Atlantic University School of Medicine

Knowledge Objectives in Human Gross Anatomy

Courses of study in Human Gross Anatomy introduce students to the language used to describe the human body. It is a basic foundation for the profession of medicine. It should provide an understanding of the dynamic three-dimensional organization of the body that is a pre requisite for: Performing a competent physical examination of any patient. Demonstrating normal and abnormal physical signs. Interpreting image data that reveal internal structures. Provide the basis for effective clinical reasoning Knowledge of bodys systems and regions Applied knowledge of functions and relations of surgical significance Subject Areas

I) Introductory Material: Learning Objectives Anatomic terminology. Orientation to the body. Planes. Skin and Fascia. Membranes. Skeletal system. Correlations Basic language to describe relationships. Positional arrangement and comparison. Structure and abbreviations of terms. Anatomical variations. Basic appreciation for regional differences/ functions. Access to internal structures (incisions). Bones and Cartilage structure and function. Growth and changes. Language to describe motions. Range of motion. Stability and mobility. Origins, insertions, functions, levers Testing defining actions

Joints: Movements and factors in stability. Types, Vasculature, innervations. Hiltons Law Muscular System: Basic arrangement & types. Growth and regeneration. Hypertrophy and Hyperplasia. Cardiovascular System: Arrangement. Arteries, Veins, Capillaries. Anastomosis and collaterals. Lymphatic System. Arrangement and composition.

Aneurysms. Ischaemia. Infarct. Varicose Veins. Circulation. Functions and circulation. Inflammation. Lymphadenitis. Lymphoedema. Immune response.

Nervous System: structure and functions.

Somatic and Autonomic Nervous System. Neurons and Nerves. Dermatomes & Myotomes. General principles of nerve supply. Segmental innervation. Spinal reflexes.

II) Upper Limb Learning Objectives Surface Anatomy. Bony landmarks. Superficial Veins. Valves Palpable nerves, tendons, other structures. Radiologic Anatomy. Plain films. Angiograms. CT Scan, MRI Scan. Muscle groups. Movements of limbs. Innervations of compartments. Brachial Plexus. Roots, Trunks, Divisions, Cords, Branches. Correlations Landmarks for physical examination. Orientation: Localising lesions. Phlebotomy. Localising lesions. Radiological examination. Fractures. Peripheral Vascular diseases. Examination of joints. Structures at various levels. Movements. Shunt muscles. Movement defects following trauma. Peripheral neuropathies. Sensory deficits. Thoracic outlet compression syndrome. Injuries. Avulsions. Erbs palsy. Klumpkes palsy. Brachial Block. Movements. Winged Scapula. Fractured Clavicle. Weight transmission. Dislocations. Muscles causing movements. Triangle of auscultation. Quadrangular space. Stability. Movements. InflammationApproach. Dislocations. Roatator Cuff tear. Fractures of Humerus. Bursitis. Frozen shoulder. Arthroplasty. Aspiration. Boundaries. Contents. Course, relations, branches, compressions. Injuries, Thrombosis. Groups, Drainage area. Lymph node dissections. Muscles, bones, nerves, vessels. Cross sectional anatomy.

Pectoral girdle. Clavicle, Acromioclavicular joint. Coracoclavicular ligaments. Thoracoappendicular region.

Shoulder joint. Glenoid fossa. Rotator Cuff. Humerus. Subdeltoid & Subacromial bursa. Ligaments, capsule of glenohumeral joint. Axilla. Axillary Artery. Axillary Vein. Axillary Lymph nodes.

Arm. Transverse sections at upper, lower

levels. Cubital fossa.

Fractures. NeuroVascular deficit. Blood pressure measurement. Boundaries, contents, relationships. Venepuncture.

Elbow joint. Proximal radio-ulnar joints.

Forearm. Transverse section thro various levels. Flexor-Pronator, Extensor-Supinator muscles. Wrist

Pronation, Supination, movements. Dislocation. Pulled elbow. Tennis Elbow, Golfers elbow. Fractures olecranon, Montegia, Gallazzi Compartments Cross-Sectional Anatomy Arrangements, Movements, Innervations. Carpal bones. Fractures. Movements. Scaphoid and Colless fracture. Tenosinovitis. Grips. Palpation of vessels, nerves, tendons. Fasciae, Bursae and infections. Thenar, Hypothenar, Midpalmar Spaces. Carpal Tunnel Syndrome. Dupuytrens contracture. Wounds. Incisions Movements and restrictions. Fractures and dislocations. Venepuncture, Arterial punctures, Palmar arteries and arches. Paronychia, Bursitis. Ganglions, Tenosynovitis. Trigger Finger. Mallet Finger. Entrapment Syndromes. Lacerations. Ape Hand. Cyclist Palsy. Ulnar Claw hand. Entrapment Syndromes. Lacerations. Guyons Canal syndrome. Wrist drop and other effects of lesions. Entrapment Syndromes.

Palm

Hand and fingers. Anatomical snuff box Blood Supply. Infections. Tendon sheaths.

Median Nerve. Course. Relations. Sensory and Motor Supply. Ulnar nerve. Course. Relations. Sensory and Motor Supply.

Radial nerve. Course. Relations. Sensory and Motor Supply.

(III) Lower Limb Learning Objectives Surface and radiological Anatomy. Bones. Normal stance. Gait. General arrangement. Fascia, vessels, nerves of lower limb. Hip bones and movements. Femur. Correlations Physical and radiological examination. Limb injuries. Fractures. Line of Gravity. Standing. Mechanisms of locomotion. Surfaces, comparison to upper limb. Varicose Veins. Pelvic girdle. Hip injuries. Dislocations. Bone marrow aspiration. Slipped epiphysis. Coxa Vara, Valgus. Fractures intra and extracapular head, neck. Boundaries. Contents. Relations. Psoas Abscess. Compartments. Infections. Groin pull. Sports injuries. Gracialis transplantation. Adductor injuries, Riders bone. Palpation of femoral artery. Femoral Hernia. Accessory obturator artery. Intramuscular injections. Sciatic nerve course. Popliteal vessel palpation, aneurysm. Bursae. Abscess. Injury to nerves. Genu Valgum and varum. Dislocation. Fractures. Chondromalacia. Tendon reflex. Unhappy triad injuries. Compartments. Compartment syndromes. Nerve entrapments. Fractures and dislocations, Fibular grafts. Tendo achilis rupture. Calf muscle pump. Movements. Potts fracture. Sprains. Fractures. Dislocation. Talipus equines varus, valgus. Tarsal Tunnel syndrome. Plantar Fascitis. Painful heel. Diabetic foot lesions. Palpation of vessels. Sites for venepuncture. Cut down. Flat foot. Club foot. Lesions. Entrapments.

Femoral triangle. Adductor Canal. Organization of thigh muscles. Hamstring muscles.

Gluteal muscles. Popliteal Fossa. Boundaries, contents, relations. Knee region and joint. Patella. Menisci, cruciate ligaments.

Leg region Tibia-Fibula and their articulations

Ankle region. Ankle joint.

Foot region. Arches of foot.

Lumbosacral plexus.

Course and distribution.

Sensory neuropathy. Anaesthetic blocks.

(IV) Abdomen: Learning Objectives Anterior Abdominal wall Boundaries, Planes, Regions, Quadrants Projection of internal viscera on wall muscles, Aponeurosis, Fasciae. Campers and Scarpas Fascia Abdominal muscles and rectus sheath Rectus abdominis, pyramydalis Linea alba Sensory innervation Motor innervation Inguinal Canal in male and females Spermatic cord and contents Pampiniform plexus of veins Scrotum Umbilicus Umbilical folds, ligaments, Structure, division, relationship of Gastro Intestinal tract Foregut. Midgut. Hindgut. Abdominal Oesophagus. Diaphragm Stomach subdivisions, relations stomach bed, lesser sae. Duodenum relations, openings Jejunum & ileum: Distinguishing Features. Caecum and appendix Large bowel and rectum

Correlations Functions in breathing, vomiting, defecation, parturition, raised intraabdominal pressure. Landmarks used in physical examination. Access to internal structures [Incisions] Role in truck movements. Obesity. Continuity with Scrotum. Extravasation urine. Gastroschisis. Divarication Epigastric, Umbilical Hernige. Dermatomes. Referred and projected pain. Muscular rigidity Inguinal Herniae Vasectomy Varicocele Temperature regulation around testis. Patients Urachus, Urachal Cysts. Hernige, Scars, Laparoscopy. Caput medusae, Tumours. Omphalocele. Appreciate basic structure of G.I tract Pattern of blood supply, innervation. Gastric reflux, Heartburn, Hiatal Hernia Vagotomy Gastritis, Gastric ulcers. Pseudocyst of pancreas. Duodenal ulcers. Obstruction to ducts. SMA Syndrome Volvulus, Intussusception, Obstruction. Meckels diverticulm Resection - anastomisis McBurneys point Appendicitis, Appendectomy Diarrhoea. Constipation. Diverticuli. Polyps. Tumours, Hirschprungs disease. Portal Hypertension & its sequele Variations in blood supply. Spread of cancer

Blood supply, portal drainage Lymphatic drainage of GI Tract

Liver and Gall Bladder Triangular and falciform ligaments. Peritoneal relation ships Biliary ductal system.

Pancreas Spleen Peritoneal Cavity Greater and lesser Sacs and omentae Retroperitoneum. Posterior Abdominal wall Abdominal Aorta Inferior Vena Cava Lymphatic system. Cysterna Chyli Kidneys location, structure Renal Fasciae Blood Supply Suprarenal glands

Appreciate Location, structure, functions, Relations, Cirrhosis Hepatic resections, Labectomy, Transplants, Cholecystitis, Cholecystectomy, Gall stones, Obstructive jaundice, ERCP, PTC Acute and chronic inflammation, cancer pancreas, ampullary tumours. Functions, Rupture, Splenectomy Peritonitis, Ascites, Peritoneal dialysis Peritoneal lavage, Paracentesis Retroperitoneal organs, Lymph nodes. Appreciate basic arrangements muscles Branches and collaterals Venous drainage. Vertebral plexus of veins. Spread of infection, cancer Horseshoe kidney, approaches, stones Renal ptosis, renal angle Structure related to renal function. Locations, position, function, blood supply Abdomen and lower limb innervation Learn landmarks used in physical examination. Structural support of pelvis Culdo Scopy, paracentesis Vaginal and rectal examination. Inspacted renal calculi Hysterectomy Cystoscopy. Urethral strictures Urination

Lumbosacral Plexus Bony pelvis = male and female pelvic diaphragm. Pelvic walls. Peritoneal pouches Vagina and rectum Relationship of ureter, urethra, urinary bladder in male and females

Prostate, Seminal vesicle Perineum Urogenital diaphragm and perineal body. Male and female external genitalia Scrotum and Testis. Penis and Clitoris Anus and anal caral. Blood supply and Lymphatic drainage of Perineum and Pudendal nerve.

Ejaculation. Pelvic pain. Urogenital and anal triangles Prolapse uterus, Episiotomy, sphincter incontinence Examination of genitalia. Testicular pain, Torsion,Tumor, Erection, Circumcision, Cancer, continence, Sphincters, Hiltons line. Spread of infection, Pudendal block.

V) Back: Learning Objectives Vertebral skeleton Posture Projections of structures of spine, Spinal Canal, Spinal cord, Meninges Intervertebral foramina and Discs. Spinal nerves Organisations of Spinal root, rami, ganglia, Dermatomes and myotomes Corelations Landmarks used in physical examination Curvature of spines. Kypho scoliosis. Physical examination of Throax Abdomen Lumbar puncture, Epidural anaesthesia. Disc prolapse, Nerve impingement. Spinal nerve injury in degeneration of spine. Radiculopathies Reffered pain. Phantom pain Neurologic examination.

VI) Thorax: Learning Objectives Thoracic wall = Structure, Organisation, Breast structure, blood supply Lymphatic drainage. Sternum, ribs, intercostal spaces Spinal nerves Angle of Louis Correlations Landmarks used in physical examination. Structures related to breast cancer, Cystic diseases, and mammography. Thoracocentesis, incisions, Thoracotomy Intercostal nerves, nerve block Structures starting, ending at it

Lungs and Pleurae Radiologic Anatomy Lines of Pleural reflection Pleura = regional designations Sensory innervation Pleural cavity recesses Distinguishing characteristics of the right and left lungs Organisation of bronchopulmonary segments Blood supply of lungs Root of lungs Normal breathing Dynamics of changes in thoracic volume Automatic innervation of lungs Diaphragm = Hiatuses, innervation Heart and Pericardium Radiologic Anatomy Development of four chambers of heart, septure, valves, great vessels. Circulatory changes at birth Adult heart = Surface, chambers Pericardium, Pericardial sinuses Cardiac landmarks on chest wall Coronary circulation, venous drainage Cardiac innervations, pacemaker, conduction system Mediastinum and subdivisions Radiologic Anatomy Trachea and bronchi Phrenic and vagus nerves Recurrent larungeal nerves

Basic structure and organisation Interpreting structures in radiographs, CT and MRI scan Relationship to thoracic wall Auscultation and percussion. Origin of pain in chest. Understand where air/fluid can collect in chest

Appreciate the diffrences between the lungs Localisation of lung pathology Segmental resections of lung. Foreign bodies Aspiration pneumonia Pulmonary and systemic circulation Understand structures entering or leaving the lung. Inspiration, expiration. Mechanics of pneumothrox Control of bronchial resistance, Asthama Hernias. Control of breathing Spinal cord injury Appreciate basic structure, location Interpreting structures in radiographs, CT, MRI Understand congenital anomalies ASD, VSD, Tetralogy of fallot cahnges in circulation, pressures External and Internal structures Pericardial effusion, cardiac tamponade Auscultation Angina Pectoris, Myocardiac infarct Coronary angioplasty, bypass Catheterizarion Abnormal heart thythms Reffered pain. Mediastinal tumors, shift Interpreting structures in radiographs, CT or MRI scans Location/distribution Location and course, relations Susceptibility to injury

Locations and principal branches of great vessels: Aorta, Superior Vena Cava Azygous Venous System Thymus gland Lymphatic drainage, thoracic duct

Catheterization of great vessels Coarctation of aorta, collateral circulation. Drainage of chest wall Location and involution Spread of infections, cancer

VII) Head, Face, Neck -Learning Objectives Skull, face, oropharynx. Pharyngeal arches, pouches, clefts.

Surface features of the face, scalp. Radiological Anatomy. Muscles of facial experession. Blood supply and sensory innervation Of the face and scalp. Orbit --- bony elements. Extraocular muscles. Eye structure and function.

Correlations Cleft lip and palate, Thyroglossal Cyst. Branchial cyst and fistolas. Failure of Thymus, Parathyroid to grow Ectopic glands. Surface landmarks, localization of pathology Interpreting structures in radiographs, CT Scan, MRI Scan. Facial nerve paralysis. Facial and Scalp lacerations. Cavernous sinus thrombosis. Diplopia, ptosis, injury. Innervation, Action, Palsy. Pupillary and corneal reflexes. Fundoscopic examination, Optic nerve.

Ear: Surface landmarks. Smell sensation, rhinorrhoea, epistaxis External auditory canal, tympanic DNS, sinusitis, drainage membrane, Tympanic cavity, Auditory tube, Vesticular apparatus, Cochlea Pharynx = Components Oral cavity. Hard and soft palate. Tonsillar pillars, Tonsils. Tongue Musculature Blood and nerve supply Lymphatic drainage Teeth Deciduous and permanent Dentition Salivary glands Mechanism of swallowing Dysphagia Regional anaesthesia. Movements, innervations. Tonsillitis, Tonsillectomy. Adenoids, Walddyers ring. Taste sensation, Gag reflex Ankyloglossia, tongue tie Malignant tumors, muscular paralysis Toothache, Periodonal diseases. Extractions. Autonomic innervation Parotitis, mumps, calculi

Jaws, Muscles of mastication. Temporo mandibular joint. Infratemporal fossa. Contents.

Fractures, innervations. Movements, degeneration, dislocation. Basic orientation, boundries, relations. Middle meningeal artery. Maxillary artery. Inferior alveolar nerve block. Lacrimation. Landmarks for physical examination. Fractures, Intracranial haemorrhage. Headache, Meningitis. Hydrocephalus. Endarterectomy, stroke, CVA, Aneurysm. Tearing of cerebral veins. Cranial nerve paralysis Neurologic testing. Fractures of skull base Cranial nerve aperture syndromes. Pitutary Adenomas. Carotid aneuysms, fistula, collaterals. Cavernous sinus thrombosis. Trigeminal neuralgia. Bells palsy. Branches and preservation during surgery Landmarks for physical examination Localization of pathology. Cervical spondylosis, dislocations, fractures Interpreting structures on Xray, CT Scan.

Pterygopalatine fossa contents. Cranial Cavity. Skull and cranial foramina. Brain and meninges. Ventricular system CSF. Blood supply of brain. Venous Sinuses Cranial nerves = path, course

Optic nerve, relations to hypophysis. Carotid artery course and relations. Cavernous Sinus relations contents. Trigeminal nerve course distribution. Facial nerve course through Temporabone and parotid Surface features of neck Cervical triangles Radiologic Anatomy