1 Tissue types
2 Cardiovascular
2-2 Heart – external anatomy
2-3 Heart – valves and chambers
2-4 Aorta
2-5 Pulmonary circulation
2-6 Portal circulation
3 Respiratory
3-2 Lung external
3-3 Pulmonary arteries, pulmonary veins, bronchi
3-4 Airway – larynx and trachea
4 Gastrointestinal
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1-1 Introduction to digitized slide viewer:
Select the “Skin; breast” slide (by clicking on the image labelled “Skin; breast.”)
A new login page will appear.
Select the “GUEST ACCESS” to login.
Select the diagonal arrows in the upper right of the image to make full screen.
Practice going back and forth between the different magnifications.
Practice moving the image around by clicking and dragging.
1-2 Epithelium
2. Identify the layers of the skin.
3. Identify a hair follicle.
4. Are there any other adnexal structures (sebaceous glands, sweat glands, etc.)? Identify each.
1-3 Connective tissue.
2. Review the different types of connective tissue.
3. What types of connective tissue can you see within the skin portion?
4. What types of connective tissue can you see within the breast portion?
1-4 Muscle – skeletal
2. First look at low power.
b. Identify which is thyroid and which is skeletal muscle.
c. Focus on the skeletal muscle portion.
ii. Identify Z-lines, A-Bands and H-Bands.
iii. Identify the muscle nucleus, capillaries and adipose tissue.
iv. Identify epimysium, perimysium and endomysium.
1-5 Muscle – cardiac
2. Identify cardiac muscle.
3. Identify the atrial, ventricular and valve tissue.
b. Which would expect to be comprised of cells vs. connective tissue — the muscle or the valve?
4. Identify muscle striations.
5. How does cardiac muscle differ from skeletal muscle?
b. Identify intercalated discs.
6. Identify capillaries.
1-6 Neural – peripheral nerve
2. Identify a nerve in the pericardial fat.
3. Identify perineurium, nerve fascicle and Schwann cells.
1-7 Neural – brain
2. Identify grey matter and white matter.
3. Identify neurons and glial cells.
1-8 View Histology for more tissue types.
Examples:
1. Blood vessels.
b. How can you tell the difference?
c. Identify each layer of the wall.
2. Blood cells.
b. What kinds of blood cells can you identify?
2-1 Arteries, veins, capillaries
1. Select the coronary artery slide in the Histology page.
b. Identify the layers of the wall: intima, media and adventitia.
c. Identify the muscular layers.
2. Select the heart slide in the Histology page.
b. Identify a small coronary artery within the epicardial fat.
c. Identify the layers of the wall: intima, media and adventitia.
d. Identify the muscular layers.
e. Identify veins in the epicardial fat.
3. View Case 13 Part 4 (00:00 – 00:33).
b. Where do they drain to?
c. What veins connected to them outside the chest?
4. View Case 14 Part 3.
b. What parts of the body do they supply?
c. What arteries will they connect or branch to?
5. Select the Lung slide in the Histology page.
b. How many cell layers is the capillary wall comprised of?
6. Select the Kidney slide in the Histology page.
b. How many cell layers is the capillary wall comprised of?
7. Explore other tissue types in the Histology page.
8. Summarize the gross, microscopic and functional differences between arteries and veins.
2-2 Heart external
1. These videos illustrate the external heart and have Anatomy Pins:
Case 28 Part 3 (00:00 – 00:09)
a. Use the Anatomy Pin video to assist. Identify the external structures.
b. Use the Free-Draw sketch pad to make a labelled diagram.
2. These videos illustrate the heart and do not have Anatomy Pins:
Case 42 Part 4
a. What structures on the external view of the heart can you identify in each video?
b. Use the Free-Draw sketch pad to make a labelled diagram.
2-3 Heart – valves
1. View Case 6 Part 9.
b. Identify papillary muscles and chordae tendineae.
c. Be able to identify the direction of flow across the valve and the chamber or vessel on each side of the valve.
d. Identify any coronary artery ostia.
2. Use the body map to identify additional videos which show valves.
2-4 Aorta
1. These videos illustrate the aorta:
b. Identify the aortic hiatus in the diaphragm.
c. Identify the main branches of the aorta and/or their ostia: right brachiocephalic, left common carotid, left subclavian, celiac, superior mesenteric, renal, inferior mesenteric, and common iliac arteries.
d. Which of these vessels continue directly to their target organ or structure? And which branch into additional named vessels prior to reaching a target organ?
e. If the vessels branch, what are the named branches and their target organs?
f. Once you identify the target organs, name the returning veins from these organs.
2-5 Pulmonary circulation
1. These cases illustrate the location of the pulmonary trunk:
Case 12 Part 4 00:00 – 00:36
Case 39 Part 3 00:15 – 00:39
Case 42 Part 4 00:00 – 00:28
a. Is the pulmonary trunk to the left or right of the aortic root?
b. Is the pulmonary trunk to anterior or posterior to the aortic root?
c. If you were to insert forceps into the pulmonary trunk, you could advance it in three different directions.
ii. Which named vessels would you be advancing through in each direction?
iii. At what main anatomic structure would arrive in each direction?
2. View Case 27 Part 8.
b. Was a pulmonary embolism identified? Was it in a pulmonary artery or vein? Was it a lobar or sublobar vessel?
3. View Case 12 Part 4.
b. View the dissection of the pulmonary artery
c. Was a pulmonary embolism identified?
d. Was it within a lobar or sublobar vessel?
e. Which lobe was it in?
4. Your patient has a pulmonary embolism in a sublobar pulmonary artery of the right upper lobe of the lung. It originated as a deep venous thrombosis in the left popliteal vein.
5. View the lung slide in Histology.
ii. What is usually inside this space?
b. Review the pulmonary circulation.
c. Explain why pulmonary edema occurs with left heart failure?
d. Would you expect pulmonary edema to occur in right heart failure?
e. What are diseases that can cause left heart, right heart or biventricular heart failure?
2-6 Portal circulation
1. View Case 39 Part 5 and Case 39 Part 8.
b. Review portal hypertension.
ii. What are consequences of portal hypertension?
c. The patient’s spleen is massively enlarged.
d. There is a clot in the splenic vein.
3-1 Pleural space
1. These cases illustrate the pleural space:
Case 29 Part 4 00:00 – 00:35
Case 30 Part 7 00:00 – 00:12
Case 34 Part 2 00:00 – 00:20
Case 37 Part 4 00:59 – 02:01
Case 39 Part 3 00:00 – 00:05 & Case 39 Part 6 00:22 – 00:45
a. Evaluate each for pleural fluid and adhesions.
b. For the case(s) with pleural effusions:
ii. Which side?
iii. Estimate how much fluid is in there.
iv. Is the fluid serous, serosanguinous or hemorrhagic? Exudative or transudative?
v. What might an x-ray show in each patient?
c. For the case(s) with adhesions:
ii. Why might they be there (review History)?
2. In this case, the patient had a procedure with instrumentation through the chest wall into the pleural space — a chest tube:
a. What anatomic layers does a chest tube pass through to get into the pleural space, beginning with the epidermis.
b. Did the chest tube in this patient enter through the lower or upper rib cage?
c. Can you estimate between which two ribs the chest tube was inserted?
d. Identify the contusion inside the chest cavity. (01:09 is a high magnification view of the right inner chest wall. In this view, the contusion is on the left; normal is on the right. 01:24 is a low magnification view including the right inner chest wall. In this view, the contusion is on the left; normal is on the right.
e. Decide if the hemorrhage is near the visceral or parietal pleura.
f. Then decide if the hemorrhage is external to the pleura, within the pleura itself, or internal to the pleura.
g. Would you expect hemorrhage inside the pleural cavity related to the procedure?
3-2 Lung external
1. These cases illustrate the external lung from various perspectives:
Case 11 Part 8
Case 13 Part 8
Case 17 Part 4
Case 14 Part 6
Case 37 Part 4
Case 38 Part 8
a. Before you begin, decide which lobe on each side occupies most of the anterior, posterior, medial and lateral surfaces of each lung.
ii. Sketch your own diagram of the lungs from each perspective.
b. Case 1 shows two different views of the lungs. Part 5 shows the lungs still in the chest cavity (in situ). Part 9 shows the lungs removed.
ii. Identify the lobes and fissures after the lung was removed (Part 9).
iii. Compare your answers in i. and ii.
iv. Did you identify each lobe correctly in Part 5 (in situ)?
c. For each case of the other cases
ii. Identify superior and inferior.
iii. Identify each visible lobe and each visible fissure.
iv. Identify the diaphragmatic surface and lingula, where visible.
v. Decide if there is any anatomic variation, or if the lungs show the usual configuration (e.g., 3 lobes on the right; 2 lobes on the left).
d. After viewing these cases, reassess your understanding of which lobe on each side occupies most of the anterior, posterior, medial or lateral surface of the lung.
i. Has your understanding changed?
ii. Was your diagram in Part a. correct?
iii. Is it the same or different in each patient?
iv. How will you apply this knowledge clinically?
3-3 Pulmonary arteries, pulmonary veins, bronchi
3-4 Airway – larynx and trachea
1. These cases illustrate the larynx and airway. (Note: some of these cases will have Anatomy Pins).
Case 2 Part 10
Case 13 Part 8
Case 23 Part 2
Case 32 Part 3
a. Decide when the view is from anterior, posterior, superior, etc.
b. Which case shows trauma?
ii. What caused it?
c. Which case shows pulmonary edema filling the airway?
d. In which case(s) can you identify the epiglottis?
e. Which case shows an anatomic abnormality?
f. Which case(s) might have been difficult to intubate and why?
g. Which cases show identifiable strap muscles?
h. Wherever it appears, identify the hyoid bone, laryngeal notch, true vocal cords, false focal cords, posterior tracheal membrane, tracheal rings, and carina.
j. Wherever it appears, identify the cricothyroid membrane (or where it would be located) and the thyrohyoid membrane.
k. Wherever the trachea appears, decide where you would position the tip of an endotracheal tube.
4-1 Esophagus
1. Note: This activity is extremely challenging. Use your text and any anatomy pin videos to assist. Be sure to turn on Closed Captions in the video to assist with audio.
2. These videos demonstrate esophageal anatomy.
Case 12 Part 3 00:00 – 00:39 and 01:13 – 02:10
Case 13 Part 10 02:00 – 02:43
Case 23 Part 2 00:00 – 01:54 and 03:15 – 04:12
Case 23 Part 3 00:00 – 00:06 and 01:10 – 02:22
Case 39 Part 6 00:00 – 00:22 and 01:10 – 02:51
3. As you watch, note what structures are anterior, posterior, right lateral, left lateral, inferior and superior to the esophagus.
b. Example:
The esophagus is anterior to the vertebral column.
4. Specific structures:
b. What does the esophagus connect to inferiorly?
c. Is the esophagus anterior or posterior to the trachea?
d. Is the esophagus anterior or posterior to the thoracic aorta? (Hint: It depends on where you look in the chest. Explain below.)
ii. Video/Time:
e. Is the esophagus anterior or posterior to the inferior vena cava?
f. What structures are right lateral to the esophagus?
g. What structures are left lateral to the esophagus?
h. What structure(s) is (are) posterior to the esophagus?
ii. Video/Time:
5. What is the name of the passageway through the diaphragm for the esophagus?
6. What is the difference between the pharynx and esophagus?
4-2 Stomach, small intestine, large intestine
1. These cases focus on the gastrointestinal tract:
Case 11
a. Familiarize yourself with these terms:
Gastroesophageal junction
Stomach
Greater curvature
Lesser curvature
Pylorus
Antrum
Body
Fundus
Small intestine
Duodenum
Jejunum
Ileum
Ileocecal junction
Appendix
Colon
Cecum
Ascending colon
Transverse colon
Descending colon
Sigmoid colon
Rectum
Mesentery
Mesenteric surface
Antimesenteric surface
Right colic flexure
Left colic flexure
Mucosa
b. Keep the list of term handy and create your own where you can add notes.
c. View the videos and identify as many of these structures as you can within the videos.
d. Add a Case, Part and video time next to each term to note when the structure is visible in the video.
Appendix: Case 11 Part 6 visible at 00:15.
e. Be able to identify the structure if asked.
f. Sharpen observation skills. See if you can identify the first time in a video the structure appears. Sometimes structures are not mentioned in the audio, but will pass by quickly during the dissection.
4-3 Liver, gallbladder
1. Use the Body Map to identify videos which include the liver and gallbladder.
b. Find one that shows the right and left lobes of the liver and the round ligament.
4-4 Pancreas
1. Use the Body Map to identify a video which shows the pancreas.
5-1 Bone marrow
1. View the bone marrow slide in Histology.
2. This case shows the cut surface of the ribs (after removing the chest plate).
a. Identify each rib by its cut surface.
b. How many ribs do you identify on each side?
c. Which ones show bone marrow on the inside and which ones do not?
ii. For the ones that do not contain bone marrow, what are they filled with?
d. One of the cut surfaces is not a rib, but a different bone.
ii. Which bone is it?
5-2 Spleen
1. This case shows a spleen dissection.
a. Identify the splenic capsule and hilum.
b. Can you identify red and white pulp?
c. What is a spleniculus?
ii. Does the patient have one?
iii. Can they be multiple?
3. This case shows a thrombosed splenic vein.
a. Review the splenic and portal circulation.
b. Identify the splenic vein thrombosis in the video.
c. Is the spleen normal in size, smaller or larger than normal?
4. This patient had a TIPS procedure.
a. Review TIPS procedure.
b. Review the history:
ii. What vessels were involved in the procedure?
c. Identify the spleen in this case.
ii. If it is abnormal, what changes are there?
iii. If there are changes, why did these happen (based on the history)?
5-3 Lymph nodes
1. These cases show lymph nodes.
Case 20 Part 4
a. Review where lymph nodes are normally located in the body.
b. Identify the lymph nodes each case.
c. Where are the lymph nodes located (near what anatomic structures)?
d. Are the lymph nodes normal in size, appearance and number in each case? If not, explain what’s different.
5-4 Blood cells
1. View the “Skin; breast” slide in the Histology page.
b. Identify red cells, lymphocytes and neutrophils.
(Platelets are not typically visible in a section of tissue but can be found in a blood smear.)
6-1 Joints
1. List the main types of joints.
2. View these cases and decide what joint is highlighted in the video and what type it is.
6-2 Tendons and Ligaments
Case 29 Part 2
Case 32 Part 3
a. Identify tendons in each video.
b. Name the muscle, insertion and origin associated with each tendon based on surrounding anatomy.
a. Identify the patellar ligament (tendon) and the quadriceps tendon.
b. Identify the knee replacement hardware.
6-3 Skeletal muscle
1. View three cases with Y-shaped incisions.
b. Which case did you pick? (list 3)
2. Identify:
Pectoralis major muscle
Pectoralis minor muscle
Ribs
Costal cartilage
Costochondral junction
Clavicle
Sternum
Sternal notch
Xyphoid process
3. Look up: what muscles attach to the clavicle.
4. Review intercostal muscle anatomy.
6-4 Skull
1. These videos show skull anatomy:
Case 12 Part 5
Case 16 Part 3
Case 31 Part 2
Case 35 Part 2
a. To the right of each video at the top of the page is a “What’s inside” list of anatomic structures.
b. Review each video and make a master list of anatomic structures.
c. Once your master list is made, go back to each video and try to identify each of the structures in your master list.
2. Clinical application: head trauma.
a. Identify where the internal and external trauma occurred (name the bones).
b. What cranial nerves are nearest the site of internal trauma?
3. Clinical application: burr (drill) hole from a past neurosurgery.
a. What is a burr hole?
b. Go to 00:45.
ii. Identify each of the visible bones and sutures.
iii. Where was the burr hole drilled?
iv. What structures did the surgeon pass through while drilling the hole?
v. What lobe of the brain was under the burr hole?
4. Clinical application: brain tumor.
a. In which cranial fossa is the tumor located.
b. Is the tumor superior or inferior to the cerebellar tentorium?
c. Where is the transverse sinus in relation to the tumor?
d. Where is the superior sagittal sinus in relation to the tumor?
e. Where is the spinal cord in relation to the tumor?
f. Is the tumor anterior or posterior to the petrous bone?
g. Which blood vessel likely supplied the tumor?
h. Is the tumor adjacent to the frontal, parietal, temporal or occipital bone?
i. Name the calvarial suture(s) that would be nearest to the tumor.
j. What portion of the brain did the tumor compress?
k. What change in function could this tumor possibly have caused?
l. Where are meningiomas typically found?
m. If the tumor had caused herniation, what type of herniation might it have caused?
n. Which of the meningeal layers contained the meningioma: pia, arachnoid or dura mater?
o. Which cranial nerves were closest to the tumor?
p. Was this a resectable tumor?
q. What surgical approach might have been used to remove this tumor?
6-5 Diaphragm
1. Find videos on the diaphragm in the Body Map (Scan “Respiratory, Gastrointestinal” option).
2. Review the anatomy of the diaphragm.
b. What is the blood supply and innervation of the diaphragm.
3. View the videos.
ii. Which one is most anterior?
iii. Which one is most to the right?
iv. Which one is most to the left?
v. Draw out each on a diagram.
b. Identify the central tendon wherever it appears in the videos.
7-1 Kidney, Ureter
1. This video shows a posterior view of the organ block and a dissection of the kidneys:
a. Keep handy or sketch out a diagram that includes these structures:
Aorta
Celiac artery
Superior mesenteric artery
Inferior mesenteric artery
Bilateral renal arteries
Bilateral kidneys
Bilateral ureters
Bilateral adrenals
b. Is the renal artery superior or inferior to the superior mesenteric artery?
c. View the video with your diagram handy.
d. Identify superior and inferior in the video.
e. Orientation switches in the video.
f. Is the aorta to the right or left of the inferior vena cava in initial view?
g. Keep track of the renal arteries.
h. Identify the kidneys and ureters when they are exposed during the dissection.
i. Have ureters already been transected near the bladder or are they still connected?
2. This video shows the prostate, bladder and right ureter. The left ureter has been cut.
a. Identify each structure (prostate, bladder, right ureter).
b. Identify where you think the left ureter would attach to the bladder.
3. This video shows a narrow view of anatomy near the pelvis. The right ureter is identified.
a. What structures are near to the ureter?
b. Beginning at the kidney, what structures does the ureter pass on the way to the bladder?
c. What structures does the ureter cross over (anterior to)?
d. What structures does the ureter cross behind (posterior to)?
4. This video shows the internal anatomy of the kidney. The kidney is not normal but the main anatomic structures and relationships can be identified.
a. View the Anatomy Pin video and pull up pins 25 – 30.
b. Identify the cortex, medulla, and renal pelvis (internal and external views).
c. Identify a medullary pyramid.
d. The patient has renal arteriolar nephrosclerosis.
ii. What causes this condition?
iii. What changes in this kidney fit for the diagnosis?
7-2 Male reproductive system, Bladder
1. Case 37 Part 7 shows the prostate, bladder and testes.
a. Identify the prostate.
ii. Is the vas deferens medial or lateral to the seminal vesicle?
b. Identify the bladder.
c. Identify the testis.
ii. From what passageway is it retrieved?
iii. What structures normally sit in this passageway?
d. The rectum is not visible in the video.
7-3 Female reproductive system
1. These videos show the female reproductive organs in the pelvis and after removal:
Case 21 Part 5
a. Identify the bladder and uterus in Part 4 and Part 5.
b. Order from anterior to posterior: rectum, bladder, uterus.
c. Identify these structures:
Cervix
Cervical os
Body of uterus
Fallopian tubes
Ovarian ligament
Ovary
Parametrium
d. What are the medial and lateral attachments of the ovarian ligament?
e. Does the fallopian tube attach directly to the ovary?
f. Is the fallopian tube anterior or posterior to the ovarian ligament?
g. At the end of the Case 21 Part 4, is the retrieved uterus viewed from anterior or posterior?
h. Is there urine in the bladder? (Part 5)
i. Identify the endocervical canal. (Part 5)
j. Identify the endometrial cavity and myometrium. (Part 5)
8-1 Brain
1. These cases show a brain dissection and include Anatomy Pins.
Case 19 Part 6
a. Identify each of the structures using the list of terms beside the Anatomy Pin video.
b. Then scroll-up the list to hide. Now review each pin and be able to identify the structure.
2. Case 51 shows a brain dissection (cerebrum) without Anatomy Pins. Try this case after viewing Case 19, above.
a. Use the list of anatomy terms from Case 19 (to the right of the Anatomy Pin video) as a guide for this case (Case 51). Identify as many structures as you can.
b. Groups: Use the Interactive Video to mark up the video.
3. Case 5 is an older case. It shows a brain dissection and includes Anatomy Pins.
Case 5 Part 3
a. Identify each of the structures using the list of terms beside the Anatomy Pin video.
b. Then scroll-up the list to hide. Now review each pin and be able to identify the structure.
4. Check your knowledge with the Self-Assessments: Brain-1 through Brain-3.