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Monday, November 7, 2005

The Syllabus for Anatomy in MBBS Course

The Syllabus for Anatomy in MBBS Course
A) GENERAL Anatomy

I) Descriptive terms
Terms used for describing the position of the body, Anatomical planes, Commonly used terms in Gross Anatomy , Terms used in Embryology, Terms related to limbs, for hollow organs, for solid organs, to indicate the side, for describing muscle, for describing movements

II) General Osteology
Definition, Nutrition & Morphological Classification, Distribution and Functions of bone Appendicular, Axial.
Diaphysis, Metaphysis, Epiphysis, Types of epiphysis
Primary centres, Secondary centers, Law of ossification, Epiphyseal plate, Blood supply of long bone
CARTILAGE
Definition, Types, structure, Distribution, Nutrition

III) General Arthrology
Classification, Synarthrosis, Amphiarthrosis, Diarthrosis.
Cartilaginous. Primary, Secondary
Synovial - Axis of movement, Structure of typical synovial joints
Classification of synovial joints, according to the shape ,axes of movement and morphology
Simple, Compound ,Complex joints,Blood supply & nerve supply.

IV) General Myology
Definition, types: Origin, Insertion, Morphological classification
Actions of muscles, nerve supply
Functional classification, Prime movers, Fixators, Antagonists, Synergists
BURSA, Structure, Functions,types:
LIGAMENTS, Types & functions,Sprains
RETINACULA & APONEUROSES

V) Integument

a) SKIN -
Introduction : Surface area
Types :Thin, Thick, hairy, Functions, innervation
Structure :
Epidermis, Dermis, Appendages

b) SUPERFICIAL FASCIA
Distribution of fat, functions

c) DEEP FASCIA
Features, Modifications, Functions

VI) General Angiology

Arteries: Muscular, Elastic; Arterioles; Capillaries: Sinusoids, Veins - Anastomosis: End arterial; Vasa vasorum, nerve supply of blood vessels

Lymphatic system
Lymph vessels, Central lymphoid tissue, Peripheral lymphoid organs, Circulating lymphocytes - T and B lymphocytes

VII) General Neurology
Structure of nervous tissue,
Neurons:Synapses :Structural – type, Functional types
Classification of neurons : According to polarity and According to relative lengths of axons and dendrites:
Neuroglia:Nerves :Cranial – Spinal, Structure of typical spinal nerve
Autonomic nervous system :Sympathetic :Sympathetic ganglia, postganglionic fibres
Parasympathetic :Cranial outflow, sacral outflow

Level 2: Mechanical properties of bones.
synthesis, histogenesis, growth of Cartilage,Factors limiting range of movement,
Kinesiologically: Sellar, Ovoid, Joint position: Loose-packed, Close-packed
Number and diameter of fibres, Range of contraction, Active insufficiency,Passive insufficiency, shunt, swing, spin
Adventitious bursae - Housemaid’s knee, Clergyman’s knee, Student’s elbow, Weaver’s bottom, Porter’s shoulder
Clinical correlation, significance of Langer’s lines, Tension lines, flexure lines Transplant
Collateral circulation, Functional end arteries, Arteriosclerosis,

Level 3: Effect of hormones on bony growth, Wolff’s law, Surface topology of articular surfaces, Spin, Swing, Cartilage Grafts, Kinesiology, Body liver system,SKIN grafts,Ischaemia, Infarct,Bursitis

B) REGIONAL Anatomy

I) UPPER LIMB
REGIONS : Mammary gland, Axilla, Cubital fossa, Fascial spaces of the hand
Relations and functional importance of individual structures, Dupuytren’s contracture, Hand as a functional unit – grips, Nerve injury, carpal tunnel syndrome, Clavipectoral fascia; Salient features about carpals;

ARTHROLOGY
Shoulder girdle; Shoulder joint; Elbow; Radioulnar joints; Wrist; Carpometacarpal joint of thumb; Bones taking part
Classification of joints, Movement with muscles causing movements,
midcarpal joint, metacarpophalangeal joints,
interphalangeal joints
Fall on the outstretched hand

Level 2Axilla: Collaterals Lymph nodes (breast) Axillary sheath cervico-axillary canal, Abscess drainage, Palm: comparative Anatomy (thumb, palmaris brevis), position of rest and of function, collaterals, Fascial spaces: Surgical significance

OSTEOLOGY
Identification; Anatomical position; Parts; Joints formed; Development; identification of individual carpals in and articulated hand)
Clavicle: Line of force transmission, commonest site of FRACTURE
Humerus: fractures -
Colles’ FRACTURE , Smith’s FRACTURE
Carpals, Metacarpals, Phalanges: Carpal tunnel syndrome, FRACTURE scaphoid
Surgical approaches, Subluxation of head of radius, carrying angle

MYOLOGY:
Muscles of upper limb, attachment, Nerve supply, Actions
Applied aspects: Volkmann’s ischaemic contracture
Quadrangular and triangular spaces, Triangle of auscultation

ANGIOLOGY: Axillary, Brachial, Radial, Ulnar Arteries, veins, lymphatics
Commencement, Termination, Main area of distribution and drainage, Anastomosis –
Applied aspects, Artery : Damage to vessels, Raynaud’s disease, Veins: Thrombosis, Lymphatics: Lymphangitis (red streaks), lymphadenitis,

NEUROLOGY:
A. Nerves
Axillary, median, ulnar, musculocutaneous, radial, Origin, course, distribution, Root value

B. Plexus: Brachial
Applied aspects: Nerve injury at various sites - Tendon reflex - Winging of scapula, Erb’s palsy, Klumpke’s palsy, Crutch palsy, ulnar paradox

II) LOWER LIMB

REGION: boundaries, major contents; Gluteal, femoral triangle; Adductor canal, compartments of thigh, leg; Popliteal fossa, Adductor canal , Sole, Arches of foot,; Gluteal IM injections
Femoral hernia
blood supply to head of femur; FRACTURE neck of femur, mechanics movement of joints; hip and knee, Trendelenburg test; Knee joint : derangement, injuries to cruciate ligaments, menisci; (tear - bucket handle type); Ankle : Sprain
mechanism of venous return, varicose veins
Applied aspects of Adductor canal, popliteal aneurysms

OSTEOLOGY: Identification, region, anatomical position; parts, joints formed,
For tarsals - identification of individual tarsals in an articulated foot.

Level 2
Applied aspects: Bony specialization for bipeds, walking and transmission of weight,
FRACTURE , femoral torsion, neck shaft angle, bone grafts

ARTHROLOGY
Hip, knee, ankle, subtalar, Tibiofibular
Hip joint : dislocation, congenital, traumatic, surgical approaches to joints (anatomical basis), traumatic effusion, bursitis

MYOLOGY
Attachments, nerve supply, actions of: Muscles of lower limb
calf pump, antigravity muscles

ANGIOLOGY
Artery: Femoral, profunda femoris, popliteal, dorsalis pedis, Commencement, termination, main area of supply, course, relations & applied
Vein: Venous drainage of lower limb, long and short saphenous veins, Communication and valves. Varicose
Lymphatics: Inguinal group of lymph nodes

Lever 2 :intermittent claudication, clinical significance of anastomosis: around knee, venous thrombosis

NEUROLOGY
a. Plexus: Lumbar and sacral, Location, Formation, Distribution
b. Nerves: Root value of sciatic, femoral, obturator, tibial, common peroneal nerves; Origin, course, distribution; sciatica, foot drop

Level 2 :Pes cavus, equinovarus, clawing of toes

III) ABDOMEN

i) Anterior abdominal wall
Rectus sheath, quadrants and regions, Testes, epididymis, spermatic cord, scrotum
Level 2: Surgical incisions of abdomen types of inguinal herniae
Peritoneum, Lesser Omentum, Omental Bursa, Epiploic Foramen, Testes
Morphology, blood supply, lymphatic drainage

SPERMATIC CORD
Definition, beginning, end, course and contents, coverings, vasectomy

ii) Abdominal organs : Morphology relations blood supply, lymphatics nerve supply & applied Anatomy of following organs
stomach, spleen , liver :,biliary apparatus, pancreas, small intestine,large intestine and vermiform appendix,kidneys, ureters,suprarenal glands

Level 2: peptic ulcer ,Splenic circulation, splenic vascular segments,liver , biopsy, Support of liver ,Gall stones ,Duct system of pancreas ,Surgical approach to kidney , stones (Renal), Ureter,Sites of constrictions, Hydronephrosis, pheochromocytoma

Level 3: Gastroscopy, Achlorhydria,Splenectomy ,liver transplant,Pancreatitis, diabetes,Renal transplant,Stones in ureter, Cushing’s disease

iii) Pelvic Viscera :- Morphology, relations, blood supply nerve supply & applied Anatomy
urinary bladder & urethra, uterus, ovaries and uterine tubes, prostate, rectum and anal canal, urogenital diaphragm (ugd)

Level 2: Supports and micturition, stones in bladder ,Ovarian cyst, enlargement complications, Fistula, Fissure, piles

Level 3: cystoscopy, Hysterectomy,cancer, Supports of rectum


iv) Perineum – Ischiorectal fossa, pudendal canal, perianal spaces Urogenital diaphragm, male urethra, penis – perineal pouches

Level 2: Ischiorectal hernia

v) Myology
Anterior abdominal wall, Rectus sheath, Psoas major, Quadratus lumborum, Thoracoabdominal diaphragm, pelvic diaphragm, Thoracolumbar fascia, perineal spaces & muscles

Level 3: Psoas abscess

vi) Osteology
Level 2: Pelvis - types
(various diameters), lumbar vertebrae, anatomical basis of disc prolapse, nerve compression
Level 3: Sacralization, Lumbarization
ARTHROLOGY
Movements of lumbar vertebrae, lumbosacral, sacroiliac, sacrococcygeal joints

vii) Angiology :- Origin, course, termination, relations, branches & applied Anatomy of
PORTAL VEIN
Level 2: portasystemic communications
Level 3: Portasystemic communications in detail; Development
INFERIOR VENA CAVA,ABDOMINAL AORTA,INTERNAL ILIAC ARTERY

viii) Neurology, lumbar plexus, sacral plexus


IV) THORAX
i) Thoracic wall,Thoracic inlet
Boundaries and contents
THORACIC OUTLET, Boundaries and contents, major openings and levels,
Typical intercostal space, Boundaries and contents, muscles Atypical intercostal space, Movements of respiration
Level 2: importance and minor openings in outlet, Accessory muscles of respiration
Level 3: Applied aspects: Barrel chest, pectus excavatum, rickety rosary

ii) Mediastinum
Divisions and major contents

Level 2: Mediastinitis, mediastinoscopy
SUPERIOR AND POSTERIOR MEDIASTINA, LIST OF STRUCTURES
Boundaries and contents:
Level 2 : Superior mediastinal Syndrome, Course, relation and branches / area of drainage
Level 3: Coarctation of aorta, aneurysm, developmental anomalies

iii)Pleura
Pleural reflections, recesses, innervation
Level 2: importance of recesses
Level 3: pleural effusion
LUNGS
Gross description including lobes, fissures and bronchopulmonary segments
Level 2: relations, blood supply, nerve supply
Level 3: Postural drainage, surgical importance, of bronchopulmonary segments, foreign body inhalation

iv)Pericardium & heart
Divisions of pericardium and sinuses
Level 2: referred pain
Level 3: Pericardial effusion
heart
Anatomical position, location, surfaces and borders, interior of all chambers, conducting system of heart ; vessels of heart
Level 2: Relations, nerve supply - foramen ovale, patent IV septum, over-riding aorta, referred pain, functional end arteries - coronaries
Level 3: PDA, Fallot’s tetralogy, etc.

v)Osteology
IDENTIFICATION and parts of VERTEBRAE , RIBS - and STERNUM
Level 2: Identification of T1, T9, T10, T11, T12, vertebrae and atypical ribs - 1, 2, 11, 12. relations, attachments, ossification
Level 3: FRACTURE ribs, flail chest, compression FRACTURE of vertebra

V) HEAD-FACE NECK

i) Regions and organs, fasciae of the neck triangles of neck

Level 2 Spaces and spread of infections, axillary sheath , Relations of contents, Damage to accessory nerve, sialogram, approach to gland, bidigital palpation of submandibular gland, Dangerous area of face, squint

Level 3: surgical neck incisions, external jugular vein - air embolism, LN biopsy, JVP, pulse, Frey’s syndrome

GLANDS
Thyroid, Parathyroid, Parotid, Submandibular, sublingual, Pituitary
Morphology, capsule, relations, nerve supply, blood supply

FACE
Muscles, nerve supply - blood supply

scalp,palate,tongue,larynx, pharynx, orbit, eyeball,styloid apparatus,nasal cavity, ear ,internal ear ,middle ear ,external ear ,meninges

ii) Osteology
Identification, anatomical position, parts, foramina in the skull, structures passing through them, norma basalis, verticalis, frontalis, lateralis, occipitalis and interior of cranial cavity
Foetal skull; Mandible: Age changes
Level 2: Fontanelles, Dental formula
Level 3: Fractures of the skull, Age of dentition, cervical rib, disc herniation

iii) Arthrology
TM JOINT
Level 2: Dislocation

iv) Myology
Sternomastoid, Digastric, Mylohyoid, Hyoglossus, Muscles of facial expression, mastication, larynx, pharynx, tongue, palate and, Extra-ocular muscles
Level 2 Relations, development
Level 3 facial nerve palsy

v) Angiology
ARTERIES
Origin, parts, course, relations, branches of:
Subclavian, Internal carotid, External carotid, Vertebral, Lingual, Facial, Maxillary
Level 2: Sub-branches, distributions
Level 3: Subclavian steal syndrome, Subclavian-axillary anastomosis
VEINS
External and internal Jugular veins, venous drainage of face

VENOUS SINUSES
Names, locations, drainage, classification
emissary veins, cavernous sinus, lymphatic drainage of head face neck

vi) Neurology
Cranial nerves,Nucleus, course, relations, branches, distribution, reflex pathways & applied Anatomy , plexus: Cervical, Brachial, parasympathetic ganglia, cervical sympathetic chain



VI) NEUROANATOMY

i) SPINAL CORD
Gross features: Extent (child / adult), enlargements, conus medullaris,
filum terminale, spinal meninges Tracts Ascending and Descending

Level 2: Spinal segments, vertebral correlation, significance of enlargements
nuclei of grey matter at upper & lower cervical, mid-thoracic, Lumbar & sacral levels
Clinical correlation of lesions

Level 3: anomalies,lamination, syringomyelia, PID, tumours, TB, trauma, dislocation, myelography

ii) MEDULLA OBLONGATA
Gross features: Motor decussation: Sensory decussation: Inferior olivary nucleus Cranial nerve nuclei

Level 2: Tuber cinereum, pontobulbar body, Order of neurons, Details of nuclei and organisation of white matter
Level 3: medullary syndromes-Bulbar palsy, increased ICT, Arnold-Chiari malformation,

iii) PONS
Cross sections at the level of:
¨ Facial colliculus, Trigeminal nucleus
General features: Peduncles, Floor of the fourth ventricle
Level 2: Relations
Level 3: Tumours, pontine haemorrhage

iv) CEREBELLUM
Gross features: Division, Lobes, relations, internal structure -
Level 2: connections of,cerebellar cortex and intracerebellar nuclei,
white matter classification, Purkinje neuron,
Level 3: dysfunction,-dysequilibrium, ataxia, hypotonia
Nuclei: Names of nuclei and important connections
Peduncles : Important tracts in the peduncles
Functions : Of archicerebellum, paleocerebellum & neocerebellum

v) MIDBRAIN
General features :
relations, contents of interpeduncular cistern, connections of red nucleus
Level 2: Weber’s syndrome, Benedikt’s syndrome
Level 1 :T.S. at inferior colliculus, TS at superior colliculus

vi) CEREBRUM
CORTEX, WHITE MATTER, BASAL NUCLEI, LIMBIC LOBE
Surfaces, borders, major sulci, gyri, poles, lobes, major functional areas, interior - gray and white matter
Gray - cortex - granular / agranular, striate, Basal nuclei - names, White matter - classification with examples; Components of limbic lobe
Level 2: handedness, Connections of limbic lobe

vii) DIENCEPHALON
Dorsal thalamus Epithalamus Metathalamus Hypothalamus Subthalamus
Boundaries, parts, relations (gross), cavity, major nuclei, gross connections
viii) VENTRICULAR SYSTEM
Parts, boundaries, foramina, correlation with parts of brain
Level 2: Choroid fissure, recesses, Queckenstedt’s test
Level 3: Hydrocephalus, VA shunt
ix) BLOOD SUPPLY OF brain
Circle of Willis, subarachnoid space, arteries, veins
Level 2: blood brain barrier, Hemiplegia
Level3: End arteries, CSF formation

x) MENINGES
Cerebral and spinal meninges, folds of dura, contents of subarachnoid spaces, arachnoid villi and granulations, direction of flow of CSF , lumbar puncture Cisterns, Definition, terminology, cisterna magna

Level 2: cisternal puncture, Queckensted’s test, vertebral venous plexus, choroid plexus
Extracerebral and intracerebral communication, CSF block,
Level 3: Epidural space


C) MICROANATOMY

I) GENERAL HISTOLOGY

i) Microscope,
Light microscope: parts, magnification, resolution,Electron microscope,
Level 2 Micro techniques, H and E staining
Level 3: Polarizing microscope, phase contrast, scanning EM

ii) Cytology
Cell,Cytoplasm and nucleus,Cytomembranes,Unit membrane, Cell organelles
Mitochondrial DNA, mitochondrial myopathy

Level 2 Specialisations of cell surface, Sarcoplasmic reticulum of muscle, Primary and secondary lysosomes, residual bodies, Effect of colchicine and anticytotic drugs on spindles preventing mitosis, Endocytosis, exocytosis, movement of microvilli; Cell mitotic activity
Level 3 Lysosomal storage disease
NUCLEUS - Structure, nuclear envelope, chromatin, Barr body, nucleolus

iii) Epithelial
Definition, Classification, Structure of various types & subtypes of epithelia
Level 2: Nutrition, Renewal, Innervation,
Level 3: Metaplasia;
Surface modifications,Cilia; Microvilli; Stereocilia; Cell junction and junctional complexes;
Glands, Classification; Unicellular and Multicellular; Exocrine, Endocrine, Amphicrine. Exocrine: Simple, Compound; Apocrine, Merocrine, Holocrine; Tubular, alveolar, tubuloalveolar; Serous; Mucous ; Mixed

iv) Connective tissue, classification, structure, fibres, ground substance,
loose areolar tissue, adipose tissue
Level 2 : Glycosaminoglycans
Level 3 : Scurvy, oedema, inflammation

v) Bone & Cartilage
Bone, Compact, Cancellous, Developing bone; ossification, Woven, lamellar bone
Cartilage, Classification, types, Perichondrium, functions
Level 2: Growth: Interstitial, Appositional; Bone callus, Osteomalacia , Osteoporosis , Osteoma
Level 3: Chondroma

vi) Muscle
Skeletal muscle Plain muscle Cardiac muscle Intercalated disc, syncitium; Sarcomere, I and A bands, myofibrils, myofilaments,; Sarcoplasmic reticulum,
Level 2: Innervation, Red fibres, white fibres
Level 3: Hypertrophy, Hyperplasia ,Rigor mortis , Myasthenia gravis

vii) Nervous
Neurons, types; Neuroglia, types; Myelinated nerve fibre LS; Non-myelinated nerve fibre; Peripheral nerve ; Nodes of Ranvier; Synapses;

viii) Vessels
Large sized artery Medium sized artery, Arteriole; Capillary, Sinusoid; Medium sized vein;
Level 2: Atherosclerosis, Aneurysm, Infarcts, clotting
Lymphoid tissue
T cells, B cells; Mucosa Associated Lymphoid Tissue; Humoral immunity, Cell mediated immunity; Lymph node section; Thymus, spleen , Tonsil
Level 2: Blood-thymus barrier, Open and closed circulation in the spleen
Level 3: Organ transplantation, Graft rejection, Autoimmune disease


II) SYSTEMIC HISTOLOGY

Basic organization, salient features, Identification
Structure and function correlation, individual features

i) Integumentary system
SKIN - Types; Epidermis and dermis; various cells, Appendages of SKIN
Level 2: Renewal of epidermis
Level 3: Albinism, melanoma, Acne

ii) Alimentary system
a) Oral tissues
Lip, Tongue, taste buds, Papillae; Tooth, Developing tooth, Salivary glands
Level 2: Striated duct, ion transport
b) GI Tract
Basic organization - 4 layers; Oesophagus with glands Stomach - Fundus, Chief cells, Parietal cells, intrinsic factor; Stomach - Pylorus Duodenum Brunner’s glands; Small intestine - with Peyer’s patch, Appendix, Large intestine
Level 3: Pernicious anaemia, ulcer, gastritis, Hirschsprung’s disease or megacolon
c) Glands
Pancreas: Exocrine, islets of Langerhans; liver , Hepatic lobule, portal lobule,; portal acinus; Gall bladder
Level 2: liver as an endocrine gland
Level 3: Diabetes mellitus, Cirrhosis of liver , liver regeneration, Chalones

iii) Respiratory system
Olfactory mucosa; Epiglottis; Trachea, Lung, Bronchus, bronchiole, alveolar duct, sac, alveoli, pulmonary type I and II cells
Level 2: Double spirally arranged bronchial smooth muscle
Level 3: Bronchial asthma, Hyaline membrane disease, heart failure cells

iv) Urinary system
Basic organization; Nephron - Parts, podocytes, Collecting system; kidney - Cortex, Medulla Ureter; Urinary bladder, Urethra
Level 2: Juxtaglomerular apparatus

v) Male reproductive system
Basic organization; Gonads, Tract, Accessory glands; Testis; Epididymis ; Vas deferens; Prostate ; Penis; Seminal vesicle
Level 2: Stages of spermatogenesis
Level 3: Immotile sperm
Female reproductive system
Basic organization; Gonads, Tracts, Accessory glands; ; Ovary - with corpus luteum; Fallopian tube; Uterus ; Cervix; Vagina, Mammary gland Active , Passive
Level 2: Stages of maturation of ovarian follicle , Phases of menstruation
Colostrum, IgA, Placenta : Maternal unit, Foetal unit, Umbilical cord: Wharton’s jelly

vi) Endocrine system: Pituitary; Adenohypophysis; Neurohypophysis; Thyroid ; Follicular, parafollicular cells; Parathyroid ; Chief cells, oxyphil cells; Adrenal; Pancreas; Testis ; Ovary
Level 2: Hypothalamo-pituitary Portal system
Level 3: Pheochromocytoma
vii) Nervous system
A. Central
Basic organization; Cerebrum; Cerebellum; Spinal cord; Cervical; Thoracic; Lumbar;
Sacral;
B. Peripheral
Sensory ganglia; Autonomic ganglia (sympathetic ganglion); Peripheral nerve
Special senses
I. Visual: Eyeball
Cornea ; Sclerocorneal junction ; Canal of Schlemm; Lens ; Retina ; Optic nerve
Level 3: Kerattoplasty, eye donation, glaucoma, retinal detachment
2. Auditory:
Internal ear ; Cochlea ; Semicircular canals; Vestibule;
3. Olfactory
Nasal cavity
4. Gustatory
Tongue with taste buds

D) DEVELOPMENT Anatomy

I) General Embryology

i) Introduction: Stages of human life phylogeny
Ontogeny, Trimester, Viability,
Terms of reference: e.g. Cranial, Rostral, Caudal, Dorsal, Ventral, Lateral, Medial, Median, Planes of section
Level 3: The law of recapitulation, "Critical period", malformations, USG, Amniocentesis Chorionic Villus Biopsy, Fetoscopy, etc Teratology History of Embryology

ii) Gametogenesis: Menstrual cycle other reproductive cycles, Germ cell Transport and Fertilisation, Sperm capacitation, Methods of contraception, SEX determination
Level 3: Teratogenic influences; Fertility and Sterility, Surrogate motherhood; Social significance of “SEX -ratio”,
iii) Cleavage, Blastocyst, Cytotrophoblast, Syncytiotrophoblast
Implantation: Normal sites, Abnormal sites,; Placenta praevia, Extra-embryonic Mesoderm and Coelom; Bilaminar disc - Prochordal plate
Level 2: “abortion”; Decidual reaction, Chorionic Gonadotropins - Pregnancy test,

iv) Primitive streak Notochord, Neural tube and its fate Neural crest cells
- their fate, Development of somites, Intra-embryonic coelom, Foetal membranes :Chorionic villi, Amnion, Yolk sac, Allantois
Level 2: Congenital malformations, Nucleus pulposus, Sacrococcygeal teratomas, Neural tube defects, Anencephaly
Level 3: Signs of pregnancy in the first trimester, Role of teratogens, Alpha-fetoprotein levels

v) Folding of the embryo: Derivatives of germ layers,
Pharyngeal arches
Level 2: Thalidomide tragedy, Estimation of Embryonic Age - Superfoetation & superfoecundation

vi) Fetal membranes: Formation Functions, fate of: Chorion ; Amnion; Yolk sac; Allantois; Decidua; Umbilical cord; Placenta - Physiological functions; Foetomaternal circulation, Placental barrier, Twinning: monozygotic, dizygotic
Level 2: Placental hormones, Uterine growth, Parturition, Estimation of fetal age,

Level 3: Types of cord attachments, Chorion villus biopsy and Amniocentesis;
Uses of amniotic membranes, Trophoblastic tumours - Rh incompatibility, Haemolytic disease of newborn,

II) Systemic Embryology

i) Cardiovascular System - Venous System; heart - Chambers - Septa - Truncus -
Aortic arches - Fetal circulation - Changes at birth, ASDs, VSDs, PDA, Fallot’s Tetralogy.
Level 2: Veins, abnormalities, Surgical corrections
ii) The Respiratory System: Development of Larynx, Trachea, Bronchi, Lungs; Tracheo-oesophageal Fistula
Level 2: malformations
Level 3: Respiratory Distress Syndrome; Premature births
iii) The Alimentary System: Foregut: Oesophagus, Stomach, (Lesser sac); Duodenum - Hepatobiliary apparatus, Pancreas, spleen, Portal vein; Midgut : Rotation and Fixation, Caecum and Appendix, Meckel’s diverticulum; Hindgut : Cloaca; Rectum and Anal Canal
Level 2: Malformation - Tracheo-oesophageal fistulae; Congenital Hypertrophic Pyloric Stenosis; Atresia; Omphalocele, Hernia; Malformations - Fistulae, Situs inversus; Nonrotation; Mixed rotation of gut

iv) The Urogenital System, Development of Kidneys and Ureters; Cloaca - Urinary Bladder and Urethra; Suprarenal gland; Genital System - Testis and Ovary; Ducts and associated glands; External genital organs, Mesonephric and paramesonephric ducts, Uterine tube, Uterus and vagina
Level 2: congenital malformations; Ambiguous genitalia and Hermaphroditism ; Remnants and Vestiges of Ducts and Tubules

v) Integument : Development of mammary gland, SKIN & appendages

vi) Pharyngeal arches, nerves, muscles, cartilage, development of face, palate


vii) Endocrine : Glands, Adrenal, Thyroid, Parathyroid, Pituitary

viii) The Nervous System: Neural Tube: Spinal Cord and brain i.e., Forebrain, Midbrain and Hindbrain, Hypophysis cerebri; Neural Crest : Peripheral Nervous System,
Level 2: correlation Spina bifida; Anencephaly, Hydrocephalus, Retinal detachment; glaucoma; Coloboma iris,
Level 3: Myelination of tracts shortening of spinal cord, Neural Tube Defects
Organs of the special senses - eye and ear
ear - Internal ear -; External and middle ear - anomalies of the ear

E) GENETICS

i) Introduction – Mendelism, Laws Genetic code
Level 2: Evolution, Eugenics and Polygenic inheritance, Radiation and mutation , SEX chromatin, Population genetics


ii) Cytogenetics
Structure and function of chromosomes, Cell cycle, Cell divisions, Spermatogenesis, Oogenesis
iii) Molecular genetics (Normal)
Gene, Genetic code, Structure and types of DNA, Structure of RNA

iv) Inheritance: Single gene inheritance, Multifactorial inheritance, Polygenic inheritance, Mitochondrial inheritance, Pedigree charts with symbols

Genetic basis of variation

Mutation, Polymorphism, Multiple allelism
Level 2: Types, Factors influencing mutational load

Developmental genetics
chromosomes; Lyon’s hypothesis; Hermaphroditism and pseudohermaphroditism; teratogenesis

Gonadal dysgenesis, Adrenogenital syndrome Androgen insensitivity

Level 3: Counselling

Pedigree charting
Chromosomal basis of disease: Numerical, Structural abnormalities Down’s, Cri-du-chat, Turner’s, Klinefelter’s
Level 2: Dermatographics
Level 3: Counselling

Prenatal diagnosis
Maternal Serum Sampling; Fetal USG; Fetal Amniocentesis; Fetal Chorion Villus Sampling
Level 2: (cordocentesis); Foetoscopy
Level 3: Eugenics

F) RADIOLOGICAL Anatomy

I) Introduction
Principles of plain radiograms and CT scan.
Identification of gross anatomical features in plain and contrast radiographs.
Identification of gross anatomical features in normal CT scan especially of the Abdomen and Head-Face-Neck-brain regions.
Diagnostic procedures. Technical details (e.g. dye) are not necessary.
Level 2 :Estimation of age if epiphyseal line seen.

II) UPPER LIMB – X-Ray of III) LOWER LIMB
Shoulder region Hip region
Arm Thigh
Elbow region Knee region
Fore arm Leg
Wrist and hand Ankle region
Foot



IV) ABDOMEN V) THORAX
Plain X-ray Plain X-ray
Ba meal Ba swallow
Ba meal follow through Bronchogram
Ba enema CT mediastinum
Oral cholecystogram High resolution CT lung
Intravenous urogram
Cystogram
Ascending pyelogram
Abdominal Aortogram
Hystero-salpingogram
Myelogram
CT abdomen



VI) HEAD-FACE
X-ray skull plain
Carotid angiogram
Vertebral arteriogram
CT Scan brain
NECK
Plain X-ray cervical region

G) SURFACE Anatomy

I) SURFACE MARKING:

i) Upper Limb
NERVES: Radial nerve, Median nerve, Ulnar nerve, Axillary nerve,
Musculocutaneous nerve
VESSELS: Axillary artery, Brachial artery, Radial artery, Ulnar artery, Superficial
and deep palmar arches


ii) Lower Limb
NERVES: Femoral, Sciatic, Common peroneal nerves
VESSELS: Great saphenous & Small saphenous veins; Femoral, Popliteal & Dorsalis pedis arteries

iii) ABDOMEN
ORGANS: 9 regions and projection of organs in them; Stomach, Duodenum, Caecum, Appendix, Ascending,, transverse and descending colon, Pancreas, liver , Gall bladder, spleen , Kidneys (ventral and dorsal)
Abdominal aorta

iv) THORAX
heart and valves, Lungs, fissures and hilum; Pleurae, Trachea


v) HEAD FACE NECK
ORGANS: Parotid gland & duct
Middle meningeal artery, Facial artery
Pterion, Bregma, Reid’s base line, Suprameatal triangle
Thyroid gland
Common carotid artery, External carotid artery, Internal carotid artery, Internal jugular vein, Trachea

vi) brain : Lateral sulcus, Central sulcus, Median longitudinal fissure, Superior sagittal sinus, Sigmoid sinus, transverse sinus

II) LIVING Anatomy :

i) UPPER LIMB
(BONY) LANDMARKS(PALPATION OF):
Clavicle, Spine of scapula, Inferior angle, Coracoid process, Epicondyles of humerus, Olecranon process of ulna; Head and styloid processes of radius and ulna, Heads of metacarpals (knuckles), Pisiform, Hook of Hammate

JOINTS (DEMONSTRATION OF MOVEMENTS):
Shoulder girdle, Shoulder joint, Elbow joint, Radio-ulnar joints, Wrist joint, 1st carpo-metacarpal joint, MP and IP joints

MUSCLES (DEMONSTRATION OF ACTION)
Principle of testing: Trapezius, Serratus anterior, Latissimus dorsi, Pectoralis major, Deltoid, Biceps Brachii, Brachioradialis, Brachialis, Extensors at the elbow, Supinators, Wrist extensors, Wrist flexors, Small muscles of the hand

NERVES: Dermatomes, Ulnar
Ulnar nerve thickening in Leprosy

VESSELS (PALPATION OF): Axillary artery, Brachial artery, Radial artery
OTHERS: Axillary groups of lymph nodes; Anatomical snuff-box (boundaries)

ii) LOWER LIMB
(BONY) LANDMARKS (PALPATION OF): Anterior superior iliac spine, Iliac crest, Tubercle of the iliac crest, Ischial tuberosity, Greater trochanter, Adductor tubercle, Head and neck of fibula, Lateral and medial malleoli, Tibial tuberosity, Subcutaneous surface of tibia, Patella
JOINTS (DEMONSTRATION OF MOVEMENTS): Hip , Knee , Ankle , Subtalar Joints
MUSCLES (DEMONSTRATION OF ACTION): Hip-Flexors, Extensors, Abductors, Adductors
Knee: Flexors, Extensors,
Ankle: Dorsiflexors, Plantar flexors
Subtalar: Invertors, Evertors
NERVES: Dermatomes, Sciatic, Tibial, Common peroneal, Femoral, Obturator
Thickening of common peroneal nerve in Leprosy

VESSELS (PALPATION OF): Femoral, Popliteal, Dorsalis pedis, Posterior tibial
OTHERS: Ligamentum patellae, Inguinal lymph nodes
TENDONS: Semitendinosus, Semimembranosus, Biceps femoris, Iliotibial tract

iii) ABDOMEN
(BONY) LANDMARKS (PALPATION OF): Anterior superior iliac spine, Pubic tubercle
JOINTS (DEMONSTRATION OF MOVEMENTS): Intervertebral
MUSCLES (DEMONSTRATION OF ACTION): Obliques, Transversus abdominis, Rectus abdominis
NERVES: Dermatomes
OTHERS: Enlarged liver , spleen , kidneys, Abdominal quadrants and regions; Position of superficial and deep inguinal rings; Renal angle; McBurney’s point;
Level2: Murphy’s sign

iv) THORAX (BONY) LANDMARKS(PALPATION OF): Sternal angle, Counting of rib spaces, locating thoracic spines
JOINTS (DEMONSTRATION OF MOVEMENTS): Intervertebral
MUSCLES (DEMONSTRATION OF ACTION): Respiratory movements
NERVES: Dermatomes
OTHERS: Apex beat, Apices of the lungs, Triangle of auscultation

v) HEAD FACE NECK - (BONY) LANDMARKS(PALPATION OF): Nasion, Glabella, Inion, Mastoid process, Suprameatal triangle, Zygoma, Zygomatic arch, Angle of mandible, Head of mandible,
JOINTS (DEMONSTRATION OF MOVEMENTS): Temporomandibular joint
MUSCLES (DEMONSTRATION OF ACTION): Of Mastication, Of Facial expression
Cranial nerves (I to XIII) testing
(PALPATION OF): Superficial temporal artery, Facial artery
(PALPATION OF): Symphysis menti, Hyoid bone, Thyroid cartilage, Cricoid cartilage, Tracheal rings, Suprasternal notch, Transverse process of atlas, Spine of C7
(DEMONSTRATION OF MOVEMENTS): Atlanto-occipital joint, Cervical joints
(DEMONSTRATION OF ACTION): Sternocleidomastoid, Neck flexors and extensors
(PALPATION OF): Common carotid artery, External carotid artery
OTHERS: Thyroid gland, Cervical lymph nodes, (Horizontal and vertical), Midline structures in the neck

NOTE :- Level 2 and 3 mentioned in the above syllabus includes the topics " desirable to know" (level-2) and " Nice to know" ( level-3. The remaining topics fall under the group " Must Know" ( level-1.)

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