Download Normal anatomy with Elements of Topographic Anatomy The term

Normal anatomy with Elements of Topographic Anatomy
The term anatomy is derived from Greek roots temnein, that mean “to dissect”
The study of anatomy is linked to dissection of cadavers, and it is complemented by viewing
previously dissected material and plastic models. Gross anatomy deals only with structures that can
be displayed by dissection and that are visible to the naked eye, without the aid of magnification.
Gross anatomy itself is divided into systemic anatomy (e.g. skeletal, vascular, nervous), regional
anatomy (e.g. limbs, head and neck) and clinical anatomy. Anatomy constitutes the basis of the gross
anatomy are:
1. familiarize students with human, topographical and clinical anatomy, which will serve as basis for
developing knowledge of further clinical disciplines,
2. to be able to identify anatomical details in specimens,
3. to introduce up-to-date teaching methods of anatomy based on the recent computer software,
4. to familiarize students with dissecting techniques of all structures,
5. to be able to use correct medical terminology,
6. to identify relationships between structures and function of different organs,
7. to apply anatomical knowledge,
8. to familiarize with control, integration and regulation mechanisms responsible for maintaining
homeostasis
Teachers:
1. dr hab. n. med. Michał Szpinda, prof. UMK
2. dr n. med. Paweł Brazis
Contact: [email protected]
Syllabus
I.
Department of Normal Anatomy
II.
Department of Human Anatomy
III.
Head of the Department: Dr hab. med. Michał Szpinda
IV.
Faculty of Medicine, first year
V.
Programme Tutor: Dr hab. med. Michał Szpinda
VI.
Lectures and tutorials
VII.
Assessment: examination (practical, theoretical: test exam laboratory works), 21 ECTS
points
VIII.
Subject Hours: lectures 70h, tutorials160h, total 230
IX.
Aims of the Subject:
1. to familiarise students with human, topographic and clinical anatomy, which will
serve as a basis for developing knowledge of further clinical disciplines,
2. to be able to identify details in anatomic specimens
3. to introduce up-to-date teaching methods of anatomy based on the recent computer
software
4. to familiarise with dissecting techniques of all structures
5. to be able to use correct medical terminology
6. to identify a relation between biological structure of organs and their function
7. to apply anatomical knowledge during clinical practice
8. to familiarise with control, integration and regulation mechanisms responsible for
maintaining homeostasis
IX.
List of practical skills that will be obtained upon completion of laboratory works:
1. Identification of all structures and their topography in relation to body regions.
2. Knowledge of the topography of organs, including skeletopy, which can be important for
examining of the patient (surface anatomy of the heart and great vessels, percussion and
auscultation areas, costal lines of pleural reflection).
3. Ability to read x-ray images showing both normal and some pathological conditions (e.g.
pneumothorax, perforation of the digestive tract, bowel obstruction, dislocation of joints
and bone fracture).
4. Ability to relate biological structure of organs and their function.
5. Ability to identify the symptoms of damages to the nerves of somatic plexuses
(cervical, brachial, lumbar and sacral).
6. Ability to identify deficiency signs of damage to the motor and sensory pathways,
occurring at different levels of central nervous system and within peripheral nervous
system.
7. Knowledge of the most important anatomic anomalies (e.g. vascular variations) and
developmental anomalies (e.g. visceral inversion, persisting urachus, Meckel’s
diverticulum, transposition of the great arteries).
X. Lecture Topics:
Semester I
1. Junctions of Vertebral Column and Thorax
2. Junctions of Upper and Lower Limbs
3. Classification of Nervous System. The Spinal Nerves
4. Biomechanics of Movement in Skeletal Muscles
5. Brachial Plexus
6. Autonomic Nervous System
7. Systemic, Pulmonary and Fetal Circulation
8. Alimentary System and Peritoneum
9. Veins of the Abdomen and Pelvis. Portocaval and Cavocaval Anastomoses.
10. Autonomic Nervous System of Abdomen and Pelvis
11. Urinary and Reproductive Systems
12. Pelvic Canal
13. Lymphatic System
14. Lumbar and Sacral Plexuses
15. Topographical Anatomy of Lower Limb
Semester II
1. Petrous Part of Temporal Bone
2. Topographical Anatomy of the Skull
3. Larynx
4. Overview of Cranial Nerves. Trigeminal Nerve
5. Cranial Nerves
6. Autonomic Nervous System of the Head and Neck
7. Carotid arteries
8. Internal Ear
9. General characteristics of the Brain
10. Motor Pathways
11. Sensory Pathways
12. Visual, auditory, olfactory and vestibulary pathways
13. Hypothalamus
14. Limbic System
15. Endocrine System
XI. Tutorials
Semester I
1. Anatomical axes and planes. General structure of bones. Classification of junctions and
joints. Classification of skeleton. Regional characteristics of the vertebrae. General structure
of vertebral column. Curvatures of the vertebral column.
2. Ribs and sternum. Skeleton of the thorax. Junctions of the thoracic wall and vertebral
column. Movements of thorax and vertebral column. Imaging of thorax and vertebral
column.
3. Bones, joints and ligaments of the upper limb. Imaging of upper limb.
4. Bones, joints and ligaments of the lower limb. Imaging of lower limb.
5. Osteology: Practise and test 1
6. Regions of upper limb. Surface anatomy of the upper limb. Muscles and fasciae of upper
limb. Synovial sheaths of hand.
7. The spinal nerves. Brachial plexus. Lesions of nerves in the upper limb.
8. Arteries, veins and lymphatic vessels of upper limb. Places for measuring pulse in the upper
limb. Fractures of upper limb’s bones causing injuries of nerves and blood vessels.
Topographical anatomy of upper limb: axillary cavity, axillary fossa, deltopectoral triangle
and groove, bicipital grooves, radial nerve canal, ulnar canal, cubital fossa, forearm grooves,
carpeal canal, radial fovea.
9. Upper limb: Practise and test 2
10. Lines and regions of thorax and back. Muscles and fasciae of thorax and back.
Diaphragm. The mammary gland.
11. Intercostal nerves. Short branches of braxial plexus. Dorsal branches of the spinal
nerves. Phrenic nerve. Thoracic part of vagus nerve. Thoracic part of sympathetic trunk.
Cardiac plexus.
12. Heart and pericardium. Surface anatomy of the heart and great vessels, percussion and
auscultation areas, heart sounds. Ascending aorta, arch of aorta, thoracic aorta. Pulmonary
trunk, pulmonary arteries. Pulmonary veins. Superior cava vein.
13. Trachea and principial bronchi. Bronchopulmonary segmentation (tree). Lungs. Pleural
cavity. Mechanics of respiration.
14. Thymus. Esophagus. Thoracic duct and right lymphatic duct. Azygos veins system.
Topographical anatomy and subdivisions of mediastinum. Topographical anatomy of the
back: suboccipital triangle, intersplenial triangle, superior and inferior lumbar triangle,
triangle of auscultation.
15. Thorax: Practise and test 3
16. Regions of abdomen. Muscles and fasciae of abdomen. Inguinal canal. Rectus sheath.
Abdominal hernias. Lower intercostal nerves. Lumbar plexus. Peritoneum. Omental bursa,
epiploic foramen, lesser and greater omentum. Peritoneal cavity and peritoneal reflections.
17. Abdominal part of esophagus, stomach, duodenum. Liver, gallbladder and biliary ducts.
Pancreas. Spleen. Celiac trunk.
18. Small and large intestines. Superior and inferior mesenteric arteries. Portal vein.
19. Retroperitoneal space. Abdominal aorta. Inferior cava vein. Abdominal lymphatic
system. Lumbar part of sympathetic trunk. Celiac and intermesenteric plexuses.
Topographical anatomy of posterior abdominal wall.
20. Abdomen: Practise and test 4
21. Regions of perineum. Pelvis and urogenital diaphragm. Internal iliac artery. Inferior
hypogastric plexus. Pudendal nerve. Lumbar splanchnic nerves. Neurovascular connective
tissue lamina. Pelvic canal. Fibrous spaces of pelvis. Ischiorectal fossa. Pubic recess. Pudendal
canal. Superficial and deep perineal space. Greater and lesser sciatic foramina.
22. Urinary system - organs, vessels and nerves
23. Male genital system - division, organs, vessels and nerves
24. Female genital system - division, organs, vessels and nerves
25. Pelvis: Practise and test 5
26. Regions of lower limb. Muscles and fasciae of lower limb. Synovial sheaths of lower limb.
27. Sacral and lumbar plexuses. Lesions of nerves in the lower limb.
28. Arteries, veins and lymphatic vessels of lower limb. The places for pulse measuring in
the lower limb.Topographical anatomy of lower limb: muscular and vascular lacuna, femoral
canal, adductor canal, greater and lesser triangles, iliopubic fossa, popliteal fossa, medial and
lateral ankle canals.
29. Lower limb: Practise and test 6
30. Revision of semester I
Semester II
1. General structure (overview) of cranium. Parietal bone, temporal bone, occipital bone.
Canals of temporal bone. Tympanic cavity.
2. Sphenoid bone, frontal bone, ethmoid bone, palatine bone, maxillae, inferior nasal
concha, zygomatic bone, lacrimal bone, vomer, nasal bone, mandible, hyoid bone. Paranasal
sinuses. Fonticuli (fontanelles).
3. Osteal exits of cranial nerves. Temporomandibular joint. Cranial synchondroses and
syndesmoses. Anterior, middle and posterior cranial fossae. Orbit. Pterygopalatine fossa.
Temporal and infatemporal fossae. Nasal cavity. Retromandibular fossa. Passage of cranial
nerves through openings in the cranial base.
4. Skull: Practise and test 1
5. Regions of neck and head. Muscles and fasciae of neck and head. Triangles of neck. Fascial
compartments of the neck.
6. External nose and nasal cavity. Paranasales sinuses. Oral cavity. Tongue. Deciduous and
permanent teeth, hard and soft palate. Pharynx. Salivary glands: submandibular, sublingual
and parotid.
7. Larynx. Thyroid and parathyroid glands. Cervical part of esophagus and trachea.
8. Common, internal and external carotid arteries. Subclavian artery.
9. Dural infoldings and dural venous sinuses. Intracranial haemorrhages. Veins of the head.
Internal, external and anterior jugular veins. Lymphatic nodes and vessels of neck and head.
10. Cervical plexus. Olfactory, optic, oculomotor, trigeminal and abducent nerves.
11. Facial, intermediate, glossopharyngeal, vagus, accessory and hypoglossal nerves.
Autonomic nervous system of neck and head. Cranial parasympathetic ganglia.
Parasympathetic innervation of lacrimal, parotid, submandibular and sublingual glands.
12. Topographical anatomy of the head: orbit, pterygopalatine fossa, temporal fossa,
infatemporal fossa, nasal cavity, oral cavity, retromandibular fossa, parapharyngeal space,
retropharyngeal space, buccal space. Limitations and contents.
13. Neck and Head: Practise and test 2
14. Visual apparatus. Eyeball, accessory visual apparatus. Optic nerve. Nerves of extraocular
muscles (III, IV, VI). Pupillary light reflex and accommodation reaction.
15. Auditory
and
vestibular
apparatuses.
Vestibulocochlear nerve. Sound pathway.
16. Sensory Organs: Practise and test 3
External,
middle
and
internal
ear.
17. Ontogenetic, topographical and anatomical classification of the brain. Gross structure of
the brain. Cerebral cortex: main sulci and fissures, lobes and gyri. The main cortical areas.
Telencephalic nuclei. White matter of hemispheres. Small brain (rhinencephalon). Limbic
system components. Lateral ventricle.
18. Diencephalon. Third ventricle. Thalamus and hypothalamus.
19. Mesencephalon. Cerebral aqueduct. Metencephalon.
20. Myelencephalon. Spinal cord. Cranial nerve nuclei in the brain stem. Fourth ventricle.
Reticular formation of the brain stem. Cranial meninges. Cerebellum and spinal cord.
Subarachnoid space. Circulation of cerebrospinal fluid. Arteries of the brain, circulus
arteriosus of Willis. Lumbar puncture.
21. Neuroscience - brain: Practise and test 4
22. Nerve fascicles of the cerebrum (association, projection and commissural fibres).
Extrapyramidal system. Pyramidal (corticospinal) tracts. Dysfunction of efferent pathways.
Spinocerebellar tracts. Vestibular tract.
23. Pathways of thalamus and hypothalamus. Integration of autonomic functions. Afferent
pathways of internal organs. Ascending tracts (dorsal funiculus, spinothalamic tracts).
Dysfunction of efferent pathways. The role of limbic system and its relation with afferent and
efferent fibres.
24. Reticular system. Tegmental central tract. Medial longitudinal fasciculus. Tracts of
extrapyramidal system. Visual, auditory, olfactory and gustatory pathways. Hemisection and
transection of the spinal cord.
25. Neuroscience - nervous pathways: Practise and test 5
26. Topographical and clinical anatomy of limbs.
27. Topographical and clinical anatomy of trunk.
28. Topographical and clinical anatomy of neck and head.
29. Topographical anatomy: Practise and test 6
30. Revision of semester II.
XI. Bibliography - basic:
1) Moore Keith L. and Dalley Arthur F. Clinically Oriented Anatomy. Lippincott Williams & Wilkins, 5th
ed., 2009.
2) Drake R. Gray’s Anatomy for Students. Ed. Churchill Livingstone, 2nd ed., 2009.
3) Tank P. W. Grant’s Dissector. Lippincott Williams & Wilkins, 13th ed., 2005.
4) Agur Anne M.R., Dalley Arthur F. Grant’s Atlas of Anatomy. Lippincott Williams & Wilkins, 11th ed.,
2005.
5) Weir J., Abrahams P.H. Imaging Atlas of Human Anatomy, Mosby, 3rd ed., 2003.
6) Chung Kuang W. Gross Anatomy - Board Review Series, Lippincott Williams & Wilkins, 5th ed.,
2005.
7) Netter Frank H. Atlas of Human Anatomy. Urban & Partner, 3rd ed., 2006.
NEUROSCIENCE
1) Young Paul A. and Young Paul H. Basic Clinical Neuroanatomy. Lippincott Williams& Wilkins, 1997.
2) Brodal Per The Central Nervous System. Oxford Univ. Press, 2004.
3) Waxman S.G. Clinical Neuroanatomy. 25th Edition, McGraw-Hill, 2003.
4) Haines Duane E. Fundamental Neuroscience for Basic and Clinical Applications. 3rd ed., Elsevier,
2006.
5) Haines Duane E. Neuroanatomy: An Atlas of Structures, Sections and Systems. 7th ed., Lippincott
Williams &Wilkins, 2007.
6) Fix, J.D. Neuroanatomy - Board Review Series, 3rd ed., Culinary and Hospitality Industry
Publications Services, 2006.
XII. Bibliography - additional
Journals: 1) „Folia Morphologica”
2)
„Annals of Anatomy”.
3. Netter Frank H. Atlas of Human Anatomy. Saunders, Elsevier 5th ed., 2011.
II. NEUROSCIENCE
1. Young Paul A. and Young Paul H. Basic Clinical Neuroanatomy. Lippincott Williams
& Wilkins, 2 nd ed., 2008.
Rules and regulations
I. Conditions of passing the subject
The condition of passing the subject is to receive 12 positive grades in tests (6 tests each
semester).
II. Conditions of passing classes
Every student should be prepared for classes according to classes’ syllabus posted up on the
notice board of Department of Normal Anatomy.
III. Conditions of passing tests
Two weeks before the beginning of each semester, deadlines of all the tests are announced
in classes’ syllabus on the notice board of Department of Normal Anatomy.
Each test consists of the two parts, practical and theoretical ones.
1) The condition of taking a test is to complete classes.
2) The condition of passing a test is to receive positive grades from both parts.
3) Receiving the negative grade from the practical part of each test is equivalent to failing the
test.
4) The condition of passing the practical part (the so called pins) is to give a minimum 60% of
correct answers.
5) The theoretical part may be either written or oral, and needs to give a minimum 60% of
correct answers.
6) Retake 1 is conducted by the assistant running classes, while retake 2 is run with head of
Department.
7) During a test it is forbidden to use any kinds of cheating notes, mobile phones, and the like.
Breaking this ban causes failing both parts of the test.
IV. An exam in this subject
The final exam in normal anatomy, consisting of practical and theoretical parts, takes place after
the 2 nd semester (in June).
1) The condition of taking the exam is passing all the tests during classes.
2) Passing the practical part of this exam (50 “pins”) is necessary to take the theoretical part of
the exam. In order to pass the practical part of the test, it should be given a minimum 60%
(30 “pins”) of correct answers.
3) The theoretical part of the exam is a single-choice test (100 questions); the condition of
passing it is to give a minimum 60% of correct answers.
4) The condition of passing the whole exam is to receive positive grades from both theoretical
and practical parts.
5) Failing the practical part equals failing the whole exam.
6) In case of the absence on the exam, Study Regulations are applied (point VIII, 32).
7) During the exam it is forbidden to use any kinds of cheating notes, mobiles, and the like.
Breaking this ban causes failing the whole exam.
8) Retake exams take place during repeat end-of-term examinations. The date of repeat
exams is set by unit’s head of department and it is posted up on the notice board a month
before deadline.
9) Students, who previously passed the practical part, have to take only the theoretical part of
the exam during retakes. Dates of all the exams that take place before the end-of-term
examinations are set by unit’s head of department.
10) Student may take the final exam before the end-of-term examinations, if an average grade
of all tests is at least 4.5.
V. Conditions of making up for missed and excused classes or classes not completed due
to other reasons
1) Student is obliged to take part in all classes.
2) The absence must be excused immediately after the reason of it disappears. It should be
done during the first class that student takes part in right after the absence.
3) In case of the absence due to sickness, sick-leave from a doctor is necessary; if the
absence is caused by bad fortune, a student’s duty is to provide a written excuse from the
proper Authorities.
4) The excused absence from classes means classes not completed.
5) The unexcused absence makes it impossible to complete thematic section.
6) It is acceptable to have one unexcused absence from only one class within thematic
section.
7) It is possible for a student to make up for missed class, according to the rules set up by the
assistant running classes.
8) Not making up for classes makes it impossible to take tests.
VI. Deadlines of supplying studies, reports etc. required in the Unit
Classes are run in the way that does not require preparing studies and reports.
VII. General and detailed health and safety-at-work legislation (BHP) required in the Unit
1) Classes take place in dissection rooms in Department of Normal Anatomy.
2) Only students of Collegium Medicum UMK dressed in clean protective clothes may enter
dissection rooms (gowns, disposable rubber gloves, bonnet or scarf).
3) It is necessary for each student to bring for classes the following items: scalpels,
anatomical tweezers, books and anatomical atlases.
4) Students must be particularly careful while preparing specimens in order not to cut
themselves or others.
5) Students are obliged to behave with respect in dissection rooms.
6) It is forbidden to leave the dissection room during classes without assistant permission.
7) It is strictly forbidden to eat, smoke and use fire in dissection rooms. It is obligatory and
necessary to keep this place clean.
8) In case of being cut or applying formalin into the conjunctiva, the assistant running classes
must be informed immediately.
9) Taking photos or making films is strictly forbidden.
10) Students are forbidden to be in the dissection rooms of Normal Anatomy Department
beyond classes and the hours of consultancy.
11) Outsiders are strictly forbidden.