Subbaiah medical college anatomy 3rd internal exam abdomen lower limb important topics MBBS

https://anatomyqa.com/important-questions-lower-limb

mkdir -p /home/daytona/workspace/anatomy-exam && cat > /home/daytona/workspace/anatomy-exam/inguinal_canal.py << 'PYEOF' from reportlab.lib.pagesizes import A4 from reportlab.lib.styles import getSampleStyleSheet, ParagraphStyle from reportlab.lib.units import cm from reportlab.lib import colors from reportlab.platypus import SimpleDocTemplate, Paragraph, Spacer, Table, TableStyle, HRFlowable from reportlab.lib.enums import TA_CENTER, TA_LEFT, TA_JUSTIFY doc = SimpleDocTemplate( "/home/daytona/workspace/anatomy-exam/Inguinal_Canal_10Mark_Answer.pdf", pagesize=A4, rightMargin=2*cm, leftMargin=2*cm, topMargin=2*cm, bottomMargin=2*cm ) styles = getSampleStyleSheet() # Custom styles title_style = ParagraphStyle('Title', parent=styles['Title'], fontSize=16, textColor=colors.HexColor('#1a237e'), spaceAfter=4, spaceBefore=0, alignment=TA_CENTER) subtitle_style = ParagraphStyle('Subtitle', parent=styles['Normal'], fontSize=10, textColor=colors.HexColor('#555555'), spaceAfter=12, alignment=TA_CENTER) heading1_style = ParagraphStyle('H1', parent=styles['Normal'], fontSize=13, textColor=colors.white, spaceBefore=12, spaceAfter=4, fontName='Helvetica-Bold', leftIndent=0) heading2_style = ParagraphStyle('H2', parent=styles['Normal'], fontSize=11, textColor=colors.HexColor('#1a237e'), spaceBefore=10, spaceAfter=3, fontName='Helvetica-Bold') body_style = ParagraphStyle('Body', parent=styles['Normal'], fontSize=10, leading=15, spaceAfter=6, alignment=TA_JUSTIFY) bullet_style = ParagraphStyle('Bullet', parent=styles['Normal'], fontSize=10, leading=14, spaceAfter=3, leftIndent=16, bulletIndent=6) clinical_style = ParagraphStyle('Clinical', parent=styles['Normal'], fontSize=10, leading=14, spaceAfter=4, leftIndent=12, textColor=colors.HexColor('#b71c1c')) story = [] # ── HEADER ────────────────────────────────────────────────────────── story.append(Paragraph("INGUINAL CANAL", title_style)) story.append(Paragraph("10-Mark Model Answer | Anatomy Internal Examination", subtitle_style)) story.append(HRFlowable(width="100%", thickness=2, color=colors.HexColor('#1a237e'), spaceAfter=10)) # ── DEFINITION ─────────────────────────────────────────────────────── def section_header(text): data = [[Paragraph(text, ParagraphStyle('hdr', fontSize=11, textColor=colors.white, fontName='Helvetica-Bold', spaceAfter=0, spaceBefore=0))]] t = Table(data, colWidths=[17*cm]) t.setStyle(TableStyle([ ('BACKGROUND', (0,0), (-1,-1), colors.HexColor('#1a237e')), ('ROUNDEDCORNERS', [4,4,4,4]), ('TOPPADDING', (0,0), (-1,-1), 5), ('BOTTOMPADDING', (0,0), (-1,-1), 5), ('LEFTPADDING', (0,0), (-1,-1), 10), ])) return t story.append(section_header("1. DEFINITION")) story.append(Spacer(1, 4)) story.append(Paragraph( "The <b>inguinal canal</b> is a slit-like oblique passage in the anterior abdominal wall that extends " "in a downward and medial direction, just above and parallel to the lower half of the inguinal ligament. " "It begins at the <b>deep inguinal ring</b> and continues for approximately <b>4 cm</b>, ending at the " "<b>superficial inguinal ring</b>.", body_style)) # ── OPENINGS ───────────────────────────────────────────────────────── story.append(section_header("2. OPENINGS")) story.append(Spacer(1, 4)) story.append(Paragraph("<b>Deep (Internal) Inguinal Ring:</b>", heading2_style)) story.append(Paragraph( "Located <b>midway between the anterior superior iliac spine (ASIS) and the pubic symphysis</b>, " "just above the inguinal ligament and immediately <b>lateral to the inferior epigastric vessels</b>. " "It is an oval opening in the transversalis fascia.", body_style)) story.append(Paragraph("<b>Superficial (External) Inguinal Ring:</b>", heading2_style)) story.append(Paragraph( "Located <b>superior to the pubic tubercle</b>. It is a triangular opening in the aponeurosis of the " "external oblique muscle, with its apex pointing superolaterally and base formed by the pubic crest. " "The medial crus attaches to the pubic symphysis; the lateral crus attaches to the pubic tubercle. " "Intercrural fibers prevent widening of the ring.", body_style)) # ── WALLS ──────────────────────────────────────────────────────────── story.append(section_header("3. WALLS (BOUNDARIES)")) story.append(Spacer(1, 4)) wall_data = [ [Paragraph('<b>Wall</b>', ParagraphStyle('th', fontSize=10, fontName='Helvetica-Bold', textColor=colors.white)), Paragraph('<b>Formation</b>', ParagraphStyle('th', fontSize=10, fontName='Helvetica-Bold', textColor=colors.white))], [Paragraph('<b>Anterior</b>', bullet_style), Paragraph('Aponeurosis of external oblique (whole length) + lower fibers of internal oblique (lateral 1/3 only, over deep ring)', body_style)], [Paragraph('<b>Posterior</b>', bullet_style), Paragraph('Transversalis fascia (whole length) + conjoint tendon/inguinal falx (medial 1/3 only, over superficial ring)', body_style)], [Paragraph('<b>Roof (Superior)</b>', bullet_style), Paragraph('Arching fibers of internal oblique + transversus abdominis muscles', body_style)], [Paragraph('<b>Floor (Inferior)</b>', bullet_style), Paragraph('Medial 1/2 of inguinal ligament + lacunar ligament (medial end)', body_style)], ] wall_table = Table(wall_data, colWidths=[4.5*cm, 12.5*cm]) wall_table.setStyle(TableStyle([ ('BACKGROUND', (0,0), (-1,0), colors.HexColor('#3949ab')), ('BACKGROUND', (0,1), (-1,1), colors.HexColor('#e8eaf6')), ('BACKGROUND', (0,2), (-1,2), colors.white), ('BACKGROUND', (0,3), (-1,3), colors.HexColor('#e8eaf6')), ('BACKGROUND', (0,4), (-1,4), colors.white), ('GRID', (0,0), (-1,-1), 0.5, colors.HexColor('#9fa8da')), ('VALIGN', (0,0), (-1,-1), 'TOP'), ('TOPPADDING', (0,0), (-1,-1), 5), ('BOTTOMPADDING', (0,0), (-1,-1), 5), ('LEFTPADDING', (0,0), (-1,-1), 8), ])) story.append(wall_table) story.append(Spacer(1, 4)) story.append(Paragraph( "<b>Memory Aid:</b> \"<i>2 walls have 2 components; 2 walls have 1</i>\" — Anterior and Posterior each have " "a main + reinforcing structure; Roof and Floor each have one main formation.", ParagraphStyle('tip', parent=styles['Normal'], fontSize=9, textColor=colors.HexColor('#4a148c'), leftIndent=10, fontName='Helvetica-Oblique', spaceAfter=6))) # ── CONTENTS ───────────────────────────────────────────────────────── story.append(section_header("4. CONTENTS")) story.append(Spacer(1, 4)) story.append(Paragraph("<b>In Males:</b>", heading2_style)) story.append(Paragraph("The spermatic cord, which contains:", body_style)) male_contents = [ "Ductus (vas) deferens", "Testicular artery (from abdominal aorta)", "Artery to ductus deferens (from inferior vesical artery)", "Cremasteric artery and vein", "Pampiniform plexus of veins (drains into testicular vein)", "Genital branch of genitofemoral nerve (innervates cremaster)", "Sympathetic nerve fibers", "Lymphatics from testis", "Remnants of processus vaginalis", ] for item in male_contents: story.append(Paragraph(f"• {item}", bullet_style)) story.append(Paragraph("<b>Three fascial coverings of spermatic cord:</b>", ParagraphStyle('h3', parent=styles['Normal'], fontSize=10, fontName='Helvetica-Bold', textColor=colors.HexColor('#1a237e'), spaceBefore=6, spaceAfter=3))) fascia_data = [ [Paragraph('<b>Layer</b>', ParagraphStyle('th2', fontSize=9, fontName='Helvetica-Bold', textColor=colors.white)), Paragraph('<b>Fascia</b>', ParagraphStyle('th2', fontSize=9, fontName='Helvetica-Bold', textColor=colors.white)), Paragraph('<b>Derived from</b>', ParagraphStyle('th2', fontSize=9, fontName='Helvetica-Bold', textColor=colors.white))], [Paragraph('Deepest', body_style), Paragraph('Internal spermatic fascia', body_style), Paragraph('Transversalis fascia', body_style)], [Paragraph('Middle', body_style), Paragraph('Cremasteric fascia + cremasteric muscle', body_style), Paragraph('Internal oblique muscle', body_style)], [Paragraph('Superficial', body_style), Paragraph('External spermatic fascia', body_style), Paragraph('Aponeurosis of external oblique', body_style)], ] ft = Table(fascia_data, colWidths=[3*cm, 7*cm, 7*cm]) ft.setStyle(TableStyle([ ('BACKGROUND', (0,0), (-1,0), colors.HexColor('#3949ab')), ('BACKGROUND', (0,1), (-1,1), colors.HexColor('#e8eaf6')), ('BACKGROUND', (0,2), (-1,2), colors.white), ('BACKGROUND', (0,3), (-1,3), colors.HexColor('#e8eaf6')), ('GRID', (0,0), (-1,-1), 0.5, colors.HexColor('#9fa8da')), ('TOPPADDING', (0,0), (-1,-1), 4), ('BOTTOMPADDING', (0,0), (-1,-1), 4), ('LEFTPADDING', (0,0), (-1,-1), 6), ('VALIGN', (0,0), (-1,-1), 'MIDDLE'), ])) story.append(ft) story.append(Spacer(1,6)) story.append(Paragraph("<b>In Females:</b>", heading2_style)) story.append(Paragraph("• Round ligament of the uterus (remnant of gubernaculum)", bullet_style)) story.append(Paragraph("• Genital branch of genitofemoral nerve", bullet_style)) story.append(Spacer(1,3)) story.append(Paragraph("<b>In Both Sexes:</b>", heading2_style)) story.append(Paragraph("• Ilioinguinal nerve (L1) — passes through part of the canal, exits via superficial ring", bullet_style)) # ── APPLIED ANATOMY ────────────────────────────────────────────────── story.append(section_header("5. APPLIED ANATOMY — INGUINAL HERNIA")) story.append(Spacer(1, 4)) hernia_data = [ [Paragraph('<b>Feature</b>', ParagraphStyle('th3', fontSize=10, fontName='Helvetica-Bold', textColor=colors.white)), Paragraph('<b>Indirect Inguinal Hernia</b>', ParagraphStyle('th3', fontSize=10, fontName='Helvetica-Bold', textColor=colors.white)), Paragraph('<b>Direct Inguinal Hernia</b>', ParagraphStyle('th3', fontSize=10, fontName='Helvetica-Bold', textColor=colors.white))], [Paragraph('Entry', body_style), Paragraph('Through deep inguinal ring', body_style), Paragraph('Through posterior wall (Hesselbach\'s triangle)', body_style)], [Paragraph('Relation to deep ring', body_style), Paragraph('Lateral to inferior epigastric vessels', body_style), Paragraph('Medial to inferior epigastric vessels', body_style)], [Paragraph('Sac position', body_style), Paragraph('Within spermatic cord coverings', body_style), Paragraph('Pushes through conjoint tendon', body_style)], [Paragraph('Scrotal descent', body_style), Paragraph('Common — enters scrotum', body_style), Paragraph('Rarely enters scrotum', body_style)], [Paragraph('Occurrence', body_style), Paragraph('More common; all ages', body_style), Paragraph('Older males; acquired weakness', body_style)], [Paragraph('Cause', body_style), Paragraph('Patent processus vaginalis', body_style), Paragraph('Weakness in posterior wall', body_style)], ] ht = Table(hernia_data, colWidths=[4*cm, 6.5*cm, 6.5*cm]) ht.setStyle(TableStyle([ ('BACKGROUND', (0,0), (-1,0), colors.HexColor('#b71c1c')), ('BACKGROUND', (0,1), (-1,1), colors.HexColor('#ffebee')), ('BACKGROUND', (0,2), (-1,2), colors.white), ('BACKGROUND', (0,3), (-1,3), colors.HexColor('#ffebee')), ('BACKGROUND', (0,4), (-1,4), colors.white), ('BACKGROUND', (0,5), (-1,5), colors.HexColor('#ffebee')), ('BACKGROUND', (0,6), (-1,6), colors.white), ('GRID', (0,0), (-1,-1), 0.5, colors.HexColor('#ef9a9a')), ('TOPPADDING', (0,0), (-1,-1), 4), ('BOTTOMPADDING', (0,0), (-1,-1), 4), ('LEFTPADDING', (0,0), (-1,-1), 6), ('VALIGN', (0,0), (-1,-1), 'TOP'), ])) story.append(ht) story.append(Spacer(1,8)) story.append(Paragraph( "<b>Hesselbach's Triangle</b> (site of direct hernia): Bounded by inferior epigastric vessels (lateral), " "lateral border of rectus abdominis (medial), and inguinal ligament (inferior).", ParagraphStyle('box', parent=styles['Normal'], fontSize=10, textColor=colors.HexColor('#b71c1c'), leftIndent=10, spaceAfter=6, fontName='Helvetica-Bold'))) # ── SUMMARY BOX ────────────────────────────────────────────────────── story.append(HRFlowable(width="100%", thickness=1.5, color=colors.HexColor('#1a237e'), spaceAfter=6)) story.append(section_header("QUICK RECALL SUMMARY")) story.append(Spacer(1, 4)) summary_items = [ "Length: ~4 cm | Direction: downward and medial, above inguinal ligament", "Rings: Deep ring (midpoint of inguinal ligament) → Superficial ring (above pubic tubercle)", "Anterior wall: Ext. oblique aponeurosis + Int. oblique (lateral 1/3)", "Posterior wall: Transversalis fascia + Conjoint tendon (medial 1/3)", "Roof: Arching fibers of Int. oblique + Transversus abdominis", "Floor: Inguinal ligament + Lacunar ligament (medially)", "Male contents: Spermatic cord + Ilioinguinal nerve", "Female contents: Round ligament of uterus + Genital br. of genitofemoral nerve + Ilioinguinal nerve", "Indirect hernia: Lateral to epigastric vessels, through deep ring, into scrotum", "Direct hernia: Medial to epigastric vessels, through Hesselbach's triangle", ] for item in summary_items: story.append(Paragraph(f"✓ {item}", bullet_style)) story.append(Spacer(1,8)) story.append(HRFlowable(width="100%", thickness=1, color=colors.HexColor('#9fa8da'), spaceAfter=4)) story.append(Paragraph( "Source: Gray's Anatomy for Students | Prepared for Subbaiah Medical College Anatomy 3rd Internal", ParagraphStyle('footer', parent=styles['Normal'], fontSize=8, textColor=colors.grey, alignment=TA_CENTER))) doc.build(story) print("PDF generated successfully!") PYEOF python3 /home/daytona/workspace/anatomy-exam/inguinal_canal.py

ls /home/daytona/workspace/anatomy-exam/

cat > /home/daytona/workspace/anatomy-exam/all_topics.py << 'PYEOF' from reportlab.lib.pagesizes import A4 from reportlab.lib.styles import getSampleStyleSheet, ParagraphStyle from reportlab.lib.units import cm from reportlab.lib import colors from reportlab.platypus import (SimpleDocTemplate, Paragraph, Spacer, Table, TableStyle, HRFlowable, PageBreak, KeepTogether) from reportlab.lib.enums import TA_CENTER, TA_LEFT, TA_JUSTIFY W = 17*cm doc = SimpleDocTemplate( "/home/daytona/workspace/anatomy-exam/Abdomen_AllTopics_ExamGuide.pdf", pagesize=A4, rightMargin=2*cm, leftMargin=2*cm, topMargin=2*cm, bottomMargin=2*cm ) styles = getSampleStyleSheet() # ── Style definitions ───────────────────────────────────────────── def S(name, **kw): base = kw.pop('parent', styles['Normal']) return ParagraphStyle(name, parent=base, **kw) cover_title = S('ct', fontSize=22, textColor=colors.HexColor('#0d47a1'), alignment=TA_CENTER, fontName='Helvetica-Bold', spaceAfter=8) cover_sub = S('cs', fontSize=12, textColor=colors.HexColor('#424242'), alignment=TA_CENTER, spaceAfter=6) cover_warn = S('cw', fontSize=11, textColor=colors.HexColor('#b71c1c'), alignment=TA_CENTER, fontName='Helvetica-Bold', spaceAfter=4) toc_item = S('ti', fontSize=11, textColor=colors.HexColor('#1a237e'), spaceAfter=4, leftIndent=10) body = S('bd', fontSize=10, leading=15, spaceAfter=5, alignment=TA_JUSTIFY) bullet = S('bl', fontSize=10, leading=14, spaceAfter=3, leftIndent=18, bulletIndent=6) sub_bullet = S('sbl', fontSize=9.5, leading=13, spaceAfter=2, leftIndent=32) h2 = S('h2', fontSize=11, fontName='Helvetica-Bold', textColor=colors.HexColor('#1a237e'), spaceBefore=8, spaceAfter=3) h3 = S('h3', fontSize=10, fontName='Helvetica-Bold', textColor=colors.HexColor('#4a148c'), spaceBefore=6, spaceAfter=2) clinical = S('cl', fontSize=10, leading=14, textColor=colors.HexColor('#b71c1c'), leftIndent=10, spaceAfter=4, fontName='Helvetica-BoldOblique') tip = S('tp', fontSize=9, textColor=colors.HexColor('#4a148c'), leftIndent=10, spaceAfter=5, fontName='Helvetica-Oblique') footer_s = S('ft', fontSize=8, textColor=colors.grey, alignment=TA_CENTER) th_s = S('th', fontSize=10, fontName='Helvetica-Bold', textColor=colors.white, spaceAfter=0, spaceBefore=0) th_s2 = S('th2', fontSize=9, fontName='Helvetica-Bold', textColor=colors.white, spaceAfter=0, spaceBefore=0) cell_s = S('cs2', fontSize=9.5, leading=13, spaceAfter=0) DARK_BLUE = colors.HexColor('#1a237e') MID_BLUE = colors.HexColor('#3949ab') LIGHT_BLUE = colors.HexColor('#e8eaf6') RED = colors.HexColor('#b71c1c') LIGHT_RED = colors.HexColor('#ffebee') PURPLE = colors.HexColor('#4a148c') LIGHT_PURP = colors.HexColor('#f3e5f5') GREEN = colors.HexColor('#1b5e20') LIGHT_GRN = colors.HexColor('#e8f5e9') ORANGE = colors.HexColor('#e65100') LIGHT_ORG = colors.HexColor('#fff3e0') def sec_hdr(text, color=DARK_BLUE): data = [[Paragraph(text, S('shdr', fontSize=12, fontName='Helvetica-Bold', textColor=colors.white, spaceAfter=0, spaceBefore=0))]] t = Table(data, colWidths=[W]) t.setStyle(TableStyle([ ('BACKGROUND', (0,0), (-1,-1), color), ('TOPPADDING', (0,0), (-1,-1), 6), ('BOTTOMPADDING', (0,0), (-1,-1), 6), ('LEFTPADDING', (0,0), (-1,-1), 10), ('RIGHTPADDING', (0,0), (-1,-1), 10), ])) return t def topic_banner(num, title, marks='', color=DARK_BLUE): txt = f"TOPIC {num}: {title}" if marks: txt += f" [{marks}]" data = [[Paragraph(txt, S('tb', fontSize=13, fontName='Helvetica-Bold', textColor=colors.white, spaceAfter=0, spaceBefore=0))]] t = Table(data, colWidths=[W]) t.setStyle(TableStyle([ ('BACKGROUND', (0,0), (-1,-1), color), ('TOPPADDING', (0,0), (-1,-1), 8), ('BOTTOMPADDING', (0,0), (-1,-1), 8), ('LEFTPADDING', (0,0), (-1,-1), 12), ])) return t def simple_table(headers, rows, col_widths, hdr_color=MID_BLUE): data = [[Paragraph(h, th_s2) for h in headers]] for i, row in enumerate(rows): data.append([Paragraph(str(c), cell_s) for c in row]) t = Table(data, colWidths=col_widths) style = [ ('BACKGROUND', (0,0), (-1,0), hdr_color), ('GRID', (0,0), (-1,-1), 0.4, colors.HexColor('#9fa8da')), ('TOPPADDING', (0,0), (-1,-1), 4), ('BOTTOMPADDING', (0,0), (-1,-1), 4), ('LEFTPADDING', (0,0), (-1,-1), 6), ('VALIGN', (0,0), (-1,-1), 'TOP'), ] for i in range(1, len(data)): bg = LIGHT_BLUE if i % 2 == 1 else colors.white style.append(('BACKGROUND', (0,i), (-1,i), bg)) t.setStyle(TableStyle(style)) return t story = [] # ═══════════════════════════════════════════════════════════════════ # COVER PAGE # ═══════════════════════════════════════════════════════════════════ story.append(Spacer(1, 1.5*cm)) story.append(Paragraph("ANATOMY 3rd INTERNAL EXAMINATION", cover_title)) story.append(Paragraph("Subbaiah Medical College", cover_sub)) story.append(Spacer(1, 0.3*cm)) story.append(HRFlowable(width="100%", thickness=3, color=DARK_BLUE, spaceAfter=10)) story.append(Paragraph("ABDOMEN — COMPLETE HIGH-YIELD NOTES", S('ct2', fontSize=16, fontName='Helvetica-Bold', textColor=RED, alignment=TA_CENTER, spaceAfter=8))) story.append(Paragraph("Source: Gray's Anatomy for Students", S('src', fontSize=10, textColor=colors.grey, alignment=TA_CENTER, spaceAfter=16))) # TOC toc_data = [ ["1", "Inguinal Canal + Inguinal Hernia ⭐⭐⭐⭐⭐", "10 marks"], ["2", "Stomach — Gross Anatomy, Blood Supply, Nerve Supply, Applied", "5–10 marks"], ["3", "Liver + Portal Vein + Portocaval Anastomosis", "10 marks"], ["4", "Pancreas + Duodenum", "5–10 marks"], ["5", "Kidney — Relations & Blood Supply", "5 marks"], ["6", "Spleen", "5 marks"], ["7", "Peritoneum — Greater & Lesser Sac", "5 marks"], ["8", "Appendix + McBurney's Point", "5 marks"], ["9", "Celiac Trunk, SMA & IMA — Branches", "5 marks"], ] toc_table = Table( [[Paragraph('#', th_s2), Paragraph('Topic', th_s2), Paragraph('Exam Weight', th_s2)]] + [[Paragraph(r[0], cell_s), Paragraph(r[1], cell_s), Paragraph(r[2], cell_s)] for r in toc_data], colWidths=[1*cm, 12*cm, 4*cm] ) toc_table.setStyle(TableStyle([ ('BACKGROUND', (0,0), (-1,0), DARK_BLUE), ('BACKGROUND', (0,1), (-1,1), LIGHT_BLUE), ('BACKGROUND', (0,2), (-1,2), colors.white), ('BACKGROUND', (0,3), (-1,3), LIGHT_BLUE), ('BACKGROUND', (0,4), (-1,4), colors.white), ('BACKGROUND', (0,5), (-1,5), LIGHT_BLUE), ('BACKGROUND', (0,6), (-1,6), colors.white), ('BACKGROUND', (0,7), (-1,7), LIGHT_BLUE), ('BACKGROUND', (0,8), (-1,8), colors.white), ('BACKGROUND', (0,9), (-1,9), LIGHT_BLUE), ('GRID', (0,0), (-1,-1), 0.4, colors.HexColor('#9fa8da')), ('TOPPADDING', (0,0), (-1,-1), 5), ('BOTTOMPADDING', (0,0), (-1,-1), 5), ('LEFTPADDING', (0,0), (-1,-1), 8), ('VALIGN', (0,0), (-1,-1), 'MIDDLE'), ])) story.append(toc_table) story.append(Spacer(1, 0.5*cm)) story.append(Paragraph("⚠ Exam Tomorrow 9:30 AM | Study Window: 11:59 PM → 4:30 AM | Sleep: 4:30–8:30 AM", cover_warn)) story.append(PageBreak()) # ═══════════════════════════════════════════════════════════════════ # TOPIC 1 — INGUINAL CANAL + HERNIA # ═══════════════════════════════════════════════════════════════════ story.append(topic_banner("1", "INGUINAL CANAL + INGUINAL HERNIA ⭐⭐⭐⭐⭐", "10 MARKS")) story.append(Spacer(1,6)) story.append(sec_hdr("DEFINITION")) story.append(Spacer(1,4)) story.append(Paragraph( "The <b>inguinal canal</b> is a slit-like oblique passage (~4 cm long) in the anterior abdominal wall, " "running downward and medially just above the inguinal ligament, from the <b>deep inguinal ring</b> to " "the <b>superficial inguinal ring</b>.", body)) story.append(sec_hdr("OPENINGS")) story.append(Spacer(1,4)) story.append(Paragraph("<b>Deep (Internal) Inguinal Ring:</b>", h2)) story.append(Paragraph("• Midpoint between ASIS and pubic symphysis", bullet)) story.append(Paragraph("• Just above inguinal ligament, LATERAL to inferior epigastric vessels", bullet)) story.append(Paragraph("• Oval opening in transversalis fascia", bullet)) story.append(Paragraph("<b>Superficial (External) Inguinal Ring:</b>", h2)) story.append(Paragraph("• Triangular opening in aponeurosis of external oblique", bullet)) story.append(Paragraph("• Located SUPERIOR to pubic tubercle", bullet)) story.append(Paragraph("• Medial crus → pubic symphysis; Lateral crus → pubic tubercle", bullet)) story.append(Paragraph("• Intercrural fibers prevent widening", bullet)) story.append(sec_hdr("WALLS / BOUNDARIES")) story.append(Spacer(1,4)) walls = simple_table( ["Wall", "Primary Formation", "Reinforcement"], [ ["Anterior", "Aponeurosis of external oblique (whole length)", "Internal oblique (lateral 1/3 — over deep ring)"], ["Posterior", "Transversalis fascia (whole length)", "Conjoint tendon (medial 1/3 — over superficial ring)"], ["Roof (Superior)", "Arching fibers of internal oblique + transversus abdominis", "—"], ["Floor (Inferior)", "Medial ½ of inguinal ligament", "Lacunar ligament (medial end)"], ], [3.5*cm, 7*cm, 6.5*cm] ) story.append(walls) story.append(Paragraph("Memory: \"2 walls have 2 components (Ant + Post); 2 walls have 1 (Roof + Floor)\"", tip)) story.append(sec_hdr("CONTENTS")) story.append(Spacer(1,4)) story.append(Paragraph("<b>MALES — Spermatic Cord contains:</b>", h2)) for item in ["Ductus (vas) deferens", "Testicular artery (from abdominal aorta)", "Artery to ductus deferens (from inferior vesical artery)", "Cremasteric artery and vein", "Pampiniform plexus of veins → testicular vein", "Genital branch of genitofemoral nerve (innervates cremaster)", "Sympathetic nerve fibers", "Lymphatics from testis", "Remnants of processus vaginalis"]: story.append(Paragraph(f"• {item}", bullet)) story.append(Paragraph("<b>3 Fascial Coverings of Spermatic Cord:</b>", h3)) story.append(simple_table( ["Layer", "Fascia", "Derived From"], [["Deepest","Internal spermatic fascia","Transversalis fascia (at deep ring)"], ["Middle","Cremasteric fascia + cremasteric muscle","Internal oblique muscle"], ["Superficial","External spermatic fascia","Aponeurosis of external oblique (at superficial ring)"]], [3*cm, 7*cm, 7*cm] )) story.append(Spacer(1,4)) story.append(Paragraph("<b>FEMALES:</b> Round ligament of uterus + Genital branch of genitofemoral nerve", h2)) story.append(Paragraph("<b>BOTH SEXES:</b> Ilioinguinal nerve (L1) — enters via abdominal wall, exits at superficial ring", h2)) story.append(sec_hdr("APPLIED — INGUINAL HERNIA", color=RED)) story.append(Spacer(1,4)) story.append(simple_table( ["Feature", "INDIRECT Inguinal Hernia", "DIRECT Inguinal Hernia"], [["Entry point", "Through deep inguinal ring", "Through posterior wall (Hesselbach's triangle)"], ["Relation to epigastric vessels", "LATERAL to inferior epigastric", "MEDIAL to inferior epigastric"], ["Sac", "Within spermatic cord coverings", "Pushes through conjoint tendon"], ["Scrotal descent", "Common — enters scrotum", "Rare"], ["Age / cause", "All ages; patent processus vaginalis", "Older males; acquired wall weakness"], ["Reduction", "Difficult to reduce", "Easier to reduce"], ["Strangulation risk", "Higher (narrow neck)", "Lower (wide neck)"]], [4*cm, 6.5*cm, 6.5*cm], hdr_color=RED )) story.append(Spacer(1,4)) story.append(Paragraph( "HESSELBACH'S TRIANGLE: Lateral border of rectus abdominis (medially) + " "inferior epigastric vessels (laterally) + inguinal ligament (inferiorly). " "Site of direct hernia.", clinical)) story.append(PageBreak()) # ═══════════════════════════════════════════════════════════════════ # TOPIC 2 — STOMACH # ═══════════════════════════════════════════════════════════════════ story.append(topic_banner("2", "STOMACH — Gross Anatomy, Blood Supply, Nerve Supply, Applied", "5–10 MARKS", color=MID_BLUE)) story.append(Spacer(1,6)) story.append(sec_hdr("GROSS ANATOMY")) story.append(Spacer(1,4)) story.append(Paragraph( "The stomach is the most dilated part of the GI tract with a J-shape. It lies in the " "<b>epigastric, umbilical, and left hypochondrium</b> regions.", body)) story.append(Paragraph("<b>Parts of Stomach:</b>", h2)) for item in [ "<b>Cardia</b> — surrounds the esophagogastric junction", "<b>Fundus</b> — dome above the level of the cardial orifice", "<b>Body</b> — largest region", "<b>Pyloric part</b> — pyloric antrum + pyloric canal → pylorus (sphincter at transpyloric plane, LI)" ]: story.append(Paragraph(f"• {item}", bullet)) story.append(Paragraph("<b>Curvatures & Features:</b>", h2)) story.append(Paragraph("• <b>Lesser curvature</b> — attachment of lesser omentum; angular incisure", bullet)) story.append(Paragraph("• <b>Greater curvature</b> — attachment of gastrosplenic ligament + greater omentum", bullet)) story.append(Paragraph("• <b>Cardial notch</b> — angle between esophagus and fundus", bullet)) story.append(Paragraph("• <b>Pyloric sphincter</b> — thickened circular muscle at LI (transpyloric plane)", bullet)) story.append(sec_hdr("BLOOD SUPPLY")) story.append(Spacer(1,4)) story.append(simple_table( ["Artery", "Origin", "Supplies"], [["Left gastric a.", "Celiac trunk (directly)", "Lesser curvature — left side"], ["Right gastric a.", "Hepatic artery proper", "Lesser curvature — right side"], ["Left gastro-omental a.", "Splenic artery", "Greater curvature — left side"], ["Right gastro-omental a.", "Gastroduodenal artery", "Greater curvature — right side"], ["Short gastric aa. (4-5)", "Splenic artery", "Fundus"], ["Posterior gastric a.", "Splenic artery", "Posterior wall of fundus/body"]], [4.5*cm, 5.5*cm, 7*cm] )) story.append(Paragraph("Venous drainage mirrors arteries → all drain into portal vein via gastric veins.", tip)) story.append(sec_hdr("NERVE SUPPLY")) story.append(Spacer(1,4)) story.append(Paragraph("<b>Parasympathetic (secretomotor + motility):</b>", h2)) story.append(Paragraph("• Anterior vagal trunk (left vagus, mostly) — enters at esophageal hiatus", bullet)) story.append(Paragraph("• Posterior vagal trunk (right vagus, mostly) — also supplies celiac plexus", bullet)) story.append(Paragraph("<b>Sympathetic (vasoconstrictor, pain):</b>", h2)) story.append(Paragraph("• T6–T9 via splanchnic nerves → celiac plexus/ganglion → travel with arteries", bullet)) story.append(Paragraph("• Pain from stomach referred to epigastrium (T6–T9 dermatomes)", bullet)) story.append(sec_hdr("APPLIED ANATOMY", color=RED)) story.append(Spacer(1,4)) for item in [ "<b>Peptic ulcer</b> — duodenal (1st part) most common; gastric ulcer on lesser curvature", "<b>Carcinoma stomach</b> — Virchow's node (left supraclavicular LN) — via thoracic duct", "<b>Gastrectomy</b> — vagotomy performed to reduce acid; truncal vs selective", "<b>Pyloric stenosis</b> — hypertrophy of pyloric sphincter in infants → projectile vomiting", "<b>Referred pain</b> — epigastric (T6–T9)" ]: story.append(Paragraph(f"• {item}", bullet)) story.append(PageBreak()) # ═══════════════════════════════════════════════════════════════════ # TOPIC 3 — LIVER + PORTAL VEIN + PORTOCAVAL ANASTOMOSIS # ═══════════════════════════════════════════════════════════════════ story.append(topic_banner("3", "LIVER + PORTAL VEIN + PORTOCAVAL ANASTOMOSIS", "10 MARKS", color=colors.HexColor('#1b5e20'))) story.append(Spacer(1,6)) story.append(sec_hdr("LIVER — GROSS ANATOMY", color=GREEN)) story.append(Spacer(1,4)) story.append(Paragraph( "Largest visceral organ. Located in <b>right hypochondrium and epigastric region</b>, " "extending into left hypochondrium.", body)) story.append(Paragraph("<b>Surfaces:</b>", h2)) story.append(Paragraph("• Diaphragmatic surface (anterior, superior, posterior) — smooth, domed", bullet)) story.append(Paragraph("• Visceral surface (inferior) — has H-shaped grooves dividing lobes", bullet)) story.append(Paragraph("<b>Lobes:</b>", h2)) story.append(Paragraph("• <b>Right lobe</b> (largest) + <b>Left lobe</b> — separated by falciform ligament (ant) / fissure for ligamentum venosum (post)", bullet)) story.append(Paragraph("• <b>Caudate lobe</b> — posterior, between IVC and fissure for ligamentum venosum", bullet)) story.append(Paragraph("• <b>Quadrate lobe</b> — inferior, between gallbladder fossa and fissure for ligamentum teres", bullet)) story.append(Paragraph("<b>Peritoneal Ligaments:</b>", h2)) story.append(simple_table( ["Ligament", "Description"], [["Falciform ligament", "Connects liver to anterior abdominal wall; contains ligamentum teres"], ["Coronary ligament", "Attaches liver to diaphragm; encloses bare area"], ["Right/Left triangular ligaments", "Lateral extensions of coronary ligament"], ["Lesser omentum (hepatogastric + hepatoduodenal)", "Connects liver to stomach and duodenum"], ["Hepatoduodenal ligament", "Contains portal triad: portal vein + hepatic artery + bile duct"]], [5*cm, 12*cm] )) story.append(Paragraph("<b>Blood Supply (DUAL):</b>", h2)) story.append(Paragraph("• <b>Hepatic artery proper</b> (branch of common hepatic a. from celiac trunk) — 25% blood, 50% O₂", bullet)) story.append(Paragraph("• <b>Portal vein</b> — 75% blood, 50% O₂ (nutrient-rich from GI tract)", bullet)) story.append(Paragraph("• <b>Hepatic veins</b> (3: right, middle, left) → drain into IVC", bullet)) story.append(Paragraph("<b>Couinaud Segments (I–VIII):</b>", h3)) story.append(Paragraph("Liver divided into 8 functionally independent segments, each with own vascular supply and biliary drainage. " "Segment I = caudate lobe. Segments II–IV = left lobe. Segments V–VIII = right lobe. " "Important for surgical resection.", body)) story.append(sec_hdr("PORTAL VEIN", color=GREEN)) story.append(Spacer(1,4)) story.append(Paragraph( "The <b>portal vein</b> is the final common pathway for venous drainage from the spleen, pancreas, gallbladder, " "and GI tract. <b>Formed by union of splenic vein + superior mesenteric vein</b> posterior to neck of pancreas " "at vertebra LII.", body)) story.append(Paragraph("<b>Course:</b>", h2)) story.append(Paragraph("• Ascends posterior to superior part of duodenum", bullet)) story.append(Paragraph("• Enters right margin of lesser omentum (hepatoduodenal ligament)", bullet)) story.append(Paragraph("• Relations in lesser omentum: Portal vein (posterior) + Bile duct (right) + Hepatic artery (left)", bullet)) story.append(Paragraph("• Divides into right and left branches at liver hilum", bullet)) story.append(Paragraph("<b>Tributaries:</b>", h2)) story.append(Paragraph("• Splenic vein (carries: short gastric, left gastro-omental, inferior mesenteric, pancreatic veins)", bullet)) story.append(Paragraph("• Superior mesenteric vein (small intestine, cecum, ascending + transverse colon)", bullet)) story.append(Paragraph("• Right and left gastric veins", bullet)) story.append(Paragraph("• Cystic veins (gallbladder)", bullet)) story.append(Paragraph("• Para-umbilical veins (anterior abdominal wall)", bullet)) story.append(sec_hdr("PORTOCAVAL ANASTOMOSES", color=RED)) story.append(Spacer(1,4)) story.append(simple_table( ["Site", "Portal Side", "Systemic Side", "Clinical Feature"], [["Lower esophagus", "Left gastric vein", "Azygos / hemiazygos vein", "Esophageal varices (haematemesis)"], ["Rectum / Anal canal", "Superior rectal vein", "Middle + inferior rectal veins", "Haemorrhoids (piles)"], ["Umbilicus", "Para-umbilical veins", "Superficial epigastric veins", "Caput medusae"], ["Bare area of liver", "Hepatic radicles", "Phrenic / diaphragmatic veins", "—"], ["Retroperitoneum", "Colic / intestinal veins", "Renal / lumbar / gonadal veins", "—"]], [3.5*cm, 3.5*cm, 4.5*cm, 5.5*cm], hdr_color=RED )) story.append(Paragraph( "PORTAL HYPERTENSION CLINICAL FEATURES: Splenomegaly + Ascites + Esophageal varices + " "Haemorrhoids + Caput medusae + Hepatic encephalopathy", clinical)) story.append(PageBreak()) # ═══════════════════════════════════════════════════════════════════ # TOPIC 4 — PANCREAS + DUODENUM # ═══════════════════════════════════════════════════════════════════ story.append(topic_banner("4", "PANCREAS + DUODENUM", "5–10 MARKS", color=colors.HexColor('#4a148c'))) story.append(Spacer(1,6)) story.append(sec_hdr("DUODENUM", color=PURPLE)) story.append(Spacer(1,4)) story.append(Paragraph( "C-shaped, 20–25 cm, retroperitoneal (except beginning). Adjacent to head of pancreas. " "Divided into 4 parts:", body)) story.append(simple_table( ["Part", "Vertebral Level", "Key Relations / Features"], [["1st (Superior)", "LI", "Duodenal cap/ampulla; most ulcers here; hepatoduodenal lig anteriorly"], ["2nd (Descending)", "LI–LIII", "Major duodenal papilla (CBD + pancreatic duct); minor papilla (accessory duct)"], ["3rd (Inferior)", "LIII", "Crosses aorta, IVC, vertebral column; SMA/SMV cross anteriorly"], ["4th (Ascending)", "LII", "Ends at duodenojejunal flexure (ligament of Treitz = suspensory muscle)"]], [2.5*cm, 3*cm, 11.5*cm] )) story.append(Paragraph("<b>Blood Supply:</b>", h2)) story.append(Paragraph("• Superior: Gastroduodenal artery (from common hepatic a.) → superior pancreaticoduodenal aa.", bullet)) story.append(Paragraph("• Inferior: Inferior pancreaticoduodenal a. (1st branch of SMA) → inferior pancreaticoduodenal aa.", bullet)) story.append(Paragraph("• Anterior and posterior branches of both anastomose forming an arterial arcade.", bullet)) story.append(sec_hdr("PANCREAS", color=PURPLE)) story.append(Spacer(1,4)) story.append(Paragraph( "Secondarily retroperitoneal (except tail). Extends from duodenum (right) to spleen (left), " "posterior to stomach.", body)) story.append(Paragraph("<b>Parts:</b>", h2)) story.append(Paragraph("• <b>Head</b> — in C-concavity of duodenum; <b>Uncinate process</b> projects posterior to SMA/SMV", bullet)) story.append(Paragraph("• <b>Neck</b> — anterior to SMV + splenic vein junction (portal vein forms here)", bullet)) story.append(Paragraph("• <b>Body</b> — posterior to stomach; related to aorta, SMA, left kidney", bullet)) story.append(Paragraph("• <b>Tail</b> — only mobile part; in splenorenal ligament; touches splenic hilum", bullet)) story.append(Paragraph("<b>Ducts:</b>", h2)) story.append(Paragraph("• <b>Main pancreatic duct (of Wirsung)</b> — runs through entire pancreas, joins CBD → <b>hepatopancreatic ampulla (of Vater)</b> → major duodenal papilla", bullet)) story.append(Paragraph("• <b>Accessory duct (of Santorini)</b> → minor duodenal papilla (just above major)", bullet)) story.append(Paragraph("• Sphincter of Oddi surrounds ampulla of Vater", bullet)) story.append(Paragraph("<b>Blood Supply:</b>", h2)) story.append(Paragraph("• Head: Superior + inferior pancreaticoduodenal arteries (anastomose — from celiac + SMA)", bullet)) story.append(Paragraph("• Body + Tail: Branches from splenic artery (runs along superior border of pancreas)", bullet)) story.append(Paragraph("<b>Applied:</b>", h3)) story.append(Paragraph("• <b>Carcinoma of head of pancreas</b> → obstructive jaundice (blocks CBD), painless jaundice, Courvoisier's sign (palpable gallbladder)", clinical)) story.append(Paragraph("• <b>Pancreatitis</b> → pain radiates to back; serum amylase/lipase elevated", clinical)) story.append(Paragraph("• <b>Annular pancreas</b> — developmental anomaly; wraps around 2nd part of duodenum → obstruction", clinical)) story.append(PageBreak()) # ═══════════════════════════════════════════════════════════════════ # TOPIC 5 — KIDNEY # ═══════════════════════════════════════════════════════════════════ story.append(topic_banner("5", "KIDNEY — Relations & Blood Supply", "5 MARKS", color=colors.HexColor('#006064'))) story.append(Spacer(1,6)) story.append(sec_hdr("RELATIONS OF KIDNEY", color=colors.HexColor('#006064'))) story.append(Spacer(1,4)) story.append(Paragraph("<b>Right Kidney:</b>", h2)) story.append(Paragraph("• Anterior: Right suprarenal gland (superior), Liver (upper 2/3), Descending duodenum (medially), Right colic flexure (lower)", bullet)) story.append(Paragraph("• Posterior: Diaphragm, Quadratus lumborum, Psoas major, Transversus abdominis", bullet)) story.append(Paragraph("<b>Left Kidney:</b>", h2)) story.append(Paragraph("• Anterior: Left suprarenal gland (superior), Stomach (upper pole), Spleen (lateral), Pancreas (body — crosses hilum), Descending colon (lower), Jejunum", bullet)) story.append(Paragraph("• Posterior: Same as right — Diaphragm, Quadratus lumborum, Psoas major, Transversus abdominis", bullet)) story.append(Paragraph("<b>Hilum contents (Anterior → Posterior):</b> Renal vein → Renal artery → Renal pelvis", h3)) story.append(sec_hdr("BLOOD SUPPLY", color=colors.HexColor('#006064'))) story.append(Spacer(1,4)) story.append(Paragraph("<b>Arteries:</b>", h2)) story.append(Paragraph("• <b>Renal artery</b> — lateral branch of abdominal aorta, between L1–L2", bullet)) story.append(Paragraph("• Left renal a. shorter (left kidney closer to aorta); Right renal a. longer (passes posterior to IVC)", bullet)) story.append(Paragraph("• Each divides into anterior and posterior branches at hilum", bullet)) story.append(Paragraph("• <b>Accessory renal arteries</b> common — end arteries (no collateral → ischaemia if blocked)", bullet)) story.append(Paragraph("<b>Veins:</b>", h2)) story.append(Paragraph("• <b>Renal veins</b> — anterior to renal arteries → drain into IVC", bullet)) story.append(Paragraph("• <b>Left renal vein</b> longer — crosses anterior to abdominal aorta; receives left gonadal + left suprarenal veins", bullet)) story.append(Paragraph("• <b>Right renal vein</b> shorter — drains directly into IVC", bullet)) story.append(Paragraph("<b>Applied:</b>", h3)) story.append(Paragraph("• Renal transplant: right kidney preferred (shorter renal vein placement easier)", clinical)) story.append(Paragraph("• Nutcracker syndrome: left renal vein compressed between aorta and SMA", clinical)) story.append(Paragraph("• Renal calculi: most commonly lodge at 3 sites — pelvi-ureteric junction, pelvic brim (crossing iliac vessels), vesico-ureteric junction", clinical)) story.append(PageBreak()) # ═══════════════════════════════════════════════════════════════════ # TOPIC 6 — SPLEEN # ═══════════════════════════════════════════════════════════════════ story.append(topic_banner("6", "SPLEEN", "5 MARKS", color=colors.HexColor('#880e4f'))) story.append(Spacer(1,6)) story.append(sec_hdr("GROSS ANATOMY & POSITION", color=colors.HexColor('#880e4f'))) story.append(Spacer(1,4)) story.append(Paragraph( "Located in <b>left hypochondrium</b>, against diaphragm at <b>ribs IX–XI</b>. " "Long axis along 10th rib. Dimensions: <b>1 × 3 × 5 inches</b>; weight ~150 g.", body)) story.append(Paragraph("• <b>Diaphragmatic surface</b> — convex, against diaphragm", bullet)) story.append(Paragraph("• <b>Visceral surface</b> — concave; has gastric, renal, colic, and pancreatic impressions", bullet)) story.append(Paragraph("• <b>Hilum</b> on medial surface — entry of splenic vessels; tail of pancreas may reach here", bullet)) story.append(Paragraph("<b>Peritoneal Ligaments:</b>", h2)) story.append(Paragraph("• <b>Gastrosplenic ligament</b> — connects to greater curvature of stomach; contains short gastric + left gastro-omental vessels", bullet)) story.append(Paragraph("• <b>Splenorenal ligament</b> — connects to left kidney; contains splenic vessels + tail of pancreas", bullet)) story.append(Paragraph("Note: Both ligaments are parts of the greater omentum.", tip)) story.append(sec_hdr("BLOOD SUPPLY", color=colors.HexColor('#880e4f'))) story.append(Spacer(1,4)) story.append(Paragraph("• <b>Splenic artery</b> — largest branch of celiac trunk; tortuous course along superior border of pancreas through splenorenal ligament", bullet)) story.append(Paragraph("• <b>Splenic vein</b> — joins SMV behind neck of pancreas to form portal vein", bullet)) story.append(sec_hdr("APPLIED ANATOMY", color=RED)) story.append(Spacer(1,4)) story.append(Paragraph("• <b>Splenomegaly</b> — palpable below left costal margin; causes: malaria, portal hypertension, CML", clinical)) story.append(Paragraph("• <b>Rupture</b> — rib fracture (9–11) → most common abdominal organ to rupture; haemoperitoneum", clinical)) story.append(Paragraph("• <b>Splenectomy</b> → risk of infections by encapsulated organisms (S. pneumoniae, H. influenzae, N. meningitidis)", clinical)) story.append(Paragraph("• <b>Referred pain</b> — tip of left shoulder (phrenic nerve C3,4,5 dermatomes) via diaphragmatic irritation", clinical)) story.append(PageBreak()) # ═══════════════════════════════════════════════════════════════════ # TOPIC 7 — PERITONEUM # ═══════════════════════════════════════════════════════════════════ story.append(topic_banner("7", "PERITONEUM — Greater & Lesser Sac", "5 MARKS", color=colors.HexColor('#e65100'))) story.append(Spacer(1,6)) story.append(sec_hdr("DEFINITION & LAYERS", color=ORANGE)) story.append(Spacer(1,4)) story.append(Paragraph( "<b>Peritoneum</b> is a thin serous membrane lining the abdominal cavity and covering the viscera. " "<b>Parietal peritoneum</b> lines the walls (somatic innervation — well-localized pain). " "<b>Visceral peritoneum</b> covers organs (autonomic innervation — diffuse/referred pain).", body)) story.append(Paragraph("• Closed sac in males; 2 openings in females (uterine tubes)", bullet)) story.append(Paragraph("• Contains ~50 mL peritoneal fluid (lubricant)", bullet)) story.append(sec_hdr("GREATER SAC (Main Peritoneal Cavity)", color=ORANGE)) story.append(Spacer(1,4)) story.append(Paragraph( "Largest part of peritoneal cavity. Extends from diaphragm to pelvis.", body)) story.append(Paragraph("<b>Intraperitoneal organs</b> (suspended by mesenteries):", h2)) story.append(Paragraph("Stomach, 1st part duodenum, jejunum, ileum, cecum, appendix, transverse colon, sigmoid colon, " "spleen, liver, ovaries", bullet)) story.append(Paragraph("<b>Retroperitoneal organs</b> (secondary — behind peritoneum):", h2)) story.append(Paragraph("Kidneys, suprarenal glands, ureters, aorta, IVC, pancreas (except tail), " "2nd/3rd/4th duodenum, ascending colon, descending colon, rectum (upper 2/3)", bullet)) story.append(Paragraph("Mnemonic: <b>SAD PUCKER</b> — Suprarenal, Aorta/IVC, Duodenum (2–4), " "Pancreas, Ureters, Colon (ascending + descending), Kidneys, Esophagus, Rectum", tip)) story.append(sec_hdr("LESSER SAC (Omental Bursa)", color=ORANGE)) story.append(Spacer(1,4)) story.append(Paragraph( "Smaller compartment posterior to stomach and lesser omentum.", body)) story.append(Paragraph("<b>Boundaries:</b>", h2)) story.append(Paragraph("• Anterior: Lesser omentum + posterior wall of stomach + gastrocolic ligament", bullet)) story.append(Paragraph("• Posterior: Parietal peritoneum over pancreas, left kidney, left suprarenal", bullet)) story.append(Paragraph("• Superior: Caudate lobe of liver + diaphragm", bullet)) story.append(Paragraph("• Inferior: Greater omentum (fused layers)", bullet)) story.append(Paragraph("• Left: Gastrosplenic ligament + Splenorenal ligament", bullet)) story.append(Paragraph("<b>Epiploic Foramen (of Winslow):</b>", h2)) story.append(Paragraph("• Only communication between greater and lesser sac", bullet)) story.append(Paragraph("• Anterior: Hepatoduodenal ligament (portal vein + hepatic artery + bile duct)", bullet)) story.append(Paragraph("• Posterior: IVC", bullet)) story.append(Paragraph("• Superior: Caudate lobe of liver", bullet)) story.append(Paragraph("• Inferior: 1st part of duodenum", bullet)) story.append(Paragraph("<b>Applied:</b> Fluid collections in lesser sac (pancreatitis) may not spread to greater sac initially. " "Posterior gastric ulcer perforates into lesser sac.", clinical)) story.append(PageBreak()) # ═══════════════════════════════════════════════════════════════════ # TOPIC 8 — APPENDIX + McBURNEY'S POINT # ═══════════════════════════════════════════════════════════════════ story.append(topic_banner("8", "APPENDIX + McBURNEY'S POINT", "5 MARKS", color=colors.HexColor('#33691e'))) story.append(Spacer(1,6)) story.append(sec_hdr("VERMIFORM APPENDIX", color=colors.HexColor('#33691e'))) story.append(Spacer(1,4)) story.append(Paragraph( "A narrow, worm-shaped (vermiform) blind-ended tube attached to the posteromedial wall of the cecum, " "about <b>2 cm below the ileocecal junction</b>. Average length: <b>8–9 cm</b>. " "Covered by peritoneum (intraperitoneal). Has its own short mesentery — <b>mesoappendix</b>.", body)) story.append(Paragraph("<b>McBURNEY'S POINT:</b>", h2)) story.append(Paragraph( "Point 1/3 of the way from the <b>right ASIS to the umbilicus</b>. " "Corresponds to the base of the appendix. " "Site of maximum tenderness in acute appendicitis.", body)) story.append(Paragraph("<b>Positions of Appendix:</b>", h2)) story.append(simple_table( ["Position", "Frequency", "Clinical Notes"], [["Retrocaecal (behind cecum)", "65–70% (most common)", "Pain may be in right flank or back"], ["Pelvic (descending into pelvis)", "25–30%", "Pain near McBurney's + pelvic symptoms"], ["Pre-ileal / Post-ileal", "~5%", "May mimic small bowel obstruction"], ["Subcaecal", "Rare", "—"], ["Left-sided (situs inversus)", "Very rare", "Pain on left side"]], [4.5*cm, 4*cm, 8.5*cm] )) story.append(sec_hdr("BLOOD SUPPLY", color=colors.HexColor('#33691e'))) story.append(Spacer(1,4)) story.append(Paragraph("• <b>Appendicular artery</b> — branch of posterior cecal artery (from ileocolic artery → SMA)", bullet)) story.append(Paragraph("• Runs in the mesoappendix; an <b>end artery</b> — thrombosis → appendicular gangrene", bullet)) story.append(sec_hdr("APPLIED ANATOMY — ACUTE APPENDICITIS", color=RED)) story.append(Spacer(1,4)) story.append(Paragraph("• <b>McBurney's point tenderness</b> — hallmark sign", bullet)) story.append(Paragraph("• <b>Rovsing's sign</b> — palpation of LIF causes pain in RIF", bullet)) story.append(Paragraph("• <b>Psoas sign</b> — pain on extending right hip (retrocaecal appendix)", bullet)) story.append(Paragraph("• <b>Obturator sign</b> — pain on internal rotation of flexed right hip (pelvic appendix)", bullet)) story.append(Paragraph("• <b>Incision for appendicectomy</b> — Gridiron incision at McBurney's point (perpendicular to spinoumbilical line)", bullet)) story.append(Paragraph("• Appendix = immunological organ (lymphoid tissue/MALT); NOT truly vestigial", bullet)) story.append(PageBreak()) # ═══════════════════════════════════════════════════════════════════ # TOPIC 9 — CELIAC TRUNK, SMA, IMA # ═══════════════════════════════════════════════════════════════════ story.append(topic_banner("9", "CELIAC TRUNK + SMA + IMA — Branches", "5 MARKS", color=colors.HexColor('#1a237e'))) story.append(Spacer(1,6)) story.append(sec_hdr("CELIAC TRUNK (Foregut Supply)")) story.append(Spacer(1,4)) story.append(Paragraph( "<b>Origin:</b> Anterior branch of abdominal aorta just below aortic hiatus, anterior to <b>vertebra T12/LI</b>. " "Supplies the <b>foregut</b> (lower esophagus → proximal duodenum).", body)) story.append(simple_table( ["Branch", "Course & Supply"], [["Left gastric a.", "Smallest branch → esophageal branches (anastomose with thoracic aortic br.) → lesser curvature of stomach"], ["Splenic a.", "Largest branch → tortuous, along superior border of pancreas → short gastric aa. + left gastro-omental a. → spleen"], ["Common hepatic a.", "→ Hepatic artery proper (→ right and left hepatic aa.) + Gastroduodenal artery (→ right gastro-omental + sup. pancreaticoduodenal aa.)"]], [4*cm, 13*cm] )) story.append(sec_hdr("SUPERIOR MESENTERIC ARTERY — SMA (Midgut Supply)")) story.append(Spacer(1,4)) story.append(Paragraph( "<b>Origin:</b> Anterior branch of abdominal aorta at <b>vertebra LI</b> (just below celiac). " "Supplies the <b>midgut</b> (distal duodenum → proximal 2/3 of transverse colon).", body)) story.append(simple_table( ["Branch", "Supplies"], [["Inferior pancreaticoduodenal a.", "Head of pancreas + duodenum (anastomoses with sup. pancreaticoduodenal from celiac)"], ["Jejunal + Ileal arteries (12–15)", "Jejunum and ileum via arcades in mesentery (vasa recta are end arteries)"], ["Ileocolic a.", "Terminal ileum, cecum, appendix (appendicular a. is branch)"], ["Right colic a.", "Ascending colon"], ["Middle colic a.", "Transverse colon (right 2/3); anastomoses with left colic (IMA) = marginal artery of Drummond"]], [5*cm, 12*cm] )) story.append(sec_hdr("INFERIOR MESENTERIC ARTERY — IMA (Hindgut Supply)")) story.append(Spacer(1,4)) story.append(Paragraph( "<b>Origin:</b> Anterior branch of abdominal aorta at <b>vertebra LIII</b>. " "Supplies the <b>hindgut</b> (distal 1/3 transverse colon → upper rectum).", body)) story.append(simple_table( ["Branch", "Supplies"], [["Left colic a.", "Ascending br. → distal transverse colon (anastomoses with middle colic); Descending br. → descending colon"], ["Sigmoid arteries (2–4)", "Sigmoid colon (sigmoid mesocolon)"], ["Superior rectal a. (terminal)", "Upper rectum; anastomoses with middle rectal (internal iliac) + inferior rectal (internal pudendal)"]], [5*cm, 12*cm] )) story.append(Paragraph("<b>Marginal Artery of Drummond:</b> Continuous arterial channel along inner border of colon formed by anastomosis of right colic, middle colic, and left colic arteries. Ensures collateral supply.", body)) story.append(Paragraph( "WATERSHED AREA: Splenic flexure (junction of SMA + IMA territories) = most vulnerable to ischaemia during aortic surgery.", clinical)) story.append(Spacer(1,6)) # ── Summary Table ────────────────────────────────────────────────── story.append(sec_hdr("MASTER SUMMARY: GIT ARTERIAL SUPPLY AT A GLANCE")) story.append(Spacer(1,4)) story.append(simple_table( ["Artery", "Vertebral Level", "Embryonic Part", "Structures Supplied"], [["Celiac trunk", "T12/LI", "Foregut", "Lower esophagus, stomach, 1st–2nd duodenum, liver, gallbladder, spleen, pancreas"], ["SMA", "LI", "Midgut", "3rd–4th duodenum, jejunum, ileum, cecum, appendix, ascending colon, 2/3 transverse colon"], ["IMA", "LIII", "Hindgut", "1/3 transverse colon, descending colon, sigmoid colon, upper rectum"]], [3*cm, 3.5*cm, 3*cm, 7.5*cm] )) story.append(Spacer(1, 0.8*cm)) story.append(HRFlowable(width="100%", thickness=1.5, color=DARK_BLUE, spaceAfter=6)) story.append(Paragraph( "Source: Gray's Anatomy for Students | Subbaiah Medical College — Anatomy 3rd Internal | Good Luck! 💪", footer_s)) doc.build(story) print("PDF generated successfully!") PYEOF python3 /home/daytona/workspace/anatomy-exam/all_topics.py