ANATOMY ACADEMY A-LEVEL STUDENTS WITH AN INTEREST IN MEDICINE Course Outline 9am – 9:30am 9:30am – 10am 10am – 11am 11am – 12pm 12pm – 1pm 1pm – 2pm 2pm – 3pm 3pm – 4pm 4pm – 5pm Registration Introduction to the Course Session 1 – The Musculoskeletal System Session 2 – The Chest Lunch Session 3 – The Abdomen Session 4 – The Groin & Pelvis Session 5 – The Head & Neck Quiz/Close (with further inspection of prosections as desired) Course Aims • To understand basic anatomical terminology • To gain an appreciation of the major organs and the gross anatomy of the human body • To develop an interest in anatomy and its relation to medicine • To develop an understanding of how the human body essentially works and how different systems interact to produce an extremely efficient human body dynamic • To supplement current knowledge developed at A-level in both Biology and Human Biology • To appreciate the intricate nature of certain anatomical structures through the use of prosections Introduction (15-30 mins) • Course outline, how things will work, introduce who everyone is & who can be contacted for further information. • Surgical Training Centre health and safety talk (inclusive of fire lecture and evacuation policy) with housekeeping rules. • Etiquette in the training centre with an introduction to plastination and respect afforded to all donors within the WMSTC. • Brief lecture/teaching session on the anatomical position & movement terms • 5-10 minute practical session on describing movements performed by one member of a group on a card Session 1: The Musculoskeletal System Verbal introduction of learning objectives. Upper Limb • Gross anatomy of the shoulder, upper limb and hand (i.e. landmarks/introduction). • Name and identify the carpal bones. • Be able to describe the “anatomical snuffbox” and its historical/clinical relevance. • Know the bony landmarks of the humerus, radius and ulnar bones. • Describe the brachial plexus at a basic level and understand carpal tunnel syndrome. • Describe the main muscles of the upper limb. • Name the four rotator cuff muscles and how they work. • Describe the arterial and venous supply of the upper limb and common sites for venepuncture / arterial sampling. • Describe common fractures including Colles’, Smith’s and scaphoid. Lower Limb • Gross anatomy of the hip and lower limb (i.e. landmarks/introduction). • Review the main bones of the lower limb & foot. • Components of the knee joint, Anterior cruciate and posterior cruciate ligament – position, function and damage. • Gain an appreciation of the structures within the popliteal fossa. • Name the muscles involved in movement of the lower limb. • Describe the arterial and venous supply to the lower limb. • Basics of the nerves involved in reflexes (+ demonstration of the knee jerk if time), movements of the lower limb. • Briefly classify femoral (Neck Of Femur) fractures and understand fixation/repair of #NoF at a basic level. Resources o o o o o o o o o The shoulder e.g. McMinn’s page 137. Bones of the arm and forearm. Prosections of upper limb e.g. McMinn’s page 152 and 153. Radiographs of upper limb with fractures. Cross section plastination of the thigh (or coronal section e.g. page 326). Prosection of the thigh e.g. McMinn’s page 323. Prosection of the knee. Prosection of the gluteal region. Bony hip. Session 2: The Chest Verbal introduction of learning objectives Thorax • Understand the anatomy of the thorax and the contents of the chest (i.e. introduction). • Be able to describe the thoracic cage and intercostal muscles. • Describe the immediate medical management of a tension pneumothorax through anatomical demonstration (I.e. where does the needle go?). • Appreciate the borders of the mediastinum & anatomy of the thymus. Respiratory System • Describe the gross anatomy of the respiratory tree. • Appreciate the major divisions of the right and left lobes. • Understand the kinetics of the lungs on breathing and the movement of the diaphragm on both inspiration and expiration. • Understand the principles of ventilation and perfusion through knowledge of the anatomy of alveoli. • Be able to identify major landmarks on a chest X-ray (depending on resources). The Heart • Be able to describe the gross anatomy of the heart, the four chambers of the heart and the four main heart valves. • Understand the mechanisms by which the heart pumps blood, where the blood supply comes from and where it leaves the heart. • Appreciate the function of the coronary vessels and the mechanism of myocardial infarction (I.e. heart attack). • Know the areas of auscultation for heart sounds and why these are heard there. • Be able to describe an electrocardiogram (ECG) in terms of calculating a patient’s heart rate and describing heart rhythm (depending on resources). Resources o o o o o o o o o Prosection of heart and coronary arteries e.g. McMinn’s page 190. Prosection – coronal section of the ventricles e.g. McMinn’s page 192. Prosection of lungs e.g. McMinn’s page 188. Prosection demonstrating the mediastinum. Prosection of pleural cavity with great vessels e.g. McMinn’s page 196. Prosection demonstrating musculature of chest wall. CXRs – w different pathology. Stethoscope. ECGs. Session 3: The Abdomen Verbal introduction of learning objectives The Oesophagus and Stomach • Gain an appreciation of the anatomy of the oesophagus, its three divisions and the angle at which it joins the stomach. • Be able to explain the anatomy of the gastro-oesophageal junction and the significance of its oblique position. • Appreciate the aetiology of the two main types of hiatus hernia and the basics of Barrett’s oesophagus. • Describe the anatomy of the stomach and its main areas. • Know the basic functions of the stomach and how food is stored in the stomach whilst digestion occurs. • Understand the function of the pylorus and its ability to regulate passage of stomach contents into the small intestine. • Be able to describe the blood supply to the stomach at a basic level. The Small and Large Bowel • Describe the main sections of the small bowel (I.e. duodenum, jejunum, ileum) and its main blood supply. • Appreciate the length and surface area of the small bowel. • Be able to indicate the site of the Ampulla of Vater, and its significance. • Describe peristalsis on a basic level. • Understand the anatomy of the ileocaecal valve, appendix and sections of the large bowel (i.e. caecum, ascending colon, transverse colon, descending colon, sigmoid colon, rectum & anus). • Relate the large bowel to its adjacent structures (i.e. hepatic flecture, splenic flecture). • Be able to describe the anatomy of the anus and anal sphincters. The Liver, Gallbladder and Pancreas • Describe the gross anatomy of the liver, biliary tree and pancreas. • Gain an appreciation of the function of the liver, gallbladder and pancreas. • Describe the various lobes of the liver. • Appreciate the sites at which gallstones form and how they may be removed surgically. • Understand the portal circulation and its relevance in certain clinical scenarios. • Discuss the exocrine and endocrine functions of the pancreas and the mechanism by which diabetes occurs. The Abdominal Wall • Describe the gross anatomy of the abdominal wall including musculature. • Be able to describe the basic function and anatomy of the peritoneum, and the role of the greater omentum as “the Abdominal Policeman”. • Appreciate the nine segments of the abdominal wall and identify underlying structures in each. Recognise the following common surgical scars on the abdomen and their associated operations: Upper midline Paramedian Kocher’s McBurney’s Pfannenstiel’s Laparoscopic Ports (e.g. cholecystectomy) Identify the following important important landmarks on the abdominal wall: McBurney’s Point Superficial Inguinal Ring Mid-Inguinal Point • • Resources o o o o o o o o o Prosection demonstrating the oesophagus Transverse slice through the trans-pyloric line Prosection of empty abdominal cavity +/- great vessels e.g. McMinn’s page 239-240 Prosection of anterior abdominal wall e.g. McMinn’s page 222 Transverse plastinate of rectus abdominis sheath Prosection of biliary tree e.g. McMinn’s page 247 Prosection of liver and its lobes e.g. McMinn’s page 246 Prosection of open abdominal cavity & bowel Lateral prosection of anal canal Session 4: The Groin and Pelvis Verbal introduction of learning objectives The Pelvis • Describe the pelvis and identify various anatomical landmarks. • Appreciate the greater and lesser sciatic foramena and understand the structures that pass through these. • Understand the basic anatomy of the inguinal canal, including its contents, and describe the pathology behind inguinal herniae. • Be able to explain the borders of the femoral triangle and its significance. • Appreciate the differences between a male and female pelvis. The Kidneys, Adrenal Glands, Ureters and Bladder • Understand the gross anatomy of the kidneys and their position in the abdomen. • Describe the renal cortex and medulla, and their basic functions. • Appreciate the function of the kidney both in excretion of urine and regulation of blood pressure. • Describe the blood supply to the kidneys at a basic level. • Understand the location and function of the adrenal glands. • Describe the pathway of the ureters and their entry into the bladder. • Explain the common locations of kidney stones and the symptoms a patient with kidney stones may complain of. • Be able to describe the anatomy of the bladder at a basic level, and understand the capacity of the bladder for urine storage. The Male Reproductive Organs • Understand the gross anatomy of the prostate, male urethra, penis and scrotum (I.e. introduction). • Describe the lobes of the prostate and the pathology behind prostate cancer and benign prostatic hypertrophy. • Appreciate the contents of the scrotum including vasculature. • Understand the basic anatomy of the penis. The Female Reproductive Organs • Describe the location and function of the uterus, cervix and vagina, and how these structures are examined clinically. • Understand the basic function of the uterus and endometrium. • Describe the gross anatomy of the cervix and vagina. • Appreciate the location of the ovaries and understand the pathway of the Fallopian tubes. • Describe the descent of the baby during pregnancy (if time permits). Resources o Prosection of kidney (inner) e.g. McMinn’s page 256 o Prosection of retroperitoneal organs including kidneys, adrenals, ureters and bladder e.g. McMinn’s page 261 o Prosection testes, scrotum and penis (lateral) e.g. McMinn’s page 266 o Prosection of the groin - inguinal ligament & femoral triangle etc e.g. McMinn’s page 269 o Diagrammatic representations of inguinal triangles, inguinal and femoral canals o KUB films (optional) Session 5: The Head and Neck Verbal introduction of learning objectives The Skull • Understand the gross anatomy of the skull and identify major landmarks. • Know the bones that make up the skull including the facial bones. • Appreciate the major structures that lie within the skull and the significance of the foramen magnum. • Basic knowledge of the Circle of Willis and the functions of the territories supplied by it. The Brain • Identify the four main lobes of the brain, the cerebellum and the brainstem, and understand the basic function of each area. • Basic knowledge of the Circle of Willis and the major arteries supplying the brain. • Be able to describe what happens when a patient suffers from a stroke, and how a stroke affecting a particular area of the brain may have different effects on a patient. • Understand the divisions of the brainstem at a basic level. • Gain an appreciation of how a stroke or intracranial haemorrhage may appear on brain imaging. The Neck • Familiarise yourself with the gross anatomy of the neck. • Describe the borders of the anterior and posterior triangles of the neck. • Understand some common neck lumps and what they may indicate. • Identify the major vessels passing through the neck and be able to palpate a carotid pulse. • Be able to describe the locations of the trachea and oesophagus, and understand the process of swallowing on a basic level. • Learn the anatomy and function of the thyroid gland. Resources o o o o o o o o Skull bases (bony) e.g. McMinn’s page 21 Prosection brain – e.g. McMinn’s page 76 Lobes of the brain e.g. McMinn’s page 73 Circle of Willis diagrammatic representation Brain (removed from skull) base Prosection of triangles of the neck Prosection of carotid arteries Prosection of thyroid with Sagittal and transverse sections of the neck