1st year mbbs

1st Year MBBS Anatomy

Study Guide 2020

CMH Lahore Medical College & Institute of Dentistry Lahore Cantt, Pakistan

1

MBBS ANATOMY PROGRAMME AT NUMS

Vision: To train undergraduate students by qualified faculty and state of the art infrastructure and technology so that students can meet the community challenges of 21st century.

Mission:

To impart core knowledge of anatomy in interesting, compact and practical way to undergraduate

students by Hybrid/Spiral integrated system of teaching so that they can differentiate between normal

and abnormal structure at gross, microscopic and embryological level.

Objectives: For this we need to impart:

Knowledge of Anatomy - On principles of pedagogy

Skills

Dissection & Prosection

Simulation – Models Cyber teaching Surface Anatomy Modern Histological techniques

Attitude:

Communication Skills

- Lecture & Presentation Self directed learning

- CBL, Museum Atlas - Integrated Journal - Cyber Teaching - E-Learning

Quest for Research - Journal club meeting - Library

Professionalism Empathy Inter Personal Skills Extra Curricular activities

2

Contents

Description Page No

List of Faculty 4

Overview 5

Time Table 6

Block –I 7

Block – II 16

Block – III 30

Table of Specifications 43

List of Recommended Books 44

3

List of Faculty Dr. Uzma Naseer HOD/ Professor

Dr. Shaista Arshad Jarral

Associate Professor

Dr. Tayyaba Mahmud

Assistant Professor

Demonstrators

Dr. Arwa Khawar

Dr. Saman Rauf

Dr. Muhammad Atif Ameer

4

Overview

Teaching & Evaluation Module No Subject Learning

Gross Anatomy Upper Limb 3 Substages

*EOB - I

General Anatomy General anatomical *EOB - I

terms Bone

Block-I Joints Muscular system (14 Weeks) Nervous system-I

(Introduction)

Embryology Mitosis and meiosis, *EOB - I

Gametogenesis

Ovulation &

Implantation 1st

week of

development 2nd

week

of development 3rd

week of development

Histology Cell (Introduction, *EOB - I

staining, cytoskeleton,

cell junctions)Surface

and glandular

epithelium Connective

tissue (General)Bone

Cartilage Muscle

Gross Anatomy Thorax 2 Substages

*EOB - II

Embryology Embryonic period, *EOB – II Fetal period

Block-II Placenta and fetal

membranes Twining

(10 Weeks)

CVS

Histology Circulatory System *EOB – II Immune system

General Anatomy Lymphatic system *EOB - II

Circulatory system

Gross Anatomy Lower Limb 3 Substages

*EOB – III

General Anatomy Skin Fascia Vertebral *EOB - III

column Nervous system-

Block-III II (10 weeks)

Embryology Birth defects Body *EOB - III

cavities

Respiratory system

Muscular System

Skeletal system except

head and neck

Development of limbs

Histology Respiratory system *EOB - III

5

Pre Prof / Send-up exam

*EOB – End of Block Exam

6

Block-I

Anatomy

Upper Limb

8

COURSE CONTENTS, PROPOSED LEARNING OBJECTIVES

SUGGESTED MIT (mode of information transfer)

Summary

Code MODULE - I Name Anatomy Duration 14 weeks

Broad Themes of Module Introduction

2. Cells and genetics (Theme: a subject that is being 3. Blood integrated a majority of time of module) 4. Loco motor (Upper limb)

Gross anatomy Upper limb General Anatomy General anatomical terns Bone Joints Muscular system Nervous system-I (Introduction) Embryology Mitosis and meiosis, Gametogenesis

Subject Themes Ovulation &Implantation 1st week of development 2nd week of development 3rd week of development Histology Cell(Introduction, staining, cytoskeleton, cell junctions) Surface and glandular epithelium Connective tissue(General) Bone Cartilage Muscle

Prerequisite Module None

Mode of Information Transfer:

MIT Lectures Dissection Demonstration CBL Practical Dissection movies

9

Anatomy learning outcomes:

GROSS ANATOMY

Topic Learning Objectives Students should be able to:

GROSS

• Identify important bony land marks of Scapula ANATOMY

UPPER LIMB • Describe the attachment of muscles& ligaments of Scapula

• Identify important bony land marks of Clavicle

Bones of upper • Describe the attachments of muscles and ligaments of

clavicle.

limb

• Identify important bony land marks of Humerus.

• Identify the different types of fractures of humerus and nerve injuries

• Describe the attachment of muscles & ligaments of Humerus

• Identify important bony land marks of radius &Ulna.

• Describe the attachments of muscles & ligaments of radius

•

and Ulna Identify the common sites of fractures of radius &Ulna.

MIT (Mode of information transfer)

LGIS/ Demo

Breast Knowledge

• Discuss the structure and divisions of breast tissue • Discuss importance of fibrous septa LGIS/ Demo

• Discuss its blood supply and venous drainage • Discuss lymphatic drainage of each quadrant of breast • Discuss the importance of sentinel lymph node • Describe supernumerary and retracted nipples • Describe breast abscess and CA breast

Scapular region Knowledge • Describe muscles connecting the upper limb to thoracic wall • Describe muscles connecting the scapula to humerus • Discuss origin insertion, nerve and blood supply of these

muscles

• Identify the boundaries of quadrangular and triangular spaces

• Identify structures present in these spaces

• Discuss arteries and nerves present in this region

Skill • Study prosected specimen and identify the muscles of this

region Acromioclavicular Knowledge and

• Describe formation, ligaments and articulation of these sternoclavicular joints joint • Discuss scapulohumeral mechanism

• Discuss blood supply and nerve supply of these joints • Discuss injury and dislocation of these joints

LGIS/ Demo

LGIS/ Demo

Shoulder joint Knowledge

• Describe movements, ligaments, nerve supply &

blood supply of Shoulder joint • Describe arterial anastomosis around shoulder joint • Describe the Dislocation of shoulder joint

LGIS/ Demo

10

• Explain Rotator Cuff & enumerate the injuries to it. • Discuss rotator cuff tendinitis

• Describe rupture of supraspinatus tendon

• Discuss dislocation of shoulder joint • Discuss shoulder pain

Skill • Perform movements of shoulder joint

• Study the model of shoulder joint and mark its ligaments and

rotator cuff muscles around it Axilla Knowledge

• Describe the boundaries & contents of Axilla • Describe the relation of cords of brachial plexus LGIS/ Demo

• Describe injury to the Axillary Vein and artery

• Describe axillary lymph nodes, their location, division and area of drainage

• Discuss lymphangitis and lymphadenitis • Describe the importance of axillary lymph nodes in CA

breast Skill

• Study prosected specimen and models of axilla

Arm

Elbow joint Proximal and distal

radioulna r joints

Cubital fossa

Knowledge

• Discuss anterior and posterior compartment of arm and structures present in it

• Discuss origin, insertion of muscles of anterior and posterior compartment of arm

• Discuss blood supply and nerve supply of these

compartments Skill

• Study the models and prosected specimen of arm and identify the structures present in this region.

Knowledge • Describe the type, capsule and ligaments of these joints

• Discuss the movements of these joints • Discuss muscles performing these movements • Discuss blood supply and nerve supply of these joints

• Describe the anatomical significance of carrying angle

• Discuss dislocation and clinical correlation of these joints • Discuss structures getting damaged in elbow

joint dislocation Skill

• Perform movements at elbow joint and discuss the muscles involved in these movements

• Study the models of elbow joint and recognize the bones and ligaments forming the joint

• Describe the boundaries of cubital fossa • Enlist the contents of cubital fossa and their arrangement • Discuss the importance of structures present in cubital fossa

Skill

• Mark the boundaries and contents of cubital fossa on a model

LGIS/ Demo

LGIS/ Demo

LGIS/ Demo

11

Forearm Knowledge • Discuss contents of anterior lateral and posterior fascial

compartments of forearm • Discuss muscles of these compartments and their blood

supply • Discuss the course of nerves and arteries present in this

region • Discuss boundaries of anatomical snuff box and its

importance • Describe flexor and extensor retinaculum • Discuss clinical correlations of this compartment including

tennis elbow

Skill • Study prosected specimen of forearm and identify muscles,

blood vessels and nerves present in this region • Study the models of forearm and discuss origin and insertion

of muscles • Mark the extensor and flexor retinacula on the model

The region of Knowledge wrist and palm of • Discuss bones of Hand hand • Describe functions of muscles in Thenar, Hypothenar &

Central compartments • Describe the fibrous sheaths of the digits of the hand • Discuss the anatomical structures involved in Tenosynovitis • Describe Palmar aponeurosis • Enumerate fascial spaces of Palm • Describe boundaries & contents of spaces of palm • Discuss clinical importance of spaces of palm • Discuss wrist joint • Explain the movements at wrist joint • Discuss ligaments of wrist joint and its relations • Discuss the anatomical structures involved in Wrist fractures • Explain the formation of Carpal tunnel and its contents • Explain the Carpal tunnel syndrome • Describe the course & branches of nerves in Hand • Discuss metacarpophalangeal and interphalangeal joints of

hand

Skill

• Perform movements of wrist joint and recognize the muscles involved in these movements

• Study the model of hand to visualize muscles of hand and insertion of long tendons

• Study prosected specimen of hand to identify muscles and blood vessels of hand.

Nerves of upper Knowledge

limb & brachial • Describe formation of Brachial Plexus with emphasis on plexus

•

Cords, Roots & trunk

Discuss injuries of the brachial plexus: Klumpke paralysis & Erb-Duchenne palsy

• Describe formation, distribution & important relations of following nerves:

LGIS/ Demo

LGIS/ Demo

LGIS/ Demo

12

➢ Axillary nerve

➢ Musculocutaneous nerve ➢ Median nerve ➢ Radial nerve ➢ Ulnar nerve Describe the innervation of each compartment and the specific deficits that occur with lesions of individual nerves at different parts along the course of following nerves: ➢ Musculocutaneous nerve ➢ Median nerve ➢ Radial nerve ➢ Ulnar nerve discuss the anatomical sites of lesion of nerve correlating them to sensory and motor loss within area of distribution

Cutaneous nerves Knowledge

of upper limb • Describe the cutaneous innervation of the arm, forearm

•

and hand. LGIS/ Demo

Compare and contrast dermatomes with the cutaneous innervation of specific nerves in Arm & forearm

Skill

• Draw & label cutaneous innervation of lower limb • Draw & label the dermatomes of lower limb

Blood supply of Knowledge upper limb • Discuss the course, extent & branches of Axillary,

Brachial, Ulnar and Radial arteries • Describe the anatomical sites of lesion of artery correlating

them to ischemia within area of distribution • Describe the formation of Superficial and Deep Palmar

Arches in hand • Describe the structures involved in Laceration of Palmar

Arches • Describe the formation & drainage of following Veins: • Axillary vein

• Basilic vein

• Cephalic vein

• Median cubital vein

• Discuss the importance of Median Cubital Vein in

venipuncture

Lymphatic Discuss the lymphatic drainage of upper limb in detail drainage of upper limb DISSECTION Perform dissection to identify main muscles of scapular region

along with their nerve supply Perform dissection to identify main muscles of arm along with their nerve supply Perform dissection to identify main muscles of forearm along with their nerve supply. Perform dissection to identify main muscles of hand along with their

nerve supply Perform dissection to identify muscles forming boundaries of cubital fossa

LGIS/ Demo

LGIS/ Demo Dissection

13

Perform dissection to identify contents of cubital fossa IMAGING Identify the common sites of fracture on radiographs correlating its Demo

predisposition to fracture in the following bones: Scapula Clavicle Humerus Radius Ulna Identify the bones and bony articulations of upper limb on AP and Lateral view of Radiographs

EMBROLOGY MITOSIS & MEIOSIS

GAMETOGENESIS-I

GAMETOGENESIS-II

OVULATION & IMPLANTATION

1ST WEEK OF DEVELOPMENT

Define Meiosis LGIS Differentiate first and second meiotic divisions. State the phases of meiotic divisions.

Justify the importance and result of meiosis in both sexes Differentiate between mitosis and meiosis. Describe the structure abnormalities in chromosomes like Euploid, Aneuploid, Trisomy, Non-disjunction, Translation Correlate’ the structure abnormalities with clinical conditions like: Down s syndrome Klinefelter and Tuner syndromes Describe the events of spermatogenesis. Describe the morphological changes during maturation of the gametes Enlist the differences between spermiogenesis and spermatogenesis Define the ovarian cycle LGIS Describe the stages of follicular maturation primary preantral, secondary, preovulatory, Explain the hormonal control (FSH, LH) of ovarian cycle Discuss the transport of ovum from the surface of ovary to ampulla of fallopian tube Define fertilization LGIS State normal site of fertilization Describe the results of fertilization Mentions the factors affecting fertilization Enumerate the changes that occur in spermatozoa before fertilization Explain the factors affecting penetration of sperm through the zona pellucida for formation of Pro nuclei Discuss the formation of zygote Correlate the transport of zygote from ampulla of fallopian tube to the uterine cavity and cleavage Explain the formation of blastocyst Explain the formation of outer and inner cell masses LGIS Discuss the further development of outer cell mass (trophoblast), Differentiate syncytiotrophoblast and cytotrophoblast with its microscopic appearance Describe the process of implantation (day wise change)

14

2ND WEEK OF DEVELOPMENT

3RD WEEK OF DEVELOPMENT

HISTOLOGY CELL (INTRODUCTION, STAINING, CYTOSKELETON, CELL JUNCTIONS)

SURFACE

& GLANDULAR EPITHELIUM

State the differentiation of embryonic pole and development of LGIS bilaminar germ disc with formation of Epiblast and hypoblast,

their cavities (amniotic cavity and primary yolk sac) Discuss the development of the chorionic sac and formation of primary

chorionic villi and growth of syncytiotrophablast

Explain the establishment of utero placental circulation Explain

why the second week is known as week of two s LGIS of three germ layers)

Define gastrulation (formation “ ’ ” Discuss the development of primitive streak and related

congenital anomalies (Sacrococcygeal teratoma)

Describe the development of notochordal process, notochord

canal, prechordal plate and cloacal membrane

Define Neurulation

List the steps of development of Neural Tube

Enumerate the derivatives of Neural Crest Cells

State the congenital anomalies resulting from abnormal

neurulation

Describe the formation of three germ layers and enlist their

derivatives

Differentiate three components of Mesoderm (Paraxial,

Intermediate and Lateral Plate Mesoderm) Define Somites

KNOWLEDGE Identify parts of Light Microscope

Discuss the working & magnification of Light Microscope LGIS Identify different types of Microscopes and their functions

Define resolution

Describe the steps involved in tissue processing Define

cell, identify various types of cells and shapes Define

Cytoskeleton.

Enumerate the cell junctions and describe their histological

structure SKILL

Identify and draw the different parts of microscope and

illustrate their usage.

Focus the prepared slide at different magnifications. Identify

the different shapes of cells and their examples Draw a

labelled diagram of different types of shapes of cells Lab

Classify the body tissue into categories LGIS Define Epithelium Classify various types of Epithelium

Discuss general features of Epithelial cells (basal, apical and

lateral surfaces)

Explain the different types of epithelium with examples

Describe glandular epithelium

Differentiate the structure of serous and mucus secreting

cells SKILL

Identify the different types of Epithelia and their examples

Draw a labelled diagram of different types of simple and Lab stratified epithelia

15

CONNECTIVE TISSUE (GENERAL)

Identify mucous and serous acini with haematoxylin and eosin Draw a labelled diagram of mucous and serous acini with haematoxylin and eosin KNOWLEDGE LGIS Explain the components of connective tissue Describe different types of cells in connective tissue Describe different types of fibers in connective tissue Discuss various constituents of ground substance Classify various types of connective tissues Describe the histology of different types of adipose tissue

SKILL Identify the microscopic structure of loose connective tissue,

dense regular and irregular connective tissue

Draw a labeled diagram showing the microscopic structure of

loose connective tissue, dense regular and irregular connective

tissue with haematoxylin and eosin

Draw a labeled diagram of the connective tissue

wit

h haematoxylin and eosin Lab BONE KNOWLEDGE LGIS Describe microscopic features of bones and types of ossification Enlist the location of different types of bones

SKILL Identify different types of bone microscopically

Draw a labelled diagram showing the histological structure of

different types of bone with hematoxylin and eosin

Lab CARTILAGE KNOWLEDGE LGIS Describe microscopic features of various types of cartilage

SKILL

Identify different types of cartilage microscopically

Draw a labeled diagram showing the histologic structure of

different types of cartilage with hematoxylin and eosin Lab MUSCLE KNOWLEDGE LGIS Describe the microscopic features of skeletal, smooth and

cardiac muscle

SKILL

Identify the different types of muscle microscopically Lab Draw a labeled histological diagram of different types of

muscles with hematoxylin and eosin

List of Histology Practical’s- 1st Year MBBS Class first module

Topic

Histology and Its Methods of Study

Epithelial Tissue

Connective Tissue

Muscle tissue

Bone

Cartilage

16

Block-II

Anatomy

Thorax



Summary

Code MODULE - II

Name Anatomy

Duration 10 weeks

Broad Themes of Module 1.Thorax

(Theme: a subject that is being 2.Cardiovascular system

integrated a majority of time of

module)

Gross anatomy

Thorax

Embryology

Embryonic period, Fetal period

Placenta and fetal membranes

Twining

Subject Themes CVS

Histology

Circulatory System

Immune system

General Anatomy

Lymphatic system

Circulatory system Prerequisite Module Y1M1


MIT

Lectures

Dissection

Tutorials (PTT)

CBL

Practicals

Class tests

18

Anatomy learning outcomes

Anatomy

PROPOSED LEARNING OBJECTIVES AND SUGGESTED MITs (mode of information transfer)

GENERAL ANATOMY

S.NO. TOPICS LEARNING OBJECTIVES MIT

Discuss the general structural plan of

blood vessels.

Classify blood vessels on anatomical and

functional basis

Explain each type of blood vessel and give

examples

Discuss general plan of systemic,

pulmonary and coronary circulatory

system.

Discuss general plan of portal system with LGIS

Circulatory brief accounts of arterial and venous (Large

System portal systems giving examples. group

Differentiate between anatomic end interactive

arteries and functional end arteries giving session)

examples

Define anastomosis; describe various

types of anastomosis with examples and

their clinical significance.

Describe blood supply of arteries and

veins.

Explain the importance of collateral

circulation

Discuss general plan of the lymphatic

circulatory system of the body.

Explain the mechanism of formation and

flow of lymph.

Enumerate the factors responsible for

Lymphatic flow of lymph.

System Discuss the structural plan of lymphatic LGIS

vessels.

Describe the structural plan of lymph

nodes and their role in lymphatic system

Enumerate the capsulated

lymphoid

organs

19

Correlate the role of lymphatic system

with spread of cancer and infection.

Correlate the role of lymphatic system

with development of edema.

HISTOLOGY

KNOWLEDGE:

Discuss the general histological plan of

blood vessels.

Describe and compare the histological

structure of: LGIS Elastic artery

Muscular artery

Arteriole

Different types of Capillaries

Venule

Medium sized vein

Circulatory Large vein

System Describe histological changes in intima in

atherosclerosis or arteriosclerosis

SKILLS:

Identify elastic artery, muscular artery and

large vein under light microscope and

enlist at least two identification points for

each. Lab Draw labelled diagram of elastic artery,

muscular artery and large vein with the

help of eosin and hematoxylin pencils on

the histology notebook

KNOWLEDGE:

Enumerate the cells of immune system.

Describe the structure of primary and LGIS

secondary lymph nodule.

Describe the histological features of:

Lymph node

Thymus

Immune Spleen

System Tonsils

Compare the histological structure of

thymus, lymph node, spleen and tonsils.

SKILLS:

Identify slides of lymph node, thymus,

spleen and palatine tonsils under light Lab microscope and enlist at least two

identification points for each.

20

Draw labelled diagram of lymph node,

thymus, spleen and palatine tonsils with

the help of eosin and hematoxylin pencils

on the histology notebook

EMBRYOLOGY

KNOWLEDGE

Define neurulation

Describe process of formation of neural LGIS

plate, neural tube and neural crest cells.

Enlist derivatives of:

Surface ectoderm

Neurectoderm

Neural crest

Intraembryonic mesoderm (paraxial,

intermediate, lateral plate)

Endoderm

Describe somitogenesis and early

differentiation of somites.

Describe the development of

intraembryonic coelom

Embryonic

Describe the folding of the embryo in the

longitudinal plane and correlate it with its

period

consequences

(3rd to 8th week)

Describe the folding of the embryo in the

horizontal plane and correlate it with its

consequences

Describe relocation of connecting stalk to

the anterior abdominal wall and its

differentiation into umbilical cord.

Describe the process of formation of blood

and blood vessels and differentiate

between angiogenesis and

vasculogenesis

Explain the embryological basis of the

neural tube defects like anencephaly and

spina bifida

Define hemangioma and explain its

embryological basis

Fetal period

Define fetal period

Enumerate various methods to estimate

LGIS (third month to

birth) fetal age

Describe factors affecting fetal growth

21

Enlist the external body landmarks from

third month to birth

Define intrauterine growth retardation

Enlist types of chorion and give fate of

each. LGIS

Enlist types of decidua and give fate of

each.

Enumerate the fetal and maternal

components of placenta.

Differentiate between stem, anchoring and

terminal villi

Enumerate the layers forming placental

barrier

Describe placental circulation (maternal

and fetal)

Enumerate functions of the placenta Enlist

the features of maternal and fetal surfaces

Placenta and of placenta.

fetal Enumerate placental changes by the end

membranes of pregnancy

List fetal membranes and their functions

Describe production, circulation and

significance of the amniotic fluid.

Describe the development of umbilical cord

Define preeclampsia and correlate it with

trophoblastic differentiation

Describe the embryological basis of

amniotic bands, umbilical cord defects,

erythroblastosis fetalis and hydrops fetalis

Define poly and oligohydramnios.

Enumerate their embryological causes and

adverse effects

Name two basic types of twins.

Describe the mechanism behind LGIS

occurrence of dizygotic & monozygotic

twins.

Twining Discuss the possible arrangements of fetal

membranes in case of monozygotic twins.

Discuss fetus papyraceus, twin

transfusion syndrome and conjoined

22

twins on basis of knowledge of

embryology

Explain the formation of heart tube.

Describe the mechanism of cardiac LGIS

looping

Enlist the parts of heart tube and their

definitive derivatives

Explain the embryological basis of

dextrocardia

Describe histogenesis of heart

Describe contribution of bulbs cordis and

sinus venosus to the development of heart

Explain different methods of septal

formation

Describe division of atrioventricular canal

Explain the embryological steps involved

in formation of interatrial septum

Correlate the internal differentiation of

right atrium with internal structure of

right atrium of definitive heart

Describe the formation of left atrium and pulmonary veins

CVS-I Explain the division of conotruncus

(Heart) Describe the formation of interventricular

septum and identify sources of

its different parts

Describe the development of valves of

heart

Describe the development of conducting

system of heart

Explain the embryological basis of the

following heart defects:

Various forms of atrial septal defects

Ventricular’ septal defects Fallot s tetralogy

Transposition of great vessels

Persistent truncus arteriosus

Pulmonary stenosis

Aortic stenosis

Tricuspid atresia

Hypertrophic right and left heart

syndromes

23

Ectopia cordis

Define aortic arches

Explain the development and fate of aortic LGIS

arches

Enumerate the developmental sources of

aorta

Justify the relationship of recurrent

laryngeal nerves on the basis of your

knowledge of embryology

Enumerate the segmental branches of

dorsal aortae & give their fate

CVS-II

Explain the fate of vitelline & umbilical

arteries

(Arteria

Explain the development of arteries of the

l

limbs

system)

Enumerate & explain the congenital

anomalies of arterial system which

include:

Patent Ductus Arteriosus

Coarctation of aorta

Double aortic arch

Right aortic arch

Abnormal origin of the Right Subclavian

Artery

An interrupted aortic arch

Explain the fate of vitelline, umbilical and

cardinal veins LGIS

Explain the development of inferior vena

cava

Explain the development of superior vena

CVS-III

cava

Correlate following anomalies of venae

(Venous

cavae with their development

system)

Double Inferior Vena Cava

Absence of Inferior Vena Cava

Left Superior Vena Cava Double

Superior Vena Cava

Explain the development of lymphatic

system

24

Describe fetal circulation

Describe following fetal LGIS

CVS-IV circulatory changes at birth:

(Fetal Closure of the umbilical vein and ductus

circulation venosus

) Closure of the ductus arteriosus

Closure of the oval foramen

SKILLS

Identify the structures related to general SGD

Embryology

development and development of (Small

cardiovascular system on given models group

and diagrams discussion)

GROSS ANATOMY

THORAX

KNOWLEDGE:

Enumerate the bones contributing in

thoracic cage SGD and

Describe the bony framework of the dissection

thoracic cage with topographic placement

of each bone

Identify structures forming the thoracic

inlet and outlet/costal margin

Discuss sternum, with reference to its parts

and attachments

Define sternal angle and discuss its

importance in clinical practice

Thoracic wall Classify ribs into true and false

(Bones and soft Determine side of ribs

parts) Discuss parts of a typical rib

Differentiate between typical and atypical

ribs

Identify typical thoracic vertebra, describe

its different parts and identification points

Compare a typical and atypical thoracic

vertebra

Describe the joints of thorax

with reference to their types and

movements Discuss and differentiate

between the pump handle and

bucket handle movements and

their effect on diameters

of chest cavity

25

Discuss the role of the accessory

respiratory muscles during inspiration

and expiration

Enlist the contents of a typical intercostal

space including muscles, nerves and

vessels

Describe the attachments, actions and

nerve supply of thoracic muscles Discuss

the arterial supply and venous drainage of

the thoracic wall.

Discuss the course and distribution of a

thoracic spinal nerve

Identify and justify the most suitable site

for an invasive procedure in an intercostal

space

Analyze the clinical scenario related to

blunt chest trauma and its complications

with anatomical reasoning

Describe the parts, attachments and nerve

supply of diaphragm SGD and

Enlist the apertures in diaphragm with dissection

their levels and structures passing

through each

Discuss the role of diaphragm and scalene

Diaphragm muscles in increasing the vertical diameter

of thoracic cavity

Analyze the clinical scenario related to

diaphragmatic hernia and phrenic nerve

lesions with anatomical reasoning

Correlate the tip of shoulder pain with

irritation of diaphragm

Enumerate and discuss various parts of SGD and

pleura and identify their locations dissection

Describe the pleural reflections and

recesses

Describe the innervation of the visceral and

Pleura parietal layers of the pleura

Discuss the clinical significance of

reflections and recesses of pleura and

pleural cavity

Define pleural effusion, pneumothorax,

empyema and hemothorax

26

Enlist the anatomical structures

encountered in chest tube insertion

Identify the side of lungs SGD and

Enlist borders and surfaces of lungs dissection

Discuss the topographic arrangement of

structures in hilum of each lung

Discuss the blood supply, nerve supply ,

lymphatic drainage and relations of

various surfaces of both lungs

Lungs Define bronchopulmonary segments.

Enlist them in each lung. Discuss their

significance.

Discuss with anatomical reasoning, the

clinical presentation of bronchogenic

carcinoma and lung trauma

Define mediastinum SGD and

Describe how the mediastinum is further dissection

divided

Mediastinum Enlist the structures lying at the level of

(General transverse thoracic plane

outline) Outline the boundaries of each division of

mediastinum

Enumerate contents of each division of

mediastinum

Outline the boundaries of SGD and

anterior mediastinum dissection

Anterior Enumerate the contents of

mediastinum anterior mediastinum

Describe the shape, relations and blood

supply of thymus

Outline the boundaries of superior SGD and

mediastinum and describe its general dissection

topography

Superior

Enumerate the contents of

superior mediastinum

mediastinum

Identify carina at the site of bifurcation of

trachea into main principal bronchi

Describe immediate relations, blood and

nerve supply of thoracic part of trachea

27

Justify the right bronchus being the most

probable site of foreign body impaction in

respiratory tract

Describe the orientation, relations and

branches of arch of aorta

Describe the formation, relations and

tributaries of superior vena cava and

brachiocephalic veins

Determine the site of ligamentum

arteriosum and its relation to left recurrent

laryngeal nerve

Describe the origin, course, relations and

distribution of both phrenic nerves

Analyze the clinical scenarios related to

compression of trachea and

damage/irritation of phrenic nerve based

upon your knowledge of Anatomy

Outline the boundaries of posterior

mediastinum and describe its general SGD and

topography dissection

Enumerate the contents of posterior

mediastinum

Describe the relations and branches of

descending aorta

Describe the course, relations and

constrictions of thoracic part of esophagus

Discuss the reason behind esophageal

varices in case of portal hypertension

Describe the thoracic duct with reference

Posterior to its formation, course,

mediastinum tributaries, termination and area of

drainage Analyze the clinical scenarios

related to chylothorax with the help

of your knowledge of Anatomy

Describe the course, relations and

distribution of both vagus nerves in thorax

Discuss the azygos system of veins with

reference to formation, course, relations,

tributaries and area of drainage of both

azygos and hemiazygos veins

Discuss the role of azygos vein in case of

caval obstruction

28

Identify the lymph nodes in the posterior

mediastinum

Define splanchnic nerves and identify the

location of thoracic sympathetic chain

Enumerate various layers of pericardium SGD and

Describe the gross features of fibrous dissection

pericardium

Describe the gross features of serous

pericardium (both parietal and visceral

layers)

Describe the reflections of parietal and

visceral pericardium resulting in formation

of transverse and oblique sinuses Identify

Pericardium

the locations of

pericardial sinuses

Describe the surgical significance of the

Transverse Pericardial Sinus

Discuss the innervation of various layers

of the pericardium

Define pericarditis and pericardial

effusion

Identify the best location for and enlist the

anatomical structures encountered

in pericardiocentesis

Describe anatomical position, borders, SGD and

surfaces, apex and base of heart Describe dissection

external features of the heart Describe

internal structure of various chambers of

heart

Compare the functional anatomy of right

and left ventricles

Describe structure of various valves of

heart

Heart Enumerate the structures comprising the

cardiac skeleton and describe its

significance

Describe the arterial supply of heart

Explain the basis of right or

left dominance of heart

Describe the venous drainage of heart

Describe nerve supply of heart

Define angina pectoris, myocardial

infarction and cardiac tamponade

29

Describe variations of coronary arteries in

context of myocardial infarction

Justify the chest pain, left upper limb pain,

jaw pain and epigastric discomfort as

presenting complaint of ischemic heart

disease with anatomical reasoning

SKILLS:

Identify muscles, bones, ligaments, nerves, SGD and

vessels, organs and their parts located in dissection

Gross Anatomy thorax:

of Thorax on a cadaver after performing dissection

on prossected specimens

on provided models

Identify the important bony landmarks of SGD and

thorax and mark them on a subject. Skills lab

Surface

Mark the borders of lungs, pleural

reflections, borders and apex of heart,

marking

valves of heart, thoracic duct, esophagus,

trachea, main vessels and nerves of

thorax on the given subject

Identify the bones of thorax, aortic SGD and

Imaging of knuckle, borders of heart, lungs, trachea, skills lab

head and neck hilar shadows, diaphragm and its recesses

on chest radiographs

List of Practical Histology (Anatomy):

Cardiac muscle

The Circulatory System-I

The Circulatory System-II

The Circulatory System-III

30

Block-III

Anatomy

Lower Limb

31



Summary

Code MODULE - III

Name Anatomy

Duration 10 weeks

Broad Themes of Module Lower Limb

(Theme: a subject that is being Respiratory System

integrated a majority of time of

module)

Gross anatomy

Lower Limb

General Anatomy

Skin Fascia

Vertebral column

Nervous system-II

Embryology

Subject Themes Birth defects

Body cavities

Respiratory system

Muscular System

Skeletal system except head and neck

Development of limbs

Histology

Respiratory system Prerequisite Module Y1M1 & Y1M2


MIT

Lectures

Dissection

Tutorials (PTT)

CBL

Practicals

Class tests

32

Anatomy learning outcomes:

ANATOMY

LEARNING OUTCOMES

S. TOPIC DISCI- MIT LEARNING OUTCOMES N PLINE

1 Hip bone Gross SG Skill:

Anatomy D Demonstrate the anatomical position of bone and

determine the side

Recognize important bony land marks on gross

inspection as well as on radiographs

Identify the muscles & ligamentous attachments on

bone

Knowledge:

Describe the muscles & ligamentous attachments on

bone

Discuss injuries of hip bone and identify them on

radiographs

Compare gender differences of hip bone 2 Gluteal Region Gross SG Skill:

Anatomy D Explore and identify the structural anatomy of

gluteal region of the cadaver after performing

dissection.

Knowledge:

Describe in tabulated form the origin, insertion,

nerve supply and action of gluteal muscles

Enumerate structures deep to gluteus maximus

Describe boundaries of greater sciatic and lesser

sciatic foramina and enumerate structures

passing through them

Summarize the origin, relations and main

branches of nerves and vessels of gluteal region

Analyze clinical scenarios regarding:

Injury to superior gluteal nerve

Injury to inferior gluteal nerve

Injury to sciatic nerve

Intragluteal injections 3 Femur Gross SG Skill:

Anatomy D Demonstrate the anatomical position of bone and

determine the side



Knowledge:

33

Describe the muscle & ligamentous attachments on

bone

Describe femoral fractures and identify them on

radiographs

Analyze clinical scenarios related with coxa vera

and coxa valga

Analyze clinical scenarios related with interruption

of blood supply to head & neck of femur 4 Anterior fascial Gross SG Skill:

Compartment of Anatomy D Dissect the front of thigh to:

Thigh Trace continuity of fascial layers of abdominal wall

with perineum & thigh

Explore the arrangement of superficial inguinal

lymph nodes & their drainage area

Locate the superficial inguinal ring

Reveal the course of great saphenous vein Explore

the fascia lata and opening contained in it Identify

the attachments of muscles of anterior facial

compartments of thigh along with their blood and

nerve supply

Explain the boundaries and contents of femoral

canal

identify the boundaries and contents of femoral

triangle

Knowledge:

Describe the boundaries, compartments, contents

and importance of femoral sheath


blood and nerve supply and actions of muscles of

anterior facial compartments of thigh

Analyze the clinical scenarios related with: Varicose

veins

Great saphenous vein cutdown 5 Medial fascial Gross SG Skill:

Compartment of Anatomy D Explore and identify the structural anatomy of

Thigh medial compartment of thigh of the cadaver after

performing dissection.

Knowledge:

Describe the origin, insertion, nerve supply and

actions of muscles of medial facial compartments of

thigh

Analyze the clinical scenario related with obturator nerve injury

34

6 The back of the Gross SG Skill:

thigh Anatomy D Explore and identify the structural anatomy of back

of thigh of the cadaver after performing dissection.

Knowledge:

Describe the origin, insertion, nerve supply and

actions of muscles of posterior facial compartments

of thigh

Mark the deep seated structures on the surface of

region

Analyze the clinical scenario related with sciatic 7 Hip joint Gross SG Skill:

Anatomy D Demonstrate the articulation of hip joint

Knowledge:

Describe the articulation, type, capsule, ligaments,

synovial membrane, nerve supply, blood supply

and important relations of hip joint

Discuss the various movements of hip joint along

with muscles responsible for these movements

Discuss the importance of artery to the ligament of

the femoral head in Fractures of the Femoral Neck

Discuss the anatomical structures involved in

Dislocation of Hip Joint

Analyze the clinical scenarios related with hip joint stability and trendelenburg s sign

8 Bones of leg Gross SG Skill: ’ Anatomy D Identify the patella and its landmarks Demonstrate

the anatomical position of tibia & fibula and

determine their side



Knowledge:

Discuss patellar dislocations & patellar fractures

Describe and identify the muscle & ligamentous

attachments on tibia & fibula

Identify the common sites of fractures of tibia and

fibula and correlate them with their clinical

presentation based on the knowledge of Anatomy

Discuss clinical importance of intraosseous

infusion of tibia in infants

9 Popliteal fossa Gross SG Skill:

Anatomy D Explore and identify the structural anatomy of

popliteal fossa of the cadaver after performing

dissection.

Knowledge:

35

Enlist the structures forming various boundaries of

popliteal fossa

Enumerate the contents of popliteal fossa and

discuss their inter-relationships

Draw and label genicular anastomosis and

discuss its clinical significance

10 Fascial Gross SG Skill:

compartments of Anatomy D Explore and identify the structural anatomy of

leg fascial compartments of leg of the cadaver after

performing dissection

Knowledge:

Enumerate the contents of anterior, lateral and

posterior compartments of leg.

Describe origin, insertion and actions of muscles

contained within anterior, lateral and posterior

compartment of leg.

Explain blood and nerve supply of anterior, lateral

and posterior compartment of leg

Discuss the following clinical conditions related

with structures in the region of leg:

Anterior compartment of leg syndrome

Tenosynovitis & dislocation of peroneus longus &

brevis tendons

Gastrocnemius & soleus muscle tears

Ruptured tendocalcaneus

Rupture of plantaris tendon

Plantaris tendon & autografts

Deep vein thrombosis & long distance air travel

Describe the retinaculae of ankle with reference to

their attachments and structures passing

underneath them

Analyze the clinical scenarios related with

common peroneal and tibial nerve injuries

36

11 Knee joint Gross SG Skill:

Anatomy D Demonstrate the articulation of knee joint

Knowledge:

Describe the articulation, type, capsule, ligaments

(extra and intra articular), synovial membrane,

nerve supply, blood supply, important relations,

and movements related to the knee joint

Explain the mechanism of locking and unlocking of

the knee joint

Name the bursae related to knee joint and point

out those which communicate with the joint cavity

Analyze the clinical scenarios related with patellar

tendon reflex and various types of bursitis Discuss

the following:

Quadriceps femoris as knee joint stabilizer

Strength of knee joint

Knee injury and synovial membrane

Ligamentous injury of knee joint

Meniscal injury of knee joint

Pneumoarthrography 12 Proximal & Gross SG Knowledge:

distal Anatomy D Describe the articulation, type, capsule, ligaments,

Tibiofibular joints nerve supply, blood supply, and movements related to these joints

13 Ankle joint Gross SG Skill:

Anatomy D Demonstrate the articulation of ankle joint

Knowledge:

Describe the articulation, type, capsule, ligaments,

synovial membrane, nerve supply, blood supply,

movements and important relations of the joint

Differentiate between acute sprains of lateral ankle

and medial ankle

Describe the fracture dislocation of ankle joint

Discuss the sensory and motor loss associated with

tibial nerve entrapment in tarsal tunnel syndrome

Analyze the clinical scenario related with achilles

37

14 Articulated foot Gross SG Skill:

Anatomy D Identify the bones of foot

Demonstrate anatomical position and determine

their side of calcaneus and talus

Recognize important bony landmarks, muscular &

ligamentous attachments on calcaneus & talus

Knowledge:

Describe articulation among various bones of foot

Describe foot as a functional unit

Describe arches of foot with reference to bones of

arches, and mechanisms of arch support

Discuss mechanism of walking

Discuss the clinical problems associated with the

arches of foot 15 Intertarsal joints Gross SG Skill:

Anatomy D Identify articulation, type of joint,

important ligaments and movements at

these joints on an

16 Sole of foot Gross SG Skill:

Anatomy D Explore and identify the structural anatomy of six

layers of sole of foot of the cadaver after

performing dissection

Knowledge:

Describe the attachments and relations of plantar

aponeurosis


nerve supply and action of muscles of sole of foot

Describe arteries and nerves of sole of foot

17 The dorsum of foot Gross SG Knowledge:

Anatomy D Describe the origin, insertion, nerve supply and

action of extensor digitorum brevis

Describe arteries and nerves of dorsum of foot

18 Cutaneous Gross SG Knowledge:

innervations of Anatomy D Describe the cutaneous nerve supply of lower limb

lower limb Draw & label cutaneous innervation of lower limb

Draw & label the dermatomes of lower limb

38

19 Blood supply of Gross SG Knowledge:

lower limb Anatomy D Describe blood supply of lower limb

Discuss the following:

Arterial palpation

Collateral circulation

Traumatic injury to femoral artery

Arterial occlusive disease of the leg

Saphnous cut down

20 Lymphatic drainage Gross SG Knowledge:

of lower limb Anatomy D Describe the lymphatic drainage of lower limb

21 Surface marking Gross SG Skill:

Anatomy D Mark the nerves and vessels of lower limb on the

surface of region with the help of important bony

HISTOLOGY

22 Respiratory system Histolog IL Enlist the main divisions of respiratory passage

y along with the structures constituting each?

Define respiratory and olfactory epithelium

Enumerate cells comprising respiratory & olfactory

epithelium. Describe their light microscopic

structure with the help of diagram

Describe the histological structure of the following

with the help of diagram:

Paranasal air sinuses

Nasopharynx

Larynx

Trachea

Lungs

Pleura

Differentiate various parts of bronchial tree on the

basis of lining epithelium, presence of cilia, glands,

cartilage, smooth muscles, and elastic fibers Analyze

clinical scenario regarding:

Immotile cilia syndrome EMBRYOLOGY

39

23 Birth defects Embryo IL Enumerate types of birth abnormalities & define

each of them with at least one example Summarize

principles of teratology

Classify teratogens with associated human

malformations in tabulated form

Enlist numerical & structural chromosomal

abnormalities

Discuss the following numerical chromosomal

abnormalities:

Trisomy 21

Trisomy 18

Trisomy 13

Klinefelter syndrome

Turner syndrome

Discuss the following structural chromosomal

abnormalities:

Cri-du-chat syndrome

Angelman s syndrome

Prader-willi’ syndrome Miler-dieker syndrome

Define mosaicism & discuss its embryological basis

Discuss critical periods of prenatal human

development

Discuss invasive and noninvasive approaches for

assessing growth & development of fetus in utero

24 Development of Embryo IL Explain transformation of single intraembryonic

body cavities coelom into pericardial, pleural and peritoneal

cavities

Enlist development sources of diaphragm Describe

development of diaphragm

Discuss positional changes of diaphragm with

reference to age of fetus

Explain the innervation of diaphragm with

reference to its developmental sources


40

25 Development of Embryo IL Describe the development of the following:

respiratory system Larynx

Trachea

Bronchi

Lungs

Describe different stages of lung maturation Enlist

factors responsible for normal lung

maturation

Enlist the postnatal changes that occur in lungs


Various types of tracheoesophageal fistulas Respiratory distress syndrome

26 Development of Embryo IL Describe histogenesis of cartilage

skeletal system Describe histogenesis of bone

Explain development of joints

Describe development of vertebral column

Define spina bifida. Enlist its different types. Give

embryological basis of bifid spine

alongwith methods of prenatal

assessment in this anomaly Explain development

of ribs and sternum with congenital defects

Discuss embryological basis and associated birth

defects of:

Klippel feil syndrome

Accessory ribs Fused

ribs Hemivertebra

Rachiscisis

Anomalies of sternum

41

27 Development of Embryo IL Describe development of skeletal musculature

muscular system Define lateral somitic frontier. Enlist the structures

whose borders are defined by lateral somitic

frontier.

Enumerate the muscles derived from primaxial and

abaxial domains

Summarize the innervation of axial skeletal

muscles

Enlist the developmental source of:

Head muscles

Limb muscles

Cardiac muscles

Smooth muscles

Discuss the following clinical anomalies:

Poland sequence

28 Development of Embryo IL Describe the formation of limb buds

limbs Define apical ectodermal ridge and discuss its role

in limb development including digits

Describe limb growth and development

Discuss rotation of limbs during development.

Describe the relationship between rotation of limbs

& cutaneous nerve supply of limbs Differentiate

between development of upper and lower limbs

Discuss development of limb musculature

Enumerate and describe the various types of limb

defects. Discuss their embryological basis

General Anatomy

29 Skin & fascia General SG Enumerate the components of integumentary

Anatomy D system.

Enlist the functions of integumentary system Enlist

the two main parts of skin. Enumerate its layers

with their general features.

Enumerate appendages of skin. Describe their

general features.

Define cleavage lines? Describe their clinical

importance.

30 Vertebral column General SG Describe the anatomy of vertebral column with

Anatomy D reference to:

Number of vertebra in different regions

Curvatures of vertebral column

Describe defects in the curvature of vertebral

42

31 Nervous system-II General SG Describe division of nervous system on gross

Anatomy D anatomical basis

Enumerate components of central and peripheral

nervous system. Describe their general features

Define autonomic nervous system (ANS). Enlist the

differences between autonomic and somatic

nervous system

Enlist the main divisions of ANS? Describe

differences of its two main divisions in tabulated

form.

Enumerate cranial parasympathetic ganglia.

Describe their general features

Define enteric nervous system. Describe its

general features.

List of Practical work:

Histology of Bronchial

Tree Histology of Lung -I

Histology of Lung -II

43

HISTOLOGY

Text Books Reference Books

Basic Histology Medical Histology by Prof. Laiq

By Luiz carlos Junqeira (14th

Edition) Hussain (6

th edition)

Di-fiore`s Atlas of Histology (12th

Edition) Histology

By Michel H. Ross (6th

Edition)

42

1st year mbbs

Documents