Ficat and Arlet first classified avascular necrosis of femoral head (AVN) in 1964 before the advent of MRI which was later modified and published in 1985 to include pre-radiographic stages relying on invasive testing procedures. The classification system later underwent further modifications that include MRI findings, patient symptoms and modifies…
Author: Epomedicine
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Development of Pituitary Gland
The pituitary gland (hypophysis cerebri) is derived from 2 sources. The anterior lobe is an upgrowth of ectoderm from the roof of the stomodeum (primitive buccal cavity), while the posterior lobe is a down growth of neuroectoderm from the diencephalon. 4th week: a diverticulum, Rathke’s pouch, grows upwards from the roof of the stomodeum towards the…
Clinical Skills and Approaches 
Bulbocavernosus Reflex (BCR)
Synonyms: Bulbospongiosus reflex (BSR), Osinski reflex Reflex arc: a. Stimulus: Briskly squeezing glans penis or clitoris or Tugging Foley’s catheter (pulling the balloon of foley’s catheter against the bladder neck) b. Afferent: Sensory fibers of pudendal nerve c. Reflex center: S2-S4 spinal segments (Polysynaptic) d. Efferent: Motor fibers of pudendal…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Micturition reflex
Micturition (Urination) is the ejection of urine from the urinary bladder through the urethra to the outside of the body. It is a type of reflex with voluntary control. The micturition cycle occurs in 2 phases: Urinary Storage Mnemonic: Storage = Sympathetic 1. Stimulus: Urine filling until tension in the…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Synovial Fluid Analysis – Made Easy
What investigations to order for synovial fluid sample? Mnemonic: 5 Cs Chemistry (pH, LDH, glucose, protein) Cell counts Cytology Culture Crystals Interpretation of synovial fluid analysis Gross Normal Non-inflammatory Inflammatory Septic Crystal Hemorrhagic Volume (ml) <3.5 >3.5 >3.5 >3.5 >3.5 >3.5 Viscosity High High Low Variable Variable Variable Color Colorless…
Clinical Skills and Approaches 
Sectoral Sign : AVN hip
The rotation of the hip must be assessed both with the hip in flexion and extension as well. In general, the range of motion for rotations are 5 to 10 degrees more in flexion compared to that in extension of hip. If the range of motion for rotation varies between…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Blood Supply of Talus
3 Main Arteries Extraosseous and intraosseous anastomoses formed by 3 main arteries: Posterior tibial artery ~ 17% contribution Anterior tibial (dorsalis pedis) artery ~ 36% contribution Perforating peroneal artery ~ 47% contribution Major Branches Tarsal sinus artery: Arises from – Dorsalis pedis artery (frequently) or Lateral tarsal artery (branch of…
Emergency Medicine 
GIK Regimen – Rule of Ten
Interchangably used as: GIK or GKI regimen. GKI stands for Glucose, Potassium and Insulin. This simple and effective combined insulin delivery method has gained wide acceptance in perioperative management of diabetic patients who would require Nil Per Oral (NPO) status. Recently, this composition has also been used for management of…