Aims - 2
Desired Learning Outcomes - 2
NC1
Foundation of Health and Medical Practice - 3
Circulation and Breathing - 4
Fluids, Nutrition and Metabolism - 6
NC2
Reproduction, Development and Genetics - 9
Movement and Musculoskeletal Biology - 10
Neuroscience and Behaviour - 15
Fundamental Principles -21
Interpretation of Basic Imaging Studies - 22
Role of Imaging in Clinical Investigation - 24
Interpretation of Advanced Imaging - 27
UCL Centre for Imaging & Clinical Anatomy (CICA) www.ucl.ac.uk/cica
ANATOMY & IMAGING

OVERVIEW
• To facilitate understanding and correlation of human anatomy on a real patient, cadaveric specimens and on different imaging modalities.
• To facilitate understanding of the correlation between gross anatomy, human physiology and pathology.
• To provide students with knowledge and understanding of the wide variety of imaging modalities and their role in clinical assessment and treatment.
• To enable students to interpret basic imaging studies in order to diagnose important clinical conditions.
• To develop appropriate attitudes necessary to balance the risks and benefits of different diagnostic and therapeutic procedures.
The overarching themes of this vertical stream, modified from “Tomorrow’s Doctors” (GMC 2009 * ), are the following.
The doctor as a scholar and scientist
• Explain normal human structure and functions.
• Justify the selection of appropriate investigations for common clinical cases.
• Explain the fundamental principles underlying such investigative techniques.
• Select appropriate forms of management for common diseases, and explain their modes of action and their risks from first principles.
• Make accurate observations of clinical phenomena and appropriate critical analysis of clinical data.
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The doctor as a practitioner
• Make an initial assessment of a patient’s problems and a differential diagnosis. Understand the processes by which doctors make and test a differential diagnosis.
• Formulate a plan of investigation in partnership with the patient, obtaining informed consent as an essential part of this process.
• Interpret the results of investigations including x-rays and the results of diagnostic procedures.
• Make clinical judgements and decisions, based on the available evidence, in conjunction with colleagues and as appropriate for the graduate’s level of training and experience. This may include situations of uncertainty.
• Formulate a plan for treatment, management and discharge, according to established principles and best evidence, in partnership with the patient, their carers, and other health professionals as appropriate. Respond to patients’ concerns and preferences, obtain informed consent, and respect the rights of patients to reach decisions with their doctor about their treatment and care and to refuse or limit treatment.
• Communicate effectively with patients and colleagues in a medical context.
The doctor as a professional
• Establish the foundations for lifelong learning and continuing professional development.
• Awareness of newer techniques such as functional imaging and interventional oncology, and their future potential.
• Learn and work effectively within a multi-professional team.
• Understand and respect the roles and expertise of health and social care professionals in the context of working and learning as a multi-professional team.
• Understand the contribution that effective interdisciplinary teamworking makes to the delivery of safe and highquality care.
• Work with colleagues in ways that best serve the interests of patients, passing on information and handing over care, demonstrating flexibility, adaptability and a problem-solving approach.
* Tomorrow’s Doctors 2009. http://www.gmc-uk.org/TomorrowsDoctors_2009.pdf_39260971.pdf
ANATOMY SYLLABUS
The anatomy syllabus is defined below with reference to modules in years NC1 and NC2. Learning objectives for each session are outlined.
These topics will subsequently be revisited as refresher courses during years NC4 to NC6.
A1.1 Introduction to Anatomy 1
• Appreciate the history of anatomical studies and the role UCL has played in this
• Recognise different ways of imaging anatomical structures in 2D and 3D
• Understand basic anatomical terminology
• Describe three basic kinds of joints found between bones
• Understand the ‘grand plan’ of the circulatory system
• Understand the need for non-invasive imaging techniques
• Understand the need to recognise and interpret normal structure
• Understand the need to communicate using a precise descriptive language of human structure
A1.2 Introduction to Medical Imaging
• Understand the physics of basic radiography and be able to interpret radiolucency and radiodensity on simple radiographs and on CT images
• Recognise contrast images such as bronchograms, angiograms and IVUs
• Understand the basis of MRI and distinguish between an MRI and CT scan
• Understand the basis of ultrasound and related imaging techniques, and recognise simple images of developing embryos or the kidneys
• Understand the importance of knowing normal structures as a basis for recognizing abnormal structures 3
A1.3 Introduction to Anatomy 2
• Describe the basic segmental arrangement of motor (efferent) and sensory (afferent) nerves
• Appreciate the ordered pattern of dermatomes and myotomes in the trunk and limbs
• Understand the basic difference between the autonomic and somatic peripheral nervous systems
• Recognise the basic components of a vertebra and understand why there is regional variation in vertebral size and shape

ANATOMY SYLLABUS
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A2.1 Chest wall
• Describe how the thoracic cage is constructed and how it is moved during respiration
• Sketch diagrams showing the nerves and blood vessels of the thoracic wall
• Illustrate and recognise diagrams showing the contents of a typical intercostal space
• Describe the surface markings of thoracic wall structures
• Discuss the anatomical location of the female breast on the thoracic wall, illustrating its general structure, blood supply and lymphatic drainage
A2.2 Diaphragm
• Discuss the development, structure, position and actions of the diaphragm
• Briefly describe the innervation, blood supply, and venous drainage of the diaphragm
• Recognise the normal position of the diaphragm on radiographs
• Understand and describe the mechanisms of breathing during quiet and deep inspiration
A2.3 Pleura and lungs
• Describe normal and abnormal development of the lungs and pleural cavities
• Describe the pleural cavities and costo-diaphragmatic recesses giving details of the parietal pleura and its reflections, including its surface markings
• Identify the surface markings of the borders, the lobes and the fissures of the lungs
• Describe a typical bronchopulmonary segment and indicate its clinical importance
• Describe the blood supply and the lymphatic drainage of the pleura and lungs
• Identify the trachea, hila, and lungs on chest radiographs
A2.4 Thoracic cavity and mediastinum
• Indicate in simple diagrams the subdivisions of the thoracic cavity and list their contents
• Describe the subdivisions of the mediastinum and their contents
• Discuss the lymphatic drainage of the thorax and describe the course of the thoracic duct
• Make and recognise a diagram showing the distribution of the vagus nerves in the thorax
• Briefly describe the thoracic sympathetic trunk, ganglia, and splanchnic nerves
• Describe the relations of the oesophagus in the thorax
• Outline the venous return to the heart
• Point out the main features of the heart and great vessels in chest radiographs
• Recognise the major structures of the heart and mediastinum on CT images at two transverse levels in the thorax (T4/5 and T8)
ANATOMY SYLLABUS
A2.5 Heart and Great Vessels
• Describe the anatomy of the heart, its chambers and the great vessels
• Draw a simple diagram of the brachiocephalic veins and superior and inferior vena cavae
• Draw a simple diagram of the pulmonary trunk, aorta and aortic arch
• Describe the surface markings, position, and chambers of the heart
• Describe the pericardial reflections and their attachments to the diaphragm
• Describe the anatomy of the four chambers of the heart and their valves
• Compare and contrast the walls and internal features of the atria and the ventricles
A2.6 Mediastinum and deep structures
• Describe the anatomy of the sympathetic chain
• Give an account of the phrenic and vagus nerves, thoracic duct and azygos veins
• Describe the diaphragm, its attachments and the levels of the structures that pass behind and through it
A2.7 Coronary circulation and conducting system
• Draw and label two simple diagrams illustrating the blood supply of the heart
• Describe the origin of the right and left coronary arteries
• Describe the course, main branches and territories of the right coronary artery
• Describe the course, main branches and territories of the left coronary artery
• Be able to identify the coronary arteries and their branches on angiograms
• Describe the course of the coronary sinus and identify its opening in the right atrium
• Understand the difference between the intrinsic conducting system and extrinsic innervation of the heart
• Know the general anatomical position of the sinoatrial node and atrioventricular node
• Describe the distribution of the right and left bundle branches
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ANATOMY SYLLABUS
A3.1 Anterior Abdominal Wall and Inguinal Region
• Describe the origin, course, insertion, innervation and function of the muscles of the anterolateral abdominal wall
• Illustrate the formation of the rectus sheath at the midpoint between the umbilicus and the xiphisternum and below the arcuate line
• List the contents of the rectus sheath
• Briefly describe the anatomical basis of two or more common surgical incisions
• Describe the inguinal canal and its contents
• Differentiate between direct and indirect inguinal hernias
• Locate the principal descriptive regions of the abdominal walls
• List the principal arterial supply, venous return and lymphatic drainage of the anterior abdominal wall
• Identify important dermatomes on the anterior abdominal wall and understand their clinical significance
• List the contents of the spermatic cord
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• Explain how embryonic folding creates the gut and peritoneal cavity (revisiting earlier work)
• Summarize the main features of the primitive oesophagus and rotation of the stomach
• Explain how rotation affects the foregut mesenteries, forming the lesser sac and greater omentum
• Describe the origins and development of the liver, biliary tree and pancreas and explain the shape of the adult pancreas in developmental terms
• Describe the routes by which the umbilical and vitelline venous systems converge on the liver
• Account for the disproportionate size of the fetal liver
• Describe where the spleen forms, and how it and the pancreas become retroperitoneal
• Outline the developmental basis and clinical relevance of oesophageal and duodenal atresia and stenosis, pyloric stenosis, biliary atresia and common pancreatic malformations
A3.3 The Embryonic Gut 2
• Show how embryonic folding isolates the midgut from the yolk sac (revisiting earlier work)
• Summarize the main features of the embryonic midgut just prior to its rotation
• Describe how midgut rotation leads to its adult anatomical arrangement and its normal variants
• Explain the term ‘physiological herniation’
• Explain how the greater omentum becomes attached to the transverse colon
• Outline the basis and clinical relevance of Meckel’s diverticulum, omphalocoele and congenital umbilical hernia, congenital aganglionic megacolon and common forms of malrotation, duplication, atresia and stenosis
• Show how the urorectal septum splits the cloaca into anterior urogenital and posterior anorectal parts
• Explain the relationship between the hindgut and the anal pit, and their contributions to the anal canal
• Outline the types and developmental bases of the commoner anorectal malformations
ANATOMY SYLLABUS
A3.4 Abdominal cavity
• Trace the GI tract from oesophagus to rectum, identifying all its parts
• Identify and recognise the greater and lesser sacs of the peritoneum
• Locate and identify the following peritoneal folds: lesser omentum, greater omentum, transverse mesocolon, sigmoid
(pelvic) mesocolon, falciform ligament, left and right triangular ligaments, upper and lower layers of the coronary ligaments
• Identify the epiploic foramen (aditus to the lesser sac; foramen of Winslow) and its boundaries
• Discuss the clinical importance of the hepatorenal recess, the paracolic gutters, the rectouterine pouch
• Describe the stomach
• Name the parts of the duodenum
• List the typical characteristics of the jejunum and ileum
• Compare the external features that distinguish the large from the small intestine
• Describe the external features and location of the vermiform appendix, the caecum, ascending, transverse, descending and sigmoid colon
A3.5 The Gut and its Derivatives
• Describe and draw the approximate surface markings of the abdominal viscera
• Comment on the importance of the gastro-oesophageal junction in preventing reflux of the stomach contents
• Explain the anatomy of the stomach giving its parts, relations, blood and nerve supply and lymphatic drainage
• Describe the stomach bed
• Describe the portal system, name the main sites of portocaval anastomoses and give an account of their clinical importance
• Describe the blood supply to the large intestine as far as the anal canal
• Describe and illustrate the surfaces, lobes, relations, and peritoneal reflections of the liver
• Discuss and explain the course and relations of the extrahepatic biliary passages
• Recognise the spleen and describe its relations and blood supply
• Describe and illustrate the formation of the inferior vena cava and its tributaries
• Explain briefly the autonomic innervation of the abdominal viscera
• Identify and explain the origin of the ligamentum teres and ligamentum venosum
• Describe the formation of the portal vein and list its tributaries
• Draw diagrams to illustrate the coeliac axis, superior mesenteric artery, inferior mesenteric artery and their main branches
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A3.6 The Retroperitoneum
• Identify the muscles of the posterior abdominal wall
• Give an account of the gross anatomy, relations and blood supply of the pancreas
• Explain and illustrate the normal surface markings of the kidneys
• Identify the coverings of the kidneys and suprarenal (adrenal) glands
• Explain and draw the anterior and posterior relations of the right and left kidneys
• Describe the arterial blood supply and venous drainage of the kidneys
• Draw a coronal section of a kidney showing its internal structure
• Give an account of the right and left suprarenal glands (adrenals), their nerve supply, shape, relations, blood supply and venous drainage
• Describe the course, nerve supply and arterial supply of the ureters
• Explain: ectopic kidney, horseshoe kidney, renal colic
• Explain and illustrate the normal surface markings of the aorta, common and external iliac arteries
• Identify the main branches of the lumbar plexus of nerves
• Write short notes on: coeliac plexus, superior and inferior mesenteric plexuses, cisterna chyli, lumbar lymph nodes
• List the structures found in the root of the mesentery (of the small intestine)

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ANATOMY SYLLABUS
A3.7 The Pelvis and Perineum
• Describe the pelvic diaphragm and its role in maintaining continence
• Describe the bladder, its apex, base and neck and the peritoneal covering of its roof
• Identify the retropubic space
• Describe the urethral sphincters and their nerve supplies
• Describe the rectum and anal canal, the anal sphincters and their nerve supplies
• Identify the rectum and describe its relationship to the sacrum and peritoneum
• Identify the valves of Huston
• Identify the anorectal junction
• Identify the superior rectal artery descending from the inferior mesenteric artery (the middle rectal artery, from the internal iliac, is more difficult to identify)
• On each side of the rectum identify the pelvic splanchnic nerves (branches from the ventral rami of S2, S3 and S4 to the pelvic plexuses)
A3.8 Female reproductive organs
• Identify the fundus of the uterus and the uterine tubes, covered by the broad ligament
• Identify the ovaries attached to the broad ligament
• Identify the female urethra, stuck to the anterior wall of the vagina
• Identify the rectouterine pouch extending down to the posterior fornix
A3.9 Male pelvic viscera
• Identify the prostate gland below the bladder and the seminal vesicles behind the bladder
• Identify the ductus deferens and follow it between the deep inguinal ring and the prostate gland
• Know the relationship of prostate gland to rectum
• Identify the rectovesical pouch of the peritoneal cavity
A3.10 Perineum
• Identify the perineal membrane and its posterior free border
• Identify the ischiorectal fossae and their anterior recess above the perineal membrane
• Describe the urethra in the male and female
A3.11 The Embryonic Urinary Tract
• Summarize the origins of intermediate (nephrogenic) mesoderm (revisiting earlier work)
• Summarize key features of the pronephros, mesonephros and mesonephric duct
• Describe the outgrowth of the ureteric bud and its repeated branching
• Describe the induction of nephrons and glomeruli in the nephrogenic blastema (cap)
• Summarize the normal ascent of the kidney and the changes in its vascular supply
• Explain how the primitive cloaca becomes divided (revisiting earlier work)
• Describe the formation of the bladder, ureters and urethra from the allantois and mesonephric ducts
• Outline the developmental basis and clinical relevance of renal agenesis, polycystic kidneys, pelvic and horseshoe kidneys, duplications of the ureter and common abnormalities of the bladder
A3.12 Clinical Radiology and Imaging of the Abdomen and Pelvis
• Define the three embryological segments of the GI tract
• Define the vascular supply to the GI tract
• Understand the three-dimensional orientation of the peritoneum and compartments it forms
• Be familiar with radiological and surgical anatomical pathology of the GI tract
• Case studies: abdominal wall hernias, perforated ulcer, gallstones, bowel obstruction
ANATOMY SYLLABUS
A4.1 The Pelvic Viscera
• Identify the bones, joints, ligaments, muscles and fascia of the pelvic walls and pelvic diaphragm
• Differentiate the female bony pelvis from that of the male and relate these differences where possible to the requirements of childbirth and/or attachment of genitalia.
• Understand the orientation of the foetal head during its passage through the pelvis
• Recognise the bony parts of the pelvis in a radiograph
• Describe the origin and course to the perineum of the pudendal nerve
• Describe and illustrate the pelvic diaphragm and its actions
• Identify the internal iliac artery (and vein) and its branches to the pelvic viscera and perineum
• Distinguish between the sacral and pelvic (nerve) plexuses
• Describe the pelvic viscera in the male and female, giving their position, locations on clinical examination and peritoneal reflections
• Recognise the pelvic viscera in the normal male and nonpregnant female on ultrasound, CT and MRI scans
• Discuss briefly the structure, blood supply, lymphatic drainage, and nerve supply of the following: uterus, ovaries, uterine tubes, prostate gland, seminal vesicles, sphincters urethrae, prostatic urethra, rectum, and urinary bladder.
In particular you should be familiar with the course of the uterine arteries and ureters
• Give an account of the structure and contents of the broad ligament
• Outline on diagrams the boundaries and subdivisions of the perineum
• Describe the contents of the anal and urogenital triangles in the male and the female
• Discuss the anatomy, nerve supply and clinical significance of the anal canal and its sphincters
• Identify the perineal membrane and its posterior free border
• Identify the ischiorectal fossa and its anterior recess above the perineal membrane
• Describe the sensory nerve supply and lymphatic drainage of the perineum
• Identify the perineal body
• Give an account of the structure, nerve and blood supply of the penis and the mechanism of erection
• Describe the spermatic cord, testis and epididymis
• Describe the greater vestibular glands, the erectile tissue in the female and its blood and nerve supply
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ANATOMY SYLLABUS
A5.1 Shoulder region
• Point out the anatomical features of the scapula, the clavicle and the proximal half of the humerus, using anatomical specimens and radiographs
• Use simple sketches to illustrate the joints of the shoulder girdle and its ligamentous and muscular support
• List the factors contributing to the stability of the shoulder joint in order of their relative importance
• Define the rotator cuff muscles and explain their importance
• List the muscles responsible for movements of the shoulder girdle, with specific reference to movements of the scapula and clavicle, and give their nerve supplies
• Explain the normal ranges of active and passive movement of the shoulder joint
• Discuss the functional importance of the arterial anastomosis around the scapula
• Complete the related tasks on the surface anatomy schedule
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A5.2 Posterior triangle
• Describe the actions, innervation and attachments of sternocleidomastoid and trapezius
• Describe the boundaries, floor and roof of the posterior triangle
• Describe the course of the spinal accessory nerve in the neck
• Give an account of the importance of scalenus anterior as a landmark in the neck and list the structures that pass anterior and posterior to its insertion
• Identify the ventral rami of the cervical spinal nerves
• Identify the trunks of the brachial plexus and know which ventral rami contribute to these structures
• Identify the prevertebral layer of deep fascia
• Identify the subclavian artery and vein
• Describe the distribution of the branches of the thyrocervical trunk to the scapular region
• Describe the distribution of the supraclavicular nerves
• Complete the related tasks on the surface anatomy schedule
A5.3 Axilla and Brachial Plexus
• Define the boundaries of the axilla and list its contents
• Delineate the extent and relationships of the axillary artery and vein, including their branches
• Schematically illustrate the formation of the brachial plexus of nerves and its branches
• Identify the location and drainage patterns of the axillary group of lymph nodes and vessels, showing its relationships to the axillary blood vessels
• Describe the pectoral muscles as to their attachments, functions, innervation and relationships to the axillary artery.
• Complete the related tasks on the surface anatomy schedule
ANATOMY SYLLABUS
A5.4 Elbow Cubital Fossa
• List the functions, the innervation and the attachments of the muscles of the anterior and posterior compartments of the arm
• Discuss the clinical significance of the following anatomical relationships in the arm: proximity of the axillary, radial and ulnar nerves to the humerus; displacement fractures above and below the insertion of the deltoid muscle; and displacement of supracondylar fractures
• On bones and radiographs identify the articulating surfaces of the elbow and proximal radio-ulnar joints, describe those surfaces and the movements permitted
• Describe the principal ligaments of the elbow and proximal radio-ulnar joint
• Illustrate on a subject the normal ranges of movement of the elbow
• Illustrate with a very simple sketch the arterial anastomoses around the elbow
• Sketch a diagram of the cubital fossa showing its boundaries and contents
• Explain the clinical significance of the bicipital aponeurosis
• Complete the related tasks on the surface anatomy schedule
A5.5 Forearm and Wrist
• Identify and sketch a diagram of the muscles originating from the medial and lateral epicondyles and supracondylar ridges of the humerus, indicating their anatomical position, insertion, functions and innervation
• Describe with the aid of a drawing the muscles originating from and acting between the radius and ulna, indicating their general insertion, functions and innervation
• Describe the course of the following branches of the brachial artery: ulnar, radial and common anterior and posterior interosseous arteries
• Identify the brachial and radial pulses
• Identify the median, ulnar, anterior interosseous and superficial radial nerves and describe their distribution
• Explain the functional anatomy of pronation and supination
• Write brief notes on the distal radio-ulnar and wrist (radiocarpal) joints, describing their articulating surfaces, movements and relations
• Describe the attachments of the flexor retinaculum at the wrist and list the tendons, nerves and blood vessels passing superficial and deep to it
• Complete the related tasks on the surface anatomy schedule
A5.6 The Hand
• Identify the carpal bones in a strung hand on a skeleton and on radiographs
• Define the movements of the thumb and fingers
• Describe the innervation and actions of the thenar and hypothenar muscles
• Describe the innervation and actions of the other intrinsic muscles of the hand
• Define the tendons forming the boundaries of the ‘anatomical snuff-box’, list its contents and describe its clinical significance
• Describe the motor and sensory deficiencies of the hand resulting from injury of the radial nerve in the arm, and the median and ulnar nerves at the elbow and wrist
• Complete the related tasks on the surface anatomy schedule
A5.7 Limb Embryology
• Describe the formation of the vertebrate limb bud
• Describe the role of the apical ectodermal ridge (AER) in limb outgrowth
• Describe the role of Fibroblast Growth Factor (FGF) in limb outgrowth
• Describe the role of the zone of polarizing activity (ZPA) in limb development
• Describe the role of Sonic Hedgehog (SHH) in limb development
• Describe human limb malformations resulting from mutations in the SHH gene
• Describe how digits are formed and the malformations resulting from defects in this process
• Describe how the drug thalidomide disrupts human limb formation
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ANATOMY SYLLABUS
A5.8 Clinical Anatomy of Upper Limb
• Appreciate how a knowledge of clinical and functional anatomy is important to interpret pathological states, and especially bone and soft tissue trauma
• Appreciate how anatomy is important in planning surgical approaches
• Understand how disorders of anatomy lead to clinically detectable changes in function
A5.9 Gluteal Region and Hip
• Identify the anatomical features of the pelvis and the ligaments that help to stabilize it
• Identify the anatomical features of the hip and the proximal half of the femur using bones and radiographs
• Discuss the hip joint with special reference to its blood supply and the role of the ligaments in restricting movements
• Explain the normal ranges of movement of the hip joint
• Describe the innervation, functions and attachments of the tensor fasciae latae, the gluteal muscles and the iliotibial tract
• List the structures passing out of the pelvis above and below piriformis
• Define the safe area for giving intramuscular injections into the gluteal region
• List the root values of the femoral, obturator and sciatic (tibial and common peroneal) nerves, describe where they leave the pelvis the muscle compartments and cutaneous areas innervated by them
• Complete the related tasks on the surface anatomy schedule
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A5.10 Thigh
• Define the boundaries, floor, and contents of the femoral triangle, and explain the clinical significance of the femoral sheath and saphenous opening
• Describe and sketch the superficial and deep groups of inguinal lymph nodes and their drainage patterns in the thigh
• Delineate the course of the femoral artery and vein, giving their branches and tributaries, respectively
• Describe the anterior, medial and posterior compartments of the thigh with respect to the functions, innervation and attachments of the muscles contained in each compartment
• Delineate the course of the sciatic nerve and its branches in the thigh and popliteal fossa
• Describe the relationships and branches of the popliteal artery
• Describe the muscles of the posterior compartment of the thigh with respect to their attachments, functions and innervation
• Draw and label a diagram of the boundaries and contents of the popliteal fossa
• Complete the related tasks on the surface anatomy schedule
A5.11 knee
• Use bones or radiographs to point out the features of the distal half of the femur, the condylar region of the tibia, the fibular head, and the patella
• Describe the normal ranges of movement, and surface features of the knee
• Describe the ligaments, menisci, capsule, synovium, bursae and vessels of the knee
• Explain the workings of the knee joint with special emphasis on the menisci, cruciate ligaments, collateral ligaments and popliteus tendon
• Discuss and explain the clinical significance of the suprapatellar and prepatellar bursae
• Complete the related tasks on the surface anatomy schedule
ANATOMY SYLLABUS
A5.12 Leg and Foot
• Describe the skeleton of the leg
• Describe the attachments, functions and innervation of the muscles of the anterior and lateral compartments of the leg
• Use radiographs or bones to demonstrate the articulating surfaces of the ankle (talocrural) joint
• Name and identify the bones of the foot
• Identify the ligaments which strengthen the ankle joint
• Sketch the attachments of the flexor, superior and inferior extensor, and peroneal retinacula, and list the structures lying deep to them
• Describe the course and distribution within the leg of the common peroneal (common fibular), deep and superficial peroneal nerves, and the tibial nerve
• Describe the arterial blood supply and venous drainage of the muscular compartments of the leg
• Identify the pulses of the anterior and posterior tibial arteries
• Complete the related tasks on the surface anatomy schedule
A5.13 Foot and Ankle
• Identify the cutaneous nerves innervating the foot and describe the dermatomes to which they contribute
• Identify the dorsal venous arch and the origin of the long saphenous vein
• Describe the arrangement of tendons, arteries and nerves at the medial side of the ankle
• Describe the arrangement of tendons, arteries and nerves on the anterior and lateral sides of the ankle
• Compare the medial, lateral and transverse arches of the sole of the foot, naming the bones involved
• Explain the importance of the extrinsic muscle tendons, the intrinsic muscles and ligaments in maintaining the above arches
• Describe the distribution of the medial and lateral plantar nerves in the sole of the foot and the toes
• Give an account of the hallux valgus deformity (bunion)
• Complete the related tasks on the surface anatomy schedule
A5.14 and A5.15 Vertebral Column 1 and 2
• Compare and contrast the principal regions of the vertebral column, giving the number of vertebrae and the characteristics of a typical vertebra in each region
• Illustrate the normal curvatures of the vertebral column in a midterm foetus and an adult, and the exaggerated curvatures of kyphosis, lordosis and scoliosis in an adult
• Explain with the aid of diagrams the intervertebral articulations between adjacent bodies and arches of vertebrae in the cervical, thoracic and lumbar regions of the vertebral column, giving the ligamentous support and movements allowed in each case
• Compare the articulating surface, the movements and the supporting ligaments of the atlanto-axial and atlanto-occipital joints
• Sketch and explain the anatomy of the lumbosacral junction giving its clinical significance in regard to fractures
• Recognise and name the components of the articulated vertebral column in radiographs
• Sketch and label the broad arrangement of the extrinsic muscles of the back, and list their general functions
• Explain the functions of the erector spinae muscles
• Explain the segmental nature of the nervous and arterial supply
• Illustrate by a sketch the shape and the level of origin and termination of the spinal cord in the newborn and adult
• Explain the functions and the clinical significance of the spinal meninges and the spaces between them
• Make a sketch showing the segmental cord origin and the emergence of the spinal nerves from the intervertebral foramina, particularly in the lumbar region
• Explain by means of a simple diagram the clinical anatomy of lumbar puncture
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A5.16 Clinical Anatomy of Lower Limb
• Functions of the lower limbs
• Clinical aspects of the pelvis with regard to lower limb function
• Clinical anatomy of the femoral triangle
• Clinical aspects of the arteries of the lower limb
• Clinical aspects of the superficial and deep venous drainage of the lower limb
• Clinical aspects of the hip joint and hip replacement
• Clinical aspects of the knee joint
• Dermatomes of the lower limb

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ANATOMY SYLLABUS
A5.17 The Walking Cycle
• Describe the phases of the walking cycle.
• Describe the stance phase and the swing phase, and their time-proportions within the walking cycle
• Explain with the aid of a diagram the pattern of changing weight distribution across the sole of the foot during the stance phase and relate this to hip and ankle movements
• Describe the sequence of muscle activity in the lower limb during the swing phase
• Describe the sequence of muscle activity in the lower limb during the stance phase
• Understand the mechanisms that minimise the vertical and horizontal displacement of the centre of gravity of the body during the walking cycle
• Understand the basic relationships between energy expenditure, lower limb length, walking and running
• Understand and explain the various causes and consequences of a positive Trendelenburg sign and gait
• Understand the various causes and consequences of foot drop
A5.18 Surgical and Imaging Anatomy of The Limbs
• Be familiar with the bony, soft tissue and vascular anatomy of the upper limb
• Be familiar with the bony, soft tissue and vascular anatomy of the lower limb
• Learn how to differentiate various nerve injuries in the upper and lower limbs, especially ulnar, median & radial nerve palsies
• Understand the various traumatic mechanisms of injury of the upper and lower limbs
• Be familiar with radiological methods of interpreting limb trauma
• Be able to interpret radiographs of the limbs
ANATOMY SYLLABUS
A6.1 Head and Neck Embryology 1
• Describe the development of the human cranium
• Understand the causes of craniosynostosis
• Describe the derivatives and evolutionary origin of the chondrocranium, neurocranium and viscerocranium.
• Sketch the segmental structure of the primitive pharynx
• Understand the role of pharyngeal arches in the development of the face
A6.2 Head and Neck Embryology 2
• Describe the development of the face from pharyngeal arches
• Understand the origin of facial clefts
• Describe the origin of facial bones, muscle, arteries and nerves
• Describe the fates of the pharyngeal pouches and clefts
A6.3 Intracranial Region
• Identify the cranial fossae and their contents
• Name the first six cranial nerves and know their function
• Identify the bones of the cranial base and the vault on a skull, and on a lateral skull X ray
• Explain the difference between a suture and a synchondrosis
• Explain the clinically important relations of the nose and the anterior cranial fossa
• Explain the relationship between the dura, periosteum and the inner table of the vault
• Describe how intra cranial bleeds may arise/originate in different ways
• Explain the difference between emissary and diploic veins
• Identify the cribiform plate, optic canal, superior orbital fissure, foramen ovale, foramen rotundum and foramen spinosum and describe what passes through them
• Describe how venous blood returns from the brain to the jugular and vertebral venous systems
• Identify and describe arachnoid granulations and their function
• Describe with diagrams the basic anatomy of the pituitary fossa and cavernous sinus
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A6.4 and A6.5 “The orbit and its contents” and “The Eye”
• Describe the structures supplied by the III, IV, V and VI cranial nerves in the orbital cavity
• Identify the III, IV and VI cranial nerves and the ciliary nerves in a dissection
• Describe the blood supply to the retina and the choroid (uveal tract)
• Explain the action of the two oblique muscles when the eye is a) abducted and b) adducted
• Test the combined actions of the extrinsic muscles that move the globe on a patient
• List and explain what conditions may result in a drooping eyelid (ptosis)
• List the peripheral autonomic nerves involved in accommodation and lacrimation

ANATOMY SYLLABUS
A6.6 The Ear
• Describe the course of the VII and VIII cranial nerves within the petrous temporal bone
• Understand how the sigmoid sinus and internal carotid artery relate to the middle and inner ear
• Describe the innervation of the pinna and external acoustic meatus
• Understand the clinical importance of the major anatomical relations of the tympanic membrane
• Explain in principle how to examine the tympanic membrane clinically.
• Recognise and name, the bones, nerves and muscles of the middle ear cavity
• Understand the relationships of the pharyngotympanic tube and mastoid antrum to the middle ear cavity and explain their clinical significance.
• Recognise the major anatomical components of the cochlea and labyrinth.
• Understand the basic mechanisms of balance and hearing
A6.7 Neck – Basic Topography
• Name, or label on diagrams, the component parts of typical and atypical cervical vertebrae
• Explain or illustrate the different movements and different degrees of movement possible in the neck
• Explain and demonstrate how to move the neck of an anaesthetised patient and maintain the airway
• Explain how the component nerves of the cervical and brachial plexuses come to emerge deep in the neck between scalenus anterior and scalenus medius
• Identify on dissections, the phrenic nerve on scalenus anterior, the brachial plexus in the root of the neck, the internal jugular vein, the common, internal and external carotid arteries and the subclavian vessels
• Test the function of trapezius and sternocleidomastoid (XI) and compare left with right
• Show where (and how) in the neck (surface markings) to get a line into a patient with confidence
• Explain how and demonstrate where to palpate major groups of lymph nodes in the neck
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A6.8 Thyroid, Larynx, Pharynx
• Identify the jugular foramen and name the first eleven cranial nerves
• Describe the course and major branches of the vagus nerve in the neck
• Identify on a dissection or on a living subject, the omohyoid and strap muscles, the surface markings of the laryngeal cartilages and the thyroid gland
• Identify the epiglottis and the piriform fossa and know their nerve supply
• Identify the vallecula; understand the principles of intubating a patient
• Identify on diagrams the embryological origins and migrations of the thyroid and parathyroid glands
• Identify on diagrams the derivatives of each of the pharyngeal pouches
• Describe which arteries supply and which veins drain the thyroid and parathyroid glands
• Describe the branches of the vagus nerve that relate to the thyroid arteries
• Understand what moves and what does not move in the neck during swallowing.
• Use a ‘surgical sieve’ to list the differential diagnosis of a lump or swelling in the neck
• Understand the basis of simple ways to gain / maintain an airway
A6.9 Face and Mouth
• Name all the cranial nerves and know how, and in what clinical situation to test each one
• Test the facial nerve on the left and right around the forehead, eye and mouth
• Draw a diagram of the sensory distributions of the ophthalmic, maxillary and mandibular nerves on the face
• Describe the nerve supply and function (and thus understand loss of function) of the buccinator
• Identify the surface markings of the supraorbital and infraorbital foramina and the mental foramen and know what passes through them
• Palpate the parotid gland and know why and how it would feel different in a subject with mumps
• Palpate the submandibular gland on a volunteer - but its duct on yourself (with a washed finger)
• Recognise a sialogram of both the parotid and submandibular glands
• Identify the surface markings of the temporalis and masseter muscles and know their nerve supply
• Palpate the facial artery at the anterior border of masseter and at the medial wall of the orbit
• Palpate the parotid duct as it crosses masseter
• Relate the motor, sensory and special sensory nerve supply of the tongue to its embryological origins and recognise diagrams that describe this
ANATOMY SYLLABUS
A6.10 Nose and Nasopharynx
• Identify on an adult face the potential sites of facial clefts in new born infants
• Identify each of the paranasal air sinuses on a lateral skull or frontal radiograph
• Describe the position of the opening (or ostium) of each air sinus
• Draw a diagram of the lateral wall of the nose and indicate where the frontal, maxillary and ethmoidal sinuses drain and where the nasolacrimal duct drains
• Easily identify the tonsils and anterior and posterior pillars of the fauces in an adult
• Know where to find and how one would examine the adenoids and the opening of the pharyngotympanic tube
• Understand the importance of the maxillary artery in relation to nose bleeds
• Identify circumvallate and fungiform papillae on the tongue
• Test the last (XIIth) cranial nerve
• Explain the effects of a bulbar palsy on the soft palate (speech), tongue and pharynx (swallowing)
A6.11 Clinical and Applied Anatomy of the Head and Neck
• Describe the distribution of lymph nodes in the neck and understand their role in the spread of head and neck cancers
• Understand the concept of space infections and their spread in the neck
• Understand the anatomical basis of maintaining an airway
• Appreciate the underlying principles of reconstructive and free-flap surgery involving the head and neck and limbs
A6.12, A6.13 and A6.14 Brainstem 1, 2 & 3
Explain with the aid of diagrams / models, the anatomy of the following structures (and how they appear in different planes of section) and some of their functions:
• TS spinal cord - enlargements, level of end of cord, meninges, CSF, lumbar cistern and lumbar puncture, grey and white matter, dorsal horn, ventral horn, dorsal columns and other columns of white matter
• Cranial nerve nuclei - what they supply and how they are tested. The principle that somatic motor nuclei are near midline
• Describe the different types of fibres in cranial nerves: somatic efferent, branchial efferent, visceral efferent, visceral afferent (including taste), somatic afferent and special sense.
• Primary afferents (1A and C fibres mentioned) and motor neurones- formation of a spinal nerve
• Knee jerk reflex
• Lamination of grey matter- I-VI in dorsal horn, substantia gelatinosa, IX in ventral horn
• Naming of parts of the CNS on sagittal sections: brainstem (medulla, pons, midbrain), cerebellum, forebrain-thalamus and cerebral hemispheres covered by cortex (which is the site of cognitive processes- thinking)
• Motor control by brain; corticospinal tracts; cell bodies in motor cortex, axons cross midline in medulla, position of lateral
CST in cord; some axons end directly on motor neurons
• Position of rubrospinal and vestibulospinal tracts
• Somatosensory pathways: 3 neuron pathway to cerebral cortex; primary afferent cell body in DRG; secondary on same side of CNS with axon crossing midline to thalamus, synapse in thalamus
• Spinothalamic tract in principle, including which sensory modalities it carries
• Dorsal column pathway in principle, including which sensory modalities it carries
• Spinocerebellar tracts in principle
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A6.15 Cerebellum
• Mark on a diagram - cerebellum: cortex, vermis and hemispheres, folia, white matter and deep nuclei
• Label nodule on diagram of sagittal section
• Identify flocculus on slide of ventral view
• Discuss the role of the following:
• Floccular nodular lobe - balance
• Spinocerebellum - locomotion etc.
• Pontocerebellum - non-stereotyped movements
• Cortical neurons: granule and Purkinje cells only; (see diagram in booklet) climbing vs mossy fibres.
• Understand that most efferents from cerebellum come from deep nuclei.
• Describe the connections of the cerebellum: olivocerebellar fibres (climbing); spinocerebellar and pontocerebellar
(mossy) fibres.

ANATOMY SYLLABUS
A6.16 Forebrain 1
Explain with the aid of diagrams / models, the anatomy of the following structures (and how they appear in different planes of section) and their functions:
• Cerebral cortex and underlying white matter
• Sulci and gyri
• Association fibres
• Longitudinal fissure
• Commisural fibres and the corpus callosum
• Lateral (Sylvian) fissure, parieto-occipital sulcus and central sulcus
• 4 lobes of cerebrum
• The insula
• The main gyri and sulci in each lobe
Functional localization:
• Primary motor and premotor areas
• Somatosensory cortex
• Somatotopic organization
• Primary auditory cortex
• Wernicke’s and Broca’s areas
• Primary visual cortex
• Visual association areas
• Prefrontal cortex
• Primary olfactory cortex
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A6.17 and A6.18 Forebrain 2 & 3
Explain with the aid of diagrams / models, the anatomy of the following structures (and how they appear in different planes of section) and their functions:
• Thalamus (see thalamus diagram):
• Ventral posterior (the main somatosensory nucleus), VL and VA (motor nuclei), dorsal medial, medial and lateral geniculate (nuclei for the auditory and visual pathways) and anterior nuclei
• The connections of the above (in particular the cortical areas with which the nuclei are connected)
• Circuit of Papez; pulvinar.
• Parts of the basal ganglia:
• The caudate nucleus, putamen, globus pallidus, subthalamic nucleus, substantia nigra, pars compacta.
• The shape of the caudate nucleus
• Simple circuitry of basal ganglia including the corticostriate pathway, nigrostriatal pathway, the globus pallidus as the major output nucleus of the basal ganglia
• Actions of basal ganglia effected through motor areas of cerebral cortex.
• Diagram of coronal section through thalamus and striatum (see basal ganglia/ internal capsule diagram)
• Internal capsule, especially the position of the motor pathways.
• Striate arteries and hemiplegic stroke.
A6.19 Motor Systems – Spinal Mechanisms
• Explain the involvement of alpha motoneurons in the control of muscle contraction
• Explain the involvement of muscle spindles and Golgi tendon organs in proprioceptive control of muscle contraction
• Explain the functional relationship between agonist and antagonist muscles in the control of movement and posture
• Explain the functional arrangement of muscle spindles
• Explain with the aid of diagrams the components, and relationships between components, in the stretch reflex, the tendon organ reflex and the flexor withdrawal reflex
A6.20 Motor Systems – Supraspinal Mechanisms
• Explain with the aid of diagrams the descending motor pathways of the spinal cord
• Explain with the aid of diagrams the ascending sensory pathways of the spinal cord
• Explain the structural and functional organisation of the primary motor cortex (M1), premotor cortex (PM) and supplementary motor area (SMA)
• Explain the structure and function of the cerebellum in the control of movement
• Explain the structure and function of the basal ganglia in the control of movement
ANATOMY SYLLABUS
A6.21 Disorders of Movement
• List and describe different forms of motor disturbances
• Explain how differences in motor disturbances allow the damage to be localised
• Explain the concept of the upper motoneuron (UMN) and the lower motoneuron (LMN)
• Describe signs of UMN and LMN damage and disease
• Describe the symptoms and pathology of basal ganglia disorders
• Describe the symptoms and pathology of cerebellar disorders
A6.22 Development of the Brain
• Describe and explain the development of the neural plate
• Describe how the neural plate rolls up, fuses along its edges and separates from the rest of the ectoderm to form the neural tube
• Outline the regional differentiation of the brain and spinal cord
• Describe how the laminar structure of the CNS is laid down through cell proliferation, differentiation and migration in the wall of the neural tube
• Outline how the neural tube is patterned along its anterior-posterior and dorsal-ventral axes
A6.23 Somatosensory System
• The organisation of sensory afferent input to the spinal cord via the dorsal roots and efferent output from the spinal cord via the ventral roots
• The laminar organisation of the grey matter and the origins of the sensory pathways in the spinal cord
• The organisation of the principal ascending pathways to the brain (the dorsal column, anterolateral and trigeminal systems) and their roles in sensation
• The pattern of sensory loss following thoracic level hemisection of the spinal cord
• How sensory information from different cutaneous receptors is mapped onto the surface of the somatosensory cortex
• The referral of phantom arm sensations to the face, and the significance of these phenomena 19
A6.24 Central Visual Pathways I
The representation of the visual field - how we know where something is in space
• Pathways leading from the eye to the brain: optic nerve optic chiasm, optic tract, lateral geniculate nucleus, optic radiation, primary visual cortex
• The circuitry for the pupillary reflex
• “Anopia” - partial loss of visual field; diagnosis of site of injury from location of field loss
• “Scotoma” - smaller region of visual field loss, often due to cortical lesions
• Organisation of primary visual cortex: visual field maps, architecture of functional modules
• Development of visual cortex: “critical periods”; the adverse effects of neonatal cataract & squint on neural wiring
A6.25 Central Visual Pathways II
Specialisation in the visual brain - how we know what we are looking at
• The structure of the cerebral cortex - how does it vary across regions?
• Parallel pathways: - the distinction between magnocellular & parvocellular pathways at the level of the lateral geniculate nucleus, and their relays through cerebral cortex
• Specialised areas and modules within areas, as revealed by anatomy, clinical studies and functional imaging:
• “Blob” modules in area V1; “stripe” modules in area V2
• Colour vision loss (“achromatopsia”) and cortical area V4
• Motion vision loss (“akinetopsia”) and cortical area V5
• Recognition loss (“agnosia”) and cortical area LO
• Face blindness (“prosopagnosia”) and cortical area FFA
• Reading disability (“alexia”) and cortical area WFA
• Visuo-spatial attention deficit (“neglect”) and parietal cortex
• Magnocellular origin theory of developmental dyslexia

AnATOMY SYLLABUS
A6.26 Vestibular System, Posture, Balance
To understand how the vestibular system contributes to the control of balance, posture and eye movements and to see how disease and damage in this system results in disturbances of these functions.
• Functional anatomy of the vestibular apparatus.
• Functional anatomy of the vestibulospinal tracts
• Functional anatomy of the ascending, medial longitudinal fasciculus.
• Vestibular information modulates spinal motoneurons to provide balance and postural control.
• Ascending vestibular information modulates oculomotor neurons to stabilize gaze during head movement.
• Clinical signs of vestibular system disease and damage
A6.27 Peripheral and Central Auditory Processing 1 & 2
• Describe and explain the sensory processes of hearing and balance.
• The ossicular system of the ear and its transmission of sound
• The structure and function of the cochlea
• How hair cells convert sound energy into nerve impulses
• The neural pathways and relay nuclei conveying auditory nerve signals to the auditory cortex
• The functional arrangement of the auditory cortex
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A6.28 An Introduction to Imaging the Brain
Technical basis:
• X-ray, Magnetic resonance, US/Doppler
X-ray Modalities:
• Radiography, Myelography/Cisternography, Angiography, Computerised Tomography, Magnetic Resonance (MR)
CT scans:
• Recognize CT Bone Windows of Skull Base and in Trauma
• Recognize Hypodense (Dark) Structures – Infarct and Tumour
• Recognize Hyperdense (Bright) structures – Calcifications and Blood
• Recognize Locations of Haemorrhage: subarachnoid, parenchymal and intraventicular, extra-axial and subdural
MRI scans:
• Base Technigues:
• T1/T2 weighted imaging, Angiography (MRA), Diffusion weighted (DWI), Perfusion weighted, Blood Oxygen Level
Dependent (BOLD) [fMRI], Spectroscopy
• Using MRI:
• Recognize CSF in T1 and T2 images; Arachnoid Cyst; Fluid Attenuated Inversion Recovery (FLAIR); Subacute
Subdural Haematomas (Basal Ganglia Haemorrhage); Microscopic MRI – Compare high-field strength MRI with histology (hippocampus)
• Diffusion Weighted Imaging (DWI):
• Water diffusion (Brownian motion) in stroke; MR Perfusion Imaging; PWI/DWI Mismatch in Acute Stroke – before and after successful thrombolysis
• Functional MRI - Principles:
• The BOLD signal; Regional Blood flow is closely related to neural activity; Task-related signal change; Statistical representation of BOLD signal – Statistical Parametric Mapping; Perilesional Activation
Angiography:
• Digital Subtraction Angiography; CT Angiography; MR Angiography (revealing Carotid Stenosis and Multiple Aneurysms)
• Rupture - Haemorrhage; Occlusion - Ischaemia; Vascularisation of a pathological process
Interventional Neuroradiology:
• Flow impairment: Stenosis - Stenting; Occlusion -Thrombolysis
• Rupture: Aneurysm - Coiling; Arteriovenous malformation - Embolisation
Recognize with imaging:
• Carotid Stenting; Thrombolysis of left MCA Occlusion; PalliativeTumour Embolisation (Skull Metastases); Coiling of
Posterior Circulation Aneurysm; Coiling of ICA Aneurysm; AVM Embolisation
IMAGInG SYLLABUS
This syllabus has been devised to closely follow the Royal College of Radiology Undergraduate Curriculum, released in 2012 * .
These fall under the following categories:
1) Anatomy and Function:
• Recognition of normal structures as they appear on imaging
• Understanding of normal function processes related to imaging investigations
• Ability to interpret basic imaging studies
• Ability to relate radiological reports to structures on images
2) Patient Safety:
• National law governing radiation protection
• Risks of MRI
• Risks of interventional procedures
• Risks of contrast media
• Ability to refer patients safely
• Understanding of the doctor’s role in limiting risk to the patient
3) Nature of Imaging Investigations:
• Indications and preparatory requirements for imaging studies, how frequently requested studies are conducted, their effects on the patient, and follow-up (where required)
• Ability to refer patients effectively and appropriately
• Ability to understand the limitations of imaging techniques
• Understanding of the requirements to the patient and the service of undergoing imaging investigations
4) Patient Awareness and Experience:
• The knowledge of what an imaging investigation entails from the point of view of the patient
• Ability to inform patients accurately prior to imaging, to prepare them adequately and to limit anxiety
• Understanding the psychological issues raised by performing investigations, and by the invasive nature of some investigations
5) Informed Consent:
• Principles and practice of informed consent
• Ability to inform patients accurately and obtain consent where relevant
• Understanding of the importance of patient involvement in consent decisions
6) Interacting with the Radiology Department:
• Roles of staff groups in radiology
• Requirements of radiology departments for accurate referral information
• Referral and reporting mechanisms
• Ability to practise effective, timely and appropriate patient referral
• Understanding of the importance of communication to effective clinical management
These principles underpin many competencies and outcomes outlined in the Foundation Doctor programme (see the RCR document * for further information).
The following sections, B1 to B3, give further detail about the syllabus content.
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* RCR Undergraduate Radiology Curriculum. http://www.rcr.ac.uk/docs/radiology/pdf/Undergraduate_Radiology_Curriculum_2012.pdf

IMAGInG SYLLABUS
Systematic interpretation of the following studies:
• Chest X-ray
• Abdominal X-ray
• Skeletal radiographs
• Cervical, thoracic and lumbosacral spine
• Hip
• Knee
• Ankle
• Foot
• Shoulder
Ability to relate appearances to gross and cross-sectional anatomy
Knowledge of, and ability to recognise the following conditions (B1.1 – B1.3).
• Elbow
• Wrist
• Hand
• Skull (* rarely used clinically, but anatomical structures should be appreciated)
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B1.1 Chest X-rays
• Cardiac enlargement
• Cardiac failure and pulmonary oedema
• Pleural effusion
• Pulmonary collapse vs. consolidation, including recognition of the lobe affected.
• Endoluminal tubes and complications associated with them
• Endotracheal
• Nasogastric
• Vascular lines
•
•
Subclavian / internal jugular line
PICC line
• Pneumothorax, including tension
• Pneumomediastinum and subcutaneous emphysema
• Hyperinflation of lungs
• Free gas beneath the diaphragm (on erect CXR)
• Detection of pulmonary and mediastinal masses
• Location within anterior, middle and posterior mediastinum is above the level of understanding required.
• Aortic aneurysm and dissection
• Foreign body
IMAGInG SYLLABUS
B1.2 Abdominal X-rays
• Small and large bowel obstruction
• Toxic megacolon
• Signs of intestinal perforation
• Common causes of normal and abnormal calcification including:
• Aortic aneurysm
• Urinary calculi
• Gallstones
• Endoluminal foreign bodies
• Endoluminal tubes:
• Nephrostomy
• Ureteric stent
• NG tube
• Biliary stents (metal and plastic)
• Endovascular stents
B1.3 Skeletal X-rays
• Common fractures:
• Femoral neck
• Wrist including scaphoid
• Shoulder, including dislocation
• Pelvic bones
•
•
•
Spine, including dislocation
Knee
Elbow
• Ability to relate the mode of injury to the type and site of fracture
• Simple vs multi-fragmented vs open fractures
• Fractures involving joint / epiphyseal plate
• Accessory signs of fracture including:
• Effusion
• Raised fat pads
• Lipohaemarthrosis
• Different radiographic projections (AP, lateral, oblique, Y-view, swimmer’s etc.)
• Signs of osteoarthritis
• Sclerotic and lytic metastases
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IMAGInG SYLLABUS
Understanding the role of the various imaging techniques in the management of patients, including their strengths, limitations and risks:
• Plain film
• Ultrasound
• Echocardiography
• Computed tomography (CT)
• Magnetic resonance imaging (MRI)
•
•
•
Contrast examinations of viscera
Radionuclide Imaging including positron-emission tomography (PET) scans
Angiography
Importance of clinical history and examination findings when requesting the correct investigation.
The relationship of clinical radiology techniques to other investigations (for example endoscopy).
Basic knowledge of the clinical possibilities of image-guided procedures and minimally invasive treatment.
The preparation required for individual investigations / procedures.
On completion of the course students will be able to demonstrate their knowledge of imaging investigation of the following presenting complaints and conditions:
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B2.1 Chest and cardiovascular disease
Presenting complaints:
• Shortness of breath
• Cough
• Haemoptysis
• Chest pain
• Thoracic trauma
Conditions:
• Heart failure
• Asthma
• Aneurysms and vascular dissection
• Pulmonary emboli
• Pulmonary neoplasms
B2.2 Gastrointestinal disease
Presenting complaints:
• Swallowing disorders
• Abdominal pain
• Jaundice
• Change in bowel habit
• GI bleeding
• Abdominal masses
• Abdominal trauma
Conditions:
• Inflammatory bowel disease
• Hepatic and pancreatic neoplasms
• Biliary disease (inclusing gallstones and strictures)
• Bowel obstruction and perforation
• Bowel neoplasms
IMAGInG SYLLABUS
B2.3 Renal and urological disease
Presenting complaints:
• Haematuria
• Urinary colic
Conditions:
• Acute kidney injury
• Urinary obstruction (including stones)
• Urological neoplasms
• Urinary (upper and lower tract) infection
• Acute presentation of testicular disease
B2.4 Endocrine and breast disease
• Thyroid dysfunction and thyroid masses
• Breast mass and abscess
B2.5 Multisystem disease
• Principles of oncological staging by imaging
• Knowledge of common staging classifications
• Investigation of haematological disease
• Including anaemia and leukaemia
• Basic knowledge of potential complications of oncological treatment and means of detection
• Investigation of “pyrexia of unknown origin”.
B2.6 Musculoskeletal disease
Presenting complaints:
• Bone pain
• Joint pain
• Neck and back pain
Conditions:
• Bone and soft tissue infection
• Bone and soft tissue trauma, including:
• Undisplaced / stress fractures
• Spinal injury
• Bone and soft tissue tumours
• Metabolic bone disease
• Arthritides
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IMAGInG SYLLABUS
B2.7 Neurological Disease
Presenting complaints:
• Head injury
• Unexplained confusion / altered consciousness
• Seizures
• Severe headache
Conditions:
• Intracranial haemorrhage and infarction
• Spinal cord compression and radiculopathy
• Intracranial space occupying lesions
B2.8 Disease of the ear nose and throat
Presenting complaints:
• Deafness
Conditions:
• Disease of paranasal sinuses
• Cervicofacial cancer
• Salivary disease
• Oropharyngeal lesions
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B2.9 Disease in childhood
Presenting complaints:
• Trauma
• Limping child
• Painful limb
Conditions:
• The basics of non-accidental injury (NAI)
• The principles of imaging in children, including protection of the patient and confidentiality
• Urinary tract infections
B2.10 Obstetric and gynaecological disease
Presenting complaints:
• Suspected pregnancy, including ectopic gestation
• Abnormal vaginal bleeding
• Pelvic pain
Conditions:
• Use of ultrasound in normal pregnancy
• Gynaecological neoplasms
IMAGInG SYLLABUS
This will be limited to recognition of a few important conditions on cross-sectional imaging (on CT unless otherwise specified)
B3.1 CNS
• Intracranial haemorrhage
• Intracerebral, subarachnoid, subdural, extradural
• Intracranial tumours
• Spinal cord compression (MRI)
B3.2 Thorax
• Pneumothorax
• Lung consolidation
• Pleural effusion
• Surgical emphysema
• Pulmonary embolism
B3.3 Abdomen
• Pneumoperitoneum
• Free intraperitoneal fluid
• Intra-abdominal haemorrhage
• Bowel obstruction
• Aortic aneurysm, including rupture
• Cholecystitis and biliary obstruction
• Hydronephrosis (CT and ultrasound)
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UCL Centre for Imaging & Clinical Anatomy (CICA) www.ucl.ac.uk/cica