The Tamil Nadu Dr. M.G.R. Medical University · First Professional MBBS (CBME)
Built from the recurring structure of TNMGRMU Paper I papers. Ranked by how often each topic has actually carried marks — read top-down, stop when you run out of night.
Every TNMGRMU Paper I in the verified set follows the same three-part shape. Knowing the shape is worth marks on its own — it tells you exactly how much to write and when to stop.
2 × 15. Both compulsory. Roughly 25 minutes each. Always answered under the sub-headings given in the stem — the examiner marks against those headings.
10 × 5. All compulsory. 8–9 minutes each. Five clean points plus a labelled diagram is a full-mark answer. This section decides your class.
20 × 1. Single-best-answer, heavily applied/clinical. Budget 15 minutes, no negative marking historically — leave nothing blank.
Thorax, Head & Neck and Neuroanatomy sit in Paper II. Do not burn tonight on the brachial plexus and the cranial nerves — only the first one is on tomorrow's paper.
In all five verified papers the two essays split the same way: one essay is an abdominal or pelvic viscus (uterus, pancreas, duodenum, urinary bladder, mammary gland) and one is a limb structure — a nerve, a plexus, a region, or a joint. If you have prepared four viscera cold and four limb nerves cold, you have almost certainly covered both essays.
Ranked by observed and structural likelihood. Bars show appearances across the five verified papers; a topic can rank high on structure even with an empty bar, because the examiner rotates within a fixed set. Every one of these should be answerable under six headings: situation & parts · relations · blood supply · lymphatic drainage & nerve supply · histology · development & clinical anatomy.
Describe the uterus — position and parts, peritoneal and visceral relations, supports, blood supply and lymphatic drainage, microstructure, development, clinical anatomy.
Supports are the mark-winner: primary active (pelvic diaphragm, perineal body, urogenital diaphragm) and primary passive (transverse cervical/Mackenrodt, uterosacral, pubocervical ligaments; uterine axis of anteversion–anteflexion). Blood supply: uterine artery from anterior division of internal iliac, crosses the ureter at the level of the internal os — "water under the bridge." Lymph: fundus → para-aortic, body → external iliac, cervix → internal + external iliac and sacral. Development: fused paramesonephric (Müllerian) ducts; anomalies — bicornuate, unicornuate, didelphys.
Draw: coronal section showing endometrium/myometrium/perimetrium + ligament diagram in the sagittal plane.
Describe the stomach under: external features and parts, relations, blood supply, lymphatic drainage, nerve supply, histology, development and clinical anatomy.
Beds of the stomach (diaphragm, left crus, spleen, left suprarenal, left kidney, pancreas, transverse mesocolon, splenic artery) is a standing favourite. Arteries: left gastric (coeliac), right gastric (hepatic), right and left gastro-epiploic, short gastric. Nerve: anterior vagal trunk → hepatic + anterior gastric (nerve of Latarjet); posterior → coeliac. Clinical: peptic ulcer and referred pain, gastric carcinoma spread, Virchow's node, Troisier's sign.
Draw: arterial arcades along both curvatures; four lymphatic zones.
Describe the pancreas — parts and relations, ducts, blood supply, histology, development and clinical anatomy.
Relations of the head (C-shaped duodenal concavity, bile duct groove) and of the body (stomach bed anteriorly; aorta, left kidney, splenic vein posteriorly). Development is the differentiator: ventral bud rotates behind the duodenum to fuse with dorsal bud → uncinate process and head from ventral; rest from dorsal. Main duct = distal dorsal + entire ventral. Anomalies: annular pancreas (bifid ventral bud → duodenal obstruction), pancreas divisum, ectopic pancreatic tissue. Clinical: carcinoma head → obstructive jaundice, Courvoisier's law; acute pancreatitis.
Draw: the rotation sequence of ventral/dorsal buds — three small panels.
Describe the liver — surfaces, lobes and peritoneal attachments, blood supply, portal vein, segmental anatomy, histology, development, clinical anatomy.
Porta hepatis contents front-to-back: right and left hepatic ducts, hepatic artery branches, portal vein. Portal vein = splenic + superior mesenteric behind the neck of pancreas; tributaries and the sites of portosystemic anastomosis. Histology: classic lobule with central vein and portal triads, sinusoids lined by endothelium and Kupffer cells, space of Disse; contrast portal lobule and the acinus of Rappaport. Clinical: portal hypertension → oesophageal varices, caput medusae, haemorrhoids; Couinaud segments for resection.
Draw: hexagonal classic lobule with the three interpretations superimposed.
Describe the duodenum — parts, relations, internal features of the second part, blood supply, histology, clinical anatomy.
Second part: major duodenal papilla with hepatopancreatic ampulla and sphincter of Oddi, minor papilla 2 cm above for the accessory duct; plicae circulares begin here. Blood supply straddles the foregut–midgut junction: superior pancreaticoduodenal (gastroduodenal) above, inferior pancreaticoduodenal (SMA) below the papilla. Histology: Brunner's glands in the submucosa are the identifying feature. Clinical: duodenal ulcer posterior wall of first part eroding the gastroduodenal artery; duodenal atresia and the double-bubble sign.
Draw: interior of the second part showing both papillae.
Describe the urinary bladder — external features, supports and relations, interior, blood supply and lymphatic drainage, nerve supply, clinical anatomy.
Trigone — smooth mucosa firmly adherent, mesodermal origin from absorbed mesonephric ducts, bounded by the two ureteric orifices and the internal urethral orifice, interureteric ridge. Nerve supply is the classic sub-question: parasympathetic S2–S4 (nervi erigentes) motor to detrusor and inhibitory to sphincter vesicae; sympathetic T11–L2. Clinical: suprapubic cystostomy above the pubic symphysis without entering peritoneum when full; automatic vs autonomous bladder.
Draw: interior of bladder, trigone labelled, in the male sagittal section.
Describe the kidney — situation, coverings, relations, hilum, blood supply, internal structure, development and clinical anatomy.
Coverings in order outward: fibrous capsule, perirenal fat, renal fascia (of Gerota), pararenal fat. Hilum front-to-back: renal vein, renal artery, ureter/pelvis. Development: pronephros → mesonephros → metanephros; ureteric bud gives collecting system, metanephric blastema gives nephron; ascent from sacral to lumbar with change in blood supply. Anomalies: horseshoe kidney arrested by the inferior mesenteric artery, pelvic kidney, polycystic kidney. Clinical: renal angle tenderness, calculus impaction at the three constrictions.
Draw: transverse section at L1 showing the fascial coverings.
Describe the mammary gland — extent, structure, relations, blood supply, lymphatic drainage, development and clinical anatomy.
Lymphatic drainage is the whole question: ~75% to axillary (anterior/pectoral, then central and apical), medial quadrants to internal mammary/parasternal, some to the opposite breast and to the abdominal (subdiaphragmatic) lymphatics. Structure: 15–20 lobes, lactiferous ducts and sinuses, suspensory ligaments of Cooper. Clinical: peau d'orange from Cooper's ligament tethering, nipple retraction, carcinoma spread routes, supernumerary nipples along the milk line.
Draw: sagittal section of breast + lymphatic drainage quadrant map.
Describe the rectum and anal canal — extent, relations, interior, blood supply, lymphatic drainage, nerve supply, development, clinical anatomy.
Pectinate line is the axis of the answer: above — endodermal hindgut, columnar epithelium, superior rectal vessels, internal iliac lymph nodes, autonomic supply, internal haemorrhoids painless; below — ectodermal proctodeum, stratified squamous, inferior rectal vessels, superficial inguinal nodes, somatic supply (inferior rectal nerve), painful. Sphincters: internal (involuntary, smooth) and external (voluntary, three parts) plus puborectalis and the anorectal ring.
Draw: coronal section of anal canal, pectinate line labelled with the differences either side.
Describe the spleen / caecum and appendix / testis and its descent (any one may substitute).
Spleen: 1-3-5-7-9-11 rule, related to ribs 9–11, notched anterior border, splenic artery tortuous course along the pancreas, splenorenal and gastrosplenic ligaments, white and red pulp. Appendix: positions (retrocaecal commonest), McBurney's point, appendicular artery in the meso-appendix is an end artery, base at the convergence of taeniae. Testis: descent through the inguinal canal, gubernaculum, processus vaginalis, coverings correlated with abdominal wall layers, cryptorchidism and congenital hernia/hydrocele.
Draw: visceral surface of spleen with impressions, or the coverings of the spermatic cord as concentric rings.
Standard headings for a nerve: origin and root value · course and relations · branches and distribution · applied anatomy of injury at each level. For a region: boundaries · contents · applied anatomy. For a joint: type · articular surfaces · ligaments · relations · movements with muscles · blood and nerve supply · applied anatomy.
Describe the formation of the brachial plexus. Add notes on its branches and the effects of injury at different levels.
Roots C5–T1 → trunks (upper C5+6, middle C7, lower C8+T1) → divisions behind the clavicle → cords named around the axillary artery → terminal branches. Supraclavicular branches: dorsal scapular, long thoracic, nerve to subclavius, suprascapular. Infraclavicular: from lateral cord — lateral pectoral, musculocutaneous, lateral root of median; medial cord — medial pectoral, medial cutaneous nerves of arm and forearm, ulnar, medial root of median; posterior cord — upper and lower subscapular, thoracodorsal, axillary, radial. Injuries: Erb–Duchenne (C5,6 — policeman's tip), Klumpke (C8,T1 — claw hand with Horner's syndrome), winging (long thoracic).
Draw: the full plexus diagram — practise it twice tonight until it takes under three minutes.
Discuss the origin, root value, course and relations, termination, branches and distribution, and clinical anatomy of the median nerve / ulnar nerve.
Median (C6–T1): two roots, no branch in the arm, enters cubital fossa medial to brachial artery, passes between the two heads of pronator teres, anterior interosseous branch, enters the hand under the flexor retinaculum. Supplies all flexors of the forearm except flexor carpi ulnaris and the medial half of flexor digitorum profundus, plus the thenar muscles and lateral two lumbricals. Injury at the wrist → ape-thumb / pointing index; carpal tunnel syndrome. Ulnar (C8,T1): pierces the medial intermuscular septum, behind the medial epicondyle, between the two heads of flexor carpi ulnaris, enters the hand superficial to the retinaculum in Guyon's canal. Injury → claw hand, worse with a distal lesion (ulnar paradox), positive Froment's sign, card test.
Draw: course of the nerve from axilla to hand with segmental supply marked.
Describe the boundaries and contents of the axilla. Write the origin, course, relations, branches and termination of the axillary artery in detail.
Axilla is a truncated pyramid — apex (cervico-axillary canal), base, anterior wall (pectoralis major/minor, subclavius, clavipectoral fascia), posterior wall (subscapularis, teres major, latissimus dorsi), medial wall (ribs 1–4 with serratus anterior), lateral wall (bicipital groove). Axillary artery: continuation of subclavian at the outer border of the first rib, becomes brachial at the lower border of teres major, divided into three parts by pectoralis minor — one branch from the first part (superior thoracic), two from the second (thoraco-acromial, lateral thoracic), three from the third (subscapular, anterior and posterior circumflex humeral). Contents: cords and branches of the plexus, axillary vein, axillary lymph nodes in five groups.
Draw: axillary artery with the three parts and branches; the five node groups.
Explain the formation of the lumbar and sacral plexus. Add a detailed note on the sciatic nerve.
Lumbar plexus (L1–L4, in psoas major): iliohypogastric, ilioinguinal, genitofemoral, lateral cutaneous nerve of thigh, femoral, obturator. Sacral plexus (L4–S4, on piriformis): superior and inferior gluteal, sciatic, posterior cutaneous nerve of thigh, pudendal. Sciatic (L4–S3): thickest nerve in the body, leaves through the greater sciatic foramen below piriformis, midway between the ischial tuberosity and greater trochanter, supplies the hamstrings and adductor magnus (hamstring part), divides at the upper angle of the popliteal fossa. Applied: safe upper-outer quadrant for gluteal injection; sciatica; the tibial vs common peroneal division deficits.
Draw: the plexus grid plus the sciatic nerve's surface marking.
Describe the femoral triangle — boundaries, floor, roof, contents; add the femoral sheath, femoral canal and femoral hernia.
Boundaries: inguinal ligament above, medial border of sartorius laterally, medial border of adductor longus medially. Floor: iliacus, psoas major, pectineus, adductor longus. Contents lateral to medial (NAVEL): femoral nerve, artery, vein, empty space, lymphatics — the nerve lies outside the femoral sheath. Femoral canal: medial compartment of the sheath, contains the node of Cloquet; femoral ring boundaries — inguinal ligament, lacunar ligament, pectineal ligament, femoral vein. Applied: femoral hernia commoner in females, passes below and lateral to the pubic tubercle, high risk of strangulation at the narrow ring.
Draw: triangle with contents and the femoral sheath's three compartments.
Describe the knee joint — type, articular surfaces, capsule and ligaments, menisci, relations, movements with muscles, locking and unlocking, blood and nerve supply, applied anatomy.
Ligaments: extracapsular (patellar, tibial and fibular collateral, oblique and arcuate popliteal) and intracapsular (anterior and posterior cruciate, menisci, transverse). ACL prevents anterior displacement of the tibia — taut in extension; PCL taut in flexion. Locking = medial rotation of the femur on the fixed tibia in the last 30°; unlocking by popliteus. Nerve supply follows Hilton's law — femoral, sciatic and obturator branches. Applied: unhappy triad (ACL + medial meniscus + tibial collateral ligament), drawer sign, housemaid's knee, genu valgum/varum. Add the anastomosis around the knee, which has itself been asked as a short note.
Draw: opened knee from above showing menisci and cruciates.
Describe in detail the arches of the foot and their clinical importance.
Medial longitudinal: calcaneus, talus, navicular, three cuneiforms, medial three metatarsals — keystone is the head of the talus; higher and more resilient. Lateral longitudinal: calcaneus, cuboid, lateral two metatarsals — keystone cuboid. Transverse: cuneiforms and cuboid, bases of metatarsals. Factors maintaining: bone shape; ligaments — plantar aponeurosis, spring (plantar calcaneonavicular), long and short plantar; muscles — tibialis anterior and posterior, peroneus longus, flexor hallucis longus, intrinsic muscles. Applied: pes planus (flat foot) from spring ligament laxity, pes cavus, the foot as a shock absorber and lever in gait.
Draw: both longitudinal arches in side view with keystones marked.
Describe the shoulder joint / hip joint — type, articular surfaces, ligaments, relations, movements, stability, blood and nerve supply, applied anatomy.
Shoulder: mobility bought at the cost of stability — shallow glenoid deepened by the labrum, lax capsule, weakest inferiorly where there is no rotator cuff, hence subglenoid dislocation with risk to the axillary nerve; supraspinatus tendinitis and the painful arc. Hip: stability by design — deep acetabulum, labrum, transverse ligament, iliofemoral (Y ligament of Bigelow, the strongest in the body) limiting extension; blood supply by retinacular vessels from the circumflex femorals plus the artery of the ligamentum teres, hence avascular necrosis after intracapsular neck fracture.
Draw: coronal section of the joint with capsule and blood supply arrows.
This is where the paper is won. Ten notes, five marks each, no choice. The list below is ordered by likelihood within each region; ★ marks a topic that has already appeared in the verified papers. Aim to be able to produce five crisp points and one labelled diagram for everything down to the ★-free entries.
| Topic | Hit | The five points that get the marks |
|---|---|---|
| Cubital fossa | ★ | Boundaries; contents medial→lateral — Median nerve, Brachial artery, Biceps Tendon (MBT), radial nerve under brachioradialis; roof with median cubital vein; venepuncture and brachial pulse. |
| Clavipectoral fascia | ★ | Extent from clavicle to axillary fascia, splits to enclose subclavius and pectoralis minor; pierced by lateral pectoral nerve, thoraco-acromial artery, cephalic vein, lymphatics; costocoracoid membrane. |
| Rotator cuff | ★ | Supraspinatus, infraspinatus, teres minor, subscapularis (SITS); insertions on the tubercles; role in stabilising the head; absent inferiorly; supraspinatus tendinitis, painful arc 60–120°. |
| Erb's point / Erb's palsy | ★ | Union of C5 and C6 to form the upper trunk; six nerves meet; cause — undue separation of head and shoulder; muscles paralysed; policeman's tip / porter's tip deformity. |
| Fascial spaces of the hand | ★ | Thenar and midpalmar spaces separated by the intermediate palmar septum; pulp space; boundaries; route of infection spread and drainage incisions. |
| Axillary nerve | ★ | C5,6 from posterior cord; passes through the quadrangular space with the posterior circumflex humeral artery; supplies deltoid and teres minor; upper lateral cutaneous nerve of arm; injured in surgical neck fracture and shoulder dislocation — regimental badge anaesthesia. |
| Profunda brachii artery | ★ | Largest branch of brachial; accompanies the radial nerve in the spiral groove; anastomoses around the elbow. |
| Intrinsic muscles of the hand | ★ | Thenar, hypothenar, lumbricals, interossei; PAD/DAB; nerve supply — median for thenar and lateral two lumbricals, ulnar for the rest; test movements. |
| Elbow joint | ★ | Type, articular surfaces, collateral ligaments, carrying angle, relations, anastomosis, applied — pulled elbow, supracondylar fracture and Volkmann's ischaemic contracture. |
| First carpometacarpal joint | ★ | Saddle joint between trapezium and first metacarpal; movements including opposition; the basis of the human grip. |
| Anatomical snuffbox | — | Boundaries; floor — scaphoid and trapezium; contents — radial artery, cephalic vein origin, superficial branch of radial nerve; tenderness in scaphoid fracture and avascular necrosis. |
| Flexor retinaculum / carpal tunnel | — | Attachments to the four carpal bones; contents — nine tendons and the median nerve; structures passing superficial to it; carpal tunnel syndrome. |
| Radial nerve in the spiral groove | — | Course, relations, branches; midshaft humeral fracture → wrist drop; sensory loss on the dorsum of the first web. |
| Quadrangular & triangular spaces | — | Boundaries and contents; axillary nerve and circumflex humeral vessels; circumflex scapular artery. |
| Dorsal venous arch / cephalic & basilic veins | — | Formation, course, termination, deltopectoral groove, clinical use for cannulation. |
| Extensor retinaculum & compartments | — | Six compartments and their tendons; de Quervain's tenosynovitis. |
| Topic | Hit | The five points that get the marks |
|---|---|---|
| Femoral triangle | ★★ | See essay 5 above — boundaries, floor, NAVEL contents, femoral sheath, femoral hernia. |
| Great saphenous vein | ★ | Begins at the medial end of the dorsal venous arch; in front of the medial malleolus; behind the medial border of the patella; through the saphenous opening 3.5 cm below and lateral to the pubic tubercle; accompanied by the saphenous nerve; perforators, varicose veins, venous cut-down. |
| Trendelenburg sign | ★★ | Gluteus medius and minimus supplied by the superior gluteal nerve; abductors normally tilt the pelvis up on the unsupported side; paralysis, dislocated hip or neck fracture → pelvis drops on the opposite (unsupported) side; lurching gait. |
| Structures under cover of gluteus maximus | ★ | Gluteus medius, piriformis, superior and inferior gluteal vessels and nerves, sciatic and posterior cutaneous nerves, obturator internus with gemelli, quadratus femoris, ischial tuberosity and bursae. |
| Ligaments of the knee joint | ★★ | Intracapsular — ACL, PCL, menisci, transverse; extracapsular — patellar, collaterals, oblique and arcuate popliteal; attachments and testing. |
| Common peroneal (fibular) nerve | ★ | L4–S2 from sciatic; winds round the neck of the fibula, most commonly injured nerve of the lower limb; divides into superficial and deep; injury → foot drop and high-stepping gait, sensory loss on the dorsum of foot. |
| Obturator nerve | ★ | L2,3,4 anterior divisions; through the obturator canal; anterior and posterior divisions; adductor supply; referred pain from hip to medial knee. |
| Hamstring muscles | ★ | Semitendinosus, semimembranosus, long head of biceps femoris + ischial part of adductor magnus; common origin from the ischial tuberosity; tibial nerve supply (short head — common peroneal); actions and hamstring injury. |
| Quadriceps femoris | ★ | Four heads, insertion via the patella, femoral nerve L2,3,4, knee jerk, vastus medialis and patellar stability. |
| Adductor magnus / adductor canal | ★ | Composite muscle with adductor and hamstring parts, dual nerve supply (obturator + sciatic), adductor hiatus. Canal of Hunter: boundaries and contents — femoral artery and vein, saphenous nerve, nerve to vastus medialis. |
| Anastomosis around the knee | ★ | Contributors — descending genicular, superior/middle/inferior genicular, descending branch of lateral circumflex femoral, anterior tibial recurrent; significance in gradual occlusion. |
| Cutaneous innervation of the dorsum of foot | ★ | Superficial peroneal for most of the dorsum; deep peroneal for the first web space; saphenous medially; sural laterally; medial and lateral plantar for the sole — draw the map. |
| Subtalar joint | ★ | Talocalcaneal articulation; inversion and eversion; interosseous talocalcaneal ligament; sprain mechanism. |
| Lateral compartment of the leg | ★ | Peroneus longus and brevis, superficial peroneal nerve, evertors, role of peroneus longus in the transverse arch. |
| Popliteal fossa | — | Boundaries, roof, floor; contents superficial→deep — tibial nerve, popliteal vein, popliteal artery; popliteal aneurysm and Baker's cyst. |
| Ankle joint | — | Hinge; mortise; deltoid and lateral ligaments; dorsiflexion is the close-packed position; Pott's fracture, inversion sprain. |
| Sole of foot / plantar aponeurosis | — | Four layers, medial and lateral plantar nerves, plantar arch, plantar fasciitis. |
| Tibialis posterior / flexor retinaculum of ankle | — | Tom, Dick And Very Nervous Harry order behind the medial malleolus; tarsal tunnel syndrome. |
| Topic | Hit | The five points that get the marks |
|---|---|---|
| Inguinal canal | ★★ | Extent, deep and superficial rings, four walls (remember: two Ms in the roof, etc.), contents in male and female, mechanisms preventing herniation — obliquity, shutter action of the internal oblique arch, ball-valve at the superficial ring, flap-valve of the posterior wall, hormonal. Direct vs indirect hernia and Hesselbach's triangle. |
| Rectus sheath | ★ | Formation at three levels — above the costal margin, between costal margin and arcuate line, below the arcuate line; contents — rectus abdominis, pyramidalis, superior and inferior epigastric vessels, lower six thoracic nerves; rectus sheath haematoma; arcuate line of Douglas. |
| Portacaval anastomosis | ★ | Four classic sites — lower oesophagus (left gastric ↔ oesophageal), anal canal (superior ↔ middle/inferior rectal), paraumbilical (↔ superficial epigastric), retroperitoneal veins of Retzius; clinical — varices, caput medusae, haemorrhoids. |
| Coeliac trunk | ★ | Arises at T12 from the aorta; three branches — left gastric, splenic, common hepatic; foregut supply; relations and the coeliac plexus. |
| Suprarenal gland | ★★ | Situation, relations (right triangular behind the IVC, left semilunar); triple arterial supply from inferior phrenic, aorta, renal; single vein — right into the IVC, left into the renal vein; histology — capsule, zona glomerulosa/fasciculata/reticularis, chromaffin medulla; development of cortex from mesoderm and medulla from neural crest. |
| Lymphatic drainage & nerve supply of stomach | ★ | Four drainage zones to the coeliac nodes; vagal trunks and nerve of Latarjet; sympathetic T6–T9 via the greater splanchnic; referred pain to the epigastrium. |
| Spermatic cord | ★ | Three coverings from three abdominal wall layers; contents — ductus deferens, three arteries, pampiniform plexus, three nerves, lymphatics, processus vaginalis remnant; varicocele commoner on the left. |
| Development of kidney | ★ | Pronephros → mesonephros → metanephros; ureteric bud vs metanephric blastema derivatives; ascent and change of blood supply; horseshoe, pelvic and polycystic kidney. |
| Development of pancreas | ★ | Ventral and dorsal buds, rotation and fusion, duct formation; annular pancreas, pancreas divisum. |
| Histology of liver | ★ | Classic lobule, portal triad, sinusoids, Kupffer cells, space of Disse, bile canaliculi; portal lobule and acinus of Rappaport with zones. |
| Microstructure of oesophagus | ★ | Non-keratinised stratified squamous epithelium; muscularis mucosae; submucosal mucous glands; muscularis externa — skeletal in the upper third, mixed in the middle, smooth in the lower third; no serosa except the abdominal part. |
| Inferior vena cava / portal vein | — | Formation, course, tributaries, developmental origin; IVC obstruction and collateral routes. |
| Superior mesenteric artery | — | Origin at L1, midgut supply, branches, relations, the third part of the duodenum and SMA syndrome. |
| Lesser sac / epiploic foramen | — | Boundaries of the foramen of Winslow, extent of the omental bursa, Pringle manoeuvre. |
| Development of the gut & midgut rotation | — | Physiological herniation at week 6, 270° anticlockwise rotation, return by week 10; malrotation, omphalocele, Meckel's diverticulum (rule of 2s), vitellointestinal duct anomalies. |
| Diaphragm — openings | — | T8 caval, T10 oesophageal, T12 aortic and their contents; origin from four sources; congenital diaphragmatic hernia. |
| Topic | Hit | The five points that get the marks |
|---|---|---|
| Ischioanal fossa | ★ | Wedge-shaped space; boundaries; contents — fat, inferior rectal vessels and nerve, pudendal canal, perforating cutaneous nerves; anterior and posterior recesses; ischioanal abscess and horseshoe spread. |
| Pudendal canal | ★ | Alcock's canal in the obturator fascia; contents — internal pudendal vessels, pudendal nerve, nerve to obturator internus; pudendal nerve block landmark at the ischial spine. |
| Pelvic diaphragm | ★ | Levator ani (pubococcygeus, puborectalis, iliococcygeus) and coccygeus; attachments to the tendinous arch; nerve supply S3,S4 and the perineal branch of the pudendal; support of the pelvic viscera, anorectal ring, prolapse. |
| Trigone of bladder | ★ | Boundaries, smooth adherent mucosa, mesodermal origin from absorbed mesonephric ducts, interureteric ridge, cystoscopy landmark. |
| Development of anal canal | ★ | Cloaca divided by the urorectal septum; upper part endodermal hindgut, lower part ectodermal proctodeum, meeting at the pectinate line; imperforate anus and anorectal fistulae. |
| Perineal body / urogenital diaphragm | — | Fibromuscular node, converging muscles, obstetric significance and episiotomy; deep perineal pouch contents. |
| Prostate | — | Lobes and zones, capsules, relations, prostatic urethra features, venous plexus and vertebral metastasis, BPH vs carcinoma. |
| Internal iliac artery | — | Anterior and posterior divisions and their branches; ureter relations. |
| Cartilaginous joints | ★ | Primary (synchondrosis) — epiphyseal plate, first sternocostal, temporary; secondary (symphysis) — pubic symphysis, intervertebral disc, manubriosternal, permanent, midline, fibrocartilage. |
| Microscopic anatomy of compact bone | ★ | Osteon/Haversian system, concentric lamellae, lacunae with osteocytes, canaliculi, Haversian and Volkmann canals, interstitial and circumferential lamellae, periosteum. |
| Neurulation | ★ | Notochord induces the neural plate; neural groove and folds; tube closure — cranial neuropore day 25, caudal day 27; neural crest derivatives; neural tube defects (anencephaly, spina bifida) and folic acid. |
| Karyotyping | ★ | Metaphase arrest with colchicine, hypotonic treatment, G-banding, arrangement in seven groups; nomenclature 46,XX / 47,XY,+21; indications — Down, Turner (45,X), Klinefelter (47,XXY). |
| Types of epithelium / skin | — | Classification with sites and function; layers of thick and thin skin; appendages. |
| Blood supply of a long bone | — | Nutrient, metaphyseal, epiphyseal and periosteal arteries; direction of the nutrient foramen ("to the elbow I go, from the knee I flee"); growing and non-growing ends. |
| Placenta & fetal membranes | — | Formation, structure, functions, circulation, placenta praevia and abruptio; umbilical cord contents. |
| Fertilisation to implantation | — | Fertilisation in the ampulla, cleavage, morula, blastocyst, bilaminar and trilaminar germ disc, gastrulation and primitive streak; ectopic pregnancy. |
| Pharyngeal arches / branchial apparatus | — | Included in some Paper I sets under general embryology — arches, nerves, derivatives, fistulae. |
Twenty marks sit here and they are the cheapest twenty in the paper. These are the applied facts that recur.
Verified TNMGRMU Human Anatomy Paper I question papers. Read them once tonight in full — the phrasing of the essay stems repeats almost verbatim, and recognising a stem is worth two minutes of thinking time in the hall.
Essays: Mammary gland (extent, relations, blood supply, lymphatic drainage, clinical anatomy) · Uterus (position, parts, external features, relations, blood supply, lymphatic drainage, clinical anatomy).
Short notes:
Essays: Pancreas (parts and relations, blood supply, development) · Formation of the lumbar plexus with a note on the sciatic nerve.
Short notes:
Essays: Duodenum (parts, relations, internal features of the second part, blood supply, histology, clinical anatomy) · Ulnar nerve (origin, root value, course and relations, termination, branches and distribution, clinical anatomy).
Short notes:
Essays: Boundaries and contents of the axilla with the axillary artery in detail · Uterus (position and parts, peritoneal and visceral relations, supports, microstructure, development, clinical anatomy).
Short notes:
Essays: Urinary bladder (external features, supports and relations, blood supply and lymphatic drainage, clinical anatomy) · Arches of the foot with clinical importance.
Short notes:
You cannot learn anatomy tonight. You can make sure that everything you already half-know becomes writable. Reading is not revision — draw, don't re-read.
Habits that quietly gain marks in every answer. Practice them so they become automatic under exam pressure.