from reportlab.lib.pagesizes import A4
from reportlab.lib import colors
from reportlab.lib.styles import getSampleStyleSheet, ParagraphStyle
from reportlab.lib.units import cm
from reportlab.platypus import (
    SimpleDocTemplate, Paragraph, Spacer, Table, TableStyle,
    HRFlowable, KeepTogether, PageBreak
)
from reportlab.lib.enums import TA_CENTER, TA_LEFT, TA_JUSTIFY

OUTPUT = "/home/daytona/workspace/mbbs-anatomy/MBBS_Anatomy_10Mark_Answers.pdf"

doc = SimpleDocTemplate(
    OUTPUT,
    pagesize=A4,
    rightMargin=2*cm, leftMargin=2*cm,
    topMargin=2*cm, bottomMargin=2*cm,
    title="MBBS 1st Year Anatomy - 10 Mark Answers (BFUHS)",
    author="Based on BDC & Gray's Anatomy for Students"
)

styles = getSampleStyleSheet()

# Custom styles
BLUE = colors.HexColor("#1a3a6b")
LIGHT_BLUE = colors.HexColor("#e8f0fb")
DARK_BLUE = colors.HexColor("#0d2545")
GOLD = colors.HexColor("#c8962a")
TABLE_HEADER = colors.HexColor("#1a3a6b")
TABLE_ALT = colors.HexColor("#f0f4fc")

title_style = ParagraphStyle(
    "TitleStyle", parent=styles["Title"],
    fontSize=20, textColor=DARK_BLUE,
    spaceAfter=6, spaceBefore=4,
    alignment=TA_CENTER, fontName="Helvetica-Bold"
)
subtitle_style = ParagraphStyle(
    "SubTitle", parent=styles["Normal"],
    fontSize=11, textColor=GOLD,
    spaceAfter=4, alignment=TA_CENTER, fontName="Helvetica-Oblique"
)
section_style = ParagraphStyle(
    "SectionStyle", parent=styles["Heading1"],
    fontSize=13, textColor=colors.white,
    spaceAfter=4, spaceBefore=10,
    fontName="Helvetica-Bold", backColor=BLUE,
    leftIndent=-10, rightIndent=-10,
    borderPad=5
)
question_style = ParagraphStyle(
    "QuestionStyle", parent=styles["Heading2"],
    fontSize=12, textColor=DARK_BLUE,
    spaceAfter=4, spaceBefore=8,
    fontName="Helvetica-Bold",
    borderPad=3, backColor=LIGHT_BLUE,
    leftIndent=0
)
h3_style = ParagraphStyle(
    "H3Style", parent=styles["Heading3"],
    fontSize=11, textColor=BLUE,
    spaceAfter=3, spaceBefore=6,
    fontName="Helvetica-Bold"
)
body_style = ParagraphStyle(
    "BodyStyle", parent=styles["Normal"],
    fontSize=10, textColor=colors.HexColor("#222222"),
    spaceAfter=4, spaceBefore=2,
    leading=15, alignment=TA_JUSTIFY,
    fontName="Helvetica"
)
bullet_style = ParagraphStyle(
    "BulletStyle", parent=styles["Normal"],
    fontSize=10, textColor=colors.HexColor("#222222"),
    spaceAfter=2, spaceBefore=1,
    leading=14, leftIndent=16,
    bulletIndent=6,
    fontName="Helvetica"
)
note_style = ParagraphStyle(
    "NoteStyle", parent=styles["Normal"],
    fontSize=9, textColor=colors.HexColor("#555555"),
    spaceAfter=3, spaceBefore=3,
    leading=13, leftIndent=10,
    fontName="Helvetica-Oblique",
    backColor=colors.HexColor("#fffde7"),
    borderPad=4
)

def S(text, style=body_style):
    return Paragraph(text, style)

def B(text):
    return Paragraph(f"• {text}", bullet_style)

def H3(text):
    return Paragraph(text, h3_style)

def HR():
    return HRFlowable(width="100%", thickness=1, color=colors.HexColor("#bbccee"), spaceAfter=4)

def section_header(text):
    return Paragraph(f"  {text}", section_style)

def question_header(num, text, years=""):
    yr = f" <font size='9' color='#666666'>({years})</font>" if years else ""
    return Paragraph(f"Q{num}. {text}{yr}", question_style)

def make_table(headers, rows, col_widths=None):
    data = [headers] + rows
    t = Table(data, colWidths=col_widths, repeatRows=1)
    style = TableStyle([
        ("BACKGROUND", (0,0), (-1,0), TABLE_HEADER),
        ("TEXTCOLOR", (0,0), (-1,0), colors.white),
        ("FONTNAME", (0,0), (-1,0), "Helvetica-Bold"),
        ("FONTSIZE", (0,0), (-1,0), 9),
        ("FONTNAME", (0,1), (-1,-1), "Helvetica"),
        ("FONTSIZE", (0,1), (-1,-1), 9),
        ("ROWBACKGROUNDS", (0,1), (-1,-1), [colors.white, TABLE_ALT]),
        ("GRID", (0,0), (-1,-1), 0.5, colors.HexColor("#aaaacc")),
        ("VALIGN", (0,0), (-1,-1), "MIDDLE"),
        ("TOPPADDING", (0,0), (-1,-1), 4),
        ("BOTTOMPADDING", (0,0), (-1,-1), 4),
        ("LEFTPADDING", (0,0), (-1,-1), 6),
    ])
    t.setStyle(style)
    return t

# ─── BUILD STORY ──────────────────────────────────────────────────────────────
story = []

# Cover / Title block
story.append(Spacer(1, 0.5*cm))
story.append(S("MBBS 1ST YEAR ANATOMY", title_style))
story.append(S("10-Mark Answers — BFUHS Unsolved Papers", subtitle_style))
story.append(S("Based on BDC Human Anatomy (9th Ed., Vol. 2) & Gray's Anatomy for Students (South Asia Edition)", subtitle_style))
story.append(HR())
story.append(Spacer(1, 0.3*cm))

# TABLE OF CONTENTS (simple)
toc_data = [
    ["#", "Question Topic", "Page Section"],
    ["Q1","Boundaries and Contents of Popliteal Fossa","Popliteal Fossa"],
    ["Q2","Foot Drop","Popliteal Fossa"],
    ["Q3","Branches of Popliteal Artery","Popliteal Fossa"],
    ["Q4","Hamstring Muscles & Characteristic Features","Back of Thigh"],
    ["Q5","Inversion and Eversion of Foot","Front of Leg / Dorsum"],
    ["Q6","Injury to Deep Peroneal Nerve (Applied)","Front of Leg / Dorsum"],
    ["Q7","Nerve Supply & Action: Tibialis Anterior","Front of Leg / Dorsum"],
    ["Q8","Nerve Supply & Action: Peroneus Longus","Front of Leg / Dorsum"],
    ["Q9","Dorsalis Pedis Artery","Front of Leg / Dorsum"],
    ["Q10","Superficial Peroneal Nerve","Front of Leg / Dorsum"],
    ["Q11","Dorsiflexors of Foot","Front of Leg / Dorsum"],
    ["Q12","Muscles of Inversion & Eversion + Nerve Supply","Front of Leg / Dorsum"],
    ["Q13","Popliteus Muscle","Back of Leg"],
    ["Q14","Soleus","Back of Leg"],
    ["Q15","Lumbricals of Foot","Sole of Foot"],
    ["Q16","First Layer of Sole","Sole of Foot"],
    ["Q17","Muscles by Deep Branch of Lateral Plantar Nerve","Sole of Foot"],
    ["Q18","Venous Drainage of Lower Limb + Applied Anatomy","Venous/Lymphatics"],
    ["Q19","Varicose Veins","Venous/Lymphatics"],
    ["Q20","Lymphatic Drainage of Lower Limb","Venous/Lymphatics"],
    ["Q21","Ankle Joint (Complete)","Joints of Lower Limb"],
    ["Q22","Locking and Unlocking of Knee Joint","Joints of Lower Limb"],
]
toc_table = make_table(toc_data[0], toc_data[1:], col_widths=[1.2*cm, 10*cm, 5*cm])
story.append(toc_table)
story.append(PageBreak())

# ═══════════════════════════════════════════════════════════════════════════════
# SECTION 1: POPLITEAL FOSSA
# ═══════════════════════════════════════════════════════════════════════════════
story.append(section_header("SECTION 1: POPLITEAL FOSSA"))
story.append(Spacer(1, 0.2*cm))

# Q1
story.append(question_header(1, "Draw and Label Boundaries and Contents of Popliteal Fossa", "2022, 2021, 2018, 2006"))
story.append(H3("Definition"))
story.append(S("The popliteal fossa is a diamond-shaped (rhombus-shaped) space situated behind the knee joint. It is the major route by which structures pass between the thigh and leg."))
story.append(H3("Boundaries"))
boundaries_data = [
    ["Wall","Structures"],
    ["Superomedial","Semitendinosus + Semimembranosus muscles"],
    ["Superolateral","Biceps femoris muscle"],
    ["Inferomedial","Medial head of Gastrocnemius"],
    ["Inferolateral","Plantaris + Lateral head of Gastrocnemius"],
    ["Floor","Posterior femur, posterior capsule of knee joint, Popliteus (inferiorly)"],
    ["Roof","Skin, superficial fascia, deep popliteal fascia (continuation of fascia lata)"],
]
story.append(make_table(boundaries_data[0], boundaries_data[1:], col_widths=[5*cm, 11.2*cm]))
story.append(Spacer(1, 0.2*cm))
story.append(H3("Contents (Superficial to Deep)"))
contents = [
    "Popliteal lymph nodes (in superficial fascia)",
    "Small saphenous vein (pierces roof to drain into popliteal vein)",
    "Posterior cutaneous nerve of the thigh",
    "Common fibular (peroneal) nerve — follows biceps femoris tendon to neck of fibula",
    "Tibial nerve — descends vertically through the fossa",
    "Popliteal vein — superficial to the artery",
    "Popliteal artery — deepest structure; continuation of femoral artery from adductor hiatus",
]
for c in contents:
    story.append(B(c))
story.append(S("<b>Mnemonic (deep to superficial):</b> Artery → Vein → Tibial nerve → Common fibular nerve → Small saphenous vein", note_style))
story.append(H3("Popliteal Artery Branches"))
story.append(S("Five <b>geniculate arteries</b>: Superior medial, Superior lateral, Middle, Inferior medial, Inferior lateral. Plus sural (muscular) branches. Terminates as Anterior tibial + Posterior tibial arteries."))
story.append(H3("Applied Anatomy"))
applied = [
    "<b>Popliteal aneurysm:</b> Most common peripheral aneurysm; presents with distal ischemia; diagnosed by duplex Doppler.",
    "<b>Popliteal pulse:</b> Palpable by deep pressure in midline with knee slightly flexed.",
    "<b>Baker's cyst:</b> Synovial fluid collection causing posterior knee swelling; communicates with knee joint.",
    "<b>Common fibular nerve injury:</b> At neck of fibula — causes foot drop.",
]
for a in applied:
    story.append(B(a))
story.append(S("<i>(Gray's Anatomy for Students, p. 720-721 | BDC, Vol. 2, p. 87-89)</i>", note_style))
story.append(Spacer(1, 0.3*cm))

# Q2
story.append(question_header(2, "Write Briefly About Foot Drop", "2023"))
story.append(H3("Definition"))
story.append(S("Foot drop is the <b>inability to dorsiflex the foot</b> due to paralysis of the muscles of the anterior compartment of the leg, caused by injury to the common fibular (peroneal) nerve."))
story.append(H3("Common Cause"))
story.append(S("Injury to the <b>common fibular nerve at the neck of the fibula</b> — the most vulnerable peripheral nerve due to its superficial course. Causes: fractures of fibular neck, tight plaster casts, prolonged leg-crossing, knee dislocation."))
story.append(H3("Muscles Paralyzed"))
muscles_data = [
    ["Nerve Branch","Muscles Affected","Loss"],
    ["Deep fibular nerve","Tibialis anterior, EHL, EDL, Peroneus tertius","Dorsiflexion"],
    ["Superficial fibular nerve","Peroneus longus, Peroneus brevis","Eversion"],
]
story.append(make_table(muscles_data[0], muscles_data[1:], col_widths=[4.5*cm, 8*cm, 3.7*cm]))
story.append(Spacer(1, 0.2*cm))
story.append(H3("Clinical Features"))
features = [
    "<b>Foot drop</b> — inability to lift the front of the foot",
    "<b>Steppage (equine) gait</b> — exaggerated hip and knee flexion to clear the ground",
    "<b>Equinovarus deformity</b> — foot plantarflexed and inverted (unopposed tibialis posterior)",
    "<b>Sensory loss</b> — dorsum of foot and anterolateral leg",
]
for f in features:
    story.append(B(f))
story.append(H3("Management"))
story.append(B("Ankle-foot orthosis (AFO) to maintain dorsiflexion"))
story.append(B("Physiotherapy and nerve decompression if indicated"))
story.append(B("Tendon transfer surgery in chronic cases"))
story.append(S("<i>(BDC Human Anatomy, 9th ed., Vol. 2, p. 92)</i>", note_style))
story.append(Spacer(1, 0.3*cm))

# Q3
story.append(question_header(3, "Enumerate Only Branches of Popliteal Artery", "2010"))
story.append(H3("Branches"))
branches = [
    "<b>Muscular branches:</b> Sural arteries (to gastrocnemius, soleus, plantaris)",
    "<b>Geniculate arteries (5):</b>",
    "  — Superior medial geniculate artery",
    "  — Superior lateral geniculate artery",
    "  — Middle geniculate artery (to cruciate ligaments and synovium)",
    "  — Inferior medial geniculate artery",
    "  — Inferior lateral geniculate artery",
    "<b>Terminal branches:</b> Anterior tibial artery + Posterior tibial artery (gives fibular/peroneal artery)",
]
for br in branches:
    story.append(B(br))
story.append(S("These 5 geniculate arteries form the <b>genicular anastomosis</b> around the knee with: descending geniculate (femoral), anterior/posterior recurrent tibial arteries, and descending branch of lateral circumflex femoral. Clinically important if popliteal artery needs ligation."))
story.append(S("<i>(BDC Human Anatomy, 9th ed., Vol. 2, p. 90)</i>", note_style))

story.append(PageBreak())

# ═══════════════════════════════════════════════════════════════════════════════
# SECTION 2: BACK OF THIGH
# ═══════════════════════════════════════════════════════════════════════════════
story.append(section_header("SECTION 2: BACK OF THIGH"))
story.append(Spacer(1, 0.2*cm))

# Q4
story.append(question_header(4, "Write Briefly About Hamstring Muscles and Their Characteristic Features", "2009"))
story.append(H3("Introduction"))
story.append(S("The hamstring muscles form the <b>posterior compartment of the thigh</b>. They are named from the old practice of butchers hanging ham using their tendons."))
story.append(H3("The Three Hamstring Muscles"))
ham_data = [
    ["Muscle","Origin","Insertion","Nerve","Actions"],
    ["Biceps femoris\n(Long head)","Ischial tuberosity","Head of fibula","Tibial n. (L5,S1,S2)","Extends hip, flexes knee, lat. rotates leg"],
    ["Biceps femoris\n(Short head)","Lateral lip of linea aspera","Head of fibula","Common fibular n. (L5,S1)","Flexes knee, lat. rotates leg"],
    ["Semitendinosus","Ischial tuberosity","Upper medial tibia (pes anserinus)","Tibial n. (L5,S1,S2)","Extends hip, flexes knee, med. rotates"],
    ["Semimembranosus","Ischial tuberosity (separate facet)","Post. medial tibial condyle","Tibial n. (L5,S1,S2)","Extends hip, flexes knee, med. rotates"],
]
story.append(make_table(ham_data[0], ham_data[1:], col_widths=[3.2*cm, 3.5*cm, 3.5*cm, 3*cm, 4*cm]))
story.append(Spacer(1, 0.2*cm))
story.append(H3("Characteristic Features"))
char = [
    "<b>Biarticular:</b> All three muscles (except short head of biceps) cross two joints — hip and knee.",
    "<b>Common origin:</b> All arise from the ischial tuberosity except short head of biceps femoris.",
    "<b>Dual action:</b> Hip extensors AND knee flexors simultaneously.",
    "<b>Nerve supply:</b> All by sciatic nerve (tibial division), except short head of biceps (common fibular division).",
    "<b>Pes anserinus:</b> Semitendinosus (+ gracilis + sartorius) inserts as the 'goose's foot' on medial tibia.",
    "<b>Semimembranosus has 5 expansions:</b> Main insertion, oblique popliteal ligament, popliteus fascia, medial meniscus, arcuate ligament.",
    "<b>Active insufficiency:</b> Hamstrings become insufficient when hip is flexed AND knee is fully extended (basis of SLR test).",
]
for c in char:
    story.append(B(c))
story.append(H3("Applied Anatomy"))
story.append(B("<b>Hamstring strain:</b> Common in sprinters; occurs at musculotendinous junction or ischial origin."))
story.append(B("<b>Straight leg raising (SLR) test:</b> Limited by tight hamstrings or L4/L5/S1 nerve root irritation."))
story.append(S("<i>(BDC Human Anatomy, 9th ed., Vol. 2, p. 95, 98)</i>", note_style))

story.append(PageBreak())

# ═══════════════════════════════════════════════════════════════════════════════
# SECTION 3: FRONT OF LEG / DORSUM OF FOOT
# ═══════════════════════════════════════════════════════════════════════════════
story.append(section_header("SECTION 3: FRONT OF LEG, DORSUM OF FOOT, LATERAL & MEDIAL SIDES"))
story.append(Spacer(1, 0.2*cm))

# Q5
story.append(question_header(5, "Write Short Note on Inversion and Eversion of Foot", "2023"))
story.append(H3("Definitions"))
story.append(B("<b>Inversion:</b> Movement in which the sole of the foot faces medially (inward). Occurs mainly at the subtalar and midtarsal joints."))
story.append(B("<b>Eversion:</b> Movement in which the sole of the foot faces laterally (outward)."))
story.append(H3("Joints Involved"))
story.append(S("Subtalar (talocalcaneal) joint + Talocalcaneonavicular joint (together forming the subtalar complex). The transverse tarsal (midtarsal) joint contributes additionally."))
story.append(H3("Muscles of Inversion"))
inv_data = [
    ["Muscle","Nerve Supply","Segment"],
    ["Tibialis anterior (prime)","Deep fibular nerve","L4, L5"],
    ["Tibialis posterior (prime)","Tibial nerve","L4, L5"],
    ["Flexor hallucis longus (accessory)","Tibial nerve","S2, S3"],
    ["Flexor digitorum longus (accessory)","Tibial nerve","L5, S1"],
    ["Extensor hallucis longus (accessory)","Deep fibular nerve","L4, L5"],
]
story.append(make_table(inv_data[0], inv_data[1:], col_widths=[6*cm, 5*cm, 5.2*cm]))
story.append(Spacer(1, 0.2*cm))
story.append(H3("Muscles of Eversion"))
ev_data = [
    ["Muscle","Nerve Supply","Segment"],
    ["Fibularis (Peroneus) longus (prime)","Superficial fibular nerve","L5, S1, S2"],
    ["Fibularis (Peroneus) brevis (prime)","Superficial fibular nerve","L5, S1, S2"],
    ["Fibularis (Peroneus) tertius","Deep fibular nerve","L5, S1"],
    ["Extensor digitorum longus (accessory)","Deep fibular nerve","L5, S1"],
]
story.append(make_table(ev_data[0], ev_data[1:], col_widths=[6*cm, 5*cm, 5.2*cm]))
story.append(Spacer(1, 0.2*cm))
story.append(H3("Applied Anatomy"))
story.append(B("<b>Inversion injury (ankle sprain):</b> Most common ankle injury; tears the anterior talofibular ligament."))
story.append(B("<b>Common fibular nerve injury:</b> Loss of eversion — foot held in inversion with equinovarus deformity."))
story.append(B("<b>Flat foot (pes planus):</b> Weak tibialis posterior → loss of medial arch + loss of inversion power."))
story.append(S("<i>(BDC Human Anatomy, 9th ed., Vol. 2, p. 112-118)</i>", note_style))
story.append(Spacer(1, 0.2*cm))

# Q6
story.append(question_header(6, "Applied Aspect of Injury to Deep Peroneal (Fibular) Nerve", "2022"))
story.append(H3("Course"))
story.append(S("The deep fibular nerve is a branch of the common fibular nerve. After the common fibular nerve winds around the neck of fibula, it divides into superficial and deep branches. The deep fibular nerve enters the anterior compartment and descends with the anterior tibial artery between tibialis anterior and extensor hallucis longus."))
story.append(H3("Motor Supply"))
motor = ["Tibialis anterior","Extensor hallucis longus","Extensor digitorum longus","Fibularis (Peroneus) tertius","Extensor digitorum brevis and extensor hallucis brevis (dorsum of foot)"]
for m in motor:
    story.append(B(m))
story.append(H3("Sensory Supply"))
story.append(S("Only the <b>first web space</b> between great toe and 2nd toe (dorsal skin). This is the smallest cutaneous territory of any nerve in the lower limb."))
story.append(H3("Effects of Injury"))
effects = [
    "<b>Foot drop:</b> Paralysis of all dorsiflexors — inability to dorsiflex the foot",
    "<b>Loss of toe extension</b>",
    "<b>Loss of eversion</b> (peroneus tertius paralyzed)",
    "<b>Steppage (equine) gait</b>",
    "<b>Sensory loss:</b> Only in the first web space",
]
for e in effects:
    story.append(B(e))
story.append(H3("Common Sites of Injury"))
sites = [
    "<b>Neck of fibula (most common):</b> Tight plaster cast, fractures, prolonged pressure",
    "<b>Anterior tarsal tunnel syndrome:</b> Compression under inferior extensor retinaculum at ankle",
    "<b>Anterior compartment syndrome:</b> Raised pressure from trauma/overuse",
    "<b>Tight footwear:</b> Pressure on dorsum of foot",
]
for s in sites:
    story.append(B(s))
story.append(S("<i>(BDC Human Anatomy, 9th ed., Vol. 2, p. 115)</i>", note_style))
story.append(Spacer(1, 0.2*cm))

# Q7
story.append(question_header(7, "Write Briefly About Nerve Supply and Action of Tibialis Anterior", "2018"))
story.append(H3("Overview"))
story.append(S("Tibialis anterior is the largest and most medial muscle of the <b>anterior compartment of the leg</b>."))
story.append(H3("Attachments"))
attach_data = [
    ["Feature","Details"],
    ["Origin","Upper 2/3 of lateral surface of tibia + adjacent interosseous membrane"],
    ["Insertion","Medial cuneiform bone + base of 1st metatarsal (medial & plantar aspects)"],
    ["Nerve Supply","Deep fibular (peroneal) nerve — L4, L5"],
    ["Blood Supply","Anterior tibial artery"],
]
story.append(make_table(attach_data[0], attach_data[1:], col_widths=[4*cm, 12.2*cm]))
story.append(Spacer(1, 0.2*cm))
story.append(H3("Actions"))
story.append(B("<b>Dorsiflexion</b> of the foot at the ankle joint (primary and most powerful dorsiflexor)"))
story.append(B("<b>Inversion</b> of the foot (at subtalar and midtarsal joints)"))
story.append(B("<b>Supports the medial longitudinal arch</b> of the foot"))
story.append(H3("Applied Anatomy"))
story.append(B("<b>Tibialis anterior rupture:</b> Spontaneous, especially in elderly; presents with foot drop + visible weakness on dorsiflexion + palpable gap above ankle."))
story.append(B("<b>Compartment syndrome:</b> Swelling in anterior compartment compresses the deep fibular nerve."))
story.append(S("<i>(BDC Human Anatomy, 9th ed., Vol. 2, p. 112)</i>", note_style))
story.append(Spacer(1, 0.2*cm))

# Q8
story.append(question_header(8, "Write Briefly About Nerve Supply and Action of Peroneus Longus Muscle", "2017"))
story.append(H3("Overview"))
story.append(S("Fibularis (Peroneus) longus is the larger muscle of the <b>lateral compartment of the leg</b>."))
story.append(H3("Attachments"))
plong_data = [
    ["Feature","Details"],
    ["Origin","Head and upper 2/3 of lateral surface of the fibula; adjacent intermuscular septa"],
    ["Insertion","Plantar surface of medial cuneiform + base of 1st metatarsal (crosses sole obliquely)"],
    ["Nerve Supply","Superficial fibular (peroneal) nerve — L5, S1, S2"],
    ["Blood Supply","Fibular (peroneal) artery"],
]
story.append(make_table(plong_data[0], plong_data[1:], col_widths=[4*cm, 12.2*cm]))
story.append(Spacer(1, 0.2*cm))
story.append(H3("Actions"))
story.append(B("<b>Eversion</b> of the foot (primary action)"))
story.append(B("<b>Plantarflexion</b> of the foot (weak)"))
story.append(B("<b>Supports the transverse arch</b> of the foot — the tendon acts as a sling across the sole"))
story.append(B("<b>Supports the medial longitudinal arch</b> as well"))
story.append(H3("Applied Anatomy"))
story.append(B("Rupture/dislocation of fibularis longus tendon can occur with ankle sprains."))
story.append(B("Loss of fibularis longus → flat foot and loss of eversion."))
story.append(S("<i>(BDC Human Anatomy, 9th ed., Vol. 2, p. 118)</i>", note_style))
story.append(Spacer(1, 0.2*cm))

# Q9
story.append(question_header(9, "Discuss Briefly the Dorsalis Pedis Artery", "2014"))
story.append(H3("Origin and Course"))
story.append(S("The dorsalis pedis artery is the <b>continuation of the anterior tibial artery</b> on the dorsum of the foot, beginning at the ankle joint (midpoint between malleoli). It passes to the proximal end of the first intermetatarsal space."))
story.append(H3("Relations"))
story.append(B("Medially: Extensor hallucis longus tendon"))
story.append(B("Laterally: Extensor digitorum longus tendon to 2nd toe"))
story.append(B("Deep fibular nerve lies lateral to it"))
story.append(H3("Branches"))
dors_data = [
    ["Branch","Distribution"],
    ["Lateral tarsal artery","Passes laterally over cuboid"],
    ["Medial tarsal arteries (2-3)","Medial side of foot"],
    ["Arcuate artery","Arches laterally across metatarsal bases; gives dorsal metatarsal arteries"],
    ["1st dorsal metatarsal artery","First interdigital cleft"],
    ["Deep plantar artery","Passes into sole via 1st intermetatarsal space; anastomoses with lateral plantar artery to complete the plantar arch"],
]
story.append(make_table(dors_data[0], dors_data[1:], col_widths=[5*cm, 11.2*cm]))
story.append(Spacer(1, 0.2*cm))
story.append(H3("Applied Anatomy"))
story.append(B("<b>Dorsalis pedis pulse:</b> Palpable between EHL and EDL tendons. Absent in ~10% of normal people (replaced by perforating fibular artery)."))
story.append(B("<b>Peripheral vascular disease/Diabetic foot:</b> Absent or weak pulse indicates ischemia."))
story.append(B("<b>Microvascular surgery:</b> Used as a recipient vessel in free-flap reconstruction."))
story.append(S("<i>(BDC Human Anatomy, 9th ed., Vol. 2, p. 115-116)</i>", note_style))
story.append(Spacer(1, 0.2*cm))

# Q10
story.append(question_header(10, "Write About Superficial Peroneal (Fibular) Nerve", "2012"))
story.append(H3("Origin"))
story.append(S("Terminal branch of the <b>common fibular (peroneal) nerve</b> at the neck of the fibula."))
story.append(H3("Course"))
story.append(S("Arises within fibularis longus → descends in the lateral compartment between fibularis longus and brevis → pierces deep fascia in the lower third of the leg → divides into medial and intermediate dorsal cutaneous nerves."))
story.append(H3("Motor Supply"))
story.append(B("Fibularis (Peroneus) longus"))
story.append(B("Fibularis (Peroneus) brevis"))
story.append(H3("Sensory Supply"))
story.append(B("Lower lateral leg"))
story.append(B("Dorsum of the foot and toes (excluding: 1st web space [deep fibular], lateral border [sural], medial side of great toe)"))
story.append(H3("Applied Anatomy"))
story.append(B("<b>Common fibular nerve injury at neck of fibula:</b> Both deep and superficial branches affected — foot drop + loss of eversion + sensory loss over dorsum of foot."))
story.append(B("<b>Isolated superficial fibular nerve injury:</b> Loss of eversion only (dorsiflexion preserved)."))
story.append(B("<b>Entrapment syndrome:</b> Where the nerve pierces deep fascia in the lower leg — pain/numbness on dorsum of foot."))
story.append(S("<i>(BDC Human Anatomy, 9th ed., Vol. 2, p. 117-118)</i>", note_style))
story.append(Spacer(1, 0.2*cm))

# Q11
story.append(question_header(11, "Write a Short Note on Dorsiflexors of Foot", "2011"))
story.append(H3("Definition"))
story.append(S("Dorsiflexion reduces the angle between the dorsum of the foot and the anterior leg (foot lifted upward). Range: ~20°."))
story.append(H3("Muscles — All in Anterior Compartment, Supplied by Deep Fibular Nerve"))
dors_m_data = [
    ["Muscle","Segmental Level","Secondary Action"],
    ["Tibialis anterior (prime mover)","L4, L5","Inversion"],
    ["Extensor hallucis longus","L4, L5","Extends great toe"],
    ["Extensor digitorum longus","L5, S1","Extends toes 2-5"],
    ["Fibularis (Peroneus) tertius","L5, S1","Eversion"],
]
story.append(make_table(dors_m_data[0], dors_m_data[1:], col_widths=[5.5*cm, 4*cm, 6.7*cm]))
story.append(Spacer(1, 0.2*cm))
story.append(H3("Applied Anatomy"))
story.append(B("<b>Testing dorsiflexion:</b> Assesses L4, L5 nerve roots and deep fibular nerve."))
story.append(B("<b>Foot drop:</b> Loss of all dorsiflexors from common fibular nerve injury."))
story.append(B("<b>Anterior compartment syndrome:</b> Ischemia of dorsiflexors; emergency fasciotomy required."))
story.append(S("<i>(BDC Human Anatomy, 9th ed., Vol. 2, p. 111-112)</i>", note_style))
story.append(Spacer(1, 0.2*cm))

# Q12
story.append(question_header(12, "Enumerate Muscles Causing Inversion and Eversion with Their Nerve Supply", "2008"))
story.append(H3("Muscles of Inversion"))
inv2_data = [
    ["Muscle","Nerve Supply","Segment"],
    ["Tibialis anterior","Deep fibular nerve","L4, L5"],
    ["Tibialis posterior","Tibial nerve","L4, L5"],
    ["Flexor hallucis longus","Tibial nerve","S2, S3"],
    ["Flexor digitorum longus","Tibial nerve","L5, S1"],
    ["Extensor hallucis longus","Deep fibular nerve","L4, L5"],
]
story.append(make_table(inv2_data[0], inv2_data[1:], col_widths=[6*cm, 5*cm, 5.2*cm]))
story.append(Spacer(1, 0.2*cm))
story.append(H3("Muscles of Eversion"))
ev2_data = [
    ["Muscle","Nerve Supply","Segment"],
    ["Fibularis (Peroneus) longus","Superficial fibular nerve","L5, S1, S2"],
    ["Fibularis (Peroneus) brevis","Superficial fibular nerve","L5, S1, S2"],
    ["Fibularis (Peroneus) tertius","Deep fibular nerve","L5, S1"],
    ["Extensor digitorum longus","Deep fibular nerve","L5, S1"],
]
story.append(make_table(ev2_data[0], ev2_data[1:], col_widths=[6*cm, 5*cm, 5.2*cm]))
story.append(S("<i>(BDC Human Anatomy, 9th ed., Vol. 2, p. 111, 118, 128)</i>", note_style))

story.append(PageBreak())

# ═══════════════════════════════════════════════════════════════════════════════
# SECTION 4: BACK OF LEG
# ═══════════════════════════════════════════════════════════════════════════════
story.append(section_header("SECTION 4: BACK OF LEG"))
story.append(Spacer(1, 0.2*cm))

# Q13
story.append(question_header(13, "Write a Short Note on Popliteus Muscle", "2019, 2017, 2011"))
story.append(H3("Introduction"))
story.append(S("Popliteus is a small, triangular muscle forming the floor of the lower part of the popliteal fossa. It is called the <b>'key to the knee joint'</b>."))
story.append(H3("Attachments"))
pop_data = [
    ["Feature","Details"],
    ["Origin","Lateral femoral condyle (a pit on outer surface); also fibular head via popliteofibular ligament"],
    ["Insertion","Posterior surface of tibia above the soleal line (widens as it descends medially)"],
    ["Nerve Supply","Tibial nerve (L4, L5, S1)"],
    ["Blood Supply","Popliteal artery; inferior medial and lateral geniculate arteries"],
]
story.append(make_table(pop_data[0], pop_data[1:], col_widths=[4*cm, 12.2*cm]))
story.append(Spacer(1, 0.2*cm))
story.append(H3("Actions"))
pop_actions = [
    "<b>UNLOCKING the knee (primary unique action):</b> Medially rotates the tibia on a fixed femur (or laterally rotates the femur on a fixed tibia) to reverse the screw-home mechanism and initiate knee flexion.",
    "<b>Weak flexion</b> of the knee",
    "<b>Stabilizes</b> the posterior knee capsule",
]
for a in pop_actions:
    story.append(B(a))
story.append(H3("Why is Popliteus Called the 'Key to the Knee'?"))
story.append(S("The knee locks in full extension by a lateral rotation of the tibia (screw-home mechanism). <b>Before flexion can begin, popliteus reverses this rotation</b> — it is the only muscle that can unlock the knee. Without popliteus, flexion from full extension cannot be initiated."))
story.append(H3("Applied Anatomy"))
story.append(B("<b>Popliteus tendinitis:</b> Pain at the posterolateral knee; common in downhill runners."))
story.append(B("<b>Posterolateral corner injury:</b> Popliteus tendon may be involved in knee ligament injuries."))
story.append(S("<i>(BDC Human Anatomy, 9th ed., Vol. 2, p. 128)</i>", note_style))
story.append(Spacer(1, 0.2*cm))

# Q14
story.append(question_header(14, "Write a Note on Soleus", "2005"))
story.append(H3("Introduction"))
story.append(S("Soleus is a broad, powerful muscle of the <b>posterior compartment of the leg</b>. Together with gastrocnemius and plantaris it forms the <b>triceps surae</b>."))
story.append(H3("Attachments"))
sol_data = [
    ["Feature","Details"],
    ["Origin","Horseshoe-shaped: (1) Fibular head + upper 1/3 posterior fibula; (2) Soleal line of tibia; (3) Fibrous tendinous arch between fibula and tibia"],
    ["Insertion","Via tendo calcaneus (Achilles tendon) into posterior surface of calcaneus"],
    ["Nerve Supply","Tibial nerve (S1, S2)"],
    ["Blood Supply","Posterior tibial artery; fibular artery; sural branches of popliteal artery"],
]
story.append(make_table(sol_data[0], sol_data[1:], col_widths=[4*cm, 12.2*cm]))
story.append(Spacer(1, 0.2*cm))
story.append(H3("Actions"))
story.append(B("<b>Plantarflexion</b> of the foot at the ankle joint (powerful prime mover)"))
story.append(B("Essential for <b>walking, running, and standing on tiptoe</b>"))
story.append(B("<b>Venous (muscle) pump:</b> Contractions squeeze deep veins of the leg, propelling blood toward the heart"))
story.append(H3("Characteristic Features of Soleus"))
char_sol = [
    "Does <b>NOT cross the knee joint</b> — acts only at the ankle (unlike gastrocnemius which is biarticular).",
    "Most effective when knee is <b>flexed</b> — gastrocnemius is slackened so soleus bears the full plantarflexion load.",
    "Contains predominantly <b>slow-twitch (type I) muscle fibers</b> — adapted for sustained postural activity.",
    "<b>Postural muscle:</b> Maintains upright stance continuously. Gastrocnemius is phasic (bursts during activity).",
    "The tendinous arch of soleus origin is traversed by the <b>popliteal vessels and tibial nerve</b>.",
]
for c in char_sol:
    story.append(B(c))
story.append(H3("Applied Anatomy"))
story.append(B("<b>DVT:</b> Thrombosis often begins in the <b>soleal sinusoids</b> (venous lakes within soleus) after immobility."))
story.append(B("<b>Achilles tendon rupture:</b> Palpable gap above heel; positive <b>Simmond's (Thompson's) test</b> — squeezing the calf fails to plantarflex the foot."))
story.append(S("<i>(BDC Human Anatomy, 9th ed., Vol. 2, p. 126-127)</i>", note_style))

story.append(PageBreak())

# ═══════════════════════════════════════════════════════════════════════════════
# SECTION 5: SOLE OF FOOT
# ═══════════════════════════════════════════════════════════════════════════════
story.append(section_header("SECTION 5: SOLE OF FOOT"))
story.append(Spacer(1, 0.2*cm))

# Q15
story.append(question_header(15, "Write Briefly About Nerve Supply and Action of Lumbricals of Foot", "2018"))
story.append(H3("Introduction"))
story.append(S("The lumbricals of the foot are <b>four small worm-shaped muscles</b> in the second layer of the sole, analogous to the lumbricals of the hand."))
story.append(H3("Attachments"))
lumb_data = [
    ["Feature","Details"],
    ["Origin — 1st lumbrical","Medial side of FDL tendon to 2nd toe (single head)"],
    ["Origin — 2nd, 3rd, 4th","Adjacent sides of FDL tendons (two heads each)"],
    ["Insertion","Medial side of dorsal digital expansion (extensor hood) of toes 2-5"],
    ["Nerve — 1st lumbrical","Medial plantar nerve (L5, S1)"],
    ["Nerve — 2nd, 3rd, 4th","Deep branch of lateral plantar nerve (S2, S3)"],
]
story.append(make_table(lumb_data[0], lumb_data[1:], col_widths=[5*cm, 11.2*cm]))
story.append(Spacer(1, 0.2*cm))
story.append(H3("Actions"))
story.append(B("<b>Flex the MTP joints</b> of toes 2-5"))
story.append(B("<b>Extend the IP joints</b> of toes 2-5 (via extensor expansion)"))
story.append(H3("Applied Anatomy"))
story.append(B("<b>Claw toes:</b> Weakness/denervation of lumbricals (intrinsic minus) → MTP hyperextension + IP flexion."))
story.append(B("<b>Diabetic neuropathy:</b> Loss of intrinsic muscles → claw toe + altered pressure distribution → plantar ulcers."))
story.append(S("<i>(BDC Human Anatomy, 9th ed., Vol. 2, p. 139)</i>", note_style))
story.append(Spacer(1, 0.2*cm))

# Q16
story.append(question_header(16, "Draw and Label Muscles of the First Layer of Sole", "2016"))
story.append(H3("Introduction"))
story.append(S("The first (most superficial) layer of the sole lies deep to the plantar aponeurosis. It contains <b>three muscles</b>: one medial, one central, one lateral."))
story.append(H3("Muscles of the First Layer"))
layer1_data = [
    ["Muscle","Origin","Insertion","Nerve Supply","Action"],
    ["Abductor hallucis","Medial calcaneal tuberosity, flexor retinaculum, plantar aponeurosis","Medial side, base of proximal phalanx of great toe","Medial plantar nerve (L5, S1)","Abducts + flexes great toe; supports medial longitudinal arch"],
    ["Flexor digitorum brevis","Medial calcaneal tuberosity, plantar aponeurosis","Middle phalanges of toes 2-5 (splits for FDL tendon)","Medial plantar nerve (L5, S1)","Flexes middle phalanges (PIP joints) of toes 2-5"],
    ["Abductor digiti minimi","Lateral + medial calcaneal tuberosities, plantar aponeurosis","Lateral side, base of proximal phalanx of 5th toe","Lateral plantar nerve (S2, S3)","Abducts 5th toe; assists flexion"],
]
story.append(make_table(layer1_data[0], layer1_data[1:], col_widths=[3.2*cm, 4*cm, 3.5*cm, 3*cm, 2.5*cm]))
story.append(Spacer(1, 0.2*cm))
story.append(H3("Diagram Layout"))
story.append(S("[Toes]", note_style))
story.append(S("Abductor hallucis (medial) — Flexor digitorum brevis (central) — Abductor digiti minimi (lateral)", note_style))
story.append(S("[All three arise from the CALCANEAL TUBEROSITY]", note_style))
story.append(H3("Note"))
story.append(S("The key difference: Flexor digitorum brevis is analogous to flexor digitorum superficialis of the hand — it splits around the FDL tendon (analogous to vinculum system)."))
story.append(S("<i>(BDC Human Anatomy, 9th ed., Vol. 2, p. 138)</i>", note_style))
story.append(Spacer(1, 0.2*cm))

# Q17
story.append(question_header(17, "Enumerate Muscles Supplied by Deep Branch of Lateral Plantar Nerve", "2008"))
story.append(H3("Context"))
story.append(S("The lateral plantar nerve (from tibial nerve) divides in the sole into superficial and deep branches. The <b>deep branch</b> curves medially across the sole (like deep branch of ulnar nerve in the hand) to supply:"))
story.append(H3("Muscles Supplied by Deep Branch of Lateral Plantar Nerve"))
deep_lp = [
    "Flexor digiti minimi brevis",
    "Adductor hallucis — oblique head",
    "Adductor hallucis — transverse head",
    "All plantar interossei (3 muscles — PAD: Plantar ADduct)",
    "All dorsal interossei (4 muscles — DAB: Dorsal ABduct)",
    "2nd lumbrical",
    "3rd lumbrical",
    "4th lumbrical",
]
for i, m in enumerate(deep_lp, 1):
    story.append(B(f"{i}. {m}"))
story.append(H3("Mnemonic"))
story.append(S("The deep branch of lateral plantar nerve supplies all the <b>intrinsic muscles of the sole EXCEPT:</b> Abductor hallucis, Flexor digitorum brevis, Flexor hallucis brevis, and 1st lumbrical (which are supplied by the medial plantar nerve)."))
story.append(S("<i>(BDC Human Anatomy, 9th ed., Vol. 2, p. 144)</i>", note_style))

story.append(PageBreak())

# ═══════════════════════════════════════════════════════════════════════════════
# SECTION 6: VENOUS AND LYMPHATIC DRAINAGE
# ═══════════════════════════════════════════════════════════════════════════════
story.append(section_header("SECTION 6: VENOUS AND LYMPHATIC DRAINAGE"))
story.append(Spacer(1, 0.2*cm))

# Q18
story.append(question_header(18, "Briefly Describe Venous Drainage of Lower Limb and Its Applied Anatomy", "2010"))
story.append(H3("Classification of Veins"))
story.append(S("Veins of the lower limb are classified into: <b>(1) Deep veins</b> — follow arteries; <b>(2) Superficial veins</b> — in subcutaneous tissue; <b>(3) Perforating veins</b> — connect superficial to deep."))
story.append(H3("Deep Veins"))
deep_v = ["Posterior tibial veins","Anterior tibial veins","Fibular (peroneal) veins","Popliteal vein (tibial veins join here)","Femoral vein (continuation of popliteal; passes through femoral triangle)","Profunda femoris vein (drains posterior thigh)","External iliac vein (continuation of femoral above inguinal ligament)"]
for v in deep_v:
    story.append(B(v))
story.append(H3("Superficial Veins"))
story.append(S("<b>1. Great (Long) Saphenous Vein:</b>"))
story.append(B("Origin: Medial side of dorsal venous arch of foot"))
story.append(B("Course: Anterior to medial malleolus → medial leg → behind medial tibial condyle → anteromedial thigh"))
story.append(B("Termination: Drains into femoral vein via saphenous opening (fossa ovalis), just below and lateral to pubic tubercle"))
story.append(B("Tributaries at sapheno-femoral junction: Superficial epigastric, superficial circumflex iliac, superficial external pudendal veins"))
story.append(B("Contains 10-12 valves"))
story.append(Spacer(1, 0.15*cm))
story.append(S("<b>2. Small (Short) Saphenous Vein:</b>"))
story.append(B("Origin: Lateral side of dorsal venous arch"))
story.append(B("Course: Posterior to lateral malleolus → up posterior midline of leg → pierces deep fascia of popliteal fossa"))
story.append(B("Termination: Drains into popliteal vein"))
story.append(H3("Perforating Veins"))
story.append(S("Connect superficial to deep; valves direct flow inward (superficial → deep). Key perforators: Dodd's (mid-thigh), Boyd's (upper calf), Cockett's/Sherman's (lower medial leg, near medial malleolus)."))
story.append(H3("Applied Anatomy"))
applied_v = [
    "<b>Varicose veins:</b> Dilated tortuous superficial veins from incompetent valves; saphenofemoral junction most common site.",
    "<b>DVT:</b> Begins in soleal sinusoids/calf veins; risk: immobility, surgery, hypercoagulability. Complication: pulmonary embolism.",
    "<b>Great saphenous vein harvest:</b> Used as conduit in CABG and peripheral arterial bypass surgery.",
    "<b>Venous ulcer:</b> Above medial malleolus (gaiter area) from chronic venous hypertension.",
    "<b>Intravenous access:</b> Great saphenous vein anterior to medial malleolus — used for emergency cutdown.",
]
for a in applied_v:
    story.append(B(a))
story.append(S("<i>(BDC Human Anatomy, 9th ed., Vol. 2, p. 148-152 | Gray's Anatomy for Students)</i>", note_style))
story.append(Spacer(1, 0.2*cm))

# Q19
story.append(question_header(19, "Write a Short Note on Varicose Veins", "2007"))
story.append(H3("Definition"))
story.append(S("Varicose veins are <b>abnormally dilated, tortuous, and elongated superficial veins</b> of the lower limb, usually involving the great or small saphenous systems."))
story.append(H3("Pathophysiology"))
story.append(S("Incompetent valves → blood refluxes → increased pressure transmitted distally → progressive valve failure → progressive dilation and tortuosity of superficial veins. Normal flow: superficial veins → deep veins (via competent perforators) → IVC."))
story.append(H3("Etiology / Risk Factors"))
varic_rf = ["Female sex (2:1 ratio)","Pregnancy (raised intra-abdominal pressure)","Genetic predisposition","Prolonged standing","Obesity","Previous deep vein thrombosis (destroys valves)"]
for r in varic_rf:
    story.append(B(r))
story.append(H3("Sites of Incompetence"))
story.append(B("<b>Sapheno-femoral junction</b> (most common)"))
story.append(B("Perforating veins — Cockett's, Boyd's, Dodd's"))
story.append(B("Sapheno-popliteal junction"))
story.append(H3("Complications"))
varic_comp = [
    "<b>Venous eczema</b> — itchy, scaly skin",
    "<b>Lipodermatosclerosis</b> — fibrous hardening of subcutaneous tissue",
    "<b>Skin pigmentation</b> — brown (hemosiderin) deposits",
    "<b>Venous ulceration</b> — above medial malleolus (gaiter area)",
    "<b>Rupture/hemorrhage</b>",
    "<b>Superficial thrombophlebitis</b>",
]
for c in varic_comp:
    story.append(B(c))
story.append(H3("Treatment"))
story.append(B("Conservative: Elevation, compression stockings, exercise"))
story.append(B("Sclerotherapy (foam injection)"))
story.append(B("Surgery: Sapheno-femoral ligation + stripping"))
story.append(B("Endovenous laser therapy (EVLT) or radiofrequency ablation (RFA)"))
story.append(S("<i>(BDC Human Anatomy, 9th ed., Vol. 2, p. 151-152 | Gray's Anatomy for Students)</i>", note_style))
story.append(Spacer(1, 0.2*cm))

# Q20
story.append(question_header(20, "Write a Short Note on Lymphatic Drainage of Lower Limb", "2005"))
story.append(H3("Overview"))
story.append(S("Lymph from the lower limb drains into two groups of lymph nodes: <b>popliteal</b> and <b>inguinal</b>."))
story.append(H3("Superficial Lymphatics"))
story.append(B("<b>Medial group:</b> Follow the great saphenous vein → superficial inguinal lymph nodes (vertical group)."))
story.append(B("<b>Lateral group:</b> Follow small saphenous vein → popliteal lymph nodes → deep inguinal nodes."))
story.append(H3("Deep Lymphatics"))
story.append(S("Follow the deep blood vessels (tibial, fibular, popliteal, femoral arteries) → deep inguinal lymph nodes."))
story.append(H3("Popliteal Lymph Nodes"))
story.append(S("Located along popliteal vessels. Receive: lateral superficial lymphatics + deep lymphatics of leg and foot. Drain to: deep inguinal nodes."))
story.append(H3("Inguinal Lymph Nodes"))
ing_data = [
    ["Group","Receives From","Drains To"],
    ["Superficial inguinal\n(horizontal group)","Gluteal region, perineum, external genitalia, lower abdominal wall","Deep inguinal nodes"],
    ["Superficial inguinal\n(vertical group)","Medial lower limb (great saphenous territory)","Deep inguinal nodes"],
    ["Deep inguinal nodes\n(medial to femoral vein)","Superficial nodes + deep lymphatics of limb","External iliac → common iliac → para-aortic → thoracic duct"],
]
story.append(make_table(ing_data[0], ing_data[1:], col_widths=[4.5*cm, 6.5*cm, 5.2*cm]))
story.append(Spacer(1, 0.2*cm))
story.append(H3("Applied Anatomy"))
story.append(B("<b>Lymphoedema:</b> Blockage (filariasis, post-surgery, radiation) → non-pitting, chronic oedema."))
story.append(B("<b>Elephantiasis:</b> Massive lymphoedema from chronic Wuchereria bancrofti filarial infection."))
story.append(B("<b>Melanoma of lower limb:</b> First spreads to inguinal nodes (sentinel node biopsy performed here)."))
story.append(B("<b>Inguinal lymphadenopathy:</b> Infected wounds of foot, leg, or perineum."))
story.append(S("<i>(BDC Human Anatomy, 9th ed., Vol. 2, p. 152-154)</i>", note_style))

story.append(PageBreak())

# ═══════════════════════════════════════════════════════════════════════════════
# SECTION 7: JOINTS OF LOWER LIMB
# ═══════════════════════════════════════════════════════════════════════════════
story.append(section_header("SECTION 7: JOINTS OF LOWER LIMB"))
story.append(Spacer(1, 0.2*cm))

# Q21
story.append(question_header(21, "Describe Ankle Joint", "2022"))

story.append(H3("a. Type and Articular Surfaces"))
story.append(S("<b>Type:</b> Synovial joint of the <b>hinge (ginglymus) type</b>."))
story.append(S("<b>Bones involved:</b> Distal tibia + distal fibula + talus."))
story.append(S("<b>Mortise socket:</b> The tibia and fibula form a bracket-shaped socket:"))
story.append(B("<b>Roof:</b> Inferior articular surface of distal tibia"))
story.append(B("<b>Medial wall:</b> Medial malleolus of tibia"))
story.append(B("<b>Lateral wall:</b> Lateral malleolus of fibula (projects more distally than medial malleolus)"))
story.append(S("<b>Talar articular surface (trochlea tali):</b> Wider anteriorly than posteriorly. In dorsiflexion, the wider anterior part is in the socket → <b>more stable</b>. In plantarflexion, narrower posterior part → <b>less stable</b> → sprains most common in plantarflexion."))
story.append(Spacer(1, 0.2*cm))

story.append(H3("b. Ligaments"))
story.append(S("<b>Medial (Deltoid) Ligament — Strong, triangular:</b>"))
story.append(B("Apex: Medial malleolus"))
story.append(B("Base: Navicular tuberosity (anteriorly) to medial tubercle of talus (posteriorly)"))
story.append(S("<b>4 parts:</b>"))
med_lig = [
    "Tibionavicular part — to navicular tuberosity and spring ligament",
    "Tibiocalcaneal part — to sustentaculum tali of calcaneus",
    "Posterior tibiotalar part — to medial tubercle of talus",
    "Anterior tibiotalar part (deep) — to medial surface of talus",
]
for p in med_lig:
    story.append(B(p))
story.append(S("<b>Note:</b> The deltoid ligament is so strong that forceful eversion fractures the medial malleolus rather than tearing the ligament.", note_style))
story.append(Spacer(1, 0.15*cm))
story.append(S("<b>Lateral Ligament — Three separate bands (weaker):</b>"))
lat_lig_data = [
    ["Ligament","Attachment","Note"],
    ["Anterior talofibular lig. (ATFL)","Anterior lateral malleolus → adjacent talus","Most commonly torn in ankle sprains"],
    ["Posterior talofibular lig. (PTFL)","Malleolar fossa → posterior process of talus","Strongest of the three"],
    ["Calcaneofibular lig. (CFL)","Tip of lateral malleolus → lateral calcaneus","2nd most commonly torn"],
]
story.append(make_table(lat_lig_data[0], lat_lig_data[1:], col_widths=[4.5*cm, 6.5*cm, 5.2*cm]))
story.append(Spacer(1, 0.2*cm))

story.append(H3("c. Movements and Muscles Responsible"))
mov_data = [
    ["Movement","Range","Muscles Responsible","Nerve Supply"],
    ["Dorsiflexion","~20°","Tibialis anterior (prime), EHL, EDL, Peroneus tertius","Deep fibular n. (L4, L5)"],
    ["Plantarflexion","~50°","Gastrocnemius + Soleus (triceps surae - prime movers), Tibialis posterior, Peroneus longus & brevis, FHL, FDL","Tibial n. (S1, S2)"],
]
story.append(make_table(mov_data[0], mov_data[1:], col_widths=[3*cm, 2*cm, 7.5*cm, 3.7*cm]))
story.append(S("<b>Note:</b> Inversion and eversion do NOT occur at the ankle joint — they occur at the subtalar and midtarsal joints."))
story.append(Spacer(1, 0.2*cm))

story.append(H3("d. Applied Anatomy"))
ankle_app = [
    "<b>Ankle sprain:</b> Most common musculoskeletal injury; inversion + plantarflexion tears ATFL first, then CFL. Treated with RICE and physiotherapy.",
    "<b>Pott's fracture:</b> Forced eversion avulses medial malleolus + fractures lateral malleolus (bimalleolar); trimalleolar adds posterior tibial lip.",
    "<b>Ottawa Ankle Rules:</b> Bone tenderness at malleoli or inability to bear weight × 4 steps → ankle X-ray required.",
    "<b>Ankle arthroplasty:</b> Total ankle replacement for end-stage osteoarthritis.",
    "<b>Posterior tibial nerve block:</b> Landmark is behind medial malleolus — used for foot surgery under regional anaesthesia.",
]
for a in ankle_app:
    story.append(B(a))
story.append(S("<i>(BDC Human Anatomy, 9th ed., Vol. 2, p. 174-177 | Gray's Anatomy for Students, p. 744-746)</i>", note_style))
story.append(Spacer(1, 0.2*cm))

# Q22
story.append(question_header(22, "Write a Short Note on Locking and Unlocking of Knee Joint", "2022"))
story.append(H3("Introduction"))
story.append(S("The knee joint is the <b>largest synovial joint</b> in the body. Because it is weight-bearing, it has a unique <b>screw-home mechanism</b> — a form of physiological locking in full extension that reduces muscle energy expenditure during standing."))
story.append(H3("Locking Mechanism (Terminal Extension)"))
story.append(S("As the knee approaches <b>full extension from flexion</b>:"))
lock_steps = [
    "The medial femoral condyle has a longer articular surface than the lateral condyle.",
    "When the lateral condyle exhausts its rolling/gliding on the lateral tibial plateau, the medial condyle continues to roll anteriorly.",
    "This causes the <b>tibia to rotate laterally (externally)</b> on the femur (in non-weight-bearing) OR the <b>femur to rotate medially</b> on a fixed tibia (in standing).",
    "This 'screwing' motion brings all bony and ligamentous components to maximum congruity and tightness.",
    "Result: The knee is <b>'locked'</b> — ACL, PCL, collateral ligaments, and capsule are all taut.",
    "In this locked position, the knee can bear weight with <b>minimal quadriceps activity</b> (energy efficient).",
]
for i, s in enumerate(lock_steps, 1):
    story.append(B(f"{i}. {s}"))
story.append(Spacer(1, 0.2*cm))
story.append(H3("Unlocking Mechanism (Initiating Flexion)"))
story.append(S("<b>Popliteus muscle</b> is the <b>sole unlocker</b> of the knee — hence it is called the <b>'key to the knee joint'.</b>"))
unlock_steps = [
    "<b>Non-weight-bearing (foot off ground):</b> Popliteus laterally rotates the tibia on the fixed femur.",
    "<b>Weight-bearing (foot fixed on ground):</b> Popliteus medially rotates the femur on the fixed tibia.",
    "This reversal of the screw-home rotation <b>releases the taut ligaments and capsule</b>.",
    "The knee is now 'unlocked' and flexion can begin.",
]
for s in unlock_steps:
    story.append(B(s))
story.append(Spacer(1, 0.2*cm))
story.append(H3("Summary Table"))
lock_data = [
    ["Phase","Tibial Movement","Femoral Movement","Muscle"],
    ["Locking (terminal extension)","Lateral (external) rotation","Medial rotation on fixed tibia","Quadriceps + condyle geometry"],
    ["Unlocking (initiating flexion)","Lateral rotation (NWB)","Medial rotation (WB)","Popliteus (ONLY)"],
]
story.append(make_table(lock_data[0], lock_data[1:], col_widths=[4*cm, 3.5*cm, 3.5*cm, 5.2*cm]))
story.append(Spacer(1, 0.2*cm))
story.append(H3("Applied Anatomy"))
knee_app = [
    "<b>Popliteus tendinitis:</b> Pain at posterolateral knee, common in downhill runners (popliteus works hard to repeatedly unlock the knee).",
    "<b>ACL injury:</b> Disrupts the normal screw-home mechanism, causing rotatory instability.",
    "<b>Pathological locking:</b> A torn meniscus fragment or loose body can block full extension — the knee 'locks' in a flexed position. This is different from physiological locking.",
    "<b>Testing popliteus:</b> Weakness makes it difficult to initiate flexion from full extension.",
]
for a in knee_app:
    story.append(B(a))
story.append(S("<i>(BDC Human Anatomy, 9th ed., Vol. 2, p. 172 | Gray's Anatomy for Students, p. 709-711)</i>", note_style))

# Final note
story.append(Spacer(1, 0.5*cm))
story.append(HR())
story.append(S("<b>References:</b> BDC Human Anatomy, 9th Edition, Volume 2 (Lower Limb) | Gray's Anatomy for Students, South Asia Edition (Elsevier)", note_style))
story.append(S("For BFUHS MBBS 1st Year Theory Examination — All answers are 10 marks", note_style))

# BUILD
doc.build(story)
print(f"PDF generated: {OUTPUT}")