemic anastomoses: main 2 places that retroperitoneals
connect into systemic RetroPeritoneals hook up with Renal
and Paravertebral veins.

Facial bones "Virgil Can Not Make
My Pet Zebra Laugh!":
Vomer
Conchae
Nasal
Maxilla
Mandible
Palatine
Zygomatic
Lacrimal

Serratus anterior: innervation SALT:
Serratus Anterior = Long Thoracic.

Carpal bones "Stop Letting Those People
Touch The Cadaver's Hand":
· Proximal row, lateral-to-medial:
Scaphoid
Lunate
Triquetrum
Pisiform
· Distal row, lateral-to-medial:
Trapezium
Trapezoid
Capitate
Hamate
· Alternatively: "Stop Letting The Professor Touch
The Cadaver's Hand"

Carpum and tarsum "SCIT":
(Artum) Superior Carpum
(Artum) Inferior Tarsum

Extraocular muscles cranial nerve innervation "LR6SO4
rest 3":
Lateral Rectus is 6th
Superior Oblique is 4th
rest are all 3rd cranial nerve

Brachial plexus organization "The Castrated 
Dog Turns Rabid":
· From lateral to medial:
Terminal branches
Cords
Divisions
Trunks
Roots

Foramen ovale contents MALE:
Mandibular nerve
Accessory meningeal artery
Lesser petrosal nerve
Emissary veins
Alternatively: also include Motor root of Trigeminal and Middle
meningeal vein under 'M'.

Supine vs. prone body position "Supine is on your 
spine.
Therefore, prone's the "other" one.
· Also, prone to suffocate in prone position.

External carotid artery branches "Sister Lucy's
Powdered Face Often Attracts Silly Medicos":
· Before entering the parotid gland:
Superior thyroid
Lingual
Posterior auricular
Facial
Occipital
Ascending pharyngeal
· Ends as:
Superficial temporal and
Maxillary bifurcating in the in the parotid gland

Carpal bones "Some Lovers Try Positions
That They Can't Handle":
· Proximal row then distal row, both lateral-to-medial:
Scaphoid
Lunate
Triquetrium
Pisiform
Trapezium
Trapezoid
Capate
Hamate
· Alternatively: "Scared Lovers..."
· Alternatively: "Senior Lecturers...".

Extrinsic muscles of tongue [for pro soccer fans] "Paris
St. Germain's Hour":
Palatoglossus
Styloglossus
Genioglossus
Hyoglossus
· PSG is a French soccer team (foreign), hence extrinsic comes to mind.

Autonomics to the gut "The PARAsympathetics follow a
rule of TWO" [pair = two]:
· The vagus does the top, the sacral splanchnics the outflow tract.
"The sympathetics follow a rule of threes":
· Greater, lesser, least splanchnic nerves go to the celiac,superior and
inferior mesenteric ganglion.

External carotid artery branches "Some Angry
Lady Figured Out PMS":
Superior thyroid
Ascending pharyngeal
Lingual
Facial
Occipital
Posterior auricular
Maxillary
Superificial temporal

Descending abdominal aorta: seven divisions "Sometimes
Intestines Get Really Stretched Causing Leakage":
Suprarenals [paired]
Inferior mesenteric
Gonadal [paired]
Renals [paired]
Superior mesenteric
Celiac
Lumbar [paired]

Vagus nerve: path into thorax "I Left my Aunt
in Vegas":
Left Vagus nerve goes Anterior descending into the thorax.

Carpal bones "Happy Cat Tom Took
Pie To Little Sister":
Hamate
Capitate
Trapezoid
Trapezium
Pisiform
Triquital
Lunate
Scaphoid

Brachial plexus: branches of posterior cord STAR:
Subscapular [upper and lower]
Thoracodorsal
Axillary
Radial

Saphenous veins: path of great vs. small at malleolus "MAGdelaine
has varicose veins" [The saphenous veins are important for varicose veins]:
Medial maleolus, Anterior to maleolus, and Great saphenous
go together.
Then the opposites of these go together: Small saphenous is posterior
to the lateral maleolus.

Menisci attachments in knee "Each meniscus has something
attached to it":
The medial meniscus has the medial collateral ligament.
The lateral meniscus is attached to the popliteal muscle.

Spermatic cord contents "3 arteries, 3 nerves,
3 other things":
3 arteries: testicular, ductus deferens, cremasteric.
3 nerves: genital branch of the genitofemoral, cremasteric, autonomics.
3 other things: ductus deferens, pampiniform plexus, lymphatics.
· Note some argument about this: Moore doesn't put in cremasteric nerve, Lumley
puts in inguinal...

Interossei muscles: actions of dorsal vs. palmar in hand "PAd
and DAb":
The Palmar Adduct and the Dorsal Abduct.
· Use your hand to dab with a pad.

V3 innervated muscles (branchial arch 1 derivatives) "M.D.
My TV":
Mastication [masseter, temporalis, pterygoids]
Digastric [anterior belly]
Mylohyoid
tensor Tympani
tensor Veli palatini

CN VII innervated muscles (branchial arch 2 derivatives)
"Imagine someone making the facial expression to say 'PSS...' ":
Facial expression muscles
Posterior belly of digastric
Stapedius
Stylohyoid

Sperm pathway through male reproductive tract SEVEN UP:
Seminiferous tubules
Epididymis
Vas deferens
Ejaculatory duct
Nothing
Urethra
Penis

Thoracic cage: relations to the important venous structures
Behind the sternoclavicular joints: the brachiocephalic veins begin.
Behind the 1st costal cartilage on the right the superior vena cava
begins.
Behind the 2nd costal cartilage on the right the azygos vein ends.
Behind the 3rd costal cartilage on the right the superior vena cava ends.

Carpal bones "Scottish Lads Take Prostitutes
To The Caledonian Hotel":
· Proximal row, then distal row:
Scaphoid
Lunate
Triquetrium
Pisiform
Trapezium
Trapezoid
Capate
Hamate
· Alternatively: "Students Like Taking Prostitutes
To The Carelton Hotel".

Carpal bones "She Looks Too Pretty;
Try To Catch Her":
· Proximal row then distal row, both lateral-to-medial:
Scaphoid
Lunate
Triquetrium
Pisiform
Trapezium
Trapezoid
Capate
Hamate
· Alternatively: "She Likes To Play; Try To
Catch Her".

Adductor magnus innervation "AM SO!":
Adductor Magnus innervated by Sciatic and Obturator.

Scalp layers SCALP:
· From superficial to deep:
Skin
Connective tissue
Aponeurosis
Loose areolar tissue
Pericranium

Lumbar plexus roots "2 from 1, 2 from 2, 2
from 3":
2 nerves from 1 root: Ilioinguinal (L1), Iliohypogastric (L1).
2 nerves from 2 roots: Genitofemoral (L1,L2), Lateral Femoral
(L2,L3).
2 nerves from 3 roots: Obturator (L2,L3,L4), Femoral (L2,L3,L4).

Female pelvic organs' blood supply "3 organs, each
get 2 blood supplies":
Uterus: uterine, vaginal.
Rectum: middle rectal, inferior rectal [inferior rectal is the end of pudendal].
Bladder: superior vesical, inferior vesical.

Cervical plexus: arrangement of the important nerves "GLAST":
· 4 compass points: clockwise from north on the right side of neck:
Great auricular
Lesser occipital
Accessory nerve pops out between L and S
Supraclavicular
Transverse cervical

Liver: side with ligamentum venosum/ caudate lobe vs. side with
quadrate lobe/ ligamentum teres "VC goes with VC":
The Venosum and Caudate is on same side as Vena Cava
[posterior]. Therefore, quadrate and teres must be on anterior by default.

Joints in the midline "SC":
In medial line, below Second Cervical, joints are Secondary
Cartilaginous and usually have a diSC.
· Notes: secondary cartilaginous is also known as symphysis. The one that
doesn't have a disc is xiphi-sternal.

Anterior forearm muscles: superficial group There are five,
like five digits of your hand.
Place your thumb into your palm, then lay that hand palm down on your other arm,
as shown in diagram.
Your 4 fingers now show distribution: spells PFPF [pass/fail, pass/fail]:
Pronator teres
Flexor carpi radialis
Palmaris longus
Flexor carpi ulnaris
Your thumb below your 4 fingers shows the muscle which is deep to the other
four: Flexor digitorum superficialis.

Median and ulnar nerves: common features Each supply 1/2 of
flexor digitorum profundus.
Each supplies 2 lumbricals.
Each has a palmar cutaneous nerve that pops off prematurely.
Each supplies an eminence group of muscles [ulnar: hypothenar. median: thenar].
Each enters forearm through two heads [ulnar: heads of flexor carpi ulnaris.
median: heads of pronator teres].
Each has no branches in upper arm.
Each makes two fingers claw when cut at wrist.
Each supplies a palmaris [median: palmaris longus. ulnar: palmaris brevis].

Thyroids: relative sizes Thyroid looks like a bra (see
picture).
Breasts are bigger in women, so thyroid bigger in women.
Pregnant women have biggest breasts of all, so they have the biggest thyroids.

Superior thyroid artery branches "May I Softly
Squeeze Charlie's Girl?":
Muscular
Infrahyoid
Superior laryngeal
Sternomastoid
Cricothyroid
Glandular

Abdominal muscles "Spare TIRE around their abdomen":
Transversus abdominis
Internal abdominal oblique
Rectus abdominis
External abdominal oblique

Perineal vs. peroneal Perineal is in between
the legs.
Peroneal is on the leg.

Cranial bones "PEST OF 6":
Parietal
Ethmoid
Sphenoid
Temporal
Occipital
Frontal
· The 6 just reminds that there's 6 of them to remember.

Deep tendon reflexes: root supply "1,2,3,4,5,6,7,8":
S1-2: ankle
L3-4: knee
C5-6: biceps, supinator
C7-8: triceps

L4 landmark: 2 items "B4U" [before you]:
Bifurcation of aorta
L4
Umbilicus

Bowel components "Dow Jones Industrial
Average Closing Stock Report":
· From proximal to distal:
Duodenum
Jejunum
Ileum
Appendix
Colon
Sigmoid
Rectum
· Alternatively: to include the cecum, "Dow Jones Industrial
Climbing Average Closing Stock Report".

Lung lobes: segments of right middle lobe "ML=ML":
Segments of Middle Lobe are Medial & Lateral.

Nasal cavity components "Never Call Me
Needle Nose!":
Nares [external]
Conchae
Meatuses
Nares [internal]
Nasopharynx
· Note mnemonic sentence is nasally-related.

Plantarflexion vs. dorsiflexion Plantar flexion
occurs when you squish a Plant with your foot.

Thyroid: isthmus location "Rings 2,3,4 make the 
isthmus floor":
Isthmus overlies tracheal rings 2,3,4

Thoracic duct: which half of upper body does it drain Know
drains all of lower body, but was it the right or the left part of the upper
body?
Answer: its Lymph from the Left of the upper body.

Soleus vs. gastrocnemius muscle function "Stand on
your Soles. Explosive gas":
You stand on soles of your shoes, so Soleus is for posture.
Gasoline is explosive, so Gastrocnemius is for explosive movement.

Inversion vs. eversion muscles in leg Second letter rule for
inversion/eversion:
· Eversion muscles:
pErineus longus
pErineus brevis
pErineus terius
· Inversion muscles:
tIbialis anterior
tIbialis posterior

Liver inferior markings showing right/left lobe vs. vascular
divisions There's a Hepatic "H" on inferior of liver. One
vertical stick of the H is the dividing line for anatomical right/left lobe and
the other vertical stick is the divider for vascular halves. Stick that divides
the liver into vascular halves is the one with vena cava impression (since vena
cava carries blood, it's fortunate that it's the divider for blood halves).

Supination vs. pronation: which is more powerful Screws were
designed to be tightened well by majority of people.
"Righty tighty": to tighten screws you turn to the right.
Majority of people are right-handed.
Turning right-hand to the right is supination.

Pleura surface markings "All the even ribs, in order: 
2,4,6,8,10,12 show its route":
Rib2: sharp angle inferiorly
Rib4: the left pleura does a lateral shift to accommodate heart
Rib6: both diverge laterally
Rib8: midclavicular line
Rib10: midaxillary line
Rib12: the back

Palmaris longus: location, relative to wrist nerves "The 
Palmaris between two Palmars":
Palmaris longus is between the Palmar cutaneous branch of Ulnar
nerve and Palmar cutaneous branch of Median nerve.

Carpal tunnel syndrome causes MEDIAN TRAP:
Myxoedema
Edema premenstrually
Diabetes
Idiopathic
Agromegaly
Neoplasm
Trauma
Rheumatoid arthritis
Amyloidosis
Pregnancy
· Mnemonic fits nicely since median nerve is trapped.

Pectoral nerves: path of lateral vs. medial "Lateral
Less, Medial More":
Lateral pectoral nerve only goes through Pectoralis major, but
Medial pectoral nerve goes though both Pectoralis major and minor.

Wrist: radial side vs. ulnar side Make a fist with your
thumb up in the air and say "Rad!".
Your thumb is now pointing to your Radius.
· Note: 'Rad!' was a late 80's catchphrase, short for 'Radical'. Things that
were good were called 'Rad'.

Median nerve: recognizing it in an opened axilla The Median
nerve is the Middle of a giant capital "M" formed by the
musculocutaneous and ulnar nerves.

Carpal bone having the hook The Hamate has the Hook.

Flexor digitorum muscles: how they insert onto fingers · A
little rhyme:
Superficialis Splits in two,
To Permit Profundus Passing through.

Ulnar nerve to ulnar artery and radial nerve to radial artery
relations Think "peripheral nerves":
The ulnar nerve is "ulnar" to the ulnar artery.
Radial nerve is "radial" to the radial artery.

Dermatome C6 location Stick arm out like crucifixion
stance. Curl your thumb and forefinger into an "OK" symbol while keeping
your other fingers straight.
Your hand should now look like a 6 shape.
So C6 dermatome is your thumb and top of arm (reason for
crucifix stance).

Brachioradialis: function, innervation, one relation, one attachment
BrachioRadialis:
Function: Its the Beer Raising muscle, flexes elbow, strongest
when wrist is oriented like holding a beer.
Innervation: Breaks Rule: it's a flexor muscle, But Radial.
(Radial nerve usually is for extensors: Recall BEST rule: B was for
brachioradialis).
Important relation: Behind it is the Radial nerve in the cubital
fossa.
Attachment: Attaches to Bottom of Radius.

Diaphram aperatures: spinal levels "Come Enter
the Abdomen:
Vena Cava [8]
Esophagus [10]
Aorta [12]

Extensor expansion location in the hand The eXtensor
eXpansion is on the proXimal phalynX.

Elbow: muscles that flex it Three B's Bend the
elBow:
Brachialis
Biceps
Brachioradialis

Murphy's point organ [for Irish] "Murphy was an Irishman
(and Murphy is a classic Irish surname), and Ireland=green":
Green organ in body is gallbladder, so Murphy's point is the gall bladder.

Anteflexed vs. anteverted: what bodypart each describes "Anteflexed
and Anteverted both bend toward Anterior".
· The "V" words go together: Verted is for the cerVix (therefore
flexed must be uterus).

Foramen spinosum: location on base of skull Foramen spinosum
is adjacent to the spine of sphenoid.

Pterygoid muscles: function of lateral vs. medial "Look at
how your jaw ends up when saying first syllable of 'Lateral' or 'Medial'
":
"La": your jaw is now open, so Lateral opens mouth.
"Me": your jaw is still closed, so medial closes the
mandible.

Face muscles: large muscle groups' cranial innervation Mandibular
nerve: Mastication.
Facial nerve: Facial expression.

Meckel's diverticulum details 2 inches long.
2 feet from end of ileum.
2 times more common in men.
2% occurrence in population.
2 types of tissues may be present.
· Note: "di-" means "two", so diverticulum is the thing
with all the twos

Leino- definition "Leino" rhymes with "spleen-o":
Therefore leino- means something to do with the spleen.

Kidney hilums at transpyloric plane [L1] L-1 goes
through hilum of only 1 kidney, and it's the Left one.

Lung lobe numbers: right vs. left Tricuspid heart
valve and tri-lobed lung both on the right side.
Bicuspid and bi-lobed lung both on the left side.

Vertebrae: recognizing a thoracic from lumbar Examine
vertebral body shape:
Thoracic is heart-shaped body since your heart is in your
thorax.
Lumbar is kidney-bean shaped since kidneys are in lumbar
area.

Navicular contacts 3 of 5 cuneiform bones "Navicular
is like the Navigator logo":
There are 3 things coming off each.
· See diagram.
Therefore, cuboid has to contact 2 of the 5.

Rotator cuff muscles "The SITS muscles":
· Clockwise from top:
Supraspinatus
Infraspinatus
Teres minor
Subscapularis
· A pro baseball pitcher has injured his rotator cuff muscles. As a result, he
SITS out for the rest of the game, and then gets sent to the minor
leagues.

Median nerve: hand muscles innervated "The LOAF
muscles":
Lumbricals 1 and 2
Opponens pollicis
Abductor pollicis brevis
Flexor pollicis brevis
· Alternatively: LLOAF, with 2 L's, to recall there's 2 lumbricals.
· To remember that these are the Median nerve muscles, think "Meat
LOAF".

Trigeminal nerve: where branches exit skull "Standing
Room Only":
Superior orbital fissure is V1
foramen Rotundum is V2
foramen Ovale is V3

Tonsils: The three types "PPL (people) have tonsils":
Pharyngeal
Palatine
Lingual

Cubital fossa contents "N-MAN":
· From lateral to medial:
Nerve
Muscle
Artery
Nerve
· Specifics are radial Nerve, biceps Muscle tendon, brachial Artery, median
Nerve.

Spleen: dimensions, weight, surface anatomy "1,3,5,7,9,11":
Spleen dimensions are 1 inch x 3 inches x 5 inches.
Weight is 7 ounces.
It underlies ribs 9 through 11.

Ureter to ovarian/testicular artery relation "Water under
the bridge":
The ureters (which carry water), are posterior to the
ovarian/testicular artery.
· Clinically important, since a common surgical error is to cut ureter instead
of ovarian artery when removing uterus.

Oblique muscles: direction of externals vs. internals "Hands
in your pockets":
When put hands in your pockets, fingers now lie on top of external obliques and
fingers point their direction of fibers: down and towards midline.
· Note: "oblique" tells that must be going at an angle.
· Internal obliques are at right angles to external.

Duodenum: lengths of parts "Counting 1 to 4 but
staggered":
1st part: 2 inches
2nd part: 3 inches
3rd part: 4 inches
4th part: 1 inch

Hip posterior dislocation: most likely arrangement for one
"Hitting the brake pedal before the accident":
You are sitting, so hip is flexed, and adducted and medially
rotated so can move your foot away from the gas pedal over to the brake
pedal.
· Note: car accidents are most likely cause of posterior dislocation because in
this position.

Buttock quadrant safest for needle insertion "Shut up
and butt out":
The Upper Outer quadrant of the Buttock safely avoids
hitting sciatic nerve.

Radial nerve: muscles supplied (simplified) "BEST
muscles":
Brachioradialis
Extensors
Supinator
Triceps

Rib costal groove: order of intercostal blood vessels and nerve
VAN:
· From superior to inferior:
Vein
Artery
Nerve

Brachial plexus subunits "Randy Travis Drinks
Cold Beer":
Roots
Trunks
Divisions
Cords
Branches
· Alternatively: "Read The Damn Cadaver Book!"
· Alternatively: "Real Texans Drink Coors Beer".

Diaphragm innervation "3, 4, 5 keeps the diaphragm
alive":
Diaphragm innervation is cervical roots 3, 4, and 5.

Serratus anterior: innervation and action "C5-6-7 
raise your wings up to heaven":
C567 injury causes inability to raise arm past 90 degrees up to 
heaven, and results in a winging of the scapula.
· Long thoracic nerve roots (567) innervate Serratus anterior.

Thoracic duct: relation to azygous vein and esophagus "The
duck between 2 gooses":
Thoracic duct (duck) is between 2 gooses, azygous and esophagus.

Bicipital groove: attachments of muscles near it "The 
lady between two majors":
Teres major attaches to medial lip of groove.
Pectoralis major to lateral lip of groove.
Latissimus (Lady) is on floor of groove, between the 2 majors.

Aortic arch: major branch order "Know your ABC'S":
Aortic arch gives rise to:
Brachiocephalic trunk
left Common Carotid
left Subclavian
· Beware though trick question of 'What is first branch of aorta?' Technically,
it's the coronary arteries.

Supine vs. prone body position Know SUPination is
your hand while carrying a bowl of SOUP. Your face follows where your
palm is facing [i.e. up]. Put a handpuppet on your hand while hand is in
supination and the puppet will be the supine position.

Carpal bones: trapezium vs. trapezoid location · Since
there's two T's in carpal bone mnemonic sentences, need to know which T is
where:
TrapeziUM is by the thUMB, TrapeziOID is inSIDE.
· Alternatively, TrapeziUM is by the thUMB, TrapezOID is by
its SIDE.

Lumbricals action Lumbrical action is to hold a pea, that is
to flex the metacarpophalangeal joint and extend the interphalangeal joints.
When look at hand in this position, can see this makes an "L" shape, since L
is for Lumbrical.

Elbow: which side has common flexor origin FM (as in
FM Radio):
Flexor Medial, so Common Flexor Origin is on the medial side.

Medial malleolus: order of tendons, artery, nerve behind it
"Tom, Dick, And Nervous Harry":
· From anterior to posterior:
Tibialis
Digitorum
Artery
Nerve
Hallicus
· Full names for these are: Tibialis Posterior, Flexor Digitorum Longus,
Posterior Tibial Artery, Posterior Tibial Nerve, Flexor Hallicus Longus.
· Alternatively: "Tom, Dick ANd Harry".
· Alternatively: "Tom, Dick And Not Harry".

Tibia vs. fibula: which is lateral The FibuLA is 
LAteral.

Popliteal fossa: muscles arrangement The two Semi's go
together, Semimembranosus and Semitendonosus.
The Membranosus is Medial and since the two semis go together,
Semitendonosus is also medial.
Therefore, Biceps Femoris has to be lateral.
Of the semi's, to remember which one is superficial: the Tendonosus is on
Top.

Femoral triangle: arrangement of contents NAVEL:
· From lateral hip towards medial navel:
Nerve (directly behind sheath)
Artery (within sheath)
Vein (within sheath)
Empty space (between vein and lymph)
Lymphatics (with deep inguinal node)
· Nerve/Artery/Vein are all called Femoral.

Femoral triangle: arrangement of nerve, artery, vein VAN:
· From medial to lateral:
Vein
Artery
Nerve
· Nerve/Artery/Vein are all called Femoral.

Bronchi: which one is more vertical "Inhale a bite,
goes down the right":
Inhaled objects more likely to lodge in right bronchus, since it is the one that
is more vertical.

Rise in day surgery has been good for patients and saved money

The rising proportion of operations carried out as day cases over the past few decades has been good for patients and a much more efficient use of NHS resources, says John Appleby, Chief Economist at the King's Fund, in a databriefing for The BMJ this week.

The article is based on a recent report by the King's Fund: Better Value in the NHS

He explains that, in 1990, a review by the Audit Commission suggested that if all health authorities in England and Wales performed day surgery for 20 common procedures, such as cataract surgery and gallbladder removal, "an additional 186,000 patients could be treated each year without increased expenditure."

Following the review, the Department of Health set up a task force on day surgery along with £15m (€21m; $23m) of capital funds to expand the number of dedicated day surgery units. By 2001, almost all trusts had at least one unit.

A 2001 follow-up review pushed for further progress: "If all trusts could achieve the levels of the best performers (the upper quartile of the distribution of the percentage of day cases), 120,000 existing inpatients in England and Wales could be treated as day cases to the benefit of all concerned."

Appleby shows that in 1974, around 7% (417,000) of all elective and non-elective procedures in England were carried out as day cases each year. This proportion increased to nearly 35% (6.3 million) by 2013.

As day case patients cost less to treat than patients who stay overnight as inpatients (in 2013-14, the average day case cost was £698 and the average elective inpatient case £3,375), the increasing proportion of day case activity has helped reduce overall costs, he writes.

But imagine if the switch to day cases had not changed, says Appleby.

Based on national reference costs reported by English hospitals, the total cost of treating the 6.96 million elective day and inpatients in 2013 was around £8.9bn. To treat this number of patients, but with the proportion of day cases as observed in 1998 would cost nearly £11bn (over 22% more).

By treating more patients as day cases, Appleby estimates that the NHS had in effect saved around £2bn by 2013, although he stresses this is likely to be an overestimate as it is based on the average costs of day cases and elective inpatients.

Even though day cases now account for nearly 80% of all elective procedures each year, it is likely that there is still scope for further increases, he adds.

"Assuming the proportion of day cases continues to increase at the same rate for the next decade as it has done in the 15 years since 1998, then, all other things being equal, the total spent on elective care in 2013 would pay for 22% more patient episodes in 2023," he concludes.

Link to article.

Could a sugar tax help combat obesity?

Following the BMA's call for a 20% sugar tax to subsidise the cost of fruit and vegetables, experts in TheBMJ this week debate whether a sugar tax could help combat obesity.

Sirpa Sarlio-Lahteenkorva, adviser at the Ministry of Social Affairs and Health in Finland, says that a specific tax on sugar would reduce consumption. "Increasing evidence suggests that taxes on soft drinks, sugar, and snacks can change diets and improve health, especially in lower socioeconomic groups," she writes.

Taxes on specific food categories that are common constituents of poor diets "are practicable because they are simple to administer," she adds.

However, she acknowledges that taxes can only be a partial solution, and suggests that a sugar tax on all products may be more acceptable "because it would treat all sources equally. It could also stimulate reformulated products, with less sugar and hence liable for less tax."

In Finland, the Sugar Tax Working Group recently concluded that the current system of using excise duty is most practicable. "A combination of excise duty for key sources of sugar with tax adjusted based on sugar content would optimally promote health - and product reformulation."

Nevertheless, Professor Sarlio-Lahteenkorva points out that taxes for health face many challenges, as recently seen with Denmark's short experiment with a tax on saturated fat, which seems to have reduced consumption of fats by 10-15% but worries about border trade and lobbing by industry led to its withdrawal. The food industry also argues that consumption taxes are ineffective, unfair, and damage the industry.

"We need fiscal policies that take health seriously," she writes. "Governments must tackle the related adverse health effects, such as diabetes, coronary heart disease, and hypertension. A tax on sugar, preferably with measures that target also saturated fat and salt, and incentives for healthy eating, would help," she concludes.

But Jack Winkler, emeritus professor of nutrition policy at London Metropolitan University, argues that such taxes would be a positive development in principle, but are politically unpalatable and would have to be enormous to have any effect.

He points out that referendums in the United States have led to soft drinks taxes in just one city (Berkeley), while only four of 53 states in WHO-Europe have adopted food taxes, all with the stated aim of raising revenue, not improving health.

Food taxes are also economically ineffective, he adds. Two rigorous UK studies found that a 10% tax would reduce average personal daily intake by 7.5 mL (less than a sip), while a 20% tax would reduce consumption by 4 kcal. "Effects of this size will not reverse global obesity," he argues.

He suggests that cutting product margins on sugar-free soft drinks would be a positive alternative, which would make the healthy choice the cheaper choice - and would would boost companies' profit.

He points out that before and after the recent UK election, government spokespeople stated repeatedly that there will be no new food taxes and immediately rejected the BMA's proposal.

Why are we still debating this idea, he asks? "Nutrition policy needs price instruments, but a more positive selection. Sugar taxes are unlikely to be adopted and would not make much difference anyway," he concludes.

Link to article

Trans fats, but not saturated fats, linked to greater risk of death and heart disease

Higher trans fat intake associated with 20-30% increased risk, say researchers

Saturated fats are not associated with an increased risk of death, heart disease, stroke, or type 2 diabetes, finds a study published in The BMJ this week. However, the findings show that trans fats are associated with greater risk of death and coronary heart disease.

The study confirms previous suggestions that industrially produced trans fats might increase the risk of coronary heart disease and calls for a careful review of dietary guidelines for these nutrients.

Guidelines currently recommend that saturated fats are limited to less than 10%, and trans fats to less than 1% of energy to reduce risk of heart disease and stroke.

Saturated fats come mainly from animal products, such as butter, cows' milk, meat, salmon and egg yolks, and some plant products such as chocolate and palm oils. Trans unsaturated fats (trans fats) are mainly produced industrially from plant oils (a process known as hydrogenation) for use in margarine, snack foods and packaged baked goods.

Contrary to prevailing dietary advice, a recent evidence review found no excess cardiovascular risk associated with intake of saturated fat. In contrast, research suggests that industrial trans fats may increase the risk of coronary heart disease.

To help clarify these controversies, researchers in Canada analysed the results of observational studies assessing the association between saturated and/or trans fats and health outcomes in adults.

Study design and quality were taken into account to minimise bias, and the certainty of associations were assessed using a recognised scoring method.

The team found no clear association between higher intake of saturated fats and all cause mortality, coronary heart disease (CHD), cardiovascular disease (CVD), ischemic stroke or type 2 diabetes, but could not, with confidence, rule out increased risk for CHD death. They did not find evidence that diets higher in saturated fat reduce cardiovascular risk.

However, consumption of industrial trans fats was associated with a 34% increase in all cause mortality, a 28% increased risk of CHD mortality, and a 21% increase in the risk of CHD.

Inconsistencies in the included studies meant that the researchers could not confirm an association between trans fats and type 2 diabetes. And they found no clear association between trans fats and ischemic stroke.

The researchers point out that the certainty of associations between saturated fat and all outcomes was "very low," which means that further research is very likely to have an important impact on our understanding of the association of saturated fats with disease. The certainty of associations of trans fat with CHD outcomes was "moderate" and "very low" to "low" for other associations.

They also stress that their results are based on observational studies, so no definitive conclusions can be drawn about cause and effect. However, they say their analysis "confirms the findings of five previous systematic reviews of saturated and trans fats and CHD."

And they conclude that dietary guidelines for saturated and trans fatty acids "must carefully consider the effect of replacement nutrients."

Link to article

Regular consumption of spicy foods linked to lower risk of death

Data suggests most benefit from eating spices regularly throughout the week

Eating spicy food more frequently as part of a daily diet is associated with a lower risk of death, suggests a new study published in The BMJ this week. The association was also found for deaths from certain conditions such as cancer, and ischaemic heart and respiratory diseases.

This is an observational study so no definitive conclusions can be drawn about cause and effect, but the authors call for more research that may "lead to updated dietary recommendations and development of functional foods."

Previous research has suggested that beneficial effects of spices and their bioactive ingredient, capsaicin, include anti-obesity, antioxidant, anti-inflammation and anticancer properties.

So an international team led by researchers at the Chinese Academy of Medical Sciences examined the association between consumption of spicy foods as part of a daily diet and the total risk and causes of death.

They undertook a prospective study of 487,375 participants, aged 30-79 years, from the China Kadoorie Biobank. Participants were enrolled between 2004-2008 and followed up for morbidities and mortality.

All participants completed a questionnaire about their general health, physical measurements, and consumption of spicy foods, and red meat, vegetable and alcohol.

Participants with a history of cancer, heart disease, and stroke were excluded from the study, and factors such as age, marital status, level of education, and physical activity were accounted for.

During a median follow-up of 7.2 years, there were 20,224 deaths.

Compared with participants who ate spicy foods less than once a week, those who consumed spicy foods 1 or 2 days a week were at a 10% reduced risk of death (hazard ratios for death was 0.90). And those who ate spicy foods 3 to 5 and 6 or 7 days a week were at a 14% reduced risk of death (hazard ratios for death 0.86, and 0.86 respectively).*

In other words, participants who ate spicy foods almost every day had a relative 14% lower risk of death compared to those who consumed spicy foods less than once a week.

The association was similar in both men and women, and was stronger in those who did not consume alcohol.

Frequent consumption of spicy foods was also linked to a lower risk of death from cancer, and ischaemic heart and respiratory system diseases, and this was more evident in women than men.

Fresh and dried chilli peppers were the most commonly used spices in those who reported eating spicy foods weekly, and further analysis showed those who consumed fresh chilli tended to have a lower risk of death from cancer, ischaemic heart disease, and diabetes.

Some of the bioactive ingredients are likely to drive this association, the authors explain, adding that fresh chilli is richer in capsaicin, vitamin C, and other nutrients. But they caution against linking any of these with lowering the risk of death.

Should people eat spicy food to improve health? In an accompanying editorial, Nita Forouhi from the University of Cambridge says it is too early to tell, and calls for more research to test whether these associations are the direct result of spicy food intake or whether this is a marker for other dietary or lifestyle factors.

* A hazard ratio is a measure of how often a particular event happens in one group compared to how often it happens in another group, over time.

Link to article

Sitting May Be Linked To Increased Blood Sugar, Cholesterol Levels

AFP-Relaxnews (8/1) reported that “being healthier may be found in something as simple as standing more and sitting less at work, said astudy” published in the European Heart Journal.

        HealthDay (8/1, Reinberg) reported that investigators “found that an extra two hours per day spent standing rather than sitting was associated with approximately 2 percent lower blood sugar levels and 11 percent lower average triglycerides.” The study also indicated that “more standing time was also associated with an increase in HDL...cholesterol and a drop in LDL...cholesterol.”

        MedPage Today (8/1, Brown) reported that “the associations of sitting with fasting glucose and lipids were independent of moderate to vigorous physical activity, according to the” investigators.7