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viiANATOMY • QuestionsSection I • Subject-wise MCQs and Answers with Explanations
ANATOMY
CONTENTS
Section I: Subject-wise MCQs and Answers with Explanations
Anatomy ......................................................................................................................................................... 3–78
Physiology ................................................................................................................................................ 79–144
Biochemistry ............................................................................................................................................145-196
Microbiology ...........................................................................................................................................197–237
Pathology ................................................................................................................................................238–319
Pharmacology .........................................................................................................................................320–398
Forensic Medicine ..................................................................................................................................399–451
Preventive and Social Medicine...........................................................................................................452–533
Ears, Nose and Throat ...........................................................................................................................534–585
Ophthalmology .......................................................................................................................................586–634
Medicine ..................................................................................................................................................635–749
Pediatrics ................................................................................................................................................750–816
Obstetrics and Gynecology .................................................................................................................817–879
General Surgery .....................................................................................................................................880–967
Orthopedics ......................................................................................................................................... 968–1002
Dermatology ......................................................................................................................................1003–1030
Psychiatry...........................................................................................................................................1031–1056
Radiodiagnosis and Radiotherapy .................................................................................................1057–1074
Anesthesia ..........................................................................................................................................1075–1129
Section II: AIIMS May 2017MCQs and Answers with Explanations
AIIMS May 2017 MCQs and Answers with Explanations .............................................................1131–1234
Part A
Part B
AIIMS (May 2017–May 2011)
viii Contents
Section III: Subject-wise Color Plates
Anatomy .............................................................................................................................................1237–1265 39 Color Plates Including Subtopic Plates
Histology ...........................................................................................................................................1266–1282 37 Color Plates Including Subtopic Plates
Microbiology ......................................................................................................................................1283–1293 31 Color Plates Including Subtopic Plates
Parastiology .......................................................................................................................................1294–1314 47 Color Plates Including Subtopic Plates
Pathology ...........................................................................................................................................1315–1358 137 Color Plates Including Subtopic Plates
Forensic Medicine .............................................................................................................................1359–1367 28 Color Plates Including Subtopic Plates
Preventive and Social Medicine......................................................................................................1368–1380 26 Color Plates Including Subtopic Plates
Ears, Nose and Throat ......................................................................................................................1381–1393 27 Color Plates Including Subtopic Plates
Ophthalmology ..................................................................................................................................1394–1418 79 Color Plates Including Subtopic Plates
Medicine .............................................................................................................................................1419–1425 12 Color Plates Including Subtopic Plates
Pediatrics ...........................................................................................................................................1426–1432 18 Color Plates Including Subtopic Plates
Obstetrics and Gynecology ............................................................................................................1433–1445 41 Color Plates Including Subtopic Plates
General Surgery ................................................................................................................................1446–1472 102 Color Plates Including Subtopic Plates
Orthopedics .......................................................................................................................................1473–1499 48 Color Plates Including Subtopic Plates
Dermatology ......................................................................................................................................1500–1536 83 Color Plates Including Subtopic Plates
Radiodiagnosis and Radiotherapy .................................................................................................1537–1566 93 Color Plates Including Subtopic Plates
Anesthesia ..........................................................................................................................................1567–1577 27 Color Plates Including Subtopic Plates
Section IV: Additional Contents given in CBS Exam Books App
AIIMS Novermber 2011 Questions and Explanations (In pdf format ) AIIMS May 2011 Questions and Explanations (In pdf format ) Subject-wise Review Test (CBT Pattern) Image-Based Q's Test Grand Test Mega Grand Test (All 20 Subjects)
1. ANATOMY
2. PHYSIOLOGY
3. BIOCHEMISTRY
4. MICROBIOLOGY
5. PATHOLOGY
6. PHARMACOLOGY
7. FORENSIC MEDICINE
8. PREVENTIVE AND SOCIAL MEDICINE
9. EARS, NOSE AND THROAT
10. OPHTHALMOLOGY
11. MEDICINE
12. GENERAL SURGERY
13. OBSTETRICS AND GYNECOLOGY
14. PEDIATRICS
15. DERMATOLOGY
16. PSYCHIATRY
17. RADIODIAGNOSIS AND RADIOTHERAPY
18. ANESTHESIA
19. ORTHOPEDICS
Section ISubject-wise MCQs and
Answers with Explanations
AIIMS NOVEMBER 2016 1. Anterior 2/3rd of the tongue demarcated by?
a. Passavants ridge b. Circumvallate papillae c. Sulcus terminalis d. Foliate papillae
2. Which of the following are the set of structures that pierce the given structure in the picture?
a. Basilic vein, lateral pectoral nerve, medial pectoral nerve
b. Cephalic vein, lateral pectoral nerve, medial pectoral nerve
c. Thoracoacromian artery, cephalic vein, lateral pectoral nerve
d. Thoracoacromian artery, cephalic vein, medial pectoral nerve
3. Which of the following muscle is supplied by the nucleus present beneath the area marked in the following picture?
a. Lateral rectus b. Risorius c. Superior oblique d. Levator palpebrae superioris
4. In the given gross section of axilla, the structures marked are? a. 1- Lateral cord of brachial plexus, 2- Long thoracic nerve,
3- Serratus anterior b. 1- Medial cord of brachial plexus, 2- Long thoracic nerve,
3- Subscapularis
ANAT PLATE 13
ANAT PLATE 15A
c. 1- Posterior cord of brachial plexus, 2- Nerve to serratus anterior, 3- Subscapularis
d. 1- Lateral cord of brachial plexus, 2- Long thoracic nerve, 3- Subscapularis
5. Relations of left ureter are all EXCEPT: a. Sigmoid mesentery b. Bifurcation of common iliac artery c. Quadratus lumborum d. Gonadal vessels
6. All are example of muscle in which fibers are arranged parallel EXCEPT:
a. Sternohyoid b. Sartorius c. Rectus abdominis d. Tibialis anterior
7. In the following image of anterior abdominal wall, the correct matching of markings is?
ANAT PLATE 12
1 Anatomy
AIIMS May 2017 & Color Plates are Given in Part B
4
AIIMS (May 2017–May 2011)
Section I • Subject-wise MCQs and Answers with ExplanationsANATOMY • Questions
a. 1. Linea alba, 2. Linea semilunaris, 3. Outer lip of iliac crest, 4. Inner lip of iliac crest, 5. Inguinal ligament, 6. Superficial inguinal ring
b. 1. Linea alba, 2. Linea semilunaris, 3. Inner lip of iliac crest, 4. Outer lip of iliac crest, 5. Inguinal ligament, 6. Deep inguinal ring
c. 1. Linea semilunaris, 2. Linea alba, 3. Outer lip of iliac crest 4. Inner lip of iliac crest 5. Inguinal ligament, 6. Superficial inguinal ring
d. 1. Linea semilunaris, 2. Linea alba, 3. Inner lip of iliac crest 4. Outer lip of iliac crest 5. Inguinal ligament, 6. Deep inguinal ring
8. Extraembryonic mesoderm develops from? a. Hypoblast b. Epiblast c. Primary yolk sac d. Secondary yolk sac
9. Injury to the area marked by the arrow in the given picture will lead to?
a. Lower limb paralysis b. Apraxia c. Aphasia d. Visual disturbance
10. Defect in the structure, the histology of which is shown in the figure, will lead to which of the following speech disorder?
HISTO PLATE 10A
a. Apraxia b. Aphasia c. Dysarthria d. Verbal dyspraxia
11. Histology image of epithelium shown in the picture is of which organ?
HISTO PLATE 6
a. Skin b. Urinary bladder c. Common bile duct d. Bile duct
12. The marked structure in the given picture is made up of all EXCEPT:
HISTO PLATE 11 C
a. Macula adherens b. Zona occludens c. Gap junction d. Fascia Adherens
AIIMS MAY 201613. The below figure depicts varrious parts from which
diaphragm develops. Congenital diaphrammatic hernia is mostly commonly due to defect in?
a. A b. B c. C d. D
AIIMS May 2017 & Color Plates are Given in Part B
12
AIIMS (May 2017–May 2011)
ANATOMY • Answers with ExplanationsSection I • Subject-wise MCQs and Answers with Explanations
AIIMS NOVEMBER 2016
1. Ans. (c) Sulcus terminalis
Ref: Gray’s 41st ed page 511, Moore - Clinically oriented Anatomy 7th edition page 940The dorsum (posterosuperior surface) is generally convex in all directions at rest. It is divided by a V-shaped sulcus terminalis into an anterior, oral (presulcal) part that faces upwards, and a posterior, pharyngeal (postsulcal) part that faces posteriorly.
Anatomy of Tongue
Parts Root, Tip, and Body, which has (a) a curved upper surface or dorsum, and (b) an inferior surface.
Dorsum The dorsum is divided into oral and pharyngeal parts. The inferior surface is confined to the oral part only. The dorsum of the tongue is convex in all directions. It is divided into:
• An oral part or anterior two-thirds • A pharyngeal part or posterior one-third, by a faint V-shaped groove, the sulcus terminalis. The two limbs
of the ‘V meet at a median pit, named the foramen caecum. They run laterally and forwards up to the palatoglossal arches. The foramen caecum represents the site from which the thyroid diverticulum grows down in the embryo.
Root The root is attached to the mandible and soft palate above, and to the hyoid bone below. Because of these attachments we are not able to swallow the tongue itself. In between the two bones, it is related to the geniohyoid and mylohyoid muscles.
Tip The tip of the tongue forms the anterior free end which, at rest, lies behind the upper incisor teeth.
Papillae of the Tongue
These are projections of mucous membrane or corium which give the anterior two-thirds of the tongue its characteristic roughness. These are of the following three types.
Vallate or circumvallate papillae
They are large in size 1–2 mm in diameter and are 8–12 in number. They are situated immediately in front of the sulcus terminalis.
Fungiform papillae
The fungiform papillae are numerous near the tip and margins of the tongue, but some of them are also scattered over the dorsum
Filiform papillae The filiform papillae or conical papillae cover the presulcal area of the dorsum of the tongue, and give it a characteristic velvety appearance. They are the smallest and most numerous of the lingual papillae. Each is pointed and covered with keratin; the apex is often split into filamentous processes
Contd…
ANSWERS WITH EXPLANATIONS
13ANATOMY • Answers with ExplanationsSection I • Subject-wise MCQs and Answers with Explanations
ANATOMY
Artery, Vein and Lymphatics of Tongue Arterial supply It is chiefly derived from the lingual artery, a branch of the external carotid artery. The root of the tongue is
also supplied by the tonsillar and ascending pharyngeal arteries
Venous drainage The arrangement of the vena comitantes veins of the tongue is variable. Two venae comitantes accompany the lingual artery, and one vena comitantes accompanies the hypoglossal nerve. The deep lingual vein is the largest and principal vein of the tongue. It is visible on the inferior surface of the tongue. It runs backwards and crosses the genioglossus and the hyoglossus below the hypoglossal nerve. These veins unite at the posterior border of the hyoglossus to form the lingual vein which ends either in the common facial vein or in the internal jugular vein.
Lymphatics • The tip of the tongue drains bilaterally to the submental nodes. • The right and left halves of the remaining part of the anterior two-thirds of the tongue drain unilaterally to
the submandibular nodes. • The posterior one-third of the tongue drains bilaterally to the juguloomohyoid nodes, these are known as
the lymph nodes of the tongue.
Sensations of tongue
General sensation Taste sensation Anterior 2/3rd Lingual nerve Chorda tympani (branch of facial)
Posterior 1/3rd Glossopharyngeal nerve Glossopharyngeal nerve
Posterior most Vagus nerve Vagus nerve
2. Ans. (c) Thoracoacromian artery, cephalic vein, lateral pectoral nerve
Ref: BDC 4th ed page 83
Note
It was a handmade line diagram in the examination
The structure in the picture is clavipectoral fasciaThe clavipectoral fascia is pierced by the following structures:
• Cephalic vein • Lateral pectoral nerve • Thoracoacromial vessels • Lymphatics passing from the breast and pectoral region to
the apical group of axillary lymph nodes.
3. Ans. (a) Lateral rectus
Ref: Gray’s 41st ed page 275, Last’s Anatomy: Regional and Applied 4th ed Page 615
See ANAT PLATE 14 KEY for details
Facial colliculus is marked in the given picture. Facial colliculus is formed by motor fibers of facial nerve around abducens nucleus, hence deeper structure beneath the facial colliculus is abducent nucleus. Abducents nucleus is motor, somatic, near midline in pons deep to facial colliculus in floor of fourth ventricle, for lateral rectus.
Section IIAIIMS MAY 2017
MCQs and Answers with Explanations ANATOMY
PHYSIOLOGY
BIOCHEMISTRY
MICROBIOLOGY
PATHOLOGY
PHARMACOLOGY
FORENSIC MEDICINE
PREVENTIVE AND SOCIAL MEDICINE
EARS, NOSE AND THROAT
OPHTHALMOLOGY
MEDICINE
PEDIATRICS
OBSTETRICS AND GYNECOLOGY
GENERAL SURGERY
ORTHOPEDICS
DERMATOLOGY
PSYCHIATRY
RADIODIAGNOSIS AND RADIOTHERAPY
ANESTHESIA
ANATOMY 1. A 5-year-old child presented with absence of thymus, hypo-
parathyroidism and tetany. Which of the following marked area is defective in this case?
a. A b. B c. C d. D
2. Nucleus pulposus originate from which of the following marked area?
a. A b. B c. C d. D
3. The area marked in the following picture of cut section of lymphatic follicle?
HISTO PLATE 4F
a. Germinal centre b. Mantle zone c. Paracortical area d. Marginal zone
4. Which cell is inhibited by the cell given in the slide?
HISTO PLATE 10C
a. Vestibular nuclei b. Deep nuclei of cerebellum c. Anterior horn of spinal d. Basal ganglia
5. Which of the following marked structure can be palpated in the infraclavicular fossa?
ANAT PLATE 17
a. A b. B c. C d. D
6. Which of the following marked structure is Pelvic Diaphragm?
ANAT PLATE 16A
a. A b. B c. C d. D
AIIMS May 2017
1134
AIIMS (May 2017–May 2011)
Section II • AIIMS May 2017 PHYSIOLOGY • Questions
7. In the following image of Transversus abdominis, which label denotes conjoint tendon?
ANAT PLATE 12
a. A b. B c. C d. D
8. In this cross section of head, the action of structure marked on the Mandible is?
ANAT PLATE 2C
a. Protraction b. Retraction c. Elevation d. Depression
9. Which of the following forms the superior boundary of epiploic foramen?
ANAT PLATE 18A
a. a b. b c. c d. d
10. The arrow marked structure in the given picture connects which of the following structure?
ANAT PLATE 5E
a. Amygdala b. Mamillary body c. Habenular nuclei d. Hippocampus
11. Mandibular branch of trigeminal nerve passes through which of the following marked structure?
ANAT PLATE 10
a. A b. B c. C d. D
12. Disease caused by the structure marked in the picture below is?
ANAT PLATE 11B
a. Paralysis agitans b. Huntington’s Chorea c. Alzheimer’s disease d. Dementia
1153
ANATOMY
ANATOMY • Answers with Explanations
ANATOMY
1. Ans. (c) C
Ref: Gray’s 41st ed page 618, 619
See table of Branchial Arches in ANATOMY AIIMS Nov 2012
The patient presents with DiGeorge syndrome caused due to defective development of 3rd and 4th pharyngeal pouches. But since thymus develops from 3rd pharyngeal pouch and there is absence of thymus in this patient, the better answer is 3rd pouch.
DiGeorge SyndromeA congenital disorder in which defective development of the 3rd and 4th pharyngeal pouches results in hypoplasia or aplasia of the thymus and parathyroid glands.
2. Ans. (a) A
Ref: Grays 41st ed page 756, Langman’s Embryology 10th ed page 140, 352 The notochord expands between the developing vertebrae as localized aggregates of cells and matrix that form the nucleus pulposus of the intervertebral disc
Plate LegendsA = Notochord B = Amniotic cavity C = Ectoderm D = Mesoderm
Nucleus pulposus is central gelatinous portion of an inter-vertebral disc derived from proliferation of notochord cells. Mesenchymal cells between cephalic and caudal parts of the original sclerotome segment do not proliferate but fill the space between two precartilaginous vertebral bodies. In this way, they contribute to formation of the intervertebral disc. Although the notochord regresses entirely in the region of the vertebral bodies, it persists and enlarges in the region of the intervertebral disc. Here it contributes to the nucleus pulposus, which is later surrounded by circular fibers of the annulus fibrosus. Combined, these two structures, form the intervertebral disc.
ANSWERS WITH EXPLANATIONS
Neurulation
1154
AIIMS (May 2017–May 2011)
Section II • AIIMS May 2017 ANATOMY • Answers with Explanations
3. Ans. (d) Marginal zone
Ref: Wolfgang 4th ed page 320, 323
See HISTO PLATE 4F
The area marked in the picture is marginal zone.
4. Ans. (b) Deep nuclei of cerebellum
Ref: Grays 41st ed page 256, 335, Ganong 24th Ed, pg 249, Guyton 12th ed page 684
See HISTO PLATE 10 KEY
Note
A question on low power histology of cerebellum was asked in AIIMS Nov 2016.
Marked cells in the plate are Purkinje cells of cerebellum. Purkinje cell is inhibitory to deep cerebellar nuclei. The developed cerebellar cortex contains three layers: namely, the molecular layer, the Purkinje layer and the granular layer. Purkinje cell axons pass into the white matter and form inhibitory synaptic connections with neurons of the deep cerebellar nuclei, releasing GABA as the neurotransmitter. GABA is the main inhibitory transmitter and glutamate is the main excitatory transmitter of Purkinje cells.
Functional Unit of the Cerebellar Cortex—The Purkinje Cell and the Deep Nuclear Cell The cerebellum has about 30 million nearly identical functional units, one of which is shown in the figure. This functional unit centers on a single, very large Purkinje cell and on a corresponding deep nuclear cell. To the top and right in
figure, the three major layers of the cerebellar cortex are shown: the molecular layer, Purkinje cell layer, and granule cell layer. Beneath these cortical layers, in the center of the cerebellar mass, are the deep cerebellar nuclei that send output signals to other parts of the nervous system.
Neuronal Circuit of the Functional UnitThe output from the functional unit is from a deep nuclear cell. This cell is continually under both excitatory and inhibitory influences.
• Deep cerebellar nuclei: From lateral to medial, the four deep cerebellar nuclei are the Dentate, Emboliform, Globose, and Fastigial (Mnemonic: “Don’t Eat Greasy Food”). The globose and the emboliform nuclei are sometimes lumped together as the interpositus nucleus in lower species; the emboliform and globose nuclei may sometimes be referred to as the anterior and posterior interposed nuclei, respectively. The dentate nucleus, which is located most laterally and is by far the largest, is the only nucleus easily visible to the naked eye.
• The excitatory influences arise from direct connections with afferent fibers that enter the cerebellum from the brain or the periphery. Primary afferent inputs: The afferent inputs to the cerebellum are mainly of two types, one called the climbing fiber type and the other called the mossy fiber type. They send collaterals to the deep nuclei and pass to the cortex. The two main inputs to the cerebellar cortex are climbing fibers and mossy fibers.
ANATOMY
HISTOLOGY
MICROBIOLOGY
PARASTIOLOGY
PATHOLOGY
FORENSIC MEDICINE
PREVENTIVE AND SOCIAL MEDICINE
EARS, NOSE AND THROAT
OPHTHALMOLOGY
MEDICINE
PEDIATRICS
OBSTETRICS AND GYNECOLOGY
GENERAL SURGERY
ORTHOPEDICS
DERMATOLOGY
RADIODIAGNOSIS AND RADIOTHERAPY
ANESTHESIA
Section IIISubject-wise Color Plates
EARS, NOSE AND THROAT
1383EARS, NOSE AND THROAT • Color PlatesSection III • Subject-wise Color Plates
ENT PLATE 2
A B
C D
E
EARS, NOSE AND THROAT
1385EARS, NOSE AND THROAT • Color PlatesSection III • Subject-wise Color Plates
ENT PLATE 2 KEY
A. Tracheotomy incision midway between sternal notch and cicoid cartilage over the 2-3 tracheal ring. Several types of incisions can be made on trachea, but most common are vertical or cruciate.
B. Tracheostomy stoma: Note the difference from the cricothyroidotomy stomy which is higher up than the tracheostomy stoma C. Cricothyroidotomy incision between the thyroid cartilage and cricoid cartilave over the cricothyroid membrane. Surgical cricothyroidotomy
provides a definitive airway (a cuffed tube in the trachea) if tracheal intubation is not possible. Technique for a surgical cricothyroidotomy is: � Using a scalpel, make a transverse skin incision, then carefully incise through the cricoid membrane � Enlarge the hole using artery forceps or the handle of the scalpel, rotate through 90° � Insert a size 6 cuffed tracheal or tracheostomy tube � Inflate the cuff, check the position and ventilate
A B
D. Cricothyroidotomy stoma: Note the difference between tracheostomy stoma which is lower down compated to cricothyroidotomy stoma. E. Percutaneous dilatational tracheostomy (PDT): PDT technique involves introduction of a guide wire into the trachea followed by
dilatation using a variable diameter single dilator (the Blue Rhino) and passage of the tracheostomy tube loaded over one of the three loading dilators. More specifically, the devices allow for two approaches to the dilation of the stoma:
1. Serial dilation (Ciaglia Percutaneous Tracheostomy Introducer Set): Ciaglia method developed in 1985 uses graded dialators. Serial dilation is achieved using numerous progressively larger dilators. Kit contains three soft loading dilators of varying outer diameters (OD), i.e. 21F (7 mm), 24F (8 mm) and 28F (9.3 mm). Cook Ciaglia percutaneous tracheostomy devices are sold sterile for single use
2. Single-stage dilation (Blue Rhino and Blue Rhino G2 Advanced Percutaneous Tracheostomy Introducer Set): Single-stage dilation is achieved wit a single rhino-horn-shaped dilator using an in-and-out motion.
Absolute contraindications Relative contraindications 1. Emergency tracheostomy 2. In pediatric (Children younger than 12 years)3. Midline neck mass 4. Non intubated patients 5. Unstable spine fracture
1. PEEP value > 20 2. Uncorrected coaculopathies 3. Infection near the intended site of tracheostomy 4. Difficult to palpate anatomical landmarks 5. Previous neck surgery distorting the anatomy
OBG PLATE 1
OBG PLATE 1 KEY
Cusco’s speculum: Bivalved self retaining speculum. Its advantage over Sim’s speculum is that no assistance is required to hold it in place. Hence, minor procedures like papsmear, IUCD insertions can be performed independently. Its disadvantage is the limited visual-ization of vagina walls.
OBG PLATE 2
OBG PLATE 2 KEY
A Bakri Postpartum Balloon works on the principle of tampon-ade (for uterine atony) to stop bleeding. Success rate approximately 85 percent. Procedure: Insertion requires two or three team members. The first performs abdominal sonography during the procedure. The second places the deflated balloon into the uterus and stabilizes it. The third member instills fluid to inflate the balloon, rapidly infusing at least 150 mL followed by further instillation over a few minutes for a total of 300 to 500 mL to arrest hemorrhage.Advantage: There is continuous drainage hence the risk of infection is reduced.
OBG PLATE 3
Obstetrics and Gynecology
AIIMS (May 2017–May 2011)
1434 OBSTETRICS AND GYNECOLOGY • Color PlatesSection III • Subject-wise Color Plates
OBG PLATE 3 KEY
Harvey Karman in the United States refined the technique of Vacuum or suction aspiration in the early 1970s with the development of the Karman cannula, a soft, flexible cannula that avoided the need for initial cervical dilatation and so reduced the risks of puncturing the uterus. The given instrument is karman cannula that comes in various sizes mainly used for termination of pregnancy. The diameters of 4-6 are used for endometrial biopsy.Material: Polypropylene
Sets of Manual Vacuum Aspiration
OBG PLATE 4
A
D E
B C
OBG PLATE 4 KEY
A. Mirena: Hormonal IUD Mirena with T shaped polyethelene frame impregnated with barium sulphate for visibility during X-rays (black arrow), hormone cylinder (red arrow) and removal thread (yellow arrow)
B. Nova T 380 � T-shaped polyethelene frame impregnated with barium sulfate
for visibility during X-rays � 380 mm2 surface area copper, in the form of copper wire with a
silver core, wrapped around the vertical stem of the T � Two removal threads pigmented with iron oxide � Suffix number of the device signifies the amount of copper
C. Multiload Cu 250/375 � Flexible curved arms � Copper wrapped around the polyethelene frame impregnated
with barium sulphate for visibility during X-rays � Two nylon thread � Suffix number of the device signifies the amount of copper
D. Copper T 380 A � T-shaped polyethelene frame impregnated with barium
sulphate for visibility during X-rays � Suffix number of the device signifies the amount of copper � 380 mm2 surface area copper, in the form of copper wire with a
silver core, wrapped around the vertical stem of the T and also the arms of the “T” hence the Suffix “a”
E. Nuva Ring � Combined hormonal contraceptive vaginal ring � It is a flexible plastic (ethylene-vinyl acetate copolymer) ring
that releases a low dose of a progestin and estrogen over three weeks.
� The exact position of NuvaRing is not important for it to be effective.
OBG PLATE 5
A
GENERAL SURGERY
1453GENERAL SURGERY • Color PlatesSection III • Subject-wise Color Plates
SURG PLATE 19 KEY
Babcock’s Tissue Forceps • Light and nontraumatic instrument having finger bows, shaft
with catch, box joint, and blades • Terminal part of blades are curved with triangular fenestrated to
hold delicate structures • Tip of the blades are non traumatic with small serrations to
provide grip • Used to hold tubular structures like appendix, bowel, fallopian
tubes, ureters, cord, etc.
SURG PLATE 20
SURG PLATE 20 KEY
Lane’s Tissue Forceps • It is short, thick, bulkier and heavy • It has finger bows, shaft with catch, box joint and blades • Blades are small compared to shaft, and are curved with
fenestrations to accomodate bulky tissue • The tip of blade have single sharp tooth on one side and groove
on other side • Used to hold bulky and slippery tissue like fat and breast tissue • Can also be used as towel clip.
SURG PLATE 21
SURG PLATE 21 KEY
Cheatle’s Forceps • Parts: finger bow, shaft, joint and blades but no catch • Curved dipped blades with large serrations at tip for firm grip • Always ready to use are it is always dipped in antiseptic solution • Used to picked the sterilized instruments, linen, etc.
SURG PLATE 22
SURG PLATE 22 KEY
Langenback’s Right Angled Retractor • Comes in different sizes • Flat solid blade right angled to the shaft for retraction, tip of blade
is also curved at right angle to the rest of the blade for better retraction
• Handle is fenestrated for better grip • Also comes with double blades at both ends • Used in superficial surgeries like hernia to retract skin, fascia and
aponeurosis.
SURG PLATE 23
SURG PLATE 23 KEY
Czerney’s Retractor • Double blades at both ends, one blade is solid while other blade
have 2 hooks • Shaft is fenestrated to reduce weight and better grip • Flat solid blade is used as Langenback’s retractor • Biflanged blade is used to retract the incision while approximating
(suturing) in midline laparotomy as the tissue to be sutured can be seen in between the two flangs.
