1

Harvey Medicine, University of Pavia 2nd Semester, Academic Year 2017/18

Structure of the Body (SOB) Gross and Systems Anatomy

Cytology, Histology, and Embryology

Course Description: Structure of the Body is a first-year course designed to provide students with a fundamental working

knowledge of normal human gross, with histology and embryology, as a basis for the practice of medicine.

20 CFU. Lecture, 80 hours (anatomy) + 40 hours (histology/ embryology); laboratory, 45 hours.

Structural survey of human body, including skeletomuscular, nervous, circulatory, respiratory, digestive,

and genitourinary systems. Laboratory includes examination of human bones, models, medical imagining

and microscopic structures.

Instructors:

Diana X Tran Email: dianaxuanhuong.tran@unipv.it Address: Human anatomy building Office hours: after lecture or by appointment

Andrea Frontini Email: andrea.frontini@unipv.it Address: Human anatomy building Office hours: by appointment Phone: 0382/987645

Andrea Casasco Email: andrea.casasco@unipv.it Office hours: after lecture or by appointment Address: Histology Institute

Meetings: All lectures are in Harvey Hall Istituto Golgi Spallanzani (Botta 2) on Via Ferrata 9, IV° floor.

Students are assigned to one 3-hr lab per week MWRF 8-11 located in the Sala Anatomia in the

Istituto di Anatomia Umana, Via Forlanini 8. See the timetable for the weekly schedule.

Websites: Lecture and lab notes will be posted on the Kiro interface. http://elearning3.unipv.it/medicina/

For weekly calendar: http://nfs.unipv.it/medeng/orario/Orario_1list.asp

Tutors:

2

Alice alice.muda01@ateneopv.it

Erin erinrenee.bowen01@ateneopv.it

Madalena mariamadalena.furtadodeantas01@ateneopv.it

Susan susanandreavik.jehne01@ateneopv.it

Textbooks:1 (See Appendix for full list of readings) Histology and Embryology

a. Ross MH & Pawlina W, Histology: a Text and Atlas, Lippincott W & W, 2015

b. Sadler TW Langman’s Medical Embryology, Lippincott Williams & Wilkins, 2014

Anatomy2

a. Moore KL and Dalley AF, Clinically Oriented Anatomy, 6th edition, 2009

b. Netter F, Atlas of Human Anatomy, 5th Edition, Saunders, 2010

Laboratory: ATTENDANCE IS MANDATORY. Please prepare by printing lab notes. All quizzes

must be taken during your assigned lab. Note: NO FOOD, OR BEVERAGES, OR CELL PHONES

ALLOWED IN LAB AT ANY TIME.

Grading:

Two courses make up the Structure of the Body module: anatomy (15 CFU) and cytology,

histology and embryology (5 CFU). One grade will be given for the lecture & lab components

combined of each course.

I. Anatomy Grades will be assigned according to percentage of total points earned as follows:

Lecture:

Exam 1 (Covering material for weeks 1-6) 180 pts

Exam 2 (Covering material for weeks 7-12) 200 pts

Oral Exam (Covering all material in lectures and labs) 160 pts

Lab:

Lab quizzes for weeks: 1-4, 7-10 (@ 20 pts each, drop lowest score) 140 pts

Practical Exams:

Skeletal, Articular, and Muscular Systems 160 pts

Nervous, Cardiovascular, Digestive & Respiratory Systems 160 pts

Total: 1000 pts

Grading Scale: The following scale will be used as a guideline to determine the anatomy course grade

that is based on points earned throughout the semester. 27 – 30 = 900 – 1000 24 – 26 = 800 – 899 21 – 23 = 700 – 799 18 – 22 = 600 – 699 Retake = 599 and below

1 Updated versions of the books below are also recommended for this class. 2 Anatomy lecture and test material will use the Moore’s and Drake’s books. The atlas will be useful in the laboratory.

3

Minimal requirements: Students must have earned at least 400 points to gain admission to the oral exam. Most students qualify after the second practical exam in June. If not, it will be necessary to wait for all exams scores and the oral will be performed during a retake session in August or September.

II. Cytology, Histology, & Embryology

The course grade will be determined in the following matter: Written exam 1 40% Written exam 2 (includes Embryology) 40% Practical exam 20%

III. Final Grading

The final grade will be a weighted average between the two subjects: Anatomy 75% Cytology, Histology and Embryology 25% For example, if a student scores 25 and 18 respectively on the two subjects, the final grade will be 23. NOTE: In borderline cases, the final grade account for unmeasured characteristic traits such as professionalism, attitude, maturity, effort, etc.

No Make-Up Exams (not lecture nor lab) will be given, other than exceptional

circumstances. Written documentation from a physician verifying the severity of the illness

requiring loss of class time will be required to excuse an absence. The exam schedule is set;

plan your life accordingly.

Re-sit Exams will be given in August and September. In anatomy, only the written exams

and/or the oral exam can be taken. The final grade will include the points accumulated

throughout the semester with the score of the re-sit exams. In histology, there will only be one

exam for the whole grade. The re-sit exam score CANNOT be voided once it has been graded.

Regulations Misconduct and disrespectful behavior may lead to a decrease by a maximum of 3 points on the

FINAL GRADE. Unannounced, unexcused absences from the oral exam shall automatically

result in a detraction of ONE point for each instance. We have a zero-tolerance policy regarding

the destruction or theft of common lab materials, including anatomical models or histological

preparations. They will be submitted for disciplinary proceedings with the Dean and President of

Medicine.

Course Organization Anatomy is divided into two blocks. The first six weeks focus on the skeletal muscular structures

of the different regions of the body: week 1) Introduction; 2) Back and Thorax; 3) Abdomen and

Upper Limb; 4) Pelvis and Lower Limb; 5) Head and Neck & Review Block 1. The last six

4

weeks focus on organ systems: weeks 6-8) Neuroanatomy; 9-10) Cardiovascular and

Respiratory; 11) Digestive, Urinary and Reproductive Systems; and 12) Review Block 2.

Cytology histology and embryology course is organized in the following way: weeks 1-2) essential cytology; 3-4) histology of the main tissues (epithelial; connective; muscle and nervous tissues); 5-7) Microscopic anatomy of systems with particular attention to GI tract and 8-10) introduction to embryology and 11-12) practical and exam.

Laboratory Schedule I. Anatomy Lab Week Dates Lab Topic 2 18 Apr - 20 Apr (1) Bones: Upper Limb, Vertebral Column Quiz 1 = 20 pts (based on Lec 1-5) 3 23 Apr – 26 Apr (2) Muscles: Back and Upper Extremity

Quiz 2 = 20 pts (based on Lec 6-9, Lab 1) 4 2 May – 4 May (3) Bones: Skull and Lower Extremity Quiz 3 = 20 pts (based on Lec 10-11, Lab 2) 5 9 May – 11 May (4) Muscles: Skull and Lower Extremity Quiz 4 = 20 pts (based on Lec 12-13, Lab 3) 6 16 May – 18 May (5) *Lab Practical 1 = 160 pts (based on Labs 1-4) 7 23 May – 25 May (6) Intro to CNS, Cerebrum, Ventricles, and Cerebellum 8 30 May – 1 Jun (7) Brain Stem, Spinal Cord Quiz 5 = 20 pts (based on Lec 20-22, Lab 6) 9 6 Jun – 8 Jun (8) Ear, Eyes, Jaw, and Cranial Nerves Quiz 6 = 20 pts (based on Lec 23-26, Lab 7) 10 13 Jun – 15 Jun (9) Cardiovascular/Respiratory Systems Quiz 7 = 20 pts (based on Lec 27-31, Lab 8) 11 20 Jun – 22 Jun (10) Gastrointestine, Urinary, & Reproductive Systems Quiz 8 = 20 pts (based on Lec 32-35, Lab 9) 12 26 Jun – 28 Jun (11) *Lab Practical 2 = 160 pts (based on Labs 6-10) * Lab practical exams will be on Weds, Thurs, and Friday on 3-5 May and 14-16 Jun. Be certain that you attend the correct day for your exam.

II. Histology Lab Week Dates Lab Topic 2 16 Apr – 19 Apr (1) Introduction to Cytology & Histology 9 4 Jun – 7 Jun (2) Histological investigation of the Gastrointestinal tract

Lecture Schedule and Reading Assignments G: Grey, M: Moore, P: Patestas Date Lecture Prof Anatomy Topics Reading Week 1: 1 DXT a) Introduction to anatomy G: 1-26

5

Mon, 9 Apr b) Medical imagining M: 1-37, 66-70

Week 1: Weds, 11 Apr

2

DXT a) Medical imagining (con’t)

b) Intro to Skin, Skeletal, Muscular systems

G: 26-50 M: 37-65

Week 1: Thurs, 12 Apr

3 DXT a) Intro to Circulatory and Nervous systems

b) Intro to Back, vertebral bones

G: 53-117 M: 439-505

Week 1: Fri, 13 Apr

3 DXT a) Back: curvature, muscles, movements, and

contents (spinal cord)

G: 53-117 M: 439-505

Week 2: Mon, 16 Apr

4 DXT a) Thoracic wall b) Diaphragm and muscles of breathing

G: 123-62, 231-42 M: 71-104, 306-9

Week 2: Weds 18 Apr

5 DXT a) Introduction to abdomen b) Abdomen quadrants and 9 pattern regions

G: 255-302, 366-72, 398-409 M: 181-206, 309-16

Week 2: Thurs 19 Apr

6 DXT a) Abdomen layers of muscles and fascia b) Inguinal canal and hernias c) Intro to Upper Limb

G: 685-719, 819-27 M: 670-13, 793-96

Week 2: Fri 20 Apr

7 DXT a) Pectoral and scapular regions b) Sternoclavicular & acromioclavicular joint c) Arm and Axilla

G: 721-66 M: 713-39, 796-800

Week 3: Mon 23 Apr

8 DXT a) Introduction to Brachial Plexus b) Forearm muscles c) Upper Limb: application and surface anatomy

G: 768-92 M: 744-66, 800-8

Week 3: Weds 26 Apr

9 DXT a) Revisit brachial plexus b) Shoulder, Elbow, Wrist, knuckles, and finger joints c) Clinical Applications of upper limbs

G: 792-814 M: 771-93, 806-13

Week 3: Weds 26 Apr

10 DXT a) Intro to Lower Limbs, Posture and Gait b) Gluteal region c) Posterior thigh

G: 535-72, 663-71 M: 510-44, 626-34

Week 4: Weds 2 May

11 DXT a) Anterior/medial thigh b) Knee joint c) Leg

G: 574-616 M: 545-583, 634-47

Week 4: Thurs 3 May

12 DXT a) Foot and clinical applications of lower limbs b) Ankle and foot joints

G: 618-59 M: 584-626, 647-59

Week 4: Fri 4 May

13 DXT Scalp, skull, and cranium bones G: 837-73, 904-27 M: 822-64

Week 5: Tues 8 May

14 DXT Face bones and muscles

G: 837-73, 904-27 M: 822-64

Week 5: Thurs 10 May

15 DXT Neck G: 837-73, 904-27 M: 822-64

Week 5: Fri 11 May

16 DXT Review: Mock Practical

Week 6: Weds 16 May

17 DXT Review: Lectures 1-6

Week 6: Thurs 17 May

18 DXT Review: Lectures 7-13

Week 6: Fri 18 May

19 DXT Review: Answers to Mock Exam 1

Week 7: Mon 21 May

20 DXT Nervous System Development G: 879-93 M: 878-88 P: 10-27

6

Week 7: Weds 23 May

21 DXT Fundamentals of Nervous tissue and Brain G: 31-37 M: 46-57 P: 1-9, 28-53

Fri 25 May 14:00-17:00

EXAM 1

EXAM 1: Covering materials in Lectures 1-19

Week 8: Mon 28 May

22 DXT Meninges, Cerebral Spinal Fluid, Cerebral Cortex P: 84-98, 171-173, 398-42

Week 8: Weds 30 May

23 DXT Blood Supply to CNS and telencephalon P: 99-117, 190-218

Week 8: Thurs 31 May

24 DXT Diencephalon and Brainstem P: 219-252, 361-397

Week 8: Fri 1 June

25 DXT Spinal Cord: ascending and descending tracts P: 54-67, 171-189

Week 9: Mon 4 June

26 DXT Autonomic nervous system: sympathetic and parasympathetic

P: 118-133 G: 32-38 M: 46-65

Week 9: Tues 5 June

27 DXT Introduction to Cranial Nerves P: 253-281 G: 894-900

M: 1073, 1076

Week 9: Tues 5 June

29 DXT Cranial Nerves of the Special Senses P: 253-281 G: 894-900 M: 1054-1079

Week 9: Weds 6 June

30 DXT Path of cranial nerves

Week 9: Fri 8 June

31 AF a) Development of Systems b) Peritoneum and Peritoneal cavity

G: 303-309 M: 217-28

Week 10: Mon 11 Jun

32 DXT Digestive tract: mouth, esophagus, stomach, small and large intestine

G: 310-327 M: 226-62

Week 10: Weds 13 Jun

33 TBA Accessory organs: liver, gall bladder, and pancreas, spleen

G: 328-365 M: 263-89

Week 10: Thurs 14 Jun

34 TBA Kidneys, Ureters, Urinary system, and Suprarenal glands

G: 373-394 M: 290-305

Week 10: Thurs 14 Jun

35 DXT Perineum: Pelvic viscera and internal genital external sex organs, bladder, GI

G: 139-141, 292-302, 502-527 M: 98, 202-10, 362-424

Week 11: Tues 19 Jun

36 DXT Reproduction Systems G: 139-141, 292-302, 502-527 M: 98, 202-10, 362-424

Week 11: Weds 20 Jun

37 DXT Heart in Mediastinum

Week 11: Thurs 21 June

38 DXT a) Coronary Circulation b) Conduction System

G: 180-230 M: 160-74

Week 11: Thurs 21 June

39 DXT Pathological Conditions of the Heart

Week 11: Fri 22 June

40 DXT a) Thoracic Cavity: viscera and pleura b) Lungs and Respiration

G: 162-179 M: 106-34

Week 11: Fri 22 June

41 DXT Review Cranial Nerve test questions

Week 12: Tues 26 Jun

42 DXT Review medical imaging

Week 12: Thurs 28 Jun

43 DXT Practice test questions for exam 2

7

Week 12: Fri 29 Jun

44 DXT Practice test questions for exam 2

Mon 2 Jul 14:00-17:00

EXAM 2 EXAM 2: Covering materials in Lectures 20-44

Prof Cytology, Histology and Embryology Topics

AF The morphological method. Cell proliferation and differentiation. Histogenesis. The cell. Cytoplasmic organelles. Cell membrane. Endoplasmic Reticulum. Smooth E. R.

AF Rough E. R. Ribosomes and protein synthesis. Golgi apparatus. Lysosomes.

AF Mitochondria. Centrioles. Cytoskeleton. Cytoplasmic inclusions.

AF Nucleus. Nuclear envelope. Chromatin. Nucleolus. Cell Cycle. Cell activities. Mitosis, meiosis.

AF Tissues. Epithelial tissue. Lining epithelia. Cell surface specializations.

AF Glands and secretion. Exocrine glands. Endocrine glands. Sensory epithelia.

AF Connective tissue: general aspects. Connective tissue proper: Loose and dense c. tissue. Extracellular matrix.

AF Connective tissue: general aspects. Connective tissue proper: Loose and dense c. tissue. Extracellular matrix. (continued)

AF Adipose Tissue.

AF Cartilage. Bone. Histogenesis of Bone

AF Cartilage. Bone. Histogenesis of Bone (continued)

AF Blood. Erytrocytes. Leucocytes. Platelets.

AF Blood cell formation (Hemopoiesis).

AF Muscular tissue. Smooth muscle. Skeletal muscle. Cardiac Muscle.

AF Nervous tissue: general organization of the nervous system. The neuron.

AF Nerve fibers. Synapsis. Peripheral nerve endings. Neuroglia.

Embryology topics

AC Female and male gametogenesis. Fertilization. Early stages of embryo development. Blastocyst and implantation. Placenta.

AC The embryo disk. Primitive embryo layers. Formation of the embryo body. Endoderm derivatives. Ectoderm and Mesoderm derivatives.

AC The embryo disk. Primitive embryo layers. Molecular basis of regulatory mechanisms of embryo development. Time evolution and 3D organization of entoderm, ectoderm and mesoderm. Embryo annexes.

AC Intraembryonic mesoderm organization. The notochord and its role in the embryonic development. Somites. Lateral and intermediate mesoderm. Ectoderm development and derivatives.

Embryo delimitation (body formation). Morphogenetic mechanisms. Endoderm development and derivatives.

Mesoderm development. Ecto-endo-mesoderm interactions and morphogenesis. From histo- and embryogenesis towards organogenesis.

8

APPENDIX RECOMMENDED READINGS (OPTIONAL) Histology and Embryology

Alberts and al., Molecular Biology of the Cell, Garland Science, 2014 Wheater's Functional Histology: A Text and Colour Atlas, 6e Moore KL, The Developing Human. Clinically Oriented Embryology, Saunders

Elsevier 2012/15 Anatomy

Drake R, Gray’s Anatomy for Students, 2nd edition, Livingstone, 2009 Gilroy M, Anatomy - An Essential Textbook, Thieme, 1st Edition3 Acland’s Video Atlas of Human Anatomy, http://www.aclandanatomy.com/

Neuroanatomy

Patestas M & Gartner LP, A Textbook of Neuroanatomy, Blackwell Publishing, 2006

Stephan Waxman, Clinical Neuroanatomy, 26th Edition, McGraw Hill, 2009 Crossman and Neary, Neuroanatomy: An Illustrated Colour Text, Churchill

Livingstone, 2010

3 The ‘Essential Text’ is an atlas and textbook combined. It is for students who want minimal text supplements.