Dr K Chaudhry |
Anatomy Made Easy With Mnemonics by
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Introduction
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AIIMS Syllabus
Total
duration of course is one year. It comprises of two semesters I and II.
Each semester is of six months duration.
Course commences from 1st August every year and ends on 15 June following year. The subject of anatomy
is taught under the following heads :
Gross anatomy
Microanatomy
Embryology and Genetics
Neuroanatomy
Total number of teaching
hours are approximately 541.
Distribution of teaching
hours for theory and practicals are as follows :
OBJECTIVES
At the end of the course,
the student should be able to:
Comprehend
the normal disposition, inter-relationships, gross, functional and applied
anatomy of the various structures in the body.
Identify
the microscopic structures of various tissues, and organs in the human
body and correlate the structure with the functions as a prerequisite for
understanding the altered state in various disease processes.
Comprehend
the basic structure and connections between the various parts of the central
nervous system so as to analyze the integrative and regulative functions
on the organs and systems. He/She should be able to locate the site of
gross lesions according to the deficits encountered.
To
understand the basic principles of embryology including genetic inheritance
and stages involved in development of the organs and systems from the time
of conception till birth. The student should recognise the critical stages
of normal development and the effects of common teratogens, genetic mutations
and environmental hazards on it. He/She should be able to explain the developmental
basis of the occurrence of major variations, abnormalities and congenital
anomalies.
COURSE
CONTENT
I.
Gross Anatomy
Introduction to Anatomy,
nomenclature, anatomical position, planes, tissues and movements.
1.
Osteology
Names
of the bones of the body and their position; classification of the bones
with examples; general features of the bone and normal development; microscopic
anatomy of bone; general pattern of blood supply; ossification of the bones
of the limbs for age determination. X-rays of bones.
Process
of repair of bone.
2.Muscular
System
Classification and identification of the muscles of the body: main attachments, nerve supply and action(s), microscopic anatomy of muscles and the nerve terminations.
Details
of attachments of the muscles; ultrastructural features of muscle; mechanism
of the movement caused by the muscle/muscles and various forces exerted
by them and their detailed action(s).
3.Arthrology Definition and classification of joints, general features of different types of joints; detailed study of major joints of the limbs and movements performed at various joints in the body.
Microscopic
anatomy of articular cartilage; maintenance of articular cartilages; blood
supply and nerve supply of the joints.
4.Cardio
Vascular System
Normal position, external features and parts of the heart; internal features of the chambers of heart, names of the blood vessels and venous drainage of the organs, structures and body as a whole, conducting system of heart, fibroskeleton of heart.
Variation(s),
developmental anomalies of heart and blood vessels, valvular defects
and their effects
in pathogenesis of the anomalies.
5.Respiratory
System
Position,
parts, relations, blood supply of upper and lower respiratory tract. Pleura,
its reflection, nerve supply, pleural recesses and their significance,
bronchopulmonary segments, their importance.
Mechanism
of respiration
6.Digestive
System
Position, extent, parts, relations, blood supply, nerve supply, lymphatic drainage and sphincters of the gastrointestinal system.
Sphincteric
action including functional implications.
7.Genito-Urinary
System
Parts, position, relations, blood supply, nerve supply and lymphatic drainage of uterus, cervix, vagina, ovary, ovarian duct, testes, epididymis, seminal vesicle, ductus deferens, prostate, kidney, ureter, urinary bladder and urethra
Innervation
of urinary bladder in detail
8.Endocrine
System and Individual Endocrine Glands
Various
endocrine glands, their location, relations, blood supply, nerve supply
and lymphatic drainage.
Clinical
manifestations of common endocrine disorders.
9.Nervous
System and its components
Parts
of nervous system, neuron meninges, nerve terminals, neuroglia, myelination,
degeneration and regeneration, ventricles, CSF, spinal cord and its blood
supply. Motor and sensory pathways, cranial nerves, thalamus, cerebellum,
limbic and autonomic pathways. Functional cortical areas, motor and sensory
cortex and their blood supply.
�10. Special Sensory Organs
(a) Gross Anatomy of :
eye ball, extra ocular muscles their nerve supply and actions (s)
ear
nose
(iv)
tongue, its musculature blood supply and lymphatic drainage.
11.Lymphatic
System
Location
of the major groups of the lymphnodes of the body and their drainage areas.
Gross anatomy of the major lymphatics specially thoracic duct and its tributaries.
12.
Surface Anatomy
Surface
features of the body and projection of the outline of heart, its borders,
surfaces and valves, lungs, their borders, fissures and hila, pleura, liver,
kidneys and various abdominal and pelvic organs and important vessels and
nerves
13. Cross Sectional Anatomy
Cross
sections of thorax, abdomen and pelvis to understand the interrelationship
of organs and structures.
II. Microanatomy
Microscope
and basic principles of microscopy, commonly used stains, basophilic and
acidophilic staining reactions and their significance. Commonly encountered
artifacts. Brief principle of electron microscopy and interpretation of
ultrastructural features.
GENERAL
HISTOLOGY
Cell : detailed
structure of cell and its components and their functional mechanisms.
Four
primary tissues
Epithelium :Microscopic
characteristics, types, functions, distribution, basal lamina, cell junctions,specialization
of the cell surface and their structural details and functions; metaplasia.
Connective
tissue :
Cells, fibers and their structural features and functions. Intercellular
substances, amorphous ground substance, types of connective
tissue (loose areolar tissue, dense connective tissue) and their distribution.
Specialized
connective tissue : different types of cartilages and their functions
and distribution. Bone : Cells, bone matrix, structural features
of compact and cancellous bone, their distribution and functions, ossification,
blood supply of a long bone.
Muscle
: General features, detailed structure of : skeletal muscle, and
molecular mechanisms ofcontraction, innvervation of skeletal muscle, neuromuscular
junction, morphological and histochemical basis of classification into
type I and type II muscle fibers and their significance, structural and
functional characteristics of cardiac and smooth muscle; innvervation of
cardiac and smooth muscle.
Nervous tissue :Structural characteristics of a neuron, axon and dendrties. Different types of neuronsand their specific structural and functional features and distribution. Axonal transport, synapse, morphological and functional characteristics of different types of synapses. Neuroglia : types, structure and functions, blood brain barrier. Brief cytoarchitecture of the central nervous system, regeneration in CNS with particular emphasis on stem cells. Sensory and autonomic ganglia, peripheral nerves, myelin and myelination, degeneration and regeneration in peripheral nerves. Histology of various organs/organ systems Exocrine glands :Characteristics, simple and compound glands; types of secretions, modes of secretion,detailed structural features of a serous secreting cell and mucous secreting cell, serous and mucous acini, duct system, features of salivary glands, exocrine pancreas, sweat and sebaceous glands, mammary gland, bulbourethral gland etc. Circulatory system :Structural features of heart; conducting and distributing arteries and arterioles;types of capillaries, their structural features and distribution and microcirculation, detailed structure of endothelium; structural characteristics of large and small veins and venules arterio-venous shunts, lymphatics. Respiratory system : Structural features of nose, nasopharynx, larynx, trachea, principal brochi, lungincluding intrapulmonary bronchi, bronchioles, alveolar ducts, atria, alveoli, blood-air-barrier. Functions of different parts of respiratory system. Skin and nerve-end-organs : Thick, thin and hairy skin, cell renewal and pigmentation of skin, skinappendages, healing of skin wounds, sensory receptors of skin. Functions of skin. Immune system and lymphoid organs : Lymphocytes, their subtypes and functions. Humoral and cellmediated immunity. Thymus, lymph nodes, spleen, tonsils and other mucous associated lymphoid follicles. Digestive system (GIT) : General organization, oral cavity, lip, cheek, tongue, taste buds, associated salivary glands. Layers of tubular digestive tract, esophagus, stomach, small intestine, gastroesophageal junction, gastroduodenal junction, large intestine, anal canal and rectoanal junction. Liver, internal organization of liver, liver lobule, liver acinus, significance of zonation in liver acinus, liver sinusoids, detailed structure of hapatocyet, bile canaliculi, bile ducts, gall bladder, bile duct and pancreas. Endocrine glands : Thyroid, parathyroid, Islets of Langerhan’s gland, adrenal cortex and medulla, theirstructural details, functional mechanisms, hypophysis cerebri, cell types secretion and their functions, hypophyseal portal circulation, common endocrine disorders Urinary system : Detailed microscopic structure of kidney, cortex, medulla, pyramids, medullary rays,cortical columns, glomerulus, nephron, glomerular filtration juxtaglomerular apparatus, its structural features and functions, renal interstitium, collecting ducts, renal sinus, minor and major calyces, microcirculation of kidney, histophysiology of the kidney, renal pelvis and ureters, urinary bladder and urethra. Female reproductive system : Ovary, ovarian stroma, primary and secondary graafian follicles, functionsof various constitutents and structural details of graafian follicles, atretic follicles, corpuluteum and its functions, corpus albicans. Oviducts, uterus, arterial supply of uterus, cyclic changes in uterine endometrium, fertilization, vagina, female external ganitalia and mammary glands. Male reproductive system : Testes, spermatogenesis, spermatozoon, cycle of seminiferous epithelium,sertoli cells, interstitial tissue Leydig cells, histophysiology of testes, epididymus, vas deferns, prostrate, seminal vesicles, penis.
III. Embryology
III. A General Embryology (a) Definition of embryology; gestation period: definition of gamete sperm,Ovum; gametogenesis,migration of primordial germ cells into gonadal ridge; spermatogenesis; structure of sperm, oogenesis; structure of ovum; growth of ovarian follicles, ovarian and uterine cycles.
Sperm in the male genital tract; sperm in the female genital tract, activation and capacitation of sperm in the female genital tract.
First Week of Development
Definition and normal site and process of fertilisation, formation of zygote, cleavage division; formation of morula and blastocyst.
Second Week of Development
Differentiation of embryoblast and trophoblast; changes in the embryoblast formation of bilainar germ disc; changes in the trophoblast; formation of cytotrophoblast, syncytiotrophoblast, amniotic membrane, yolk sac, extra embryonic mesoderm and extra embryonic coelom and connecting stalk; formation of chorion, amniotic cavity, primary yolk sac cavity appearance of prochordal plate.
Implantation; formation of decidua, types of implantation and abnormal sites of implantation
Third Week of Development
Appearance of primitive streak and primitive node; formation of intraembroynic mesoderm resulting in trilaminar germ disc; gastrulation formation of notochord, buccopharyngeal and cloacal membranes, paraxial, intermediate and lateral plate mesoderm, secondary yolk sac, intraembryonic coelom and allantoic diverticulum; derivatives of ectoderm, mesoderm and endoderm.
Fourth
To Eighth week of Development (Embryonic period)
Formation
of somites, neural tube, cephalocaudal folding, lateral foldings, body
form, stomodeum, proctodeum, gut and vitelline duct; subdivisions of gut
into foregut, midgut and hindgut.
Development from
third month to birth (Fetal period)
Maturation of tissues and organs and rapid growth of body.
Estimation
of age.
Placenta
Formation
of placenta and chorionic villi, decidua basalis; features and functions
of placenta; placental circulation; abnormalities; placental barrier; placentome,
types of placenta.
Umbilical Cord
(j) Formation of umbilical cord; features of umbilical
cord.
Amniotic Cavity
Amniotic cavity and membrane; amniotic fluid – functions, expansions of amniotic cavity and fusion with chorion; chorion laeve with decidua capsularis; decidua capsularis with parietalis; obliteration of chorionic and uterine cavities; function of fused foetal membranes to dilate cervical canal.
Abnormalities; obliteration of chorionic and uterine cavities; abnormalities of chorion.
Formation of twins and types of twins.
Arrangement
of foetal membranes. Conjoined twins.
Teratology
Genetical and environmental factors as causative factors for congenital malformations.
Mode of actions of teratogenes and critical periods. III.B
Systemic Embryology
Development of the individual organs of digestive system, genital system, urinary system,, respiratory system, cardiovascular system. Nervous system, special sensory organs, endocrine glands and mammary gland.
Developmental abnormalities of individual organs/systems, pathogenesis of the anomalies.
Histogenesis of various organs.
Development of skeletal system, muscular system and derivatives of coelomic cavaties
Development
of face and the pharyngeal arches and the associated congenital anomalies.
III.C
Human Genetics
Cell, cell division, mitosis and meiosis, nucleus, DNA, chromosomes, classification, karyotype, chromosomal aberrations (Klinefelter, Turner and Down’s Syndrome) Prenatal diagnosis for congenital abnormalities, sex determination.
Pedigree
chart, pathogenesis of chromosomal aberrations and their effects, recombinant
DNA, genetic inheritance, genetic counselling, inborn errors of metabolism.
PRACTICALS
Gross
Anatomy
Upper Limb: Dissection:
Pectoral and scapular, axillary and shoulder region, arm, forearm.
Prosected parts: Joints,
Palm and dorsum of hand.
Thorax : Dissection:
Chest wall, mediastinum, pleura, lungs, heart.
Abdomen:
Dissection: Anterior abdominal wall and inguinal region, external genitalia.
Viscera and Posterior Abdominal wall and nerve plexus.
Pelvis: Dissection
: Pelvic viscera, blood vessels and nerves.
Prosected Parts: Perineum
including ischio-rectal fossa.
Lower
Limb: Dissection: Gluteal region, front and back of thigh popliteal fossa,
front back and lateral side of leg and dorsum of foot.
Prosected Parts: Sole
of the foot and joints
Head & Neck: Dissection:
Superficial and deep dissection of face and neck, orbit and eye ball.
Submandibular region temporal and infratemporal fossa,
cranial cavity, naso and oropharyngeal regions.
Ear,. Larynx and pharynx.
Neuro
Anatomy
Gross
specimen of full brain, meninges, spinal cord, prosected specimens to demonstrate
visual system, auditory and vesibular pathways and major functional areas.
Stained sections of brain and spinal cord at various levels to demonstrate cranial nerve nuclei, ascending and descending tracts, thalamic nuclei and important functional areas. Demonstrations
– Bones
of skull and vertebral column
– Brain
and spinal cord
– Cross-sectional
anatomy
– Radiological
anatomy
– CT and
MRI scan
Microscopic
Anatomy
– Routine
and special stained slides of all the tissues and organs of body.
–
Electronmicrographs to demonstrate filtration barrier of kidney, alveolar
septum, tight junctions of capillaries and such relevant areas.
Developmental
Anatomy
– Models
to demonstrate various stages of early foetus and different organ development.
–
Slides of ovary and testis to show follicles and stages of maturation of
spermatozoa: early chick and pig embryos to understand the development
of tissues and organs from conception till term.
Genetics
Demonstration of normal karyotype
and common abnormal conditions including banding; Pedigree chart, syndromes
and their clinical phenotype. Demonstration of various new techniques such
as FISH.
Skills
Demonstrate surface markings of important organs.
Localise important pulsation and the structures against which pressure can be applied in case of bleeding from a particular artery.
Demonstrate muscle testing and movements at joints.
Locate sites for : Lumbar puncture, sternal puncture, pericardial tapping, liver biopsy.
Locate veins for venae puncture.
Locate the site for emergency tracheostomy.
Locate
the subcutaneous positions of large veins.
TEACHING
AND LEARNING METHODOLOGY
Departmental
Faculty and Staff emphasizes on teaching basic fundamentals of Gross anatomy,
Microscopic anatomy and its correlation with function, developmental anatomy
and anatomical basis of occurrence of congenital defects, nerve lesions
and its anatomical basis and the applied aspects of relevant clinical conditions.
All divisions of Anatomy i.e. Gross, Histology, Embryology, Genetics and Neuroanatomy are taught with the help of didactic lectures on specific topics followed by dissection / practicals. The general pattern of teaching methodology followed by all the faculty members and teaching staff in the department is : Didactic Lectures : discussing the topic in detail in one hour lecture time.
Practicals
Learning objectives are given to students before each session.
Dissection : is done by students on the cadavers and is being assisted/supervised by a team of teachers. Some prossected specimen/dissection are shown on Ultrascope which is telecasted on TV monitors fitted in dissection Hall.
Video tapes of some dissections are also shown on TV after the completion of dissection of the part/ region to recaptulate the details of the part/region dissected.
Cross sections of whole body and brain are shown to correlate with MRI. X-rays are shown after dissection of each region.
Self assessment MCQs are given at the end of dissection of each region and discussed with teachers in-charge.
Handouts are given at the end of completion of part/region to the students to recaptulate and remember the Gross anatomy, Neuroanatomy, Embryology and Histology.
In microanatomy, a preview of the slides is given on TV monitor in small groups to understand the structural details of tissue/structure/organ.
In embryology, the serial sections of early chick embryos and pig embryos are demonstrated to understand the sequence of events involved in development of various systems and to understand the developmental basis of occurrence of various congenital abnormalities. Computer assisted programs for understanding the normal development of organ/systems is also demonstrated. Specimen and models depicting normal development of system are shown.
In genetics, the phenotype photographs, karyotyPes and pictures of various banding techniques are shown to understand the chromosomal abnormalities and various syndromes.
In
Neuroanatomy, the stained sections at various levels of brain and spinal
cord are shown on slides and computers to localize the cranial nerve nuclei
and trace the origin, course and termination of ascending and descending
tracts in order to understand the effects produced as a result of lesions.
Case studies of neural lesions are discussed to understand the location and level of lesions.
Demonstrations : Mainly the bones of the entire body, few dissected specimen are taught in small groups.
By
a combination of the above teaching-Learning tools and modalities the student
is able to understand the development, gross and microscopic structure
of the organ systems and gain an insight into the structure-function correlation.
This combined with the knowledge of applied/clinical anatomy provides an
understanding of the anatomical basis of health and disease.
LIST
OF BOOKS RECOMMENDED
Gross
Anatomy
EXAMINATION
PATTERN & MARKS DISTRIBUTION
Internal Assessment
: These assessments in
theory and practical are held as given below :
Theory
Papers
Comprise
mainly Short Answer Questions (SAQs), diagrams of cross sections and important
arrangement / relation of viscera, fill in the blanks etc.
Practicals
Include
identification of slides, models, photographs, specimen, prossected parts,
X-rays, MRI and structure in cross sections at various levels of body.
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