Anatomy course – curriculum-guided labs

 
 

1. View three cases with Y-shaped incisions.

2. Identify:

Subcutaneous tissue
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.

Can you identify any in your video?

 
4. Review intercostal muscle anatomy.

What is the blood supply an innervation of the intercostal muscles.

 
 

1. Find videos on the diaphragm in the Body Map (Scan “Respiratory, Gastrointestinal” option).

2. Find a diagram of the diaphragm.

3. Be able to identify the esophageal, aortic and caval hiatus.

4. Which one is nearest the spine? Which one is nearest the skin?

5. Which one most to the right? Which one is most to the left?

6. Draw out each on a diagram.

7. Identify the central tendon.

8. What is the function diaphragm.

9. What is the blood supply and innervation of the diaphragm.

 
 

1. These cases show valves and chambers:

 
2. Identify the mitral, tricuspid, and semilunar (pulmonic and aortic) valves in each video.

3. Identify these structures in each video: annulus, leaflet, papillary muscle, chordae tendineae.

4. Correctly identify which chamber or major blood vessel is on which side of each valve.

5. Be able to correctly describe the flow of blood across each valve (which direction it flows).

6. Identify the coronary sinuses and right and left coronary artery ostia.

7. Orient the specimen and identify each leaflet: anterior, medial, posterior, left and/or right cusps depending on each valve.

8. Identify the commissures.

9. Identify any dissection-related changes in the valve.

Which leaflets were transected or incised during the autopsy dissection?

 
8. Look up some valve abnormalities and learn about them (bicuspid valve, mitral valve prolapse, etc.).

9. Look up types of valve replacements and learn about them (Björk-Shiley, etc.).

 
 

Introduction to digitized slide viewer:

Go to the Histology page.

Select the “Skin and Breast*” slide.

Use the “Guest option” on the new page.

Viewing skills: Use the [asterisk/star] on the left panel to make full screen. Use the [Esc] button to return.

Viewing skills: Be able to scan from low to high magnification and move around the slide.

First look on low power.

How many portions of tissue are on the slide?

Identify which is skin and which is breast tissue.

Go back to the Histology page and check your skills on another tissue type.

*The breast section has no glandular tissue.

 

 
 

Epithelium

Select the “Skin and Breast” slide from Histology.

Identify the layers of the skin.

Identify a hair follicle.

Are there any other adnexal structures (sebaceous glands, sweat glands, etc.)?

 

 
 

Connective tissue.

Select the “Skin and Breast” slide from Histology.

What types of connective tissue can you see within the skin portion.

What types of connective tissue can you see within the breast portion.

 

 
 

Muscle – skeletal

View the “Thyroid, skeletal m.” slide.

First look on low power.

How many portions of tissue are on the slide?

Identify which is thyroid and which is skeletal m.

Identify the muscle cells.

Identify Z-lines, A-Bands and H-Bands.

Identify the muscle nucleus, capillaries and adipose tissue.

Identify epimysium, perimysium and endomysium.

 
 

Muscle – cardiac

Select the “Heart” slide in Histology.

Identify cardiac muscle.

Identify the atrial, ventricular and valve tissue.

Which would you expect to be thicker — the atrium or the ventricle?

Which would expect to be comprised of cells vs. connective tissue — the muscle or the valve?

How does cardiac muscle differ from skeletal muscle?

Where is the nucleus located in cardiac muscle compared to skeletal muscle cells?

Identify intercalated discs.

Identify muscle striations.

Identify capillaries.

 
 

Neural – peripheral nerve

Select the “Heart” slide in Histology and look in the pericardial fat.

Identify a nerve in the pericardial fat.

Identify perineurium, nerve fascicle and Schwann cells.

 
 

Neural – brain

View the “Brain” slide in the Histology page.

Identify grey matter and white matter.

Identify neurons and glial cells.

 
 

Blood vessels.

Select the “Skin and Breast” slide from Histology.

Find a capillary, artery and vein.

How can you tell the difference?

Identify the layers in the wall of each.

 

 
 

Blood cells

Select the “Skin and Breast” slide from Histology.

Go to high power on a blood vessel with blood in it.

What kinds of blood cells can you identify?

 
 

Esophagus

View the esophageal videos on the body map.

 

What structures are anterior, posterior and lateral to the esophagus?

Is the esophagus anterior or posterior to the trachea?

Is the esophagus anterior or posterior to the thoracic aorta? Does it depend on where you look in the chest?

Is the esophagus anterior or posterior to the inferior vena cava?

What is the name of the passageway through the diaphragm for the esophagus?

 
 

Lymph nodes

Identify the lymph nodes in Case 39 Part 6 and Case 20 Part 4.

Where are the lymph nodes located in each video?

Are lymph nodes normal in size, appearance and number in each video? If not, explain what’s different.

Where are normal locations for lymph nodes in the body?

 
 

Tendons and Ligaments

View Case 15 Part 2, Case 29 Part 2 and Case 32 Part 3.

Identify tendons in each video.

What are common characteristics?

 
Name the muscle, insertion and origin associated with each tendon based on surrounding anatomy. Note: This is an extremely challenging, but not impossible activity for some of these videos.

View Case 30 Part 2.

Identify the patellar ligament (tendon) and the quadriceps tendon. In which has there been a tear and a surgical repair?

 
 

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.
Case 5 Part 1
Case 17 Part 3
Case 30 Part 4

 
 

1. Select the coronary artery slide in the Histology page.

Identify a region without plaque.

Identify the layers of the wall: intima, media and adventitia.

Identify the muscular layers.

2. Select the heart slide in the Histology page.

Identify the epicardial fat.

Identify a small coronary artery within the epicardial fat.

Identify the layers of the wall: intima, media and adventitia.

Identify the muscular layers.

Identify veins in the epicardial fat.

What is the difference between the wall of an artery and a vein?

 
3. View Case 13 Part 4.

What veins are being demonstrated?

Where do they drain to?

What veins connected to them outside the chest?

4. View Case 17 Part 6.

What arteries are being demonstrated?

What parts of the body do they supply?

What arteries will they connect or branch to?

5. Select the Lung slide in the Histology page.

Identify capillaries in the alveolar septae.

How many cell layers is the capillary wall comprised of?

6. Select the Kidney slide in the Histology page.

Identify capillaries in the glomeruli.

How many cell layers is the capillary wall comprised of?

7. Explore other tissue types in the Histology page.

Identify microscopic arteries, veins and capillaries.

 
8. Summarize the gross, microscopic and functional differences between arteries and veins.

 
 

These videos illustrate the external heart:
Case 17 Part 5
Case 12 Part 4

Identify the external structures.

 

 
 

1. View Case 6 Part 9.

Identify and name each valve.

Identify papillary muscles and chordae tendineae.

Be able to identify the direction of flow across the valve and the chamber or vessel on each side of the valve.

Identify any coronary artery ostia.

 
2. Use the body map to identify additional videos which show valves.

 
 

1. These videos illustrate the aorta:

 
Identify where you see the aortic root, aortic arch, descending aorta, thoracic aorta and abdominal aorta.

Identify the aortic hiatus in the diaphragm.

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.

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?

If the vessels branch, what are the named branches and their target organs?

Once you identify the target organs, name the returning veins from these organs.

 
 

1. These cases illustrate the location of the pulmonary trunk:

 

Is the pulmonary trunk to the left or right of the aortic root?

Is the pulmonary trunk to anterior or posterior to the aortic root?

If you were to insert a forceps into the pulmonary trunk, you could advance it in three different directions.

What directions could you advance your forceps?

Which vessels would you be advancing through in each direction?

And at what main anatomic structure would arrive in each direction?

2. View Case 27 Part 8.

Identify the main hilar structures: pulmonary artery, pulmonary veins, mainstem bronchus.

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.

Identify the part of the video that shows exploration of the right pulmonary artery (between the pulmonary trunk and the right lung).

View the dissection of the pulmonary artery

Was a pulmonary embolism identified?

Was it within a lobar or sublobar vessel?

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.

Trace the path it travelled naming all the vessels and heart chambers along the way.

 
5. View the lung slide in Histology.

Identify the pulmonary edema.

Where is the pulmonary edema (inside what space)?

What is usually inside this space?

Review the pulmonary circulation.

Explain how blood gets into and out of the lungs, naming the heart chambers and blood vessels comprising this circulation as they branch down to the capillaries inside the alveolar septae and then back again to the heart.

 
Explain why pulmonary edema occurs with left heart failure?

Would you expect pulmonary edema to occur in right heart failure?

What are diseases that can cause left heart, right heart or biventricular heart failure?

 
 

1. View Case 39 Part 5 and Case 39 Part 8.

Review the portal circulation.

Identify and name the vessels and organs involved.

 
Review portal hypertension.

What are causes of portal hypertension?

What are consequences of portal hypertension?

The patient’s spleen is massively enlarged.

Why does this happen in portal hypertension?

 
There is a clot in the splenic vein.

Why might this happen in portal hypertension?

 
 

1. These cases illustrate the pleural space:

Case 17 Part 4
Case 29 Part 4
Case 30 Part 7
Case 34 Part 2
Case 37 Part 4
Case 39 Part 3 & Case 39 Part 6

Evaluate each for pleural fluid and adhesions.

For the case(s) with pleural effusions:

Are they unilateral or bilateral?

Which side?

Estimate how much fluid is in there.

Is the fluid serous, serosanguinous or hemorrhagic? Exudative or transudative?

What might an x-ray show in each patient?

For the case(s) with adhesions:

What are the adhesions between (example: right upper lobe to chest wall, right middle lobe to mediastinum, etc.)?

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:
Case 38 Part 5

Identify the contusion inside the chest cavity.

Decide if the hemorrhage is near the visceral or parietal pleura.

Then decide if the hemorrhage is external to the pleura, within the pleura itself, or internal to the pleura.

Would you expect hemorrhage inside the pleural cavity related to the procedure?

 
 

1. These cases illustrate the external lung from various perspectives:

Case 1 Part 5 & Case 1 Part 9
Case 11 Part 8
Case 13 Part 8
Case 17 Part 4
Case 14 Part 6
Case 37 Part 4
Case 38 Part 8

Before you begin, decide which lobe on each side occupies most of the anterior, posterior, medial and lateral surfaces of each lung.

Refer to a diagram if need be.

 
For each case, decide when you are looking anterior, posterior, medial or lateral to the organ. Some cases show multiple perspectives.

For each case, identify superior and inferior.

Identify each visible lobe and each visible fissure.

Identify the diaphragmatic surface and lingula, where visible.

For Case 1, use the organ block (Part 9) to check if you correctly identified the lobes in situ (Part 5).

Decide for each case if there is any anatomic variation or if the lungs show the usual configuration (3 lobes on the right; 2 lobes on the left).

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.

Has your understanding changed?

Was your diagram correct?

Is it the same or different in each patient?

How will you apply this knowledge clinically?

 
 

1. These cases illustrate the larynx and airway (note, some of these will have Anatomy Pins).

 
Decide when the view is from anterior, posterior, superior, etc.

Which case shows trauma?

Where is it?

What caused it?

Which case shows pulmonary edema filling the airway?

What caused it?

 
In which case(s) can you identify the epiglottis?

Is it complete or transected?

 
Which case shows an anatomic abnormality?

Which case(s) might have been difficult to intubate and why?

Which cases show identifiable strap muscles?

Which strap muscles can you identify?

 
Wherever it appears, identify the hyoid bone, laryngeal notch, true vocal cords, false focal cords, posterior tracheal membrane, tracheal rings, and carina.

Wherever it appears, identify the cricothyroid membrane (or where it would be located) and the thyrohyoid membrane.

Wherever the trachea appears, decide where would you position the tip of an endotracheal tube.

 
 

1. View the bone marrow slide in Histology.

Identify precursors of each cell type (red cell, white cell, platelets).

 
2. Case 13 Part 2 shows the cut surface of the ribs after removing the chest plate.

Identify each rib by its cut surface.

How many ribs do you identify on each side?

Which ones show bone marrow on the inside and which one do not?

How can you tell the difference?

For the ones that do not contain bone marrow, what are they filled with?

Note: One of the cut surfaces is not a rib, but a different bone.

Which cut surface is not part of the rib?

Which bone is it?

 
 

1. Case 9 Part 1 shows a spleen dissection.

Identify the splenic capsule and hilum.

Can you identify red and white pulp?

What is a spleniculus?

How common are these?

Does the patient have one?

Can they be multiple?

2. The patient in Case 39 had marked thrombocytopenia.

Review the case and decide why.

What factors normally regulate platelet levels?

What disease can raise platelet levels?

What diseases can decrease platelet levels?

3. Review the splenic and portal circulation.

Case 39 Part 8 shows a thrombosed splenic vein.

Where did this vein drain to next (name the vein and/or organ it drains to)?

 
4. Review TIPS procedure. The patient in Case 8 had TIPS procedure that was “converted to a transplenic approach” mid-procedure.

What does this mean?

What vessels were involved?

 
 

1. View the Skin and Breast slide in the Histology page.

Find a blood vessel with blood inside it.

Identify red cells, lymphocytes and neutrophils.

(Platelets are not typically visible in a section of tissue but can be found in a blood smear.)

 
 

1. These videos show skull anatomy:

Case 5 Part 1
Case 12 Part 5
Case 16 Part 3
Case 31 Part 2
Case 35 Part 2

Review each video and make a master list of anatomy structures highlighted in the video and the “What’s inside” list.

Once your master list is made, go back to each video and try to identify each of the structures on the master list.

 

2. Apply your understanding of cranial anatomy to Case 19 Part 4.

In which cranial fossa is the tumor located.

Is the tumor superior or inferior to the cerebellar tentorium?

Where is the transverse sinus in relation to the tumor?

Where is the superior sagittal sinus in relation to the tumor?

Where is the spinal cord in relation to the tumor?

Is the tumor anterior or posterior to the petrous bone?

Which blood vessel likely supplied the tumor?

Is the tumor adjacent to the frontal, parietal, temporal or occipital bone?

Name the calvarial suture(s) that would be nearest to the tumor.

What portion of the brain did the tumor compress?

What change in function could this tumor possibly have caused?

Where are meningiomas typically found?

If the tumor had caused herniation, what type of herniation might it have caused.

Which of the meningeal layers contained the meningioma: pia, arachnoid or dura mater?

Which cranial nerves were closest to the tumor?

Was this a resectable tumor?

What surgical approach might have been used to remove this tumor?

 
 
3. Apply your understanding of cranial anatomy to Case 31 Part 2.

Identify where the internal and external trauma occurred (name the bones).

What cranial nerves are nearest the site of internal trauma?

 
4. Apply your understanding of cranial anatomy to Case 7 Part 6.

Go to 00:45.

Orient the patient (decide what is anterior, posterior, right and left).

Identify each of the visible bones and suture.

Where was the burr hole drilled?

What structures did the surgeon pass through while drilling the hole?

What lobe of the brain was under the burr hole?

 
 

1. This video shows a posterior view of the organ block and a dissection of the kidneys:

Case 5 Part 1

Keep handy or sketch out a diagram that includes these structures:

Bilateral common iliac arteries
Aorta
Celiac artery
Superior mesenteric artery
Inferior mesenteric artery
Bilateral renal arteries
Bilateral kidneys
Bilateral ureters
Bilateral adrenals

 
Is the renal artery superior or inferior to the superior mesenteric artery?

View the video with your diagram handy.

It is a posterior view of the organ block.

 
Identify superior and inferior in the video.

Orientation switches in the video.

Identify when that happens.

Is the aorta to the right or left of the inferior vena cava in this view?

Keep track of the renal arteries.

Identify the kidneys and ureters when they are exposed during the dissection.

Have ureters already been transected near the bladder or are they still connected.

Mark your diagram every 15 seconds as you watch the video to indicate where the dissection is taking place.

Example: Place an “X” and “00:30” at the right renal artery ostium — the focus of the dissection video at that point in the video.

Groups — add an arrow and label on the interactive video.

2. Case 20 Part 6 at 5:35 shows the prostate, bladder and right ureter. The left ureter has been cut.

Identify where you think the left ureter would go.

 
3. Case 7 Part 4 shows narrow view of anatomy near the pelvis. The right ureter is identified.

What structures are nearby to the ureter?

Beginning at the kidney, what structures does the ureter pass on the way to the bladder?

What structures does the ureter cross over?

What structures does the ureter cross behind?

 
 

1. Case 37 Part 7 shows the prostate, bladder and testes.

Identify the prostate.

Identify the prostatic urethra, seminal vesicles and vas deferens.

Is the vas deferens medial or lateral to the seminal vesicles?

Identify the bladder.

Is there any urine inside?

 
Identify the testis.

Is it the right or left testis?

From what passageway is it retrieved?

What structure normally sits in this passageway?

The rectum is not visible in the video.

Is the rectum anterior or posterior to the prostate and bladder?

 
 

1. These videos shows the female reproductive organs in the pelvis and after removal:

 
Identify the bladder and uterus in Part 4 and Part 5.

Order from anterior to posterior: rectum, bladder, uterus.

Identify these structures:

Vaginal wall
Cervix
Cervical os
Body of uterus
Fallopian tubes
Ovarian ligament
Ovary
Parametrium

 
What are the medial and lateral attachments of the ovarian ligament?

Does the fallopian tube attach directly to the ovary?

Is the fallopian tube anterior or posterior to the ovarian ligament?

At the end of the Case 21 Part 4, is the retrieved uterus viewed from anterior or posterior?

How can you tell?

 
Is there urine in the bladder? (Part 4)

Identify the endocervical canal. (Part 4)

Identify the endometrial cavity and myometrium. (Part 4)

 
 

1. These cases show a brain dissection and include Anatomy Pins.

 
Identify each of the structures using the list of terms beside the Anatomy Pins.

Then scroll-up the list to hide. Now review each pin and be able to identify the structure.

 
2. These cases show a brain dissection but do not include Anatomy Pins.

 
Begin by identifying external structures (cerebrum, midbrain, brainstem, pons, cerebellum, fissures, lobes, cranial nerves, blood vessels).

Follow the dissection.

Identify the same internal structures in these videos you identified in Case 5 Part 2 and Case 5 Part 3.

Can you identify any other structures?

For groups — use the interactive video to label each structure.

 
 

1. These cases show retrieval of the spinal cord.

 
Decide if the segment(s) of spinal cord being removed is cervical, thoracic or lumbar.

How caudal does the spinal cord go?

Identify the cauda equina.

At what vertebral level is it found?

 
What structures or spaces surround the spinal cord?

Begin with the spinal cord and end with the vertebral bone.

Which ones are identifiable in the videos?

Can you identify any peripheral nerve roots in any of the videos?

What is the blood supply of the spinal cord?

Review the anatomy of vertebral bone.

What portions of the vertebral bone were cut to access the spinal cord?

 
 

1. Review the videos with gastrointestinal anatomy pins here.

Use the anatomy list to identify each structure.

Scroll up the anatomy list to hide. Be able to view a pin and identify the structure.

2. These cases focus on the gastrointestinal tract:

Case 10
Case 11
 
Familiarize yourself with these terms:

Esophagus
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

 
View the videos and identify as many of these structures as you can within the videos.

Groups — use the interactive video to add labels.

 
 

Coming soon.