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    Giovanni CIRILLO

    Insegnamento di Anatomia Umana

    Corso di laurea magistrale a ciclo unico in MEDICINA E CHIRURGIA (Sede di Caserta)

    SSD: BIO/16

    CFU: 9,00

    ORE PER UNITÀ DIDATTICA: 90,00

    Periodo di Erogazione: Secondo Semestre

    Italiano

    Lingua di insegnamento

    ITALIANO

    Contenuti

    Lo studente deve essere in grado di condurre una corretta diagnosi di
    immagini anatomiche di
    superficie, di sezioni o di apparati o di loro parti. Condurre una corretta
    diagnosi di immagini
    anatomiche ottenute mediante techniche radiologiche e similari, quali
    esami radiografici, esami
    radiografici ottenuti con mezzi radiopachi, esami tomografici assiali
    computerizzati (TAC), esami
    ecografici, esami ottenuti mediante risonanza magnetica nucleare (RMN),
    e successive
    elaborazioni (DTI, fMRI). Condurre una corretta diagnosi di organo e
    regione al microscopio
    ottico, con individuazione e descrizione dei componenti anatomo
    microscopici del preparato in osservazione

    Testi di riferimento

    ANATOMIA DEL GRAY 42ma edizione Le basi anatomiche per la pratica
    clinica, 2022, EDRA Ed.
    Barr: Il Sistema Nervoso dell'Uomo Basi di Neuroanatomia J.A. Kiernan –
    N. Rajakumar - EDISESIL
    SISTEMA NERVOSO CENTRALE, NIEUWENHUYS, VOOGD, VAN HUIJZEN,
    Ed.
    SPRINGER-VERLAG ITALIA, 2010 disponibile per il download gratuito sulla
    biblioteca di Ateneo
    PROMETEUS ATLANTE DI ANATOMIA UMANA Ed. EDISES, 2016

    Obiettivi formativi

    Lo scopo medico-pedagogico dello studio dell’Anatomia Umana quello di
    consentire agli studenti
    del corso di laurea in medicina e chirurgia nel futuro ruolo di medici, di
    comunicare efficacemente
    con i colleghi, di comprendere e utilizzare la terminologia anatomica
    internazionale (FCAT), al fine
    di descrivere la struttura normale del corpo umano, nell’ambito dei settori di Anatomia Umana,
    Radiologica, Clinica, Microscopica e Neuroanatomia, come previsti
    dall’ordinamento del MUR

    Prerequisiti

    conoscenza parlata e scritta della lingua Italiana

    Metodologie didattiche

    DIDATTICA FRONTALE, DIDATTICA A GRUPPI PER LO STUDIO DI SEGMENTI
    SCHELETRICI, STUDIO DI PREPARATI AL MICROSCOPIO,
    STUDIO MEDIANTE IMAGING ECOGRAFICO ED ECOCOLOR DOPPLER,
    STUDIO DI
    IMMAGINI CT, RM, XRAY

    Metodi di valutazione

    Al termine del I semestre del CI di Anatomia Umana, non   previsto
    svolgimento di esame, ma un test di idoneit  a libera scelta di
    partecipazione da parte dello studente

    Altre informazioni

    OBBLIGATORIA LA PARTECIPAZIONE MINIMO AL AL 75% PER CENTO
    DELLA
    DIDATTICA FRONTALE IN AULA E MINIMO AL 90 % DELLA DIDATTICA A
    GRUPPI.

    Programma del corso

    Colonna vertebrale
    Lo studente in medicina deve essere in grado di riconoscere i tratti
    caratteristici delle vertebre delle
    cinque regioni della colonna vertebrale, sapere come la colonna
    vertebrale si articola nel suo
    insieme, si muove e come le sue normali curvature si sviluppano e
    stabilizzano . Deve essere in
    grado di interpretare le relative immagini cliniche, di distinguere le
    deviazioni dal normale, sapere
    l'organizzazione dei contenuti del canale vertebrale cio le meningi ,
    midollo spinale, radici nervose
    spinali , nervi spinali e loro particolari relazioni con le vertebre e le
    articolazioni del rachide. Queste
    conoscenze costituiscono la base per la comprensione di patologie
    vertebrali comuni quali il
    “comune” mal di schiena, il prolasso di un disco intervertebrale, le lesioni
    a carico del midollo
    spinale e dei nervi. Lo studente in medicina deve essere in grado di
    descrivere anatomicamente le
    fasi relative alla procedura di atti medici quali la rachicentesi e
    l’anestesia epidurale e regionale. Lo
    studente di medicina deve avere una appropriata conoscenza delle
    caratteristiche dell’anatomia di
    superficie e dei muscoli al fine di poter in seguito apprendere le
    procedure per una corretta
    valutazione delle strutture locomotorie. Deve avere una conoscenza dei
    dermatomeri e la relativa
    distribuzione dei nervi periferici, conoscere le funzioni dei gruppi
    muscolari e la loro innervazione,
    al fine di poter in seguito apprendere la tecnica per poter eseguire un
    corretto esame neurologico di
    base del tronco e degli arti.
    Arto superiore
    Lo studente in medicina deve essere in grado di riconoscere le principali
    caratteristiche palpabili e
    di imaging delle ossa dell'arto superiore, conoscere i siti delle fratture
    comuni e relative
    complicazioni. Deve essere a conoscenza dei fattori che influenzano la
    stabilit delle articolazioni di
    spalla, gomito, polso e articolazioni interfalangee al fine di comprendere
    nel prosieguo degli studi,
    la natura e le conseguenze delle comune lesioni. Allo scopo di
    apprendere nel corso di laurea le
    procedure cliniche in modo sicuro ed efficace, lo studente deve essere in
    grado di descrivere le
    naturali relazioni e distribuzione delle principali strutture neurovascolari
    dell’ arto superiore. Deve
    essere in grado di descrivere e rilevare i principali punti di repere dei
    diversi polsi arteriosi,
    posizione delle vene (per un corretto accesso venoso) e conoscere i
    luoghi comuni di lesioni dei
    nervi periferici e dei loro possibili effetti funzionali (lesioni del plesso
    brachiale, nervo ascellare,
    radiale, ulnare e lesioni del nervo mediano). Deve essere in grado di
    spiegare la base anatomica
    delle comuni morbidit a carico dell'arto superiore (le lesioni della cuffia
    dei rotatori, la sindrome
    del tunnel carpale ) e le vie anatomiche di diffusione di processi
    infiammatori e/o infettivi nell'arto.
    Deve essere in grado di descrivere l'organizzazione dei linfonodi ascellari
    e le vie di drenaggio
    linfatico della mammella e spiegare le basi anatomiche che influenzano
    l'incidenza in relazione alla
    diffusione metastatica del cancro del seno e del melanoma .
    Arto inferiore
    Lo studente in medicina deve essere in grado di riconoscere le principali
    caratteristiche palpabili e
    di imaging delle ossa dell’ arto inferiore, conoscere i principali siti di
    fratture comuni (collo e diafisi
    di femore, tibia e perone) e l’anatomia che sottende le possibili
    complicazioni che potrebbero
    derivare da queste. Deve essere in grado di spiegare i fattori che
    determinano e modulano la
    stabilit dell'anca, del ginocchio e della caviglia, le lesioni legamentose
    comuni, al fine di essere in
    grado di apprendere la procedura clinica per verificare l'integrit dei
    legamenti. Allo scopo di poter
    eseguire, nel corso degli studi, le procedure cliniche in modo sicuro ed
    efficace, lo studente deve
    essere in grado di descrivere il corso e la distribuzione delle principali
    strutture neurovascolari
    dell'arto inferiore (ad esempio, al fine di evitare di danneggiare il nervo
    sciatico quando si effettua
    una iniezione intramuscolare), essere in grado di indicare i principali punti
    di repere del polso
    arterioso (femorale, popliteo, tibiale posteriore e dorsale del piede) , la
    posizione delle principali
    vene (per l’esposizione chirurgica, praticata in emergenza per l’accesso
    venoso e per la valutazione
    delle vene varicose). Deve conoscere le sedi comuni dei nervi per
    comprenderne le lesioni e i
    possibili effetti funzionali di tali danni (ad esempio sciatico e nervo
    peroneo comune al collo del
    perone ). Deve avere una conoscenza di anatomia di superficie, dei
    dermatomeri e della
    distribuzione dei relativi nervi periferici, conoscere accuratamente le
    funzioni dei principali gruppi
    muscolari e la loro innervazione al fine di possedere una base
    neuroanatomica per poter apprendere
    negli anni successivi con cognizione di causa l’esame dell'arto inferiore.
    Lo studente deve
    conoscere l'organizzazione dei linfonodi inguinali e le vie anatomiche
    responsabili del drenaggio
    linfatico dell'arto, dei tegumenti del tronco e del perineo. Deve conoscere
    l’organizzazione delle
    fascie profonde degli arti inferiori e la loro rilevanza anatomica per
    comprendere le sindromi
    compartimentali. I meccanismi anatomofunzionali che permettono il
    ritorno del sangue dalle gambe
    al cuore e come alterazioni di questi meccanismi possano causare lo
    sviluppo di varici, trombosi
    venose profonde ed embolia.
    Testa e collo
    Lo studente in medicina deve essere in grado di riconoscere le principali
    Testi in inglese
    Italian
    caratteristiche palpabili e
    di imaging del cranio e della colonna cervicale per essere in grado di
    interpretare le immagini
    mediche pertinenti. Lo studente, al fine di poter apprendere, nel corso
    degli studi, agevolmente,
    l'esame clinico della testa e del collo deve conoscere la posizione, i
    rapporti delle strutture
    neurovascolari, della rete venosa e il drenaggio linfatico delle seguenti
    principali strutture: corso e
    distribuzione dei nervi cranici, orecchio e tuba faringotimpanica, occhi,
    palpebre e congiuntiva,
    cavit nasali e seni paranasali , cavit orale e lingua, tonsille, palato
    molle, faringe, ghiandole
    salivari, laringe e trachea, tiroide e ghiandole paratiroidi e contenuto
    della guaina carotidea. Lo
    studente in medicina deve essere in grado di descrivere le fascie e gli
    spazi fasciali del collo in
    relazione alla diffusione delle infezioni. Queste conoscenze sono
    necessarie per comprendere nel
    corso degli studi le sordit trasmissive e neurosensoriali, l’otalgia e le
    probabili fonti di dolore
    riferito all'orecchio, le paralisi del nervo facciale, le epistassi, le tonsilliti,
    la disfagia, l’ostruzione
    delle vie aerifere superiori, lo stridore infantile, le sinusiti, le paralisi delle
    corde vocali e la
    raucedine, le tumefazioni del collo e delle ghiandole salivari. Lo studente
    in medicina deve avere
    accurata conoscenza anatomica per poter descrivere le vie aeree, al fine
    di apprendere nel corso
    degli studi la tecnica per inserire un tubo endotracheale o nasogastrico,
    ed eseguire una
    tracheotomia o una laringotomia. Deve avere una conoscenza
    dell’anatomia di superficie, dei
    territori di distribuzione dei nervi cranici, della sede e delle funzioni dei
    principali muscoli della
    testa e del collo e della loro innervazione al fine di poter sviluppare nel
    corso degli studi le capacit
    per eseguire un esame neurologico di base.
    Per tutte le strutture, l'enfasi va posta su quelle parti che sono pi
    comunemente coinvolte in
    processi patologici o in procedure interventistiche. Per il sistema
    muscolo-scheletrico, l'attenzione
    va posta sui punti di repere e la conoscenza radiologica dello scheletro,
    sui legamenti maggiormente
    coinvolti in patologie, sui gruppi muscolari e su singoli muscoli in termini
    funzionali con
    particolare riferimento alla loro innervazione da parte dei nervi spinali .
    Per il sistema
    cardiovascolare si richiede un buona conoscenza del cuore dei vari punti
    di pulsazione arteriosa e
    dei segmenti arteriosi maggiormente esposti a danno e studiati mediante
    tecniche di eco-doppler, i
    punti di accesso venoso, una ottima conoscenza delle vie di drenaggio
    linfatico. Per il sistema
    nervoso periferico l'accento deve essere alle arre di distribuzione cutanea
    e ai gruppi muscolari

    English

    Teaching language

    Italian

    Contents

    A medical student should be able to:
    1. Define and demonstrate the following terms relative to the anatomical
    position: medial,
    lateral, proximal, distal, superior, inferior, deep, superficial, palmar,
    plantar, anterior/ventral,
    posterior/dorsal, rostral, caudal.
    2. Describe the following anatomical planes: axial / transverse /
    horizontal, sagittal and
    coronal.
    3. Define and demonstrate the terms used to describe the movements of
    the limbs and
    vertebral column: flexion, extension, lateral flexion, pronation,
    supination, abduction,
    adduction, medial and lateral rotation, inversion, eversion, plantarflexion,
    dorsi-flexion,
    protraction, retraction and circumduction.
    4. Define the terms somatic and visceral when used to describe parts and
    systems (e.g.
    somatic and visceral motor systems) of the body.

    Textbook and course materials

    ANATOMIA DEL GRAY 42ma edizione Le basi anatomiche per la pratica
    clinica, 2022, EDRA Ed.
    Barr: Il Sistema Nervoso dell'Uomo Basi di Neuroanatomia J.A. Kiernan –
    N. Rajakumar - EDISESIL
    SISTEMA NERVOSO CENTRALE, NIEUWENHUYS, VOOGD, VAN HUIJZEN,
    Ed.
    SPRINGER-VERLAG ITALIA, 2010 disponibile per il download gratuito sulla
    biblioteca di Ateneo
    PROMETEUS ATLANTE DI ANATOMIA UMANA Ed. EDISES, 2016

    Course objectives

    The medical-pedagogical purpose of the Human Anatomy study is to
    enable students of the medical and surgical degree course in the future
    role of physicians, to communicate effectively with colleagues, to
    understand and use international anatomical terminology (FCAT), in order
    to describe the normal structure of the human body, within the areas of
    Human Anatomy, Radiology, Clinic, Microscopy and Neuroanatomy, as
    required by the MIUR system.

    Prerequisites

    spoken and written knowledge of the Italian language

    Teaching methods

    CLASS TEACHING, GROUP TEACHING FOR THE STUDY OF SKELETAL
    SEGMENTS, STUDY OF MICROSCOPE PREPARATIONS,
    STUDY USING ULTRASOUND IMAGING AND ECOCOLOR DOPPLER, CT, MRI,
    XRAY IMAGING STUDY

    Evaluation methods

    At the end of the first semester of the CI of Human Anatomy, there is no
    exam, but an eligibility test at the free choice of participation by the
    student

    Other information

    THE PARTICIPATION MINIMUM 75% IN THE LESSONS IS MANDATORY

    Course Syllabus

    Vertebral Column
    A medical student should be able to:
    1. Describe the main anatomical features of a typical vertebra. Identify
    the atlas, axis,
    typical cervical, thoracic, lumbar vertebrae and sacrum and recognise
    their characteristic
    features.
    2. Describe the structures, regions and functions of the vertebral column.
    Describe the
    range of movement of the entire vertebral column and its individual
    regions. Explain what
    makes spinal injuries stable and unstable.
    3. Describe the anatomy of intervertebral facet joints and intervertebral
    discs. Explain the
    role of the discs in weight-bearing by the vertebral column and give
    examples of common
    disc lesions, and how they may impinge upon spinal nerve roots and / or
    the spinal cord.
    4. Describe the anatomy of a spinal nerve (e.g. as exemplified by a
    thoracic spinal nerve,
    including its origin from dorsal and ventral spinal roots, its main motor
    and cutaneous
    branches and any autonomic component.
    5. Identify the muscle and ligaments of the vertebral column and surface
    features in order
    to be able to perform an examination of the back, discuss their functional
    role in stability
    and movement of the vertebral column.
    6. Describe the anatomical relationships of the meninges to the spinal
    cord and dorsal and
    ventral nerve roots, particularly in relation to root compression and the
    placement of
    epidural and spinal injections. Describe the anatomy of lumbar puncture.
    7. Interpret standard diagnostic images of the vertebral column and be
    able to recognise
    common abnormalities.
    Upper Limb
    A medical student should be able to:
    1. Describe and demonstrate the main anatomical landmarks of the
    clavicle, scapula,
    humerus, radius and ulna. Recognise the bones of the wrist and hand and
    their relative
    positions, identify those bones that are commonly damaged (scaphoid
    and lunate).
    2. Describe the close relations of the bones and joints (e.g. bursae, blood
    vessels, nerves
    ligaments and tendons), which may be injured by fractures or dislocation
    and predict what
    the functional effects of such damage might be.
    3. Describe the fascial compartments delimiting the muscles of the upper
    limb. Explain the
    functional importance of those compartments and their contents.
    4. Describe the origin, course and distribution of the arteries and their
    branches that supply
    the shoulder, arm and forearm in relation to common sites of injury.
    Explain the importance
    of anastomoses between branches of these arteries at the shoulder and
    in the upper limb.
    5. Demonstrate the sites at which pulses in the brachial, radial and ulnar
    arteries may be
    located.
    6. Describe the courses of the veins of the upper limb; classify and
    contrast the functions
    of the deep and superficial veins. Identify the common sites of venous
    access and
    describe their key anatomical relations. Explain the relationship between
    venous and
    lymphatic drainage channels.
    7. Describe the organisation of the brachial plexus, its origin in the neck
    and continuation
    to the axilla and upper limb.
    8. Describe the origin, course and function of the axillary, radial,
    musculocutaneous,
    median and ulnar nerves in the arm, forearm, wrist and hand. Name the
    muscles that
    these nerves supply as well as their sensory distribution. Predict the
    consequences of
    injury to these nerves and describe how to test their functional integrity.
    9. Describe the boundaries of the axilla. List its contents, including the
    vessels, parts of the
    brachial plexus and lymph node groups. 10. Describe the movements of
    the pectoral girdle; identify the muscles
    responsible for its
    movements and summarise their main attachments and somatic motor
    nerve supply.
    11. Describe the factors that contribute to the stability of the shoulder
    joint and explain the
    functional and possible pathological consequences of its dislocation.
    12. Describe the anatomy of the elbow joint. Demonstrate the
    movements of flexion and
    extension, identify the muscles responsible for these movements and
    summarise their
    main attachments and somatic motor nerve supply.
    13: Describe the anatomy of the superior and inferior radio-ulnar joints.
    Explain the
    movements of supination and pronation; identify the muscles responsible
    for these
    movements and summarise their attachments and somatic motor nerve
    supply.
    14. Describe the anatomy of the wrist. Describe and demonstrate
    movements at these
    joints and name and identify the muscles responsible for the movements.
    Describe the
    relative positions of the tendons, vessels and nerves at the wrist in
    relation to injuries.
    15. Name and demonstrate the movements of the fingers and thumb.
    Describe the
    position, function and nerve supply of the muscles and tendons involved
    in these
    movements, differentiating between those in the forearm and those
    intrinsic to the hand.
    16. Explain the main types of grip (power, precision and hook) and the
    role of the muscles
    and nerves involved in executing them.
    17. Describe the position and function of the retinacula of the wrist and
    the tendon sheaths
    of the wrist and hand. Explain carpal tunnel syndrome and the spread of
    infection in
    tendon sheaths.
    18: Explain why and describe where the axillary, musculocutaneous,
    radial, median and
    ulnar nerves are commonly injured and be able to describe the functional
    consequences of
    these injuries.
    19. Explain the loss of function resulting from injuries to the different
    parts of the brachial
    plexus. Demonstrate how to test for motor and sensory nerve function.
    20. Describe the anatomical basis of: the assessment of cutaneous
    sensation in the
    dermatomes of the upper limb, tendon jerk testing of biceps and triceps
    and comparative
    strength tests.
    21. Describe the anatomy of the axillary lymph nodes and explain their
    importance in the
    lymphatic drainage of the breast and the skin of the trunk and upper limb
    and in the spread
    of tumours.
    22. Interpret standard diagnostic images of the upper limb and be able to
    recognize
    common abnormalities
    Lower Limb
    A medical student should be able to:
    1. Recognise the features and surface landmarks of the pelvis, femur,
    tibia, fibula, ankle
    and foot. Demonstrate their palpable and imaging landmarks. Appreciate
    which bones and
    joints are vulnerable to damage and what the consequences of such
    damage could be.
    2. Describe the close relations of the bones and joints (e.g. bursae, blood
    vessels, nerves
    ligaments and tendons), which may be injured in fractures or dislocations
    and predict what
    the functional effects of such damage would be.
    3. Describe the fascial compartments enclosing the muscles and explain
    the functional
    importance of these compartments and their contents in relation to
    compartment
    syndromes.
    4. Demonstrate the origin, course and branches of the arteries that
    supply the hip, gluteal
    region, thigh, leg, ankle and foot. Explain the functional significance of
    anastomoses
    between branches of these arteries at the hip and knee.
    5. Demonstrate the locations at which the femoral, popliteal, dorsalis
    pedis and posterior
    tibial pulses can be felt.
    6. Demonstrate the course of the principal veins of the lower limb.
    Explain the role of the
    perforator vein connections between the superficial and deep veins and
    the function of the
    ‘muscle pump’ for venous return to the heart. Describe the sites of
    venous access that can
    be used for ‘cut- down’ procedures in emergencies.
    7. Outline the origin of the lumbosacral plexus and the formation of its
    branches.
    8. Describe the origin, course and function of the sciatic, femoral,
    obturator, common
    peroneal and tibial nerves, sural and saphenous nerves and summarise
    the muscles that
    each supplies as well as their sensory distribution.
    9. Describe the structure and movements of the hip joint. Summarise the
    muscles
    responsible for these movements, their innervation and main
    attachments.
    10. Describe the structures responsible for stability of the hip joint and
    their relative
    contribution to maintaining the lower limb in different positions.
    11 Describe the structures at risk from a fracture of the femoral neck or
    dislocation of the
    hip and explain the functional consequences of these injuries.
    12. Describe the boundaries of the femoral triangle and the anatomical
    relationships of the
    femoral nerve, artery, vein and lymph nodes to each other and to the
    inguinal ligament,
    with particular regard to arterial blood sampling and catheter placement.
    13. Describe the anatomy of the gluteal (but- tock) region and the course
    of the sciatic
    nerve within it. Explain how to avoid damage to the sciatic nerve when
    giving
    intramuscular injections.
    14. Describe the structure and movements of the knee joint. Summarise
    the muscles
    responsible for these movements, their innervation and main
    attachments.
    15. Describe the close relations of the knee joint including bursae and
    explain which
    structures may be injured by trauma (including fractures and dislocation)
    to the knee.
    Identify the factors responsible for maintaining the stability of the knee
    joint. Describe the
    menisci, ligaments and the locking mechanism close to full extension.
    Explain the
    anatomical basis of tests which assess the integrity of the cruciate
    ligaments.
    Describe the boundaries and contents of the popliteal fossa.
    16. Describe the anatomy of the ankle joint. Explain the movements of
    flexion, extension, plantarflexion, dorsiflexion, inversion and eversion.
    Describe the muscles
    responsible for
    these movements, their innervation and their attachments.
    17. Describe the factors responsible for stability of the ankle joint,
    especially the lateral
    ligaments, and explain the anatomical basis of “sprain” injuries.
    18. Describe the arches of the foot and the bony, ligamentous and
    muscular factors that
    maintain them.
    19. Describe the movements of inversion and eversion at the subtalar
    joint, the muscles
    responsible, their innervation and main attachments.
    20. Describe the anatomical basis (nerve root or peripheral nerve) for loss
    of movements
    and reflexes at the knee and ankle resulting from spinal injuries, disc
    lesions and common
    peripheral nerve injuries. Describe the dermatomes of the lower limb and
    perineum used
    to assess spinal injuries.
    21. Describe the structures at risk to a fracture of the femoral neck or
    dislocation of the hip
    and describe the functional consequences of these conditions.
    22. Describe the lymphatic drainage of the lower limb and its relationship
    to tumour
    spread.
    23. Discuss the structures of the lower limb that may be used for
    autografts.
    24. Interpret standard diagnostic images of the lower limb and be able to
    recognise
    common abnormalities.
    Head and Neck
    A medical student should be able to:
    1. Demonstrate the position, palpable and imaging landmarks of the
    bones of the skull,
    including the frontal, parietal, occipital, temporal, maxilla, zygoma,
    mandible, sphenoid,
    nasal and ethmoid bones. Demonstrate the palpable position of the hyoid
    bone, thyroid
    and cricoid cartilages, lateral mass of the atlas and the spine of C7.
    Demonstrate the
    sutural joints and describe the fontanelles of the fetal skull.
    2. Describe the boundaries, walls and floors of the cranial fossae.
    3. Identify the external and internal features of the cranial foraminae and
    list the structures
    that each transmits.
    4. Demonstrate the position of the anterior and posterior triangles of the
    neck defined by
    the sternum, clavicle, mandible, mastoid process, trapezius and
    sternocleido-mastoid.
    5. In the posterior triangle, demonstrate the position of the spinal
    accessory nerve, the
    roots and trunks of the brachial plexus, the external jugular vein and
    subclavian vessels in
    relation to penetrating neck trauma.
    6. In the anterior triangle, demonstrate the position of the common,
    internal and external
    carotid arteries, the internal jugular vein and vagus nerve, the trachea,
    thyroid cartilage,
    larynx, thyroid and parathyroid glands. Explain their significance in
    relation to carotid
    insufficiency, central venous line insertion, emergency airway
    management and diagnosis
    of thyroid disease.
    7. Describe the location and anatomical relations of the thyroid and
    parathyroid glands,
    their blood supply and the significance of the courses of the laryngeal
    nerves. 8. Demonstrate the origin, course and branches of the common,
    internal
    and external
    carotid arteries and locate the carotid pulse.
    9. Describe the courses of the accessory, vagus and phrenic nerves in the
    neck.
    10. Identify the structures passing between the neck and the thorax.
    Describe the courses
    and relationships of the subclavian arteries and veins.
    11. Describe the anatomy of the scalp, naming its individual layers.
    Describe the blood
    supply of the scalp and its significance in laceration injuries.
    12. Demonstrate the extracranial course of the branches of the facial
    nerve. Desscribe the
    muscles of facial expression supplied by each branch and describe the
    consequences of
    injury to each branch.
    13. Describe the intracranial and intrapetrous course of the facial nerve
    and the
    relationships of its branches to the middle ear in relation to damage of
    the nerve
    within the facial canal.
    14. Describe the anatomy of the temporo-mandibular joint. Explain the
    movements that
    occur during chewing and describe the muscles involved including their
    innervation.
    Explain what occurs in anterior joint dislocation and relocation.
    15. Describe the origin, function and branches of the sensory and motor
    components of
    the trigeminal nerve.
    16. Describe the origins and summarise the courses and major branches
    of the facial and
    maxillary arteries, including the course and intracranial relations of the
    middle meningeal
    artery and its significance in extradural haemorrhage.
    17. Describe the relationship of the termination of the facial vein
    (draining into the internal
    jugular vein) and the mandibular branch of the retromandibular vein
    (supplying facial
    muscles controlling the angle of the mouth) to the submandibular gland
    and related upper
    jugular lymph nodes in relation to exploration of this area.
    18. Describe the key anatomical relations of the parotid, submandibular
    and sublingual
    salivary glands, the course of their ducts into the oral cavity and their
    autonomic
    secretomotor innervation. Appreciate the narrow points of the ducts in
    relation to salivary
    stone impaction.
    19. Demonstrate the features and boundaries of the oral cavity and
    describe its sensory
    innervation.
    20. Describe the functional anatomy of the tongue, including its motor
    and sensory
    innervation and the role of the extrinsic and intrinsic muscles. Explain the
    deviation of the
    tongue after hypoglossal nerve injuries.
    21. Describe the anatomical arrangement and functional significance of
    the lymphoid
    tissue in the tonsils, pharyngeal, and posterior nasal walls.
    22. Describe the muscles that compose the pharyngeal walls and move
    the soft palate;
    summarise their functions and nerve supply. Describe the components of
    the gag reflex.
    23. Describe the hyoid bone and cartilages of the larynx. Explain how
    these structures are
    linked together by the thyrohyoid, cricothyroid, and quadrangular
    membranes.
    24. Describe the intrinsic and extrinsic laryngeal muscles responsible for
    closing the
    laryngeal inlet, controlling vocal cord position and tension. Explain how
    these muscles
    function during phonation, laryngeal closure, the cough reflex and
    regulation of
    intrathoracic pressure.
    25. Describe the origin, course and functions of the motor and sensory
    nerve supply of the
    larynx and the functional consequences of injury to them.
    26. Describe the stages of swallowing and the functions of the muscles of
    the jaw, cheek,
    lips, tongue, soft palate, pharynx, larynx and oesophagus during
    swallowing.
    27. Describe the location, actions and nerve supply of the intrinsic and
    extra-ocular
    muscles and apply this knowledge to explain the consequences of injury
    to the nerve
    supply of these muscles.
    28. Describe the anatomy of the eyelids, conjunctiva and lacrimal glands.
    Explain their
    importance for the maintenance of corneal integrity.
    29. Describe the functional anatomy of the external auditory meatus,
    tympanic membrane,
    ear ossicles and auditory tube, together with their major anatomical
    relations.
    30. Describe the bones of the nasal cavity and the major features of the
    lateral wall of the
    nasal cavity. Describe the major arteries that supply the lateral wall and
    nasal septum in
    relation to nosebleeds.
    31. Name the paranasal sinuses, describe their relationships to the nasal
    cavities and sites
    of drainage on its lateral wall and explain their innervation in relation to
    referred pain.
    32. Describe the arrangement of the dura mater, and its main reflections
    within the cranial
    cavity and their relationship to the major venous sinuses and the brain
    itself.
    33. Describe the arrangement of the venous sinuses of the cranial cavity;
    explain the
    entrance of cerebral veins into the superior sagittal sinus in relation to
    subdural
    haemorrhage, and how connections between sinuses and extracranial
    veins may permit
    intracranial infection
    34. Describe the relationships between the brain and the anterior, middle
    and posterior
    cranial fossae.
    35. Describe the anatomy of the motor and sensory nerves to the head
    and neck and
    apply this to a basic neurological assessment of the cranial nerves and
    upper cervical
    spinal nerves.
    36. Describe the sympathetic innervation of the head and neck and the
    features and
    casual lesions in Horner’s syndrome.
    37. Demonstrate the positions of the external and internal jugular veins
    and the surface
    landmarks that are used when inserting a central venous line.
    38. Describe the arrangement of the lymphatic drainage of the head and
    neck, the groups
    of lymph nodes and the potential routes for the spread of infection and
    malignant disease.
    39. Interpret standard diagnostic images of the head and neck and be
    able to recognise
    common abnormalities.
    40. Describe the anatomical microscopical structure at light and electron
    microscopy level of all head and neck viscera

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