SECTION – I(Course Content
HEAD AND NECK
Schedule1.
POSTERIOR TRIANGLE OF THE NECK.Lecture: 02 hrs
Dissection/ Prosection: 10 hrsTutorials: 01 hr
LECTURES:
Triangles of the neck. Cervical fascia.
DISSECTION/ PROSECTION:
Identification of relevant skeletal features:temporal bone mastoid processmandible angle; lower border; symphysis menti.sternum jugular notch.clavicle medial end; shaft; lateral end.Subcutaneous structures: platysma, external jugular vein; lesser occipital nerve; great auricular nerve; transverse cutaneous nerve of the neck;supraclavicular nerves.Deep fascia:investing layer forming roof of the posterior triangle; prevertebral fascia; axillary sheath.Muscles: sternomastoid; trapezius; inferior belly of omohyoid; scalenus anterior; scaleenus medius; levator scapulae; splenius capitis;semispinalis capitis.Nerves: accessory nerve; brachial plexus: roots, trunks, dorsal scapular; nerve to subclavius; suprascapular; long thoracic; cervical plexus;cutaneous branches; phrenic nerve.Arteries: occipital; transverse cervical; suprascapular; subclavian;.Veins: suprascapular; transverse cervical; anterior jugular; subclavian.Lymph nodes: superficial cervical nodes along the external jugular vein.Surface anatomy: accessory nerve; external jugular vein.Applied anatomy: injury to roots and trunks of brachial plexus.
TUTORIAL TOPICS FOR THE WEEK Relevant osteology. Relevant radiological anatomy. Relevant living anatomy. Relevant crosssectional anatomy.
Schedule2.ANTERIOR TRIANGLE OF THE NECK.
Lecture: 04 hrsDissection/ Prosection: 10 hrs
Tutorials: 01 hr LECTURES:
Oesophagus Trachea Thyriod and parathyroid Carotid arteries
DISSECTION/ PROSECTION:Identification of relevant skeletal features:Occipital bone superior nuchal line; temporal bone mastoid process; mandible lower border, symphysis menti; hyoid bone body, lesser andgreater cornua; thyroid cartilage thyroid notch, oblique line; cricoid cartilage arch; trachea cartilaginous rings; manubrium sterni jugularnotch.Subcutaneous structures: platysma; anterior jugular vein; cervical branch of facial nerve; transverse cutaneous nerve of neck; submentallymph nodes.Deep fascia cervical fascia investing layer, pretracheal, prevertebral; carotid sheath.Ligaments: median thyroid; cricothyroid; cricotracheal.Glands: parotid; thyroid; parathyroid.Trachea: cervical part.Oesophagus: cervical part.Muscles: strenomastoid; digastric; mylohyoid; levator glandulae thyroidea; strnohyoid; superior belly of omohyoid; sternothyroid; thyrohyoid;
cricothyroid; inferior constrictor of pharynx.Nerves: external laryngeal; internal laryngeal; recurrent laryngeal; hypoglossal; ansa cervicalis; vagus; sympathetic trunk. Arteries: common carotid; internal carotid;external carotid; superior thyroid; lingual; facial; occipital; posterior auricular; inferior thyroid;thyroidea ima.Veins: internal jugular; superior thyroid; middle thyroid; inferior thyroid; brachiocephalic.Lymph nodes: anterior cervical; jugulodigastric; juguloomohyoid.Surface anatomy: thyroid gland; comon carotid artery.Applied anatomy: tracheostomy; laryngostomy.
TUTORIAL TOPICS FOR THE WEEK Relevant osteology. Relevant radiological anatomy. Relevant living anatomy. Relevant crosssectional anatomy.
Schedule3.FACE AND SCALP.
Lecture: 01 hrsDissection/ Prosection: 10 hrs
Tutorials: 01 hr
LECTURES:
Scalp and face blood supply, nerve supply & applied anatomy.
DISSECTION/ PROSECTION:
Face Identification of relevant skeletal features: nasal bone root of nose; maxilla body, processes, infraorbital foramen; zygomatic bone arch,zygomaticoorbital, zygomaticofacial and zygomaticotemporal foramina; mandible ramus, angle, body, symphysis, mental foramen.Subcutaneous structures: palpebral branch of the lacrimal; infratrochlear; external nasal; infraorbital; zygomaticofacial; buccal; mental andgreat auricular nerves.Muscles: orbicularis oculi; orbicularis oris; buccinator and other muscles of facial expression.Nerves: temporal; zygomatic; buccinator; mandibular and cervical branches of facial nerve.Arteries: facial; transverse facial; buccal; infraorbital branches of maxillary artery.Veins:facial and transverse facial veins.Surface anatomy: parotid duct; facial artery (pulse).Applied anatomy: scalp wounds; 'dangerous area' of scalp. Scalp Identification of relevant skeletal features:1.skull vault and base; 2.individual bones frontal, parietal, temporal, occipital;3.sutures sagittal, coronal, lambdoid; 4. meeting point of thesesutures bregma, lambda, pterion and asterion; 5.eminences frontal, parietal; 6.landmarks nasion, superior orbital margins, supraorbital notch;temporal lines; mastoid process; inion; external occipital protruberance; superior nuchal line; 7. Emissary veins parietal; mastoid; condylar etc.,Subcutaneous structures: supratrochlear nerve and vessels; supraorbital nerve and vessels; zygomaticotemporal nerve and superficialtemporal vessels; great auricular nerve; lesser occipital nerve; greater occipital nerve and vessels; third occipital nerve; posterior auricularvessels.Deep fascia:temporalis fascia.Muscles: occipitofrontalis muscle; epicranial aponeurosis.Nerves:posterior auricular artery and temporal branch of facial.Lymph nodes:occipital; mastoid.Applied anatomy:scalp wounds; 'dangerous area' of scalp.
TUTORIAL TOPICS FOR THE WEEK Relevant osteology. Relevant radiological anatomy. Relevant living anatomy. Relevant crosssectional anatomy.
Schedule4.
CRANIAL CAVITY.Lecture: 02 hrs
Dissection/ Prosection: 10 hrsTutorials: 01 hr
LECTURES:
Dural venous sinuses, cavernous sinus; internal jugular vein. Pituitary gland.
DISSECTION/ PROSECTION:
Identification of relevant skeletal features: skull vault; inner and outer tables; diploe. Anterior cranial fossa: ethmoid bone cribriform plate; crista galli; frontal bone frontal crest, orbital plates; sphenoid bone jugum
sphenoidale, lesser wing; anterior clinoid process; foramina olfactory, anterior and posterior ethmoidal; optic canal; foramen caecum. Middle cranial fossa: sphenoid bone body, sella turcica, dorsum sellae,
posterior clinoid process, basisphenoid, groove for cavernous sinus, greater wing; temporal bone superior surface of petrous part, squamous part,groove for posterior branch of middle meningeal artery and vein; foramina superior orbital fissure, foramen rotundum, canaliculus innominatus,foramen lacerum, foramen ovale, foramen spinosum, hiatuses for greater and lesser petrosal nerves.
Posterior cranial fossa: temporal bone posterior surface of petrous part,squamouspart, mastoid part; groove for sigmoid sinus; occipital bone groove for superior sagittal sinus, internal occipital crest, groove fortransverse sinus; parietl bone posteroinferior angle, groove for sigmoid sinus; foraminainternal acoustic meatus, jugular foramen; hypoglossalcanal, foramen magnum.
Dural folds: falx cerebri; falx cerebelli; tentorium cerebelli; diaphrgma sellae;cavum trigeminale.
Dural venous sinuses: superior sagital sinus, inferior sagittal sinus, straight sinus, occipital sinus, sphenoparietal sinus, cavernous sinus,superiior petrosal sinus, inferior petrosal sinus, transverse sinus, sigmoid sinus.Emissary foramina: foramen caecum; emissary sphenoidal foramen; parietal foramen; mastoid foaren; condylar canal.
Cranial nerves: olfactory; optic, oculomotor; trochlear; trigeminal; abducent; facial;vestibulocochlear; glossopharyngeal, vagus; accessory; hypoglossal.Arteries: middle meningeal (extradural); internal carotid and its branches.Surface anatomy: middle meningeal artery.Applied anatomy:subdural and extradural haemorrhage; fracture of base of skull.
TUTORIAL TOPICS FOR THE WEEK Relevant osteology. Relevant radiological anatomy. Relevant living anatomy. Relevant crosssectional anatomy.
Schedule5.ORBIT AND LACRIMAL APPARATUS.
Lecture: 03 hrsDissection/ Prosection: 10 hrs
Tutorials: 01 hr LECTURES:
Lacrimal apparatus. Extraocular muscles: innervation and action. Ciliary ganglion; superior orbital fissure.
DISSECTION/ PROSECTION:
Identification of relevant skeletal features:1. bony orbit axis; 2. Medial wall frontal process of the maxilla; lacrimal; orbital plate of ethmoid; body of the sphenoid; 3. Floor zygomatic;maxilla; orbital process of palatine; 4. Lateral wall zygomatic; greater wing of sphenoid; 5. roof orbital plate of the frontal; lesser wing of thesphenoid; 6. Openings optic canal; superior orbital fissure; inferior orbital fissure; infraorbital foramen; supraorbital notch or foramen;nasolacrimal canal; anterior ethmoidal foramen; zygomaticoorbital foramen.Fossa for lacrimal gland; Whitnall's tubercleFascia bulbi: check ligaments; suspensory ligament.Extraocular muscles: levator palpebrae superioris; superior rectus; inferior rectus; medial rectus; lateral rectus; superior oblique; inferioroblique.Nerves: optic; ophthalmic division of trigeminal; oculomotor; trochlear; abducent; zygomatic; infraorbital.Ciliary ganglion.Arteries: ophtahlmic artery and its branches.Veins: superior and inferior ophthalmic.Lacrimal apparatus:Lacrimal gland; lacrimal ducts; conjunctival sac; lacus lacrimalis; lacrimal punctum; lacrimal canaliculus; lacrimal sac; nasolacrimal duct;nasolacrimal fold.Surface anatomy: supraorbital foramen; infraorbital foramen.Applied anatomy: spread of infection to cavernous sinus; occlusion of central artery of retina; lesions of oculomotor, trochlear and abducentnerves.
TUTORIAL TOPICS FOR THE WEEK Relevant osteology.
Relevant radiological anatomy. Relevant living anatomy. Relevant crosssectional anatomy.
Schedule6.PAROTID AND INFRATEMPORAL FOSSA.
Lecture: 03 hrsDissection/ Prosection: 10 hrs
Tutorials: 01 hr LECTURES:
Parotid gland and seventh cranial nerve. Temporomandibular joint Maxillary artery.
DISSECTION/ PROSECTION: Parotid and infratemporal regions Identification of relevant skeletal features:1. mandible body; mylohyoid and groove; mental foramen; angle; ramus;
condylar process (head, neck); pterygoid fovea; coronoid process;mandibular notch; lingula; mandibular foramen.
2. temporal bone squamous; petromastoid; tympanic plate; styloid process;zygomatic process; external acoustic meatus; mastoid process;stylomastoid foramen; squamotympanic and petrotympanic fissures; mandibular fossa; articular tubercle; postglenoid tubercle.
3. sphenoid bone greater wing; infratemporal crest; lateral and medial pterygoid plates;scaphoid fossa; spine; formaen ovale; foramen spinosuum;emissary sphenoidal foramen.
4. Maxilla tuberosity; posterior surface. Pterygomaxillary fissure; pterygopalatine fossaDeep fascia: capsule of the parotid gland.Ligaments: stylomandibular; sphenomandibular.Parotid gland: surfaces and relations; duct; facial nerve and branches; retromandibular vein; external carotid artery; lymph nodes; nerve supplyto the gland.Muscles: masseter; temporalis; pterygoids.Nerves: mandibular and branches; chorda tympani; maxillary and branches.Arteries: maxillary artery and branches.Veins: pterygoid plexus.Surface anatomy: parotid duct.Applied anatomy: facial palsy; parotid infections; parotid tumours. Temporomandibular Joint:Muscles in relation to the capsule: lateral pterygoid.Capsule:attachments.Ligaments: lateral ligaments.Accessory ligaments: sphenomandibular; stylomandibular.Intraarticular structures: articular disc.Synovial membrane:reflection.Movements: protraction, retraction; elevation, depression; side to side movements.Nerve supply: auriculotemporal nerve.Blood supply: superficial temporal artery.Applied anatomy:dislocation; mandibular nerve palsy.
TUTORIAL TOPICS FOR THE WEEK Relevant osteology. Relevant radiological anatomy. Relevant living anatomy. Relevant crosssectional anatomy.
Schedule7.SUBMANDIBULAR REGION AND DEEP DISSECTION OF THE NECK.
Lecture: 02 hrs
Dissection/ Prosection: 10 hrsTutorials: 01 hr
LECTURE:
Submandibular gland, sublingual gland; innervation. Lymphatic drainage of the head and neck.
DISSECTION/ PROSECTION:
Submandibular region. Identification of relevant skeletal features:1. mandible lower border; digastric fossa; superior and inferior mental spine.2. hyoid bone body, lesser and greater cornua.3. temporal bone mastoid and styloid processes; mastoid notch.Ligaments: stylohyoid ligament.Submandibular gland:surfaces; relations; duct; nerve supply.Muscles: digastric; mylohyoid; hyoglossus; genioglossus; geniohyoid; styloglossus; middle and supoerior constrictors of the pharynx.Nerves: lingual; inferior alveolar; facial; glosspharyngeal; hypoglossal; submandibular ganglion.Arteries: facial, lingual.Veins: facial; common facial; retromandibular.Surface anatomy: facial artery.Applied anatomy: salivary calculi; veins and lymph nodes in relation to submandibular gland. Deep Dissection of the neck. Identification of relevant skeletal features:cervical vertebra transverse processes, foramen transversaria;first rib neck, shaft, scalene tubercle.Deep fascia: prevertebral.Muscles: sternomastoid; scalenus anterior; scalenus medius and posterior; rectus capitis anterior; rectus capitis lateralis; longus colli; longuscapitis.Nerves: glosspoharyngeal; vagus; accessory; hypoglossal; synpathetic trunk; cervical plexus.Arteries:common carotid; internal carotid; external carotid; subclavian; vertebral.Veins:internal jugular; subclavian; brachiocephalic; vertebral.Lymphatic ducts: thoracic; right lymphatic.Surface anatomy: apex of lung and pleura; carotid arteries; subclavian artery; accessory nerve.Applied anatomy: fascial spaces of the neck; jugular venous pulse; vertebrobasilar insufficiency; thoracic duct at the root of the neck.
TUTORIAL TOPICS FOR THE WEEK Relevant osteology. Relevant radiological anatomy. Relevant living anatomy. Relevant crosssectional anatomy.
Schedule8.DEEP STRUCTURES OF THE BACK OF THE NECK AND TRUNK.
Lecture: 02 hrs
Dissection/ Prosection: 10 hrsTutorials: 01 hr
LECTURE:
Joints of the vertebral column atlantooccipital, atlantoaxial. Joints of the vertebral coulmn joints between vertebral bodies.
DISSECTION/ PROSECTION: Deep dissection of the back. Identification of relevant skeletal features:Occipital bone superior and inferior nuchal lines; foramen magnum, temporal bone mastoid process;vertebral column atlas (posterior tubercle, posterior arch, transverse
processes); axis odentoid process, spine, vertebral arch;typical vertebrae spinous process, laminae, transverse processes; sacrum sacral canal; coccyx.
Subcutaneous structures: greater occipital nerve; occipital artery. Deep fascia: thoracolumbar. Ligaments:supraspinous; interspinous; ligamenta flava; posterior atlanto
occipital membrane.Muscles:splenius capitis; semispinalis capitis; rectus capitis posterior major andminor; obliquus capitis posterior major and minor; obliquus capitis superior andinferior; erector spinae.Nerves: suboccipital; dorsal rami of spinal nerves.Arteries: deep cervical; vertebral.Veins: suboccipital plexus.Surface anatomy: transverse process of atlas.Applied anatomy: cisternal puncture. Spinal cord and meninges Coverings: dura mater; arachnoid mater; pia mater and its processes.Spaces: epidural containing vertebral venous plexus; subdural containing lymph;subarachnoid containing cerebrospinal fluid.Spinal cord: anteromedian sulcus; posteromedian fissure; antero and posterolateral fissures; cervical and lumbar enlargements; conus medullaris.Spinal nerves: 31 pairs; rootlets; roots; ganglia; trunk; cauda equina.Arteries: anterior and posterior spinal; spinal branches of intersegmentalarteries.Veins:longitudenal venous channels.Surface anatomy: emergence of spinal nerves in relation to the vertebrae; conusmedullaris.Applied Anatomy: lumbar puncture.
Joints of the skull; Joints of the vertebral Column; Sacroiliac joint. Joints of the skull: sutural joints between the skull bones; primary cartilagenousjoint between basisphenoid and basiocciput; peg and socket joints betweenteeth and alveolar margins.Joints of the vertebral column: secondary cartilagenous joints betweenvertebral bodies; synovial joints between atlas and occiput; synovial jointsbetween odontoid process of axis and atlas; synovial joints between the articularprocesses of the adjacent vertebrae.Ligaments: atlantooccipital membranes; membrana tectoria; cruciate ligament;transverse ligament of the atlas; apical; alar.Sacroiliac joint: synovial type.Ligaments: ventral, dorsal and interosseous sacroiliac ligaments; iliolumbar;sacrotuberous; sacrospinous.
TUTORIAL TOPICS FOR THE WEEK Relevant osteology. Relevant radiological anatomy. Relevant living anatomy. Relevant crosssectional anatomy.
SPECIAL LECTURES/ PROSECTIONSDEMONSTRATIONS.
( Each topic of two hours duration )Total: 12 hrs
1. Nasal cavity and paranasal air sinuses 4. Larynx2. Oral cavity; tongue; tonsil. 5. Eye3. Soft palate and pharynx. 6. Ear external & middle.
SECTION – II(Course Content under Level – I, II, III)
LECTURESOUTLINE OF LECTURES
S.No TOPIC MUST KNOW SHOULD KNOW COULD KNOW
1. SCALP 1. Layers: Skin,Connecttive
tissue (superficial fascia& deep fascia),Apopneurotic layer,Loose connective tissueand Periosteum.
2. 2. Contents of connectivetissue layer: vessels,nerves
3. Lymphatic drainage4. a. Applied anatomy: Sebaceous cysts Closed woundspainful Open wounds bleedprofusely Emissary veins Blackeye Sfaety valvehaematoma
5. b. Applied
anatomy: Invertedflame shaped Haemorrhage Cephalohaematoma
2. CERVICAL FASCIA 1. Components Generalinvesting layer,pretracheal layer,prevertebral layer
2. General investing layer horizontal extent, verticalextent(cranial and caudalattachments), features
3. Pretracheal layer horizontal extent, verticalextent and features
4. Prevertebral layer horizontal extent, verticalextent, features
5. Axillary sheath
fascial spaces6. a. Ligament of
Berry
6. b.. Cold Abscess,other abscesses
3. POSTERIOR TRIANGLE 1. BoundariesAnterior,Posterior, Base Apex,Roof, Floor
2. Subdivisions occipital,omoclavicular
3. Contents4. Applied4a. Compression ofsubclavian artery to stop bleeding in upper limb4b. Wry neck
4c. Air embolism
4d. Phrenic crush4e. Acessoryphrenic nerve
4. ORBIT
1. Extrinsic muscles Recti/Obliques / LPS (Origin,insertion, nerve supply LR6SO4/3) Actions ofmuscles
2. Movement of eyeball in 3axis Vertical adduction/abductionHorizontalelevation/depressionApIntorsion/ExtorsionMuscles causing thesemovements
3. a. Applied Anatomy
3. b. Stability of
eyeVertical suspensory ligAPbonyattachment ofRecti, orbital fat,forward pull ofObliques
5. LACRIMAL APPARATUS 1. Components Lacrimalgland, ducts, conjunctivalsac, Lacrimal puncta,canaliculi and sac,nasolacrimal duct 4. Nerve supply of lacrimalgland
1. Parts of lacrimal
gland andrelation to LPS
2. Flow of lacrimalfluid
6. THYROID GLAND 1. Components lobes,isthmus
2. Isthmus Extent,surfaces & borders,Relations, Capsules(trueand false), Blood
4a. Pyramidal lobe
supply(superior thyroid,inferior thyroid artery,relation to the nerves)venous drainage(superior, middle andinferior thyroid veins),nerve supply, lymphdrainage
5a. Applied AnatomyPertaining to posteromedialborderThyroidectomy beforeremoval and during removal
4b. Levatorglandulae thyroidae 5b. Ligament ofberry Venous plexus Thyroidea ima Twigs fromOesophageal and trachealbranches Vein of Kocher
6. Synthesis ofthroxine and itsregulation
7. PAROTID
1. Situation2. Shape3. Extent sup, inf, ant, post4. Borders sup, ant, post,
med5. Surfaces sup,
superficial,medial(anteromedial,postermedial)
6. Relations structuresembedded in parotid lymph nodes,retromandibular vein,external carotid artery,fascial nerve
8. Capsules9. Parotid duct size, lumen,opening10. Blood supply11. Nerve supply(oticganglion)12. Applied anatomy Painful swelling(swellingaffects opening of mouth,parotidectomy incisionparallel to zygomaticbone(preserve VII nerve)Parotid abscess
7.Parotid space structures in depth ofparotid space 13. Development
8. TEMPORAL ANDINFRATEMPORALREGION
1. Muscles (Temporalis,Masseter)
Attachments &Actions2. Boundaries3. Contents
a. Superficial Pterygoidmuscles, pterygoidvenous plexus,Sphenomandibularligament, maxillaryartery
b. Deep mandibularnerve, cauda tympani,otic ganglion
c. Origin, insertion andactions of muscles
4. Mandibular nerve course, relations and branches
4. Branches of
maxillary artery5. Cauda tympani6. Otic ganglion connections and branches
5. # spine ofsphenoid
9. JUGULAR VEINS
1. Formation2. Course3. Relations4. Tributaries
5. Applied anatomy
Queckenstedt'stestJugular venouspressure
6. Anterior andOblique Jugularveins
10. TEMPEROMANDIBULARJOINT
1. Classification2. Articular surfaces3. Capsules and ligaments capsules Lateral ligament Sphenomandibularligament
Stylomandibularligament4. Articular disc5. Synovial membrane6. Blood supply7. Nerve supply8a. Movements9. Applied Anatomya. Dislocation
8b. Sequence ofmovements foropening of mouth 9b. Treatment ofdislocation
10. Stability of TMjoint
11. TONGUE 1. Functions2. Components root, body,
inferior surface, dorsalsurface(Anterior 2/3rd ,posterior 1/3rd )
3. Muscles: a. extrinsic4. Blood supply arterial /
venous5. Nerve supply motor,
general sensory supply,taste sensations,proprioception
6. Lymphatic drainage7. Applied anatomy Tongue pulled anteriorly toprevent choking Pulled anteriorly to preventbleeding Paralysis of XII nerve
3. b. Muscles:intrinsic
8. Carcinoma
tongue operation9. Alternate taste
pathway
12. SUBMANDIBULAR REGION
1. Boundaries2. Contents3a. Submaxillary salivaryglands Extent, components (superficial and deep)Relations of the threesurfacesWharton's ductBlood supply3b. Nerve supplySubmandibular ganglion
13. PHARYNX 1. Introduction2. Communicates with oral
cavity, nasal cavity andlaryngeal cavity
3. Relations4. MusculatureLongitudinal Stylopharyngeus Palatopharyngeus SalpingopharyngeusCircular musclesConstrictors( superior, middleand inferior )Blood supply arterial,venousNerve supply motor,sensory6. Interior (oropharynx,Nasopharynx, and Laryngopharynx) Piriform fossa
5. Origin, Insertion
and parts ofconstrictors
8. a. Appliedanatomy:
7. b. Appliedanatomy Space of Morgagni KillianJamison space Pharyngealdiverticula
14. PALATE
1. Introduction and function2. Features
Anterior or oral surfaceBorders
3. Muscles of soft palate Tensor palati Levator palati Palatoglossus Palatopharyngeus6. Blood supply arterial and
venous7. Nerve supply Motor,
Sensory(Generalsensations and taste
3. Origin, Insertionand actions ofmuscles of softpalate
sensations), Secretomotor supply
8. a. Applied anatomy :Cleft palate
9. b. Appliedanatomy:
Process ofdegluttition
Passvant’s ridge
15. PALATINE TONSIL 1. Waldeyers' ring2. Features 2 poles, 2
borders and 2 surfaces 3. Blood supply arterial and
venous4. Nerve supply5. Applied anatomy
Tonsillitis, tonsillectomy
2a. Surface relations
5b. Care duringtonsilectomy
16. LARYNX
3. Components Cartilages
LigamentsMusclesMembranesVocal cordsVestibular foldsRima glottides
3b. Joints formed by thecartilages 5. Muscles Extrinsic andintrinsic 7. Blood supply8. Lymphatic drainage9. Nerve supply10. Funcional considerations10. Applied anatomyDiphtheriaTracheostomyCadaveric positionDamage to recurrentlaryngeal nerve
3a. Cartilages Unpaired epiglottis, thyroid, cricoid Paired Arytenoid, Corniculate,cuneiforms 4. LigamentsExtrinsic Medianthyrohyoid Ligament Lateral thyrohyoid Thyroepiglottic Hyoepiglottic Cricotracheal lig.Intrinsic Mediancricothyroid Lateral cricothyroid Cricovocalmembrane 6. Origin, Insertion,Direction of musclefibres and action ofinstrinsic muscles
1. Size: Male,female
17a. EXTERNAL EAR 1. Components Pinna,External Acoustic meatus
3. External acoustic meatus Length Two parts Direction Lining Tympanic membrane4. Blood supply5. Nerve supply
2. Pinna: Parts ofpinna, structure andnerve supply
17b. MIDDLE EAR
1. Boundaries ant wall, postwall, medial wall, lateralwall, roof, floor 4. Ossicles Malleus, Incusand stapes
2. Features seen at theboundaries 5. Muscles TensorTympani andstapedius
3. Applied anatomy Otitis media Infection ofmiddle ear in children Meningitis
18. HYPOGLOSSAL NERVE 1. Nerve components2. Nucleus 3. Course
IntraneuralIntracranialExtracranial
4. Branches meningeal andmotor
2a. Location ofNucleus
Tympanic Branches Nerve toStylopharyngeus Carotid sinus branch Pharyngeal branch Tonsillar branch
5. AppliedThrombosis ofanterior spinalartery care of XIInerve duringoperation andlingual artery
19. GLOSSOPHARYNGEAL NERVE
1.Components2. Nuclei 3. Course
IntraneuralIntracranialExtracranial
4. Branches Tympanic Branches Nerve toStylopharyngeus Carotid sinus branch Pharyngeal branch Tonsillar branch
2a. Position of Nuclei
5. Applied anatomy Eagles' syndrome
20. FACIAL NERVE
1. Nerve components2. Nuclei 3. Course Intraneural Intracranial (Motor rootand sensory root greater superficial petrosaland chorda tympani) Extracranial 4. Branches
2a. Position of Nuclei
5. Applied AnatomySupranuclear leisonNuclear lesionInfranuclear lesion
21. OCULOMOTOR NERVE 1. Nerve Components2. Nuclei 3. Course Intraneural Intracranial Extracranial 4. Branches5b. Light reflex,Accomodation reflex, ArgyllRobertson's pupil
2a. Position ofNucleus2b. Components ofnucleus
5a. AppliedAnatomy weber'ssyndrome
22. ABDUCENT &TROCHLEAR
1. Nerve components2. Nuclei 3. Course intraneural ,
intracranial andextracranial
4. Muscles supplied by the
nerves
2a. Position of Nuclei
5. Applied anatomy Paralysis ofmuscles supplies squint / Diplopia
23. DURAL VENOUSSINUSES
1. Difference between veinsand sinuses
2. ClassificationUnpaired Superiorsagittal, Inferior sagittal,straight sinus, occipitalsinusPaired Sphenoparietal,cavernous, superiorpetrosal sinus, inferiorpetrosal sinus, transversesinus, sigmoid sinus
3. Flow of blood in sinuses4. Covernous sinuses
situationFormationExtentSize
5. b. Applied
RelationsTributaries
5. a. Applied anatomy : Dangerous area of face thrombosis ofcavernous sinus
Anatomy Queckenstedt'stest
24 ANTERIOR TRIANGLEOF THE NECK
1.Boundaries andsubdivisions2.Carotid triangle :Boundaries and contents Carotid arteries 3. Trachea: extent and
relations4. Oesophagus: extent and
relations
4b. Sites ofconstrictions 5. Parathyroids
25HYPOPHYSIS CEREBRI 1. Parts, Location,
Relations2. Blood supply3. Microscopic structure4. Development
5. Hormonessecreted
6. Tumours of thepituitary
Hypophysectomy
26 JOINTS OF THE HEADAND NECK
1. Atlanto occipital:Ligamanets, movementsand muscles causingthese movements
2. Atlanto axial:Ligamanets, movementsand muscles causingthese movements
3. Joints between thevertebral bodies
4. Applied anatomy:Spondylosis
SECTION – II(Course Content under Level – I, II, III)
DISSECTIONLearning Objectives of Dissection
S.No
TOPIC
DISSECTIONSTEPS
WHAT IS EXPECTED FROM THE STUDENTS
SUMMARY
LEVEL 1 LEVEL 2 LEVEL 3 IDENTIFY UNDERSTAND 1. SCALP Place a wooden
block under thehead end andraise the head
Make a medianincision in theskin of scalpfrom root ofnose to externaloccipitalprotuberance
Make a coronalincision frommiddle ofmedian incisionto the tragus onboth sides.Continue thisover the auricleto mastoidprocess andzygomatic arch.
Reflect the skinflaps, takingcare not todamage Ns &Vs. insucutaneoustissue
Expose upper
Main layers of
Scalp Skin Dense CT Galea Superficial
temporal Vs Frontal belly of
frontoocipitalis Lateral
attachement ofepicranialaponeurosis
Occipital belly of
frontooccipitalis
Deep layers of
scalp LCT Pericranium Auriculotemporal
N Great auricular N Lesser occipital N
Brs. of
supratrochlearandsupraorbitalNs. & Vs.
Temporal brs.of VII CN
1. Main layers ofscalp2. Musclesfrontalisoccipitalisepicranialaponeurosis3. Nervessupratrochlearauriculotemporal4. Vesselssupraorbitalsupratrochlearsuperficialtemporal
Open woundsof scalp bleedprofusely
Scalp swellingare painful
APPLIED ASPECTS
Sebaceous cysts Clinical importance of mobility of
superficial layers of scalp onpericardium and suturing of scalpwounds
part oforbicularisocculi. Trace &define
Clean andidentify nervesbehind theauricle
Expose ant. partof epicranialaponeurosis.Note itsattachment intotemple onsuperiortemporal line
Defineattachments ofoccipitalis andepicranialaponeurosis onhighest nuchallines.
Epicranialaponeurosis
3rd occipital
N
Incised margins of galeaaponeuotica medicolegalimportance
Dangerous area of scalp andemissary veins
Black eye Traumatic cephalhydrocoele Pedicles of scalp flaps with vessels
and nerves for grafts in plasticsurgery
Clinical testing of VII CN
S.No
TOPIC
DISSECTION
STEPS
WHAT IS EXPECTED FROM THE STUDENTS
SUMMARY
LEVEL 1 LEVEL 2 LEVEL 3 IDENTIFY UNDERSTAND 2 SUPERFICIAL
DISSECTION OFFACE
Make amedianincisionfrom root ofnose to chinandhorizontalincisionfrom anglemouth topost. borderof ramus ofmandible
Reflect skinflaps.Exposemajor facialmusclestaking carenot to cutthroughthem
Pull eyeballlaterally &identify
Detachrisorius andreflect italong withplatysmatowardscorner ofmouth
Exposefacial ofmasseter andnote theirrelations andcourse
Orbicularis
occuli Platysma Depressor
anguli oris Depressor
labiiinferioris
Orbicularisoris
Buccinator Facial artery Facial vein
Zygomaticusmajor &minor
Levator labiisuperioris
Different
parts oforbicularisocculi
Risorius Levator
labii sup.Aleque nasi
Proserusnasalis
Mentalis Medial
palpebrallig. andorbital partoforbicularisocculi
Muscles offacialexpression
Facial artery Facial vein
Embryologicalbasis of cutaneousinnervation of face
Actions of facialmuscle
Bleeding from bothcut ends of artery
APPLIED ASPECTS
Palpation of facial artery Clinical testing of facial muscles &
VII CN Suturing of facial wounds Dangerous area of face
S.No
TOPIC
DISSECTION
STEPS
WHAT IS EXPECTED FROM THE STUDENTS
SUMMARY
LEVEL 1 LEVEL 2 LEVEL 3 IDENTIFY UNDERSTAND 3 POSTERIOR
TRIANGLE Make an
incision from
1. Boundariesand
Deep cervicalfascia
mastoidprocess tosternal end ofclavicle alongthe middle ofSCM
Extend theincisionalong clavicleto itsacromial endand reflectthe skin flapupto anteriorborder oftrapezius.Clean anddefine vesselsand nerves
Clean thesuperficialfascia anddefineattachmentsof SCM onclavicle andsternum
Identify Ns.alongposteriorborder ofSCM
Clean &identify in theroof
Cut throughinvestingfascia aboveclavicle andalongposteriorborder ofSCM andexpose
Clean anddefinemusclesforming floorof posteriortriangle
Clean andidentify thecontents ofposteriortriangle
Accessory N Lymph nodes External
jugular vein Inferior belly
of omohyoid Occipital
triangle Omoclavicular
triangle Accessory N
(entering Tz) Cords of
brachialplexus
Subclavianvein artery
Subclavianvein and entryof EJV
Phrenic nerveover scalenusanterior
Great auricular
N Lesser occipital
N Suprascapular
Ns. Muscular floor
of posteriortriangle
Dorsal scapular
N Long thoracic N
Greater
OccipitalN (at theapex oftriangle)
Tr.
Cervicalartery
N. tosubclavius
subdivisionsof posteriortriangle
2. Structures inthe roof
3. Contents
especiallyinvesting layer
Prevertebralfascia
Brachialplexus cordsentering intopost. triangle
Axillarysheath
APPLIED ASPECTS
Spasmodic torticollis. Injury to accessory nerve during
surgery in posterior triangle Air embolism CVP line Brachial plexus injuries involving Roots Trunks Branches Anatomical basis of cervical rib
syndrome injuries to subclavianartery
Compression of subclavian art.
S.No
TOPIC
DISSECTION
STEPS
WHAT IS EXPECTED FROM THE STUDENTS
SUMMARY
LEVEL 1 LEVEL 2 LEVEL 3 IDENTIFY UNDERSTAND 4. DISSECTION
OF BACK Give a vertical
incisionextendingfrom inion tospine of C,and external itlaterally toacromion,reflect theskin flaps andstudy
Clean andidentifyvessels andnerves
Trapezius Lat. Dorsi Accessory
nerve
Post triangle
from behind Greater
occipital N Occipital
artery
Occipital
branch ofpost.auricularnerve
3rd occipitalN
Branches
from 3rd &
Muscles of back1.Superficiallayer
2.Intermediatelayer
3.Deep layer
Arrangement ofmuscles of back
Actions of thesemuscles
Nerve supply ofmuscles of back
Clean andidentify 1srlayer of backmuscles
Separatetrapezius fromsup. Nuchalline andreflect itlaterally anddivideertically about1cm awayfrom vertebralspines andidentify
Clean andidentify 2ndlayer of backmuscles
Trace Reflect
serratusposteriorsuperiorl
Removethoracic partofthracolumbarfascia toexpose erectorspinae andspleni curvingacross it
Defineattachment ofsplenius &separate itfrom vertebralspine & turn itsuperlaterally& expose.
Levator
scapulae Serratus
posteriorsuperior
Serratusposteriorinferior
Erectorspinae
Spleniuscapitis
Semispinalis Longissimus
muscle Sup.
Obliquecapitis
Dorsal
scapular N
4th cervicalNs.
Superficialbr. of Tr.Cervicalartery
Deep br. ofTr. Cervicalartery
N. supply of
splenius
APPLIED ASPECTS
Muscle spasm
S.No
TOPIC
DISSECTIONSTEPS
WHAT IS EXPECTED FROM THE
STUDENTS
SUMMARY
LEVEL 1 LEVEL 2 LEVEL 3 IDENTIFY UNDERSTAND 5 SUBOCCIPITAL
TRIANGLE Position of
cadaver Remove the
dense fibroustissue from theregion
Clean and tracegreateroccipital N.crossing thetriangle
Clean anddefine themusclesforming theboundaries
Find dorsal
ramus of C1 bytracing back br.to semispinaliscapitis to theramus(between post.
Rectus
capitisposteriormajor &minor
Inferiorobliquecapitis
Superiorobliquecapitis
Vertebral
artery (3rdpart)
Greater
occipital N Doral
ramus ofC1
Suboccipital
venousplexus
Boundaries ofsuboccipitaltriangle
Contents a. Dorsalramus of C1 b. vertebral artery(3rdpart)
Communicationsof suboccipitalvenous plexus
APPLIED ASPECTS
Clinical considerations of suboccipitalvenous plexus
Cisternal puncture
arch of atlas &vertebralartery)
Clean &identify
S.No
TOPIC
DISSECTION
STEPS
WHAT IS EXPECTED FROM THE STUDENTS
SUMMARY
LEVEL 1 LEVEL 2 LEVEL 3 IDENTIFY UNDERSTAND 6 ORBIT Strip
periosteumfrom ant.cranial fossa
Break orbitalplate offrontal boneincludinglesser wingof sphenoid,leavingmargins ofoptic canalintact
Open the sup.Orbitalfissure &trace variousnerves to theorbit
Trace frontalN. on LPS ¬e itsdivisions
Cut frontal N.close to sup..orbitalfissure, LPS& SR andturn themaside
Post. toeyeball, noteloose tissue
Afterreflecting SR,clean, defineand expose
Posteriorlystructurescrossingoptic N.(3)
Defineattachmentsofextraocularmuscles bydiving opticN. close toeyeball &turn itforwardswith eyeball
Expose ¬e
Expose allrectusmuscles &trace
Extraoccularmuscles
LPS SR SO IO MR LR IR Nerves :
Optic Trochlear Abducent Frontal Optic N Ophthalmic
artery Attachments
ofextraocularmuscles oneyeball
Lacrimal
gland Nasocilliary
nerves Lacrimal
nerves Nasocilliary N Two heads of
LR
Ciliary ganglion Supratrochlear
N Supraorbital N Fascial sheath
of eyeball Extension of
sheath overmuscles at theirattachments oneyeball
Sup. Opthalmicvein
Nerves to IO,
IM & MR frominf. div. Of IIICN
1. Extraoccularmuscles2. Cranial Ns IICN IIICN IV CN VI CN Opthalmic
division ofV CN
3. Lacrimalgland4. Ciliaryganglia
Actions ofextraocularmuscles
Ciliary ganglion
APPLIED ASPECTS
Squint Convergent Divergent Ptosis Clinical importance of venous
drainage of orbit Horner's syndrome Accomodation reflex Pulsating eyeball
S.No
TOPIC
DISSECTION
STEPS
WHAT IS EXPECTED FROM THE STUDENTS
SUMMARY
LEVEL 1 LEVEL 2 LEVEL 3 IDENTIFY UNDERSTAND 7 DEEP
DISSECTIONOF FACEINCLUDINGPAROTIDGLAND
Clean &define theparotid gland
Cut facialcovering ofparotid infront ofauricle fromzygomaticarch to angleof mandible
Dissectfasciaforwards tothe marginsof gland &identifyvariousnerves,vessels &ductemerging atthe borders
Trace buccalbranch offacial N. tobuuinator
Clean &identify atupper borderof gland
Clean &identify atlower borderof gland
Clean &identifyvariousbranchesfrom 3 div.Of V CN
After identifyingfacial artery atanteroinf.angleof masseter,trace it towardsmedial angle ofeye & identifyits variousbranches
Parotid gland Parotid duct( 1
finger breadthbelow zygomaticarch) at theant.border ofgland
Superficial
temporal Vs. Auriculotemporal
N Retromandibular
vein Facial artery
Above the duct Tr. Facial Vs Zygomatic
br.of VII CN Below duct,
brs. of VIICN
Buccal Mandibular Cervical Buccinator
muscle Buccal N.
from VII CN Temporal br.
of VII Cervical br.
of VII CN Inf. labial art Sup. Labial
art Angular art
Process of parotid Parotid lymphnodes
Ant. & post.
divisions ofretromandibularvein
V1 supraorbitalsupratrochlear
V2Zygomaticofacialinfraorbital
V3 Buccal N.Mental N.
Last. Nasal art
Parotidgland &duct
Branchesof facial N
SuperficialtemporalVs.
Facial art Facial vein
Secretomotorpathway forparotid gland
Factorsfacilitatingspread ofinfection tocavernoussinus
APPLIED ASPECTS
Parotid swelling Sialoliths Facial N. palsy Cavernous sinus thrombosis Herpes zoster
S.No
TOPIC
DISSECTION
STEPS
WHAT IS EXPECTED FROM THE STUDENTS
SUMMARY
LEVEL 1 LEVEL 2 LEVEL 3 IDENTIFY UNDERSTAND 7Contd
DEEPDISSECTIONOF FACEINCLUDINGPAROTIDGLAND(Continued)
Remove
part ofglandpiecemeal& exposethestructureswithin thegland
Facial vein Common facial
vein Parotid duct Buccinator Trunk of VII CN Post. auricular br.
of VII CN
Post.
auricularart.
Terminal
Supratrochlear
vein Supraorbital
vein Angular vein Deep facial
vein
APPLIED ASPECTS
Facial N Ext. carotid art Retromandibular
vein
brs. ofECAMaxillaryart.Superficialtemporal
Br. of VII CNto post. belly ofdigastric &styloid
S.No
TOPIC
DISSECTIONSTEPS
WHAT IS EXPECTED FROM THE STUDENTS
SUMMARY
LEVEL 1 LEVEL 2 LEVEL 3 IDENTIFY UNDERSTAND 8. ANTERIOR
TRIANGLEOF NECK
Give amidlineincisionfrom chin tosternum andreflect skinflaps
Reflectplatysmaupwards andexpose thedeep fasciafrom ant.Bellies ofdigastrics &areabetweenthem
Removefascia belowhyoid &expose
infrahyoidmuscles Separate
thesemuscles inmidline andexpose
Clean fasciaininfrahyoidregion ¬e
At lowerborder ofmandibleidentify
Clean &define thedigastrictriangle ¬e
Remove fat& fasciabetweenpost. bellyof omohyoidto exposecarotidtriangle
Clean &define theboundariesof musulartriangle
Cut sternal& head ofSCM &expose
Raise sup.Belly ofomohyoid &trace its N.
Boundaries ofant. triangle &its varioussubdivisions
Platysma Digastric ms.
& triangle Mylohyoid Infrahyoid
muscles Laryngeal
prominence Isthmus of
thyroid gland Facial artery
& vein Digastric
triangle Superficial
part ofsubmandibular gland
Boundaries ofcarotidtriangle
CCA, ICA &ECA
IJV IX & XII
nerve Boundaries &
floor ofmusculartriangle
Ant. jugular vein Cerv.br. of VII
Cn Submental
triangle Pretracheal fascia Inf. thyroid veins Jugular arch Submandibular
LN Facial vein Mylohyoid N Branches from
ECA in carotidtriangle
Sup. & Inf. rootof ansa cervicalis
Intermediate
tendon ofomohyoid
Ansa cervicalis
Submental
LN Median
thyrohyoidlig
Levatorglandulaethyroidae
Submentalbr. of facialartery
Submentalartery
Nerves
supplyinginfrahyoidstrap
Intermediate
tendon ofomohyoid
Ansa
cervicalis
1. Boundaries &subdivisionsof ant. triangle
2. MusclessuprahyoidInfrahyoid
3. Vessels CCA,ICA, ECA &its brs. Facialveins IJV
4. Nerves VII,X, XII CNsAnsacervicalis
5. Other struct.Lymph nodesubmandibularsalivary gland
Deep cervicalfascia & itsvariouscomponents
Ansacervicalis
Midlinestructures inthe neck
APPLIED ASPECTS
Carotid pulse Jugular venous pressure
S.No
TOPIC
DISSECTION
STEPS
WHAT IS EXPECTED FROM THE STUDENTS
SUMMARY
LEVEL 1 LEVEL 2 LEVEL 3 IDENTIFY UNDERSTAND 9 DEEP
DISSECTIONOF NECKANDTHYROIDGLAND
Displace SCm& sup. Bellyof OH laterally
Cutsternohyoidnear its lowerend & turn itupwards
Remove fat &fascia fromfront oftrachea
Remove fasciafrom lobes ofthyroid &expose itsblood Vs.
Lift lower partof gland &expose lat.Surface oftrachea &oesophagus
Clean &identify bld.Vs. of thyroid&accompanyingnerves
Lift thyroid &look forparathyroidglands on itsposterioraspect
Removecarotid sheathand exposevagus betweenCCA & IJV.Expose andidentify
Pull scalenusanteriorlaterally &expose
Separate IJV& CCA.Identify post.to them.
Displace CCAlat. & expose
Trace thesympathetictrunkssuperiorly &find
Trachea Thyroid in situ &
study it. Oesophagus Recurrent
laryngeal N.between them
Sup. Thyroid
artery Inf. thyroid
artery Sup. Laryngeal
N. External
laryngeal N. Rec. laryngeal N. Brachiocephalic
veins Branchiocephalic
trunk on rightside only
Subclavian artery Costocervical
trunk Sympathetic
trunk
Remains of
thymus Anastomosis
between sup.& inf.thyroidarteries
Thyroidea ina artery
Middle
cervicalganglion
1. Thyroid gland& its blood Vs.2. Nerves RLNSympathetictrunks3.Vessels brachiocephalicvs. subclavianarterycostocervicaltrunks4. Trachea5. Oesophagus
Pretrachealfascia
Lymphaticdrainage of head& neck
Thoracic duct inneck
APPLIED ASPECTS
Thyroid swellings Anatomical considerations during
thyroid surgery
S.No
TOPIC
DISSECTIONSTEPS
WHAT IS EXPECTED FROM THE STUDENTS
SUMMARY
LEVEL 1 LEVEL 2 LEVEL 3 IDENTIFY UNDERSTAND 10. INFRATEMPORAL
REGION Clean, define
& identify Divide
zygomaticarch ant. &post. toattachment of
Temporal fascia Masseter Temporalis
Neurovascular bundleentering masseter Buccal N & Vs
Muscles ofmastication1. Temporalis2. Masseter3. Lat. &
med.Pterygoid
Actions ofmuscles ofmastication
masseter &turn it downalong with themuscle
Strip masseterfrom surfaceof mandibleupto angle &exposeTemporalis
Separatecoronoidprocess frommandible byoblique cutfrommandibularnotch uptoant. margin oframusmeeting bodyof mandible
Turn coronoidprocess &attachedtemporalisupwards &separatemuscle fibresfrom temporalfossa toexpose
Exposestructures ininfratemporalfossa byremoval ofpart ofmandible asper figure andidentify
Give onehorizontal cutthrough neckof mandible &second abovemandibularforamen.
Remove pieceof bone &exposeunderlyingmuscles,nerves &vessels
Sphenomandibular
lig. Lat. Pterygoid Med.pterygoid Maxillary artery
Deep
temporalN & Vs
Structures
piercing thesphenomandibularlig.
Pterygoid venousplexus
APPLIED ASPECTS
Clinical consideration ofpterygoid venous plexus
S.No
TOPIC
DISSECTION
STEPS
WHAT IS EXPECTED FROM THE STUDENTS
SUMMARY
LEVEL 1 LEVEL 2 LEVEL 3 IDENTIFY UNDERSTAND 11. INFRATEMPORAL
REGION(Continued)INCLUDING T.M.JOINT
Separate twoheads of lat.Pterygoid
Expose theunderlyingstructures atlower borderof lat.Pterygoid
Removeupper head oflat. Pterygoidby detachingit fromcapsule of
Capsule of
T.M. joint Middle
meningealart.
MandibularN. & itsbranches
Lingual N Inf. alveolar
N.
Lat. Ligament ofT.M. Joint
Two roots ofauriculotemporalN.
Acc. Meningealart
AuriculotemporalN (curvingaround med. &post. surface ofjoint capsule).
Articular disc
Buccal N.(betweentwo headsof lat.Pterygoid)
Otherbranches ofmandibularN.
1. Nerves. Mandibular N &its two majorbranches lingualN. inf. alveolarN. chordatympaniAuriculotemporal N.
2. Vesselsmaxillary arterymiddlemeningeal artacc. Meningealart. Inf. alveolarart.
Movements ofT.M. joint
Course &distribution ofmandibular N
Distribution ofchordatympani
Course anddistribution ofmaxillaryartery
T.M. joint &remove itpiecemealfrominfratemporalfossa
Separatelower headfrom lateralpterygoidplate &strip it
Disarticulatehead ofmandiblefrom articulardisc &remove itwithpterygoid &identify
LiftmandibularN. laterally &expose oticganglionmedial to it
Expose tensorpalati medialto MMA &mandibular N
Lift contentsof orbitupwards &medially andexpose
Removeperiosteumfrom orbitalfloor &identify
Exposemandibularcanal byremovingouter table ofbone withchisel &identifystructureswithin canal
Chorda
tympani
Otic gangilon Tensor palati Infraorbital
groove Infraorbital N &
Vs Inf. alveolar N &
Vs
Zygomatic
N. Brs. from
inf. alveolarN
Dental brs. Mental N
APPLIED ASPECTS
Dislocation of T.M. joint. Lingual N. block in tooth extraction Pterion & middle meningeal art Referred pain from diseased tooth Taking care of articular disc and facial
nerve
S.No
TOPIC
DISSECTIONSTEPS
WHAT IS EXPECTED FROM THE STUDENTS
SUMMARY
LEVEL 1 LEVEL 2 LEVEL 3 IDENTIFY UNDERSTAND 12
SUBMANDIBULARREGION &SUBMANDIBULARGLAND
Cut facial
vessels atlower borderof mandible
Detach ant.belly ofdigastric frommandible
Clean &expose post.belly ofdigastric &stylohyoid .
Turnsuperficial partof
Superficial partincludessubmentaltriangle digastrictriangle
Deep partincludes root oftongue floor ofmouth
Facial vessels Both bellies of
digastric Stylohyoid
muscle Submandibular
gland superficialpart
Mylohyoidmuscle
Continuation of
Stylomandibular
lig. Submental art.
Facial nerve Glandular brs.
of facial art N. to
1. Submandibulargland & its bothparts
2. Muscles Both bellies ofdigastricMyohyoidStylohyoidHyoglossusGeniohyoidGenioglossusStyloglossusStylopharyngeusMiddle constrictor
Submandibukarganglion
submandibulargland hookingaround post.free border ofmyohyoid
Dissect &clean facialartery fromdeep surfaceof gland &trace itsbranches
Trace &identify N. tomylohyoid onmylohyoid.
Turn S.M.glandanteriorly &identify
Displace S.M.
gland &submental Vs.posteriorly
Turn ant. bellyof digastricdownwards
deep &superficial partsof gland aroundpost. border ofmylohyoid
Facial art Deep part of
gland Hyoglossus XII CN over
hyoglossus Lingual N
(crossing theuscle at higherlevel)
Submandibularduct
Mylohyoid & itsattachments
mylohyoid Submandibular
ganglionsuspendedfrom lingual N
APPLIED ASPECTS
Submandibular salivary calculi Veins related to submandibular gland
S.No
TOPIC
DISSECTION
STEPS
WHAT IS EXPECTED FROM THE STUDENTS
SUMMARY
LEVEL 1 LEVEL 2 LEVEL 3 IDENTIFY UNDERSTAND 13. SUBMANDI
BULARREGION &SUBMANDIBULARGLAND(Continued)
Take the sagittalsection of the head& neck onalternate table(one in 3 tables) ineach row
After identifyingcut edge ofmylohyoid onmedial surface,separate it fromoverlyinggeniohyoid
Identify plane ofseparationbetweengeniohyoid &genioglossus
Pull tongue awayfrom mandible cutm.m. between it &mandible
Strip m.m fromfloor of mouth &mandible and turnit down andexpose
Trace styloglossusback to styloidprocess andconfirmstylopharyngeuspassing deep tohyoglossus
Below IX CN,identify sup.Border of middleconstrictor & traceit to hyoid bone
Geniohyoid Genioglossus Submandibular
duct Lingual N Hypoglossal N Styloglossus Stylopharyngeus Glossopharyngeal
N Middle constrictor Lingual art Post. part of
Genioglossus Middle constrictor
Sublingual
gland Stylohyoid
ligament Lingual
veins
Deep
lingual vein Dorsal
branches oflingualartery
1. Submandibularduct
2. Nerves XII CNlingual N &SMD ganglionIX CN
3. Arteries facialsubmentallingual
4. Sublingualgland
APPLIED ASPECTS
Detach hyoglossusfrom hyoid & turnit upwards andexpose
S.No
TOPIC
DISSECTIONSTEPS
WHAT IS EXPECTED FROM THE STUDENTS
SUMMARY
LEVEL 1 LEVEL 2 LEVEL 3 IDENTIFY UNDERSTAND 14.
PHARYNX PROSECTION
Removebuccopharyngealfascia from ext.surface ofpharyngealmuscles
Clean & expose
IX CN windinground post.surface ofstylopharyngeus
Clean & definestructures atupper border ofsup. Constrictor
Clean & definestructuresbetween sup. &middleconstrictor
Clean & definestructuresbetween middle& inf.constrictors
Clean & definestructures atlower border ofinf. constrictor
Constrictors ofpharynx sup.Constrictormiddleconstrictor inf.constrictor
Stylopharyngeus IX Cranial
Nerve Levator palati Tensor palati Stylopharyngeus IX CN
Buccopharyngealfascia
Auditory tube Sup. Laryngeal N
& Vessels Recurrent
laryngeal Nerve
Pharyngealplexus of veins
Branch to
stylopharyngeus Ascending
palatine artery Inferior
laryngeal artey
1. MusclespharynxConstrictorsStylopharyngeuspalateLevator palti2. Nerves IX CN Sup.Laryngeal recurrentlaryngealrecurrentlaryngeal3. Vessels: Ascending palatine arteryInferiorlaryngeal artery.
Arrangementofconstrictorsof pharynx
Innervationof pharyngealmuslces &pharyngealplexus
APPLIED ASPECTS
Killian's dehiscence Pharyngeal abcess
S.No
TOPIC
DISSECTION
STEPS
WHAT IS EXPECTED FROM THE STUDENTS
SUMMARY
LEVEL 1 LEVEL 2 LEVEL 3 IDENTIFY UNDERSTAND 15. PHARYNX
(Coninued) ANDSOFT PALATE PROSECTION
In the midsagittal cutspecimen ofhead andneck studythe interior ofpharynx.Strip off itsmucousmembrane toexpose thepharyngealmuscles frommedial slide.
Identify
differentparts ofpharynx, notetheir extent &features
Identify the
Pharyngeal muscles a. Nasopharynxopening of auditorytube b. Oropharynxpalatine tonsil intonsillar fossa c. LaryngopharynxAnt. wall showinglaryngeal inletlat. Wall presentingpiriform fossa Muscles of soft
palate levatorpalatipalatoglossuspalatopharygeusmusculus uvulae
Tubal elevation Salpingopharyngeal
fold Pharyngeal recess Pharyngeal tonsil Palatoglossal arch Palatopharyngeal
arch Aryepiglottic fold Thyrohyoid
membrane IX CN
(anterolateral tostypharyngeus)
Tubal tonsil Bed of tonsil Ascending
palatine art
1. Muscles ofpharynxconstrictors.LongitudinalpalatopharyngeusstylopharyngeusSaplingopharyngeus2. Muscles of softpalateLevator palatiTensor palatiPalatopharyngeus Musculus uvulae3. Palatine tonsil4. Opening ofauditory tube5. Epiglottis6. Laryngeal inlet7. Piriform fossa8. Nerves
Deglutition Blood supply of
palatine tonsil Passavant's
ridge
APPLIED ASPECTS
Dysphagia
soft palate Clean &
define themuscles afterstriping offthe mucousmembrane
Tonsillitis & anatomicalconsiderations in tonsillectomy
Quinsy Removal of foreign bodies from
piriform fossa Embryological basis of cleft palate
S.No
TOPIC
DISSECTIONSTEPS
WHAT IS EXPECTED FROM THE STUDENTS
SUMMARY
LEVEL 1 LEVEL 2 LEVEL 3 IDENTIFY UNDERSTAND 16. NASAL CAVITY
PROSECTION
In the mid
sagitally cutspecimen ofhead &neck,identify nasalseptum
Strip themucousmembranefrom theseptum &expose
Study &
identifyvariousfeatures of lat.Wall of nose
Identifyopenings &features ofmeatuses
Remove ant.part of inf.concha &exposeopening of
TracenasopalatineN. from nasalseptum acrossthe roof ofnasal cavity tosphenopalatineforamen
Breakperpendicularplate ofpalatine andexpose
Nasal septum Vomer Perpendicular
plate of ethmoid Sphenoethmoidal
recess Nasal conchae Meatuses a. Spheno
sph.recessb. Sup. Meatus
post. ethmoidalcells.
c. Middle meatusfrontal air sinusmaxillary & ant.ethmoidal
d. Inf. meatusnasolacrimalduct
Septal
cartilage Vestibule of
nose Atrium of
middle meatus Infundibulum Hiatus
semilunaris Bulla
ethmoidae
Parts ofMaxillaPalatineNasalSphenoid formingnasal septum Mucocutaneous
junction Nasopalatine
N. Greater palatine
1. Nasalseptum &itsformativeconstituents
2. Lat. Wall ofnose & itsfeatures
3. Conchae4. Meatuses
Nerve supply & bloodsupply of Nasal septum Lat. Wall of nose
Pterygopalatineganglion Functional aspects of
paranasal sinuses
APPLIED ASPECTS
Little's area & epistaxis Sinusitis Dacryocyctitis
S.No
TOPIC
DISSECTION
STEPS
WHAT IS EXPECTED FROM THE STUDENTS
SUMMARY
LEVEL 1 LEVEL 2 LEVEL 3 IDENTIFY UNDERSTAND 17. LARYNX
PROSECTION
Study Cut through
sternothyroidupward &define itsattachment tothyroidcartilage
Identifyattachments ofinf. constrictoron thyroid andcricoidcartilages
Larynx in situ Thyroid cartilage &
laryngeal prominencesternothyroidmuscle
Thyrohyond muscle Cricoid cartilage Inf. constrictor Cricothyroid muscle Thyrohyoid muscle
Sup. Thyroid
notch
Cricothyroid
lig.
1. Cartilage2. Membranes
& ligaments3. Larynx and
its variouscomponents
Cricothyroid &cricoarytenoidjoints, theirmovements &muscles causingthem
N. & Bld.Supply of larynx
Lymphaticdrainage oflarynx
Expose inf.contrictor ÷ ithorizontally
Trace inf. hornof the thyroidcartilage to itsarticulationswith cricoidcartilage
Expose Clean and
exposethyrohyoidmuscle
Cut throughthyrohyoidmuscle &expose
On sectionalsurface oflarynx identify
Study theinterior oflarynx
Thyrohyoid memb Sup. Laryngeal Vs. Int. laryngeal N Epiglottis Arytenoid cartilage Vestibule of larynx Vestibular folds Vocal folds Ventricle of larynx
Glossoepiglottic
folds Quadrate lig. Rima vestibuli Rima glottides
Thyrohyoid
lig. Hyoepiglottic
lig. Corniculate
cartilage Tubercle of
epiglottis Saccule of
larynx
APPLIED ASPECTS
Simons law Laryngeal oedema Laryngoscopy Vocal cord palsy
S.No
TOPIC
DISSECTIONSTEPS
WHAT IS EXPECTED FROM THE STUDENTS
SUMMARY
LEVEL 1 LEVEL 2 LEVEL 3 IDENTIFY UNDERSTAND
LARYNX(continued)
Cut vestibularfolds fromupper part ofarytenoidscartilage & stripit forwards fromthe wall oflarynx & notethe underlyingmuscle
Strip mucousmembrane frominf. surface ofvocal fold &expose
Strip mucousmembrane fromsup. Surface ofvocal fold &expose uppersurface of
In the specimenof larynx, clean& identifymuscles
Remove
cricothyroid onone side alonglower part oflamina & inf.horn of thyroidcartilage &expose
Thyroarytenoid Cricothyroid Post.
cricoarytenoid Tr. & oblique
arytenoid
Thyroepiglotticus Conus elasticus Thyroartenoid Thyroepiglotticus Cricothyroid joint
Vocal lig.
1. Muscle of larynx2. Cricothyroid3. Postcricoarytenoid
4. Tr. & obliqueartynoid
5. Lat.Cricoarytenoid
6. Extrinsic musclesacting on larynx
7. Thyrohyoid8. stylopharyngeus9. Palatopharyngeus10. Sternothyroid
APPLIED ASPECTS
SECTION – II(Course Content under Level – I, II, III)
TUTORIALS
LEARNING OBJECTIVES OF TUTORIALSOUTLINE OF TUTORIALS
S.No TOPIC MUST KNOW SHOULD KNOW COULD KNOW
1. ANT. CRANIALFOSSA
1. Boundaries Crista Galli ,Cribriform plate ofethmoid
2. Orbital plate of frontalbone
3. Lesser wing of sphenoid4. Ant clinoid process
1a. Foramen Caecum2a. Frontal crest
1b. Ant & Postethmoidal canal2b. JugumSphenoidal3a. Caroticoclinoidforamen
2. MIDDLE CRANIALFOSSA
1. Boundaries2. Sulcus chiamatis3. Optic canal4. Sella turcica5. Post clinoid process6. Groove for ICA7. Cavernous sinus8. Foramen ovale &
spinosum9. Superior orbital fissure &
contents
1a. Attachment oftentorium cerebelli2a. Foramen rotundum& F.lacerum3a. Meckel's cave4a. Arcuate eminence5a. Tegmen tympani6a. Squamotympanicfissure
1b. Dorello's canal2b. Foramen ofvesalius3b. Canaliculusinnomnatus4b. Hiatus forgreater & lesserpetrosal nerves
3. POSTERIORCRANIAL FOSSA
1. Boundaries2. Clivus basiocciput &
basisphenoid3. Foramen magnum4. Internal occipital crest &
protruberance5. Jugular foramen6. Hypoglossal canal7. Internal acoutic meatus8. Transverse & sigmoid
sulcus
2a. Structure attached toclivus
1a. Condylar canal2b.Petro occipitalfissure3a. Opening ofvestibular aqueduct
4. INTERIOR OFCRANIUM
1. Bones2. Sutures & types3. Frontal crest4. Sagittal sulcus
1a. Vascular impressions
1b. Parietalforamina2b. Impressions forcerebral gyri
5a. SKULL NORMAFRONTALIS
1. Anatomical positionReid's base lineFrankfurt's plane
2. Bones forming 4. Supercilliary arch5. Frontal eminence6. Glabella7. Nasion 9. Orbital margins10. Boundaries of Orbit Supraorbital foramen Infraorbital foramen Superior orbital fissure Inferior orbital fissure11. Ant. Nasal Aperture12. Parts of Maxilla
3. Sutures Metopicsuture 8. Lacrimal fossa 13. Incisive foramen14. Canine fossa15. Muscle attachments16. Applied Frontal sinuses
17. Ethmoidalforamen18. Whitnall'stubercle
5b. SKULL NORMAVERTICALIS
1. Bones taking part2. Sutures3. Bregma, lambda, vertex4. Fontanelle5. Parietal eminence
6. Parietal foramen 7. Temporal lines 9. Applied # of parietalbones
8. Sutural bones
5b. SKULL NORMAVERTICALIS
1. Bones taking part2. Sutures3. Bregma, lambda, vertex4. Fontanelle5. Parietal eminence
6. Parietal foramen 8. Temporal lines
7. Obelion
10. Applied # ofparietal bones
9. Sutural bones
6a. SKULL NORMAOCCIPITALIS
1. Bones taking part2. Lambdoid suture 4. External occipital protuberance5. Inion6. Nuchal lines
3. Mastoid foramen 7. Muscle attachments
8. Interparietalbones
6b. SKULL NORMALATERALIS
1. Bones taking part2. Sutures3. Pterion4. Asterion 6. Zygomatic arch 8. Ext. acoustic meatus9.Suprameatal triangle10.Infratemporal fossa boundaries & contents 12. Mastoid process13. Styloid process
5. Temporal lines 11. Pterygopalatine fossa 14. Muscles attachments Masseter Temporalis
7. SKULL NORMABASALIS
Boundaries1. Ant. part hard palate sutures & formation 4. Palatine crest5. Post. nasal spine 7. Middle part union of
basiocciput & basiphenoid 9. Pterygoid plate 10. Pterygoid hamulus Greater wing of sphenoid Identification Spine of sphenoid Foramen 13. Petrous temporal F. Lacerum Carotid canal Mandibular fossa15. Tympanic part of temporalbone 16. Post. Partf. Magnum17. Ext. Occipital crest18. Ext. Occipital protuberance19. Hypoglossal canal 20. Jugular foramen 21. Styloid process 22. Stylomastoid foramen23. Mastoid notch24. Occipital condyles
2. Palatine foramen3. Incisive fossa 6. Muscle attachments 11. Pterygoid fossa12. Muscle attachments 14. Squamotympanicfissure 25. Post. Condylar canal 26. Jugular fossa27. Mastoid canaliculus 28. Muscle attachment29. Applied facialnerve damage
8. Palatovaginalcanal
8. MANDIBLE
1. Parts2. Body symphysis menti3. Metal protuberance4. Mental tubercle5. Metal foramen 7. Oblique line8. Base9. Myloyoid line & groove 11. Ramusmandibularforamen12. Linula
6. Mental fossa 10. Genial tubercles
13. Myelohyoid groove14. Codyloid & coronoid
processes15. Atachments of muscles of
mastication16. Relation of vessels &
nerves17. Relation of salivary gland18. Age changes 19. Movements of mandible &muscle causing it.
20. Ossification21. Applied # Mandible Dislocation Lingual N. block
22. Growth of
mandible23. Sex differences
9. CERVICALVERTEBRAE
1. Total no. Typical Atypical
2. Identifying features 3. Articulations 4. C1 identifying features7. Anatomical position8. \Parts9. Course of vertebral art 10. Joints and movements 11. C2identifying features12. Anatomical position13. Odontoid process14. C7 identifying features15. Anatomical features16. Vertebra prominence
5. Costal & transverse
elements6. Carotid tubercle
17. Muscleattachment18. Sex differences
10. INDIVIDUAL BONESTEMPORALFRONTAL PARIETAL
1. Identification2. Parts3. Articulation : sutures 5. Fontanellae6. Relations on the internalsurface
7. Muscle attachments
4. Sutural bones
11a. SPHENOID
1. Identification2. Articulation, sutures3. Relations on the internal
surface4. Identify sup, orbital
fissure, Foramenrotundum. Foramen ovale& foramen spinosum
5. Muscle attachments6. Ossification
11b. MAXILLA 1. Identification, parts2. Articulation3. Maxillary air sinuses4. Infraorbital foramen
5. Muscle attachments6. Age changes7. Applied importance8. Ossification
11c. OCCIPITAL 1. Identification, parts2. Articulation3. Anatomical position4. Relations on the external &
internal surfaces
5. Muscle attachments6. Ossification
7. Interparietal bone
12a. FOETAL SKULL 1. Difference between skullat birth and skull
2. Fontanelle Time of closure Applied importance3. Closure of sutures4. Sex differences
5. Craniometry6. Cranial capacity
7. Mechanism of
growth8. Applied
Forensic reconstructionwith skeletalremainsestimation of age.
12b. SMALL BONESVOMER, LACRIMAL,INFERIOR NASAL,CONCHA NASAL,ETHMOID,PALATINE
1. Identification
2. Ossification
3. Obelion 4. Sutural bones