Handbook> Electives > Anatomy & Cell Biology > Clinically Oriented Gross Anatomy

Electives - Anatomy and Cell Biology

Clinically Oriented Gross Anatomy

Elective Number: 3801 (Lottery)

Rotation Supervisor: Dr. David Moyer

Duration: 4 weeks

Available:

MSK: Rotation 6 (7/31-8/26)

Trunk: Rotation 7 (8/28-9/23)

Head & Neck: Rotation 8 (9/25-10/21)

Report to: Dr. Moyer

Time to Report: 9:00 am

Place to Report: TBA

Typical day: 8:00 am - noon

Attendance: Attendance at elective activities is mandatory. Students are NOT permitted to take ACLS or PALS during this rotation.

  • Anyone who is ill or has a personal or family emergency must contact Student Affairs and the Attending on Service.
  • Students are allowed to take off up to 1 day per week to interview between November 1 and February 1.
    • Specific days missed must be approved by the Attending on Service.

Number of Students Per Rotation: 4/8 

Course Description: By the fourth year of medical school, students have acquired a greater appreciation for the importance of anatomy in their future medical practice. The Department of Cell Biology offers students the opportunity to review one or more regions of the body with emphasis on clinical relevance. For otolaryngology, ophthalmology, neurosurgery, plastic surgery and dermatology aspirants, head and neck anatomy is the obvious choice. For students interested in orthopaedics, rehabilitative or sports medicine, musculoskeletal anatomy is appropriate. Students contemplating residency in surgery, medicine, obstetrics/gynecology or urology should consider trunk anatomy. Any of the three offerings would be appropriate for students going into radiology or anesthesiology.

The primary focus of this elective is on quality dissection including review of basic structures and on special dissections not done in the first-year course such as plantar foot, temporal bone and surgical approaches. During conferences with the supervisor, students discuss various clinical considerations and surgical approaches for repair or removal of specific structures. Anatomical landmarks and relationships, fascial planes, muscular layers, regional innervation and vascularization, common variation and anomalies are all considered. The students are expected to use the library and clinical facilities in preparing for these sessions and are encouraged to attend appropriate surgeries and conferences. Independent dissections, from two to four weeks in duration, can be arranged outside the first semester, dependent on the availability of dissection material.

MSK Learning Objectives - Rotation 6
1. On the bony pelvis identify: ASIS, AIIS, pubic tubercle, acetabulum, inguinal ligament, pubic crest.
2. Identify bony landmarks on the femur.
3. Describe the saphenous opening and what goes through it.
4. Know the origin, insertion, action and innervation of each muscle that comprises the femoral triangle.
5. Describe the cutaneous innervation superficial to the femoral triangle.
6. List the contents of the femoral triangle from lateral to medial.
7. Describe the femoral sheath.
8. List the major branches of the femoral artery and describe how they leave the femoral triangle.
9. What is the principal blood supply to the femoral head? Why is it clinically important?
10. Describe the boundaries and contents of the adductor canal.
11. Describe the adductor hiatus and what goes through it.
12. Describe the course of the saphenous nerve. How does it enter the leg?
13. Define meralgia paraesthetica
14. Describe the fascia lata and how it divides the thigh into muscular compartments.
15. Describe the significance of the iliotibial tract.
16. List the three major components (aside from fat) of the superficial fascia of the anterior thigh. Describe their course and significance.
17. List the muscles in the anterior and medial compartments of the thigh. Know the origin, insertion, action and innervation of each.
18. What is the nerve of the anterior compartment of the thigh?
19. What is the nerve of the medial compartment of the thigh and what is the exception?
20. Describe the course of the femoral and obturator nerves in the thigh.
21. Learn the components of the bony pelvis, bony landmarks and ligaments.
22. Describe the greater and lesser sciatic foraminae.
23. List the three sources of cutaneous nerves of the gluteal region.
24. The muscles of the gluteal region can be divided into two group: gluteal and six small lateral rotators: List the members of each group, there origin, insertion, action and innervation.
25. Why is piriformis considered key to the gluteal region?
26. List the muscle and neurovascular structures passing through the greater sciatic foramen.
27. Which neurovascular structures are superior to the muscle and which are inferior?
28. Be able to draw the lumbosacral plexus.
29. Describe the motor nerves of lower extremity in terms of anterior and posterior divisions nerves of the lumbosacral plexus.
30. Know the variations in the relationship between piriformis and the common fibular nerve.
31. Name the principal internal rotator of the hip.
32. Know the significance of the mnemonic POPSIQ.
Posterior thigh and popliteal fossa
1. Name the muscles, their origin, insertion and innervation, of the posterior compartment of the thigh.
2. Define: hamstring muscle. Which muscle in the posterior compartment is not a hamstring muscle?
3. Why is adductor magnus considered a “pseudo-hamstring” muscle?
4. Describe the pes anserine and discuss why it is important.
5. Describe the borders and contents of the popliteal fossa.
Posterior Leg
1. Describe the major vein and cutaneous nerves in the superficial fascia on the posterior leg.
2. Describe the fascial compartments of the posterior leg. Name the muscles in each compartment and know their origin, insertion and innervation and action.
3. Describe the course of the tibial nerve in the posterior leg.
4. Identify the important bony landmarks on the tibia and fibula.
5. Name the terminal branches of the popliteal artery
6. Describe the course of the posterior tibial artery and its major branch.
7. Describe the retinaculae of the distal leg, ankle/foot.
8. Describe the relationship of neurovascular structures passing into the foot posterior to the medial malleolus. What is the significance of the mnemonic “Tom, Dick and a very nervous Harry”?
9. Know the significance of the soleal line in compartmentalizing the posterior leg.
Anterior and lateral leg
1. Describe the course of the common fibular nerve and its branches as it leaves the popliteal fossa.
2. Describe the boundaries and content of the lateral and anterior compartment of the leg.
3. Know the origin, insertion, innervation and action of each muscle in the lateral and anterior leg.
4. Describe injury to the common fibular nerve.
5. Describe the fate of the popliteal artery after it leaves the popliteal fossa.
6. Know the bony landmarks on the tibia and fibula.
Plantar foot
1. Identify the bones of the foot and their prominent bony features.
2. Describes the muscles of the foot in terms of layers and compartments.
3. Name each intrinsic muscles of the plantar foot .
4. Describe the course of the plantar arteries and nerves in the plantar foot.
5. Describe the arches of the foot and identify the elements that support them.
Joints of the lower limb
1. Know the bony landmarks of the hip, knee and ankle joint.
2. Be able to list the intrinsic and extrinsic ligaments associated with each joint.
3. For each joint, identify the structures that help stabilize the joint.
Vertebral column and spinal cord
1. Know the features of the typical vertebra.
2. Know the defining characteristics of cervical, thoracic and lumbar vertebrae.
3. Describe the vertebral curvatures.
4. Define spinal cord segment.
5. Describe the relationship between the vertebral column and spinal nerve at each level, cervical, thoracic and lumbar.
6. Describe the sacrum and the relationship on sacral nerves to the sacrum.
7. Define “Scotty Dog” and posterolateral corner, artery of Adamkiewicz.
Superficial back
1. Describe the cutaneous innervation of the posterior head, neck and back.
2. Describe the muscles of the back region in terms of layers.
3. Know which layers of the back are innervated by VPR and which are innervated by DPR.
Deep back and suboccipital triangle
1. Describe the layers of the deep back.
2. Describe the boundaries of the suboccipital triangle.
3. Describe the contents of the suboccipital triangle.
Shoulder
1. List the three bones of the pectoral girdle.
2. Name the joints of the shoulder region.
3. List the extrinsic muscles of the shoulder and know the origin, insertion, innervation and action of each.
4. List the intrinsic muscles of the shoulder. Know the origin, insertion, innervation and action of each.
5. List all the muscles attached to the scapula.
6. Describe the blood supply to the posterior shoulder.
7. Describe the boundaries and contents of the quadrilateral triangle.
8. Describe the boundaries and contents of the triangular space and triangular interval.
Pectoral region
1. Define the deltopectoral triangle and its contents.
2. Name the muscles of the pectoral region, their origin, insertion, innervation and action.
3. Name the neurovascular structures that pass through the clavipectoral fascia.
4. Describe the course of the cephalic and basilic veins in the upper extremity.
5. Describe the course of the following cutaneous nerves in the upper extremity: lateral brachial cutaneous, medial antebrachial cutaneous, superficial radial, dorsal ulnar.
6. Describe the flow of lymph in the upper extremity.
Axilla
1. Identify the boundaries of the axilla.
2. Describe the axillary sheath.
3. List the contents of the axillary sheath.
4. Be able to draw out the brachial plexus.
5. Describe the course of the axillary artery and its branches.
Arm and cubital fossa
1. Know the bony landmarks of the humerus and proximal radius and ulna.
2. Describe the muscular compartments of the arm.
3. Name the muscles in each compartment and know their origin, insertion, innervation and action.
4. Describe the significance of a supracondylar process
5. Describe the boundaries and contents of the cubital fossa.
6. Describe the course of the musculocutaneous, median, ulnar and radial nerves in the arm.
Anterior forearm
1. Know the bony landmarks of the radius, ulna and hand.
2. Describe the fascial compartments of the anterior forearm.
3. Know the origin, insertion, innervation and action of each muscle in the superficial anterior forearm
4. Know the origin, insertion, innervation and action of each muscle in the deep anterior forearm.
5. Describe the course of the median and ulnar nerves in the anterior forearm.
6. Describe the course of the radial and ulnar arteries in the anterior forearm.
7. Know the relationship on tendons and neurovascular structures at the wrist.
8. List the contents of the carpal tunnel.
Posterior forearm and dorsum of the hand
1. Describe the fascial compartments of the posterior forearm.
2. Name each muscle in the posterior forearm compartments and know their origin, insertion, innervation and action.
3. Describe the boundaries of the anatomical snuff box, its contents and significance.
4. Describe the components of the extensor expansion.
5. Name the “outcropping muscles” and understand why they are so named.
6. Name the contents of the 6 wrist compartments.
Palmar hand
1. List the five muscular compartments of the hand.
2. Name the muscles in each hand compartment and describe their action in and out of the anatomical position.
3. Know the innervation of the intrinsic hand muscles.
4. Describe the course of the ulnar and median nerves in the hand.
5. Be able to define “Guyon’s canal”.
6. Know the arteries that comprise the superficial and deep palmar arches.
7. Describe the digital pulleys and know which are most important.
8. Describe the role of lumbricals and interossei in flexing and extending the fingers.
Joints of the upper extremity
1. Know the bony landmarks of the shoulder, elbow and wrist joint.
2. Be able to list the intrinsic and extrinsic ligaments associated with each joint.
3. For each joint, identify the structures that help stabilize the joint.

Head & neck learning objectives - Rotation 8
1. Identify the bones of the face.
2. Identify the foramina in the face and name the neurovascular structures that pass through them.
3. Name the two types of muscles on the face, their embryological origin and innervation.
4. Describe the blood supply to the face.
5. Name the five terminal branches of the facial nerve.
6. Name the sutures of the calvaria.
7. List the layers of the scalp.
8. Identify the blood and nerve supply to the scalp.
9. Describe the meninges of the brain and the spaces between them.
10. List the major dural reflections
11. Describe the blood supply to the brain.
12. Describe the course of the dural sinuses.
13. Explain how cerebrospinal fluid is returned to the blood stream.
14. Identify the foramina in the floor of the anterior, middle and posterior cranial fossae and what neurovascular structures that pass though each.
15. Define the crescent of foramina.
16. Describe the contents of the cavernous sinus.
17. Identify the bones that make up each wall of the orbit.
18. Identify the foramina and fissures that open into the orbit and name the neurovascular structures that pass through each.
19. Identify the location and major parts of the lacrimal apparatus.
20. Name the intrinsic muscles of the orbit, their origin, insertion and innervation.
21. Describe the branching of the ophthalmic artery and nerve.
22. Define the ciliary ganglion and its three sources of input.
23. Identify the intrinsic muscles of the eyeball, their function and innervation.
24. Describe the conjunctival sac.
25. List the layers of the eyelid.
26. Describe the function of levator palpebrae superioris
27. Define the triangles of the neck.
28. Explain the cutaneous innervation of the neck.
29. Describe the roof, floor and contents of the posterior triangle of the neck.
30. Describe the contents of each triangle in the anterior neck.
31. Describe the contents of the carotid sheath.
32. Name the strap muscles and describe its innervation.
33. Describe the thyroid gland and its blood supply.
34. Describe the branches of the vagus nerve in the neck.
35. Describe the branches of the subclavian artery.
36. Describe the course of the thoracic duct in the neck.
37. Describe the boundaries of the infratemporal fossa.
38. Describe the relationship between the lateral pterygoid muscle and the maxillary artery.
39. List the muscles of mastication, their origin, insertion and innervation.
40. Describe the branches of the mandibular nerve.
41. Define chorda tympani and describes its function.
42. Identify the topographic features of the mandible and know the significance of each.
43. List the branches of the maxillary.
44. Know where the pterygoid venous plexus can potentially drain.
45. Know the essential bony landmarks and ligaments of the atlanto-occipital and atlanto-axial joints.
46. Describe the course of the glossopharyngeal nerve and its branches.
47. Identify three muscles and their innervation that originate from the stylomastoid foramen.
48. Describe the three parts on the pharynx.
49. Know the layers of the pharynx.
50. Describe the arrangement of longitudinal and circular muscle in the pharynx.
51. List each pharyngeal muscle and its innervation.
52. Know what structures pass through the pharyngeal intervals.
53. Describe the sensory innervation to the pharyngeal mucosa.
54. Describe the topographic features of the pharyngeal lining and explain the significance of each feature.
55. Describe the boundaries and blood supply of the palatine tonsil.
56. Know the essential bony features of the hard palate.
57. Identify the foramina in the hard palate and list the neurovascular structures that pass through each.
58. List the layers on the soft palate from inferior to superior.
59. Know the muscles of the soft palate, their origin, insertion, innervation and action.
60. Describe the topographic features on the tongue.
61. Identify the extrinsic muscles of the tongue.
62. Know the bones that make up the nose and nasal sinuses.
63. Know the essential bone features of the lateral and septal walls of the nose.
64. Describe the topographic features on the nasal cavities.
65. Describe the innervation and drainage of each nasal sinus.
66. Describe the blood and nerve supply to the nose.
67. Describe the boundaries of the pterygopalatine fossa.
68. List the openings in and out of the pterygopalatine fossa and name the neurovascular structures passing through each.
69. Describe the formation and course of the nerve of the pterygoid canal.
70. Know how parasympathetic innervation reaches the lacrimal gland.
71. Describe the innervation of the ear canal and tympanum.
72. Describe to topography of the middle ear cavity.
73. Identify the muscles of the middle ear, their innervation and function.
74. Understand the function on the tympanic plexus.
75. Describe the course of chorda tympani.
76. Describe the course and function of the lesser petrosal nerve.
77. Identify the two parts of the inner ear.
78. Describe the innervation from the inner ear.
79. Describe the course of the facial nerve, including all of its branches, from posterior cranial fossa to stylomastoid foramen.
80. Understand the function of nervus intermedius.
81. Describe the structures found in the floor of the mouth.
82. Identify the essential cartilages that make up the structure of the larynx.
83. Identify the essential ligaments of the larynx.
84. Describe the sensory and motor innervation of the larynx.
85. Name the muscles of the larynx and how the act to produce sound and protect the airway.

Thorax learning objectives - Rotation 7
Surface anatomy and bony thorax

1. Be able to find the sternal angle on the chest wall.
2. Relate the plural cavity to the chest wall at the mid-clavicular line, mid-axillary line and paravertebral line.
3. Relate the lung to the mid-clavicular line, mid-axillary line and paravertebral line.
4. Relate the borders of the heart to the anterior chest wall.
5. Know the bony features of the typical thoracic vertebra, typical rib and sternum.
6. Know how typical vertebra articulates with the vertebral column.
7. Define the boundaries of the superior thoracic aperature.
8. Understand why a cervical rib can be clinically important.
Plural cavity and lung
1. Describe the relationship between the pleural cavity and lung
2. Distinguish between visceral and parietal pleural and the significance of their innervation.
3. Describe the subdivisions of the parietal pleural and its innervation.
4. Know the difference between the root of the lung and the hilum of the lung.
5. Know the surfaces, lobes, and fissures of the lung and how they differ for the right and left lungs.
6. Know the arrangement of the bronchi and pulmonary vessels at the hilum of the right and left lungs.
7. Describe the pulmonary circulation.
8. Define azygos lobe.
The bronchial tree
1. Define the bronchopulmonary segment and explain its significance.
2. Describe the blood supply of the bronchial tree.
3. Be able to draw and label the bronchial tree for both the right and left lung.
Mediastinum
1. Know the boundaries and contents of each mediastinal compartment.
2. Identify the superior vena cava and its major tributaries.
3. Identify the aortic arch and its branches.
4. Know the course of the aorta in the thorax.
5. Identify the following; right and left vagus nn. , right and left phrenic nn. , left recurrent laryngeal nerve, trachea.
6. Be able to identify major thoracic structures in cross-section.
7. Know the differences between the right and left main bronchus.
Middle mediastinum
1. Know the contents of the middle mediastinum.
2. Know the layers of the pericardial sac.
3. Understand the arrangement of the oblique and transverse pericardial sinuses.
4. Know the borders and surfaces of the heart.
5. Know the grooves and sulci of the heart and the vessels contained in them.
6. Know the arterial supply and venous drainage of the heart.
Heart and posterior mediastinum
1. Know the landmarks and features of each chamber of the heart.
2. Know the general location of sinoatrial and atrioventricular nodes and conducting system.
3. Know the position, structure and function of the heart valve.
4. Describe the passage of blood through the heart and lungs beginning at the superior vena cava and ending at the ascending aorta.
5. Know the course of the vagus and phrenic nerve and relationship to surrounding structures.
6. Describe the azygos venous system
7. Identify the thoracic duct and describe its importance.
8. Describe the course of the esophagus through the mediastinum.
Chest wall
1. Understand the distribution of the typical spinal nerve.
2. Know how the intercostal spaces relate to the ribs.
3. Know the arrangement and extent of the intercostal muscles.
4. Lists the layers of the thoracic wall from superficial to deep.
5. Describe the sympathetic trunk, the distribution of its rame and the distribution of the splanchnic nerves.

Abdomen Learning objective - Rotation 8
Abdominal wall and inguinal canal
1. Describe the subdivision of the anterior abdominal wall in terms of a tic tac tow board.
2. Identify the layers of the abdominal wall from superficial to deep.
3. Identify the layers of the rectus sheath.
4. Name the two muscles in the rectus sheath.
5. List the boundaries of the inguinal canal from lateral to medial.
6. Know the boundaries of the inguinal triangle
Peritoneal cavity
1. Explain the difference between the abdominal cavity and the peritoneal cavity.
2. Describe the boundaries of the lesser sac.
3. Describe the ligaments and mesenteries that suspend the GI tract and spleen.
4. Explains the difference between intraperitoneal and retroperitoneal.
Foregut
1. List the parts of the GI tract and organs that are derived from the embryonic foregut.
2. Draw out the major branches of the celiac trunk.
3. Explain the difference between the portal and systemic venous systems.
4. Draw out the biliary tree.
5. Describe how the liver is divided into 8 lobes.
Mid and hindgut
1. Identify the boundaries between foregut, midgut and hindgut.
2. List the parts of GI tract derived from embryonic midgut.
3. List the parts of GI tract derived from embryonic hindgut.
4. Draw out the major branches of the superior mesenteric artery.
5. Draw out the major branches of the inferior mesenteric artery.
6. Draw out the tributaries of the portal vein.
7. Describe four major portal-caval anastomoses.
Posterior abdominal viscera
1. Describe the fascia and adipose related to the kidney.
2. Describe the blood supply to the kidney.
3. Describe the blood supply to the suprarenal glands.
4. Describe the course of the ureters from kidney to bladder
5. Be able to locate cisterna chyli and be able to follow it into the thorax as thoracic duct.
Posterior abdominal wall
1. List the paired visceral and parietal branches of the abdominal aorta from proximal to distal.
2. Describe the muscles of the posterior abdominal wall and their relationship to thoracolumbar fascia.
3. Identify the branches of the lumbar plexus on the posterior abdominal wall.
4. Identify the cruses and foraminae of the diaphragm and know structures what passes through each.
5. List the muscles that make up the wall and floor of the pelvic cavity.
Pelvis and perineum- anal triangle
1. Know the differences between the male and female pelvis
2. Know the boundaries of the greater and lesser sciatic foraminae and what passes through each.
3. Describe the boundaries and contents of the ischioanal triangle.
4. Describe the course and branching of the internal pudendal artery and pudendal nerve.
5. Describe the mechanism of action of each part of the external anal sphincter.
6. Explain the importance of the perineal body.
Pelvis and perineum- male urogenital triangle
1. Name and describe the derivation of each layer of the scrotum and spermatic cord.
2. Describe the contents of the spermatic cord.
3. Describe the boundaries and contents of the superficial and deep perineal pouches in the male.
4. Describe the components of the penis
5. Describe the blood flow through the penis.
Pelvis and perineum- female urogenital triangle
1. Using the correct anatomical terminology describe to topographic features of the female external genitalia.
2. Describe the boundaries and contents of the female urogenital triangle.
3. Name the muscles and ligament that attach to the perineal body.
Pelvis and perineum
1. Describe the peritoneal reflections over the female pelvic viscera.
2. Describe the peritoneal reflections over the male pelvic viscera.
3. Describe the role of endopelvic fascia in maintaining the stability of midline pelvic viscera.
4. List the parts of the pelvic floor.
5. Describe the internal features of the bladder.
6. Describe the internal features of the anal canal
7. Name three things that change at the pectinate line.
8. List the parts of the male urethra.
9. Draw out the internal iliac artery and it branches
10. Know the differences in the internal iliac branches in the male and female.
11. Describe the topography of the prostatic urethra.
12. Describe the course and augmentation of seminal fluid beginning with sperm in the teste and ending in the outside world.

 

Opportunities in 1st year curriculum teaching may be available during these rotations.