Medical Education

Anatomy Syllabus for MBBS(MCI)

First-year

Total duration of course is one year. It comprises of two semesters I and II. Each semester is of six months duration. Course commences from 1st August every year and ends on 15 June following year. The subject of anatomy is taught under the following heads :

  1. Gross anatomy
  2. Microanatomy
  3. Embryology and Genetics
  4. Neuroanatomy
    Total number of teaching hours are approximately 541

OBJECTIVES

At the end of the course, the student should be able to:

• Comprehend the normal disposition, inter-relationships, gross, functional and applied anatomy of the various structures in the body.
• Identify the microscopic structures of various tissues, and organs in the human body and correlate the structure with the functions as a prerequisite for understanding the altered state in various disease processes.
• Comprehend the basic structure and connections between the various parts of the central nervous system so as to analyze the integrative and regulative functions on the organs and systems. He/She should be able to locate the site of gross lesions according to the deficits encountered.
• To understand the basic principles of embryology including genetic inheritance and stages involved in development of the organs and systems from the time of conception till birth. The student should recognise the critical stages of normal development and the effects of common teratogens, genetic mutations and environmental hazards on it. He/She should be able to explain the developmental basis of the occurrence of major variations, abnormalities and congenital anomalies.

Anatomy

COURSE CONTENT

  1. Gross Anatomy
    Introduction to Anatomy, nomenclature, anatomical position, planes, tissues and movements.

I. Osteology

(a) Names of the bones of the body and their position; classification of the bones with examples;
general features of the bone and normal development; microscopic anatomy of bone; general pattern of blood supply; ossification of the bones of the limbs for age determination. X-rays of bones.
(b) Process of repair of bone.

Muscular System

(a) Classification and identification of the muscles of the body: main attachments, nerve supply and action(s), microscopic anatomy of muscles and the nerve terminations.

(b) Details of attachments of the muscles; ultrastructural features of muscle; mechanism of the movement caused by the muscle/muscles and various forces exerted by them and their detailed action(s).

Arthrology

(a) Definition and classification of joints, general features of different types of joints; detailed study of major joints of the limbs and movements performed at various joints in the body.

(b) Microscopic anatomy of articular cartilage; maintenance of articular cartilages; blood supply and nerve supply of the joints.

Cardio Vascular System

(a) Normal position, external features and parts of the heart; internal features of the chambers of heart, names of the blood vessels and venous drainage of the organs, structures and body as a whole, conducting system of heart, fibroskeleton of heart.
(b) Variation(s), developmental anomalies of heart and blood vessels, valvular defects and their effects in pathogenesis of the anomalies.

Respiratory System

(a) Position, parts, relations, blood supply of upper and lower respiratory tract. Pleura, its reflection, nerve supply, pleural recesses and their significance, bronchopulmonary segments, their importance.

(b) Mechanism of respiration

Digestive System

(a) Position, extent, parts, relations, blood supply, nerve supply, lymphatic drainage and sphincters of the gastrointestinal system.
(b) Sphincteric action including functional implications.

Genito-Urinary System

(a) Parts, position, relations, blood supply, nerve supply and lymphatic drainage of uterus, cervix, vagina, ovary, ovarian duct, testes, epididymis, seminal vesicle, ductus deferens, prostate, kidney, ureter, urinary bladder and urethra

(b) Innervation of urinary bladder in detail

Endocrine System and Individual Endocrine Glands

(a) Various endocrine glands, their location, relations, blood supply, nerve supply and lymphatic drainage.
(b) Clinical manifestations of common endocrine disorders.

Nervous System and its components

(a) Parts of nervous system, neuron meninges, nerve terminals, neuroglia, myelination, degeneration and regeneration, ventricles, CSF, spinal cord and its blood supply. Motor and sensory pathways, cranial nerves, thalamus, cerebellum, limbic and autonomic pathways. Functional cortical areas, motor and sensory cortex and their blood supply.

Special Sensory Organs

(a) Gross Anatomy of :

(i) eye ball, extra ocular muscles their nerve supply and actions (s)
(ii) ear
(iii) nose

(iv) tongue, its musculature blood supply and lymphatic drainage.

Lymphatic System

(a) Location of the major groups of the lymphnodes of the body and their drainage areas. Gross anatomy of the major lymphatics specially thoracic duct and its tributaries.

Surface Anatomy

(a) Surface features of the body and projection of the outline of heart, its borders, surfaces and valves, lungs, their borders, fissures and hila, pleura, liver, kidneys and various abdominal and pelvic organs and important vessels and nerves

Cross Sectional Anatomy

Cross sections of thorax, abdomen and pelvis to understand the interrelationship of organs and structures.

II. Microanatomy

Microscope and basic principles of microscopy, commonly used stains, basophilic and acidophilic staining reactions and their significance. Commonly encountered artifacts. Brief principle of electron microscopy and interpretation of ultrastructural features.

GENERAL HISTOLOGY

Cell : detailed structure of cell and its components and their functional mechanisms.
Four primary tissues Epithelium : Microscopic characteristics, types, functions, distribution, basal lamina, cell junctions,
specialization of the cell surface and their structural details and functions; metaplasia.

Connective tissue: Cells, fibers and their structural features and functions. Intercellular substances, amorphous ground substance, types of connective tissue (loose areolar tissue, dense connective tissue) and their distribution. Specialized connective tissue : different types of cartilages and their functions and distribution. Bone : Cells, bone matrix, structural features of compact and cancellous bone, their distribution
and functions, ossification, blood supply of a long bone.

Muscle: General features, detailed structure of : skeletal muscle, and molecular mechanisms of contraction, innvervation of skeletal muscle, neuromuscular junction, morphological and histochemical basis of classification into type I and type II muscle fibers and their significance, structural and functional characteristics of cardiac and smooth muscle; innvervation of cardiac and smooth muscle.

Nervous tissue: Structural characteristics of a neuron, axon and dendrties. Different types of neurons and their specific structural and functional features and distribution. Axonal transport, synapse, morphological and functional characteristics of different types of synapses.

Neuroglia : types, structure and functions, blood brain barrier. Brief cytoarchitecture of the central nervous system, regeneration in CNS with particular emphasis on stem cells. Sensory and autonomic ganglia, peripheral nerves, myelin and myelination, degeneration and regeneration in peripheral nerves.

Histology of various organs/organ systems

Exocrine glands : Characteristics, simple and compound glands; types of secretions, modes of secretion, detailed structural features of a serous secreting cell and mucous secreting cell, serous and mucous acini, duct system, features of salivary glands, exocrine pancreas, sweat and sebaceous glands, mammary gland, bulbourethral gland etc.

Circulatory system : Structural features of heart; conducting and distributing arteries and arterioles; types of capillaries, their structural features and distribution and microcirculation, detailed structure of endothelium; structural characteristics of large and small veins and venules arterio-venous shunts, lymphatics.

Respiratory system : Structural features of nose, nasopharynx, larynx, trachea, principal brochi, lung including intrapulmonary bronchi, bronchioles, alveolar ducts, atria, alveoli, blood-air-barrier. Functions of different parts of respiratory system.

Skin and nerve-end-organs: Thick, thin and hairy skin, cell renewal and pigmentation of skin, skin appendages, healing of skin wounds, sensory receptors of skin. Functions of skin.

Immune system and lymphoid organs: Lymphocytes, their subtypes and functions. Humoral and cell mediated immunity. Thymus, lymph nodes, spleen, tonsils and other mucous associated lymphoid follicles.

Digestive system (GIT): General organization, oral cavity, lip, cheek, tongue, taste buds, associated salivary glands. Layers of tubular digestive tract, esophagus, stomach, small intestine, gastroesophageal junction, gastroduodenal junction, large intestine, anal canal and rectoanal junction. Liver, internal organization of liver, liver lobule, liver acinus, significance of zonation in liver acinus, liver sinusoids,detailed structure of hapatocyet, bile canaliculi, bile ducts, gall bladder, bile duct and pancreas.

Endocrine glands: Thyroid, parathyroid, Islets of Langerhan’s gland, adrenal cortex and medulla, their structural details, functional mechanisms, hypophysis cerebri, cell types secretion and their functions, hypophyseal portal circulation, common endocrine disorders

Urinary system: Detailed microscopic structure of kidney, cortex, medulla, pyramids, medullary rays, cortical columns, glomerulus, nephron, glomerular filtration juxtaglomerular apparatus, its structural features and functions, renal interstitium, collecting ducts, renal sinus, minor and major calyces, microcirculation of kidney, histophysiology of the kidney, renal pelvis and ureters, urinary bladder and
urethra.

Female reproductive system: Ovary, ovarian stroma, primary and secondary graafian follicles, functions of various constitutents and structural details of graafian follicles, atretic follicles, corpuluteum and its functions, corpus albicans. Oviducts, uterus, arterial supply of uterus, cyclic changes in uterine endometrium, fertilization, vagina, female external ganitalia and mammary glands.

Male reproductive system: Testes, spermatogenesis, spermatozoon, cycle of seminiferous epithelium, sertoli cells, interstitial tissue Leydig cells, histophysiology of testes, epididymus, vas deferns, prostate, seminal vesicles, penis.

III. Embryology

III. A General Embryology

(a) Definition of embryology; gestation period: definition of gamete sperm, Ovum; gametogenesis,migration of primordial germ cells into gonadal ridge; spermatogenesis; structure of sperm,oogenesis; structure of ovum; growth of ovarian follicles, ovarian and uterine cycles.

(b) Sperm in the male genital tract; sperm in the female genital tract, activation and capacitation of sperm in the female genital tract.

(c) First Week of Development Definition and normal site and process of fertilisation, formation of zygote, cleavage division; formation of morula and blastocyst.

(d) Second Week of Development
Differentiation of embryoblast and trophoblast; changes in the embryoblast formation of bilainar germ disc; changes in the trophoblast; formation of cytotrophoblast, syncytiotrophoblast, amniotic membrane, yolk sac, extra embryonic mesoderm and extra embryonic coelom and connecting stalk; formation of chorion, amniotic cavity, primary yolk sac cavity appearance of prochordal plate.

Implantation; formation of decidua, types of implantation and abnormal sites of implantation

(e) Third Week of Development
Appearance of primitive streak and primitive node; formation of intraembroynic mesoderm resulting in trilaminar germ disc; gastrulation formation of notochord, buccopharyngeal and cloacal membranes, paraxial, intermediate and lateral plate mesoderm, secondary yolk sac, intraembryonic coelom and allantoic diverticulum; derivatives of ectoderm, mesoderm and endoderm.

(f) Fourth To Eighth week of Development (Embryonic period)
Formation of somites, neural tube, cephalocaudal folding, lateral foldings, body form, stomodeum, proctodeum, gut and vitelline duct; subdivisions of gut into foregut, midgut and hindgut.
Development from third month to birth (Fetal period)

(g) Maturation of tissues and organs and rapid growth of body.

(h) Estimation of age.

Placenta

(i) Formation of placenta and chorionic villi, decidua basalis; features and functions of placenta; placental circulation; abnormalities; placental barrier; placentome, types of placenta.

Umbilical Cord

(j) Formation of umbilical cord; features of umbilical cord.
Amniotic Cavity
(k) Amniotic cavity and membrane; amniotic fluid – functions, expansions of amniotic cavity and fusion with chorion; chorion laeve with decidua capsularis; decidua capsularis with parietalis;
obliteration of chorionic and uterine cavities; function of fused foetal membranes to dilate cervical canal.
(l) Abnormalities; obliteration of chorionic and uterine cavities; abnormalities of chorion.
(m) Formation of twins and types of twins.
(n) Arrangement of foetal membranes. Conjoined twins.

Teratology

(o) Genetical and environmental factors as causative factors for congenital alformations.
(p) Mode of actions of teratogenes and critical periods.

III.B Systemic Embryology

(a) Development of the individual organs of digestive system, genital system, urinary system,, respiratory system, cardiovascular system. Nervous system, special sensory organs, endocrine glands and mammary gland.

(b) Developmental abnormalities of individual organs/systems, pathogenesis of the anomalies.
(c) Histogenesis of various organs.
(d) Development of skeletal system, muscular system and derivatives of coelomic cavaties
(e) Development of face and the pharyngeal arches and the associated congenital anomalies.

III.C Human Genetics

(a) Cell, cell division, mitosis and meiosis, nucleus, DNA, chromosomes, classification, karyotype,chromosomal aberrations (Klinefelter, Turner and Down’s Syndrome) Prenatal diagnosis for congenital abnormalities, sex determination.

(b) Pedigree chart, pathogenesis of chromosomal aberrations and their effects, recombinant DNA,genetic inheritance, genetic counselling, inborn errors of metabolism.

PRACTICALS

Gross Anatomy

Upper Limb: Dissection: Pectoral and scapular, axillary and shoulder region, arm, forearm.

Prosected parts: Joints, Palm and dorsum of hand.

Thorax : Dissection: Chest wall, mediastinum, pleura, lungs, heart.

Abdomen: Dissection: Anterior abdominal wall and inguinal region, external genitalia.

Viscera and Posterior

Abdominal wall and nerve plexus.

Pelvis: Dissection : Pelvic viscera, blood vessels and nerves.

Prosected Parts: Perineum including ischio-rectal fossa.

Lower Limb: Dissection: Gluteal region, front and back of thigh popliteal fossa, front back and lateral side of leg and dorsum of foot.

Prosected Parts: Sole of the foot and joints

Head & Neck: Dissection: Superficial and deep dissection of face and neck, orbit and eye ball.

Submandibular region temporal and infratemporal fossa, cranial cavity, naso and oropharyngeal regions.

Ear,. Larynx and pharynx.

Neuro Anatomy

Gross specimen of full brain, meninges, spinal cord, prosected specimens to demonstrate visual system, auditory and vesibular pathways and major functional areas.

Stained sections of brain and spinal cord at various levels to demonstrate cranial nerve nuclei, ascending and descending tracts, thalamic nuclei and important functional areas.

Demonstrations

– Bones of skull and vertebral column
– Brain and spinal cord
– Cross-sectional anatomy
– Radiological anatomy
– CT and MRI scan

Microscopic Anatomy

– Routine and special stained slides of all the tissues and organs of body.
– Electronmicrographs to demonstrate filtration barrier of kidney, alveolar septum, tight junctions of capillaries and such relevant areas.

Developmental Anatomy

– Models to demonstrate various stages of early foetus and different organ development.
– Slides of ovary and testis to show follicles and stages of maturation of spermatozoa: early chick and
pig embryos to understand the development of tissues and organs from conception till term.

Genetics

Demonstration of normal karyotype and common abnormal conditions including banding; Pedigree
chart, syndromes and their clinical phenotype. Demonstration of various new techniques such as FISH.

Skills

  1. Demonstrate surface markings of important organs.
  2. Localise important pulsation and the structures against which pressure can be applied in case of
    bleeding from a particular artery.
  3. Demonstrate muscle testing and movements at joints.
  4. Locate sites for : Lumbar puncture, sternal puncture, pericardial tapping, liver biopsy.
  5. Locate veins for venae puncture.
  6. Locate the site for emergency tracheostomy.
  7. Locate the subcutaneous positions of large veins.

LIST OF BOOKS RECOMMENDED

I. Gross Anatomy

  1. Cunningham’s Manual of Practical Anatomy G.L.Romanes
    Vols.I, II & III Oxford University Press, 15th edition (1996)
  2. Clinical Anatomy for Medical Student, 6th Edition R.S. Snell
  3. Text book of Human Osteology, Jaypee Brothers, I.B.Singh
    Medical Publishers.

II. Histology

  1. Histology : A text & atlas, 3rd edition (1995), M.H. Ross, E.& L.J
    Williams & Wilkins Romell, G.I. Kaye
  2. Atlas of Histology with functional correlation. Di Fiore’s
    International Edition 9th (2000).
  3. Textbook of Human Histology (4th Edition) Inderbir Singh
    Jaypee Brother, 2002.

III. Developmental Anatomy

  1. Medical Embryology, 8th Edition Williams & Wilkins Jan Langman

IV. Neuroanatomy

1. The Human Nervous System : An Anatomical Murray L Barr & Keirman
View Point, 7th Edition, 1998. Harper & Row

  1. Neuroanatomy : An Illustrated Color Text, AR Crossman and
    2nd Edition, 2000 D Neary Churchill Livingstone
    V. 1. Surface and Radiological Anatomy, 1st Edition, A.Halim
    1998, CBS Publishers.

VI. Genetics

  1. Thomson and Thomson
    Genetics in Medicine, 6th Edition, 2001 Robert L.Nussbaum
    W.B.Saunders Company Roderick R.Mc.Innes Huntington E.Willard

Contents of Human Histology by Inderbir Singh

Chapter-01 Cell Structure

Chapter-02 Epithelia

Chapter-03 Glands

Chapter-04 General Connective Tissue

Chapter-05 The Blood and the Mononuclear Phagocyte System

Chapter-06 Cartilage

Chapter-07 Bone

Chapter-08 Muscle

Chapter-09 Nervous Tissue

Chapter-10 The Cardiovascular System

Chapter-11 Lymphatics and Lymphoid Tissue

Chapter-12 Skin and its Appendages

Chapter-13 Respiratory System

Chapter-14 Oral Cavity and Related Structures

Chapter-15 Oesophagus, Stomach and Intestines

Chapter-16 The Liver and Pancreas

Chapter-17 The Urinary Organs

Chapter-18 The Male Reproductive Organs

Chapter-19 The Female Reproductive Organs

Chapter-20 The Endocrine System

Chapter-21 The Eye

Chapter-22 The Ear

Chapter-23 Spinal Cord; Cerebellar Cortex; Cerebral Cortex

Colour Atlas and Practical Guide


Textbook of Clinical Neuroanatomy Vishram Singh 2nd Edition.

Development of the Nervous System
Organization and Functions of the Nervous System
Peripheral Nerves and Ganglia
Receptors and Effectors
Dermatomes and Muscular Activity
Central Nervous System: An Overview
Spinal Cord
Brainstem
Nuclei, Functional Components, and Distribution of Cranial Nerves
Cerebellum and Fourth Ventricle
Diencephalon and Third Ventricle
Cerebrum
Basal Nuclei (Basal Ganglia)
White Matter of the Cerebrum and Lateral Ventricles
Blood Supply of the Brain
Meninges and Cerebrospinal Fluid
Somatic Motor and Sensory Pathways
Special Senses and Their Neural Pathways
Reticular Formation and Limbic System
Autonomic Nervous System.


Clinical Neuroanatomy and Neuroscience Fitzgerald :

Embryology
Cerebral topography
Midbrain, hindbrain, spinal cord
Meninges
Blood supply of the brain
Neurons and neuroglia: an overview
Electrical events
Transmitters and receptors
Peripheral nerves
Innervation of muscles and joints
Innervation of skin
Electrodiagnostic examination
Autonomic nervous system and visceral afferents
Nerve roots
Spinal cord: ascending pathways
Spinal cord: descending pathways
Brainstem
The lowest four cranial nerves
Vestibular nerve
Cochlear nerve
Trigeminal nerve
Facial nerve
Ocular motor nerves
Reticular formation


Cunningham’s Manual of Practical Anatomy VOL 1 Upper and Lower limbs 16th Edition

Part 1 Introduction
1. General introduction

Part 2 The upper limb
2. Introduction to the upper limb
3. The pectoral region and axilla
4. The back
5. The free upper limb
6. The shoulder
7. The arm
8. The forearm and hand
9. The joints of the upper limb
10. The nerves of the upper limb
11. MCQs for part 2: The upper limb

Part 3 The lower limb
12. Introduction to the lower limb
13. The front and medial side of the thigh
14. The gluteal region
15. The popliteal fossa
16. The back of the thigh
17. The hip joint
18. The leg and foot
19. The joints of the lower limb
20. The nerves of the lower limb
21. MCQs for part 3: The lower limb

Cunningham’s Manual of Practical Anatomy VOL 2 16th Edition :

Part 1 Introduction
1. Introduction to the trunk

Part 2 The thorax
2. Introduction to the thorax
3. The walls of the thorax
4. The cavity of the thorax
5. The joints of the thorax
6. MCQs for part 2: The thorax

Part 3 The abdomen
7. Introduction to the abdomen
8. The anterior abdominal wall
9. The male external genital organs
10. The lower back
11. The abdominal cavity
12. The diaphragm
13. The posterior abdominal wall
14. MCQs for part 3: The abdomen

Part 4 The pelvis and perineum
15. Introduction to the pelvis and perineum
16. The perineum
17. The pelvic viscera
18. The pelvic wall
19. MCQs for part 4: The pelvis and perineum

Part 5 The trunk
20. Movements of the trunk and muscles involved in bodily functions
21. Cross-sectional anatomy of the trunk.