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    Antonio DE LUCA

    Insegnamento di HUMAN ANATOMY 1

    Corso di laurea magistrale a ciclo unico in MEDICINA E CHIRURGIA

    SSD: BIO/16

    CFU: 9,00

    ORE PER UNITÀ DIDATTICA: 90,00

    Periodo di Erogazione: Secondo Semestre

    Italiano

    Lingua di insegnamento

    INGLESE

    Contenuti

    Lo studente deve essere in grado di condurre una corretta diagnosi di
    immagini anatomiche di superficie, di sezioni o di apparati o di loro parti.
    Condurre una corretta diagnosi di immagini anatomiche ottenute
    mediante techniche radiologiche e similari, quali esami radiografici,
    esami radiografici ottenuti con mezzi radiopachi, esami tomografici
    assiali computerizzati (TAC), esami ecografici, esami ottenuti mediante
    risonanza magnetica nucleare (RMN), e successive elaborazioni (DTI,
    fMRI). Condurre una corretta diagnosi di organo e regione al microscopio
    ottico, con individuazione e descrizione dei componenti anatomo
    microscopici del preparato in osservazione

    Testi di riferimento

    Gray's Anatomy for Students, 3rd Edition
    January 2015
    Publisher: elsivier
    Histology: A Text and Atlas, with Correlated Cell and Molecular Biology,
    6th Edition by Michael H. Ross
    AND Wojciech Pawlina
    The Central Nervous System (English Edition) 4th Edition by PER BRODAL

    Obiettivi formativi

    Lo scopo medico-pedagogico dello studio dell’Anatomia Umana è quello
    di consentire agli studenti del corso di laurea in medicina e chirurgia nel
    futuro ruolo di medici, di comunicare efficacemente con i colleghi, di
    comprendere e utilizzare la terminologia anatomica internazionale
    (FCAT), al fine di descrivere la struttura normale del corpo umano,
    nell’ambito dei settori di Anatomia Umana, Radiologica, Clinica,
    Microscopica e Neuroanatomia, come previsti dall’ordinamento del MIUR

    Prerequisiti

    NO

    Metodologie didattiche

    LEZIONI FRONTALI ESERCITAZIONI AL MICROSCOPIO LUCE

    Metodi di valutazione

    NON è PREVISTA VERIFICA

    Programma del corso

    Colonna vertebrale
    Lo studente in medicina deve essere in grado di riconoscere i tratti caratteristici delle vertebre delle cinque regioni della colonna vertebrale, sapere come la colonna vertebrale si articola nel suo insieme, si muove e come le sue normali curvature si sviluppano e stabilizzano . Deve essere in grado di interpretare le relative immagini cliniche, di distinguere le deviazioni dal normale, sapere l'organizzazione dei contenuti del canale vertebrale cioè le meningi , midollo spinale, radici nervose spinali , nervi spinali e loro particolari relazioni con le vertebre e le articolazioni del rachide. Queste conoscenze costituiscono la base per la comprensione di patologie vertebrali comuni quali il “comune” mal di schiena, il prolasso di un disco intervertebrale, le lesioni a carico del midollo spinale e dei nervi. Lo studente in medicina deve essere in grado di descrivere anatomicamente le fasi relative alla procedura di atti medici quali la rachicentesi e l’anestesia epidurale e regionale. Lo studente di medicina deve avere una appropriata conoscenza delle caratteristiche dell’anatomia di superficie e dei muscoli al fine di poter in seguito apprendere le procedure per una corretta valutazione delle strutture locomotorie. Deve avere una conoscenza dei dermatomeri e la relativa distribuzione dei nervi periferici, conoscere le funzioni dei gruppi muscolari e la loro innervazione, al fine di poter in seguito apprendere la tecnica per poter eseguire un corretto esame neurologico di base del tronco e degli arti.

    Arto superiore
    Lo studente in medicina deve essere in grado di riconoscere le principali caratteristiche palpabili e di imaging delle ossa dell'arto superiore, conoscere i siti delle fratture comuni e relative complicazioni. Deve essere a conoscenza dei fattori che influenzano la stabilità delle articolazioni di spalla, gomito, polso e articolazioni interfalangee al fine di comprendere nel prosieguo degli studi, la natura e le conseguenze delle comune lesioni. Allo scopo di apprendere nel corso di laurea le procedure cliniche in modo sicuro ed efficace, lo studente deve essere in grado di descrivere le naturali relazioni e distribuzione delle principali strutture neurovascolari dell’ arto superiore. Deve essere in grado di descrivere e rilevare i principali punti di repere dei diversi polsi arteriosi, posizione delle vene (per un corretto accesso venoso) e conoscere i luoghi comuni di lesioni dei nervi periferici e dei loro possibili effetti funzionali (lesioni del plesso brachiale, nervo ascellare, radiale, ulnare e lesioni del nervo mediano). Deve essere in grado di spiegare la base anatomica delle comuni morbidità a carico dell'arto superiore (le lesioni della cuffia dei rotatori, la sindrome del tunnel carpale ) e le vie anatomiche di diffusione di processi infiammatori e/o infettivi nell'arto. Deve essere in grado di descrivere l'organizzazione dei linfonodi ascellari e le vie di drenaggio linfatico della mammella e spiegare le basi anatomiche che influenzano l'incidenza in relazione alla diffusione metastatica del cancro del seno e del melanoma .

    Arto inferiore
    Lo studente in medicina deve essere in grado di riconoscere le principali caratteristiche palpabili e di imaging delle ossa dell’ arto inferiore, conoscere i principali siti di fratture comuni (collo e diafisi di femore, tibia e perone) e l’anatomia che sottende le possibili complicazioni che potrebbero derivare da queste. Deve essere in grado di spiegare i fattori che determinano e modulano la stabilità dell'anca, del ginocchio e della caviglia, le lesioni legamentose comuni, al fine di essere in grado di apprendere la procedura clinica per verificare l'integrità dei legamenti. Allo scopo di poter eseguire, nel corso degli studi, le procedure cliniche in modo sicuro ed efficace, lo studente deve essere in grado di descrivere il corso e la distribuzione delle principali strutture neurovascolari dell'arto inferiore (ad esempio, al fine di evitare di danneggiare il nervo sciatico quando si effettua una iniezione intramuscolare), essere in grado di indicare i principali punti di repere del polso arterioso (femorale, popliteo, tibiale posteriore e dorsale del piede) , la posizione delle principali vene (per l’esposizione chirurgica, praticata in emergenza per l’accesso venoso e per la valutazione delle vene varicose). Deve conoscere le sedi comuni dei nervi per comprenderne le lesioni e i possibili effetti funzionali di tali danni (ad esempio sciatico e nervo peroneo comune al collo del perone ). Deve avere una conoscenza di anatomia di superficie, dei dermatomeri e della distribuzione dei relativi nervi periferici, conoscere accuratamente le funzioni dei principali gruppi muscolari e la loro innervazione al fine di possedere una base neuroanatomica per poter apprendere negli anni successivi con cognizione di causa l’esame dell'arto inferiore. Lo studente deve conoscere l'organizzazione dei linfonodi inguinali e le vie anatomiche responsabili del drenaggio linfatico dell'arto, dei tegumenti del tronco e del perineo. Deve conoscere l’organizzazione delle fascie profonde degli arti inferiori e la loro rilevanza anatomica per comprendere le sindromi compartimentali. I meccanismi anatomofunzionali che permettono il ritorno del sangue dalle gambe al cuore e come alterazioni di questi meccanismi possano causare lo sviluppo di varici, trombosi venose profonde ed embolia.

    Testa e collo
    Lo studente in medicina deve essere in grado di riconoscere le principali caratteristiche palpabili e di imaging del cranio e della colonna cervicale per essere in grado di interpretare le immagini mediche pertinenti. Lo studente, al fine di poter apprendere, nel corso degli studi, agevolmente, l'esame clinico della testa e del collo deve conoscere la posizione, i rapporti delle strutture neurovascolari, della rete venosa e il drenaggio linfatico delle seguenti principali strutture: corso e distribuzione dei nervi cranici, orecchio e tuba faringotimpanica, occhi, palpebre e congiuntiva, cavità nasali e seni paranasali , cavità orale e lingua, tonsille, palato molle, faringe, ghiandole salivari, laringe e trachea, tiroide e ghiandole paratiroidi e contenuto della guaina carotidea. Lo studente in medicina deve essere in grado di descrivere le fascie e gli spazi fasciali del collo in relazione alla diffusione delle infezioni. Queste conoscenze sono necessarie per comprendere nel corso degli studi le sordità trasmissive e neurosensoriali, l’otalgia e le probabili fonti di dolore riferito all'orecchio, le paralisi del nervo facciale, le epistassi, le tonsilliti, la disfagia, l’ostruzione delle vie aerifere superiori, lo stridore infantile, le sinusiti, le paralisi delle corde vocali e la raucedine, le tumefazioni del collo e delle ghiandole salivari. Lo studente in medicina deve avere accurata conoscenza anatomica per poter descrivere le vie aeree, al fine di apprendere nel corso degli studi la tecnica per inserire un tubo endotracheale o nasogastrico, ed eseguire una tracheotomia o una laringotomia. Deve avere una conoscenza dell’anatomia di superficie, dei territori di distribuzione dei nervi cranici, della sede e delle funzioni dei principali muscoli della testa e del collo e della loro innervazione al fine di poter sviluppare nel corso degli studi le capacità per eseguire un esame neurologico di base.

    Per tutte le strutture, l'enfasi va posta su quelle parti che sono più comunemente coinvolte in processi patologici o in procedure interventistiche. Per il sistema muscolo-scheletrico, l'attenzione va posta sui punti di repere e la conoscenza radiologica dello scheletro, sui legamenti maggiormente coinvolti in patologie, sui gruppi muscolari e su singoli muscoli in termini funzionali con particolare riferimento alla loro innervazione da parte dei nervi spinali . Per il sistema cardiovascolare si richiede un buona conoscenza del cuore dei vari punti di pulsazione arteriosa e dei segmenti arteriosi maggiormente esposti a danno e studiati mediante tecniche di eco-doppler, i punti di accesso venoso, una ottima conoscenza delle vie di drenaggio linfatico. Per il sistema nervoso periferico l'accento deve essere alle arre di distribuzione cutanea e ai gruppi muscolari

    English

    Teaching language

    ENGLISH

    Contents

    A medical student should be able to:
    1. Define and demonstrate the following terms relative to the anatomical
    position: medial,
    lateral, proximal, distal, superior, inferior, deep, superficial, palmar,
    plantar, anterior/ventral,
    posterior/dorsal, rostral, caudal.
    2. Describe the following anatomical planes: axial / transverse /
    horizontal, sagittal and
    coronal.
    3. Define and demonstrate the terms used to describe the movements of
    the limbs and
    vertebral column: flexion, extension, lateral flexion, pronation,
    supination, abduction,
    adduction, medial and lateral rotation, inversion, eversion, plantarflexion,
    dorsi-flexion,
    protraction, retraction and circumduction.
    4. Define the terms somatic and visceral when used to describe parts and
    systems (e.g.
    somatic and visceral motor systems) of the body.

    Textbook and course materials

    Gray's Anatomy for Students, 3rd Edition
    January 2015
    Publisher: elsivier
    Histology: A Text and Atlas, with Correlated Cell and Molecular Biology,
    6th Edition by Michael H. Ross
    AND Wojciech Pawlina
    The Central Nervous System (English Edition) 4th Edition by PER BRODAL

    Course objectives

    The medical-pedagogical purpose of the Human Anatomy study is to
    enable students of the medical and surgical degree course in the future
    role of physicians, to communicate effectively with colleagues, to
    understand and use international anatomical terminology (FCAT), in order
    to describe the normal structure of the human body, within the areas of
    Human Anatomy, Radiology, Clinic, Microscopy and Neuroanatomy, as
    required by the MIUR system.

    Prerequisites

    NO

    Teaching methods

    CLASS AND EXERCISES TO THE LIGHT MICROSCOPE

    Evaluation methods

    NO EXAM AT THE END OF THIS SEMESTER

    Course Syllabus

    Vertebral Column
    A medical student should be able to:
    1. Describe the main anatomical features of a typical vertebra. Identify the atlas, axis,
    typical cervical, thoracic, lumbar vertebrae and sacrum and recognise their characteristic
    features.
    2. Describe the structures, regions and functions of the vertebral column. Describe the
    range of movement of the entire vertebral column and its individual regions. Explain what
    makes spinal injuries stable and unstable.
    3. Describe the anatomy of intervertebral facet joints and intervertebral discs. Explain the
    role of the discs in weight-bearing by the vertebral column and give examples of common
    disc lesions, and how they may impinge upon spinal nerve roots and / or the spinal cord.
    4. Describe the anatomy of a spinal nerve (e.g. as exemplified by a thoracic spinal nerve,
    including its origin from dorsal and ventral spinal roots, its main motor and cutaneous
    branches and any autonomic component.
    5. Identify the muscle and ligaments of the vertebral column and surface features in order
    to be able to perform an examination of the back, discuss their functional role in stability
    and movement of the vertebral column.
    6. Describe the anatomical relationships of the meninges to the spinal cord and dorsal and
    ventral nerve roots, particularly in relation to root compression and the placement of
    epidural and spinal injections. Describe the anatomy of lumbar puncture.
    7. Interpret standard diagnostic images of the vertebral column and be able to recognise
    common abnormalities.
    Upper Limb
    A medical student should be able to:
    1. Describe and demonstrate the main anatomical landmarks of the clavicle, scapula,
    humerus, radius and ulna. Recognise the bones of the wrist and hand and their relative
    positions, identify those bones that are commonly damaged (scaphoid and lunate).
    2. Describe the close relations of the bones and joints (e.g. bursae, blood vessels, nerves
    ligaments and tendons), which may be injured by fractures or dislocation and predict what
    the functional effects of such damage might be.
    3. Describe the fascial compartments delimiting the muscles of the upper limb. Explain the
    functional importance of those compartments and their contents.
    4. Describe the origin, course and distribution of the arteries and their branches that supply
    the shoulder, arm and forearm in relation to common sites of injury. Explain the importance
    of anastomoses between branches of these arteries at the shoulder and in the upper limb.
    5. Demonstrate the sites at which pulses in the brachial, radial and ulnar arteries may be
    located.
    6. Describe the courses of the veins of the upper limb; classify and contrast the functions
    of the deep and superficial veins. Identify the common sites of venous access and
    describe their key anatomical relations. Explain the relationship between venous and
    lymphatic drainage channels.
    7. Describe the organisation of the brachial plexus, its origin in the neck and continuation
    to the axilla and upper limb.
    8. Describe the origin, course and function of the axillary, radial, musculocutaneous,
    median and ulnar nerves in the arm, forearm, wrist and hand. Name the muscles that
    these nerves supply as well as their sensory distribution. Predict the consequences of
    injury to these nerves and describe how to test their functional integrity.
    9. Describe the boundaries of the axilla. List its contents, including the vessels, parts of the
    brachial plexus and lymph node groups.
    10. Describe the movements of the pectoral girdle; identify the muscles responsible for its
    movements and summarise their main attachments and somatic motor nerve supply.
    11. Describe the factors that contribute to the stability of the shoulder joint and explain the
    functional and possible pathological consequences of its dislocation.
    12. Describe the anatomy of the elbow joint. Demonstrate the movements of flexion and
    extension, identify the muscles responsible for these movements and summarise their
    main attachments and somatic motor nerve supply.
    13: Describe the anatomy of the superior and inferior radio-ulnar joints. Explain the
    movements of supination and pronation; identify the muscles responsible for these
    movements and summarise their attachments and somatic motor nerve supply.
    14. Describe the anatomy of the wrist. Describe and demonstrate movements at these
    joints and name and identify the muscles responsible for the movements. Describe the
    relative positions of the tendons, vessels and nerves at the wrist in relation to injuries.
    15. Name and demonstrate the movements of the fingers and thumb. Describe the
    position, function and nerve supply of the muscles and tendons involved in these
    movements, differentiating between those in the forearm and those intrinsic to the hand.
    16. Explain the main types of grip (power, precision and hook) and the role of the muscles
    and nerves involved in executing them.
    17. Describe the position and function of the retinacula of the wrist and the tendon sheaths
    of the wrist and hand. Explain carpal tunnel syndrome and the spread of infection in
    tendon sheaths.
    18: Explain why and describe where the axillary, musculocutaneous, radial, median and
    ulnar nerves are commonly injured and be able to describe the functional consequences of
    these injuries.
    19. Explain the loss of function resulting from injuries to the different parts of the brachial
    plexus. Demonstrate how to test for motor and sensory nerve function.
    20. Describe the anatomical basis of: the assessment of cutaneous sensation in the
    dermatomes of the upper limb, tendon jerk testing of biceps and triceps and comparative
    strength tests.
    21. Describe the anatomy of the axillary lymph nodes and explain their importance in the
    lymphatic drainage of the breast and the skin of the trunk and upper limb and in the spread
    of tumours.
    22. Interpret standard diagnostic images of the upper limb and be able to recognize
    common abnormalities
    Lower Limb
    A medical student should be able to:
    1. Recognise the features and surface landmarks of the pelvis, femur, tibia, fibula, ankle
    and foot. Demonstrate their palpable and imaging landmarks. Appreciate which bones and
    joints are vulnerable to damage and what the consequences of such damage could be.
    2. Describe the close relations of the bones and joints (e.g. bursae, blood vessels, nerves
    ligaments and tendons), which may be injured in fractures or dislocations and predict what
    the functional effects of such damage would be.
    3. Describe the fascial compartments enclosing the muscles and explain the functional
    importance of these compartments and their contents in relation to compartment
    syndromes.
    4. Demonstrate the origin, course and branches of the arteries that supply the hip, gluteal
    region, thigh, leg, ankle and foot. Explain the functional significance of anastomoses
    between branches of these arteries at the hip and knee.
    5. Demonstrate the locations at which the femoral, popliteal, dorsalis pedis and posterior
    tibial pulses can be felt.
    6. Demonstrate the course of the principal veins of the lower limb. Explain the role of the
    perforator vein connections between the superficial and deep veins and the function of the
    ‘muscle pump’ for venous return to the heart. Describe the sites of venous access that can
    be used for ‘cut- down’ procedures in emergencies.
    7. Outline the origin of the lumbosacral plexus and the formation of its branches.
    8. Describe the origin, course and function of the sciatic, femoral, obturator, common
    peroneal and tibial nerves, sural and saphenous nerves and summarise the muscles that
    each supplies as well as their sensory distribution.
    9. Describe the structure and movements of the hip joint. Summarise the muscles
    responsible for these movements, their innervation and main attachments.
    10. Describe the structures responsible for stability of the hip joint and their relative
    contribution to maintaining the lower limb in different positions.
    11 Describe the structures at risk from a fracture of the femoral neck or dislocation of the
    hip and explain the functional consequences of these injuries.
    12. Describe the boundaries of the femoral triangle and the anatomical relationships of the
    femoral nerve, artery, vein and lymph nodes to each other and to the inguinal ligament,
    with particular regard to arterial blood sampling and catheter placement.
    13. Describe the anatomy of the gluteal (but- tock) region and the course of the sciatic
    nerve within it. Explain how to avoid damage to the sciatic nerve when giving
    intramuscular injections.
    14. Describe the structure and movements of the knee joint. Summarise the muscles
    responsible for these movements, their innervation and main attachments.
    15. Describe the close relations of the knee joint including bursae and explain which
    structures may be injured by trauma (including fractures and dislocation) to the knee.
    Identify the factors responsible for maintaining the stability of the knee joint. Describe the
    menisci, ligaments and the locking mechanism close to full extension. Explain the
    anatomical basis of tests which assess the integrity of the cruciate ligaments.
    Describe the boundaries and contents of the popliteal fossa.
    16. Describe the anatomy of the ankle joint. Explain the movements of flexion, extension,
    plantarflexion, dorsiflexion, inversion and eversion. Describe the muscles responsible for
    these movements, their innervation and their attachments.
    17. Describe the factors responsible for stability of the ankle joint, especially the lateral
    ligaments, and explain the anatomical basis of “sprain” injuries.
    18. Describe the arches of the foot and the bony, ligamentous and muscular factors that
    maintain them.
    19. Describe the movements of inversion and eversion at the subtalar joint, the muscles
    responsible, their innervation and main attachments.
    20. Describe the anatomical basis (nerve root or peripheral nerve) for loss of movements
    and reflexes at the knee and ankle resulting from spinal injuries, disc lesions and common
    peripheral nerve injuries. Describe the dermatomes of the lower limb and perineum used
    to assess spinal injuries.
    21. Describe the structures at risk to a fracture of the femoral neck or dislocation of the hip
    and describe the functional consequences of these conditions.
    22. Describe the lymphatic drainage of the lower limb and its relationship to tumour
    spread.
    23. Discuss the structures of the lower limb that may be used for autografts.
    24. Interpret standard diagnostic images of the lower limb and be able to recognise
    common abnormalities.
    Head and Neck
    A medical student should be able to:
    1. Demonstrate the position, palpable and imaging landmarks of the bones of the skull,
    including the frontal, parietal, occipital, temporal, maxilla, zygoma, mandible, sphenoid,
    nasal and ethmoid bones. Demonstrate the palpable position of the hyoid bone, thyroid
    and cricoid cartilages, lateral mass of the atlas and the spine of C7. Demonstrate the
    sutural joints and describe the fontanelles of the fetal skull.
    2. Describe the boundaries, walls and floors of the cranial fossae.
    3. Identify the external and internal features of the cranial foraminae and list the structures
    that each transmits.
    4. Demonstrate the position of the anterior and posterior triangles of the neck defined by
    the sternum, clavicle, mandible, mastoid process, trapezius and sternocleido-mastoid.
    5. In the posterior triangle, demonstrate the position of the spinal accessory nerve, the
    roots and trunks of the brachial plexus, the external jugular vein and subclavian vessels in
    relation to penetrating neck trauma.
    6. In the anterior triangle, demonstrate the position of the common, internal and external
    carotid arteries, the internal jugular vein and vagus nerve, the trachea, thyroid cartilage,
    larynx, thyroid and parathyroid glands. Explain their significance in relation to carotid
    insufficiency, central venous line insertion, emergency airway management and diagnosis
    of thyroid disease.
    7. Describe the location and anatomical relations of the thyroid and parathyroid glands,
    their blood supply and the significance of the courses of the laryngeal nerves.
    8. Demonstrate the origin, course and branches of the common, internal and external
    carotid arteries and locate the carotid pulse.
    9. Describe the courses of the accessory, vagus and phrenic nerves in the neck.
    10. Identify the structures passing between the neck and the thorax. Describe the courses
    and relationships of the subclavian arteries and veins.
    11. Describe the anatomy of the scalp, naming its individual layers. Describe the blood
    supply of the scalp and its significance in laceration injuries.
    12. Demonstrate the extracranial course of the branches of the facial nerve. Desscribe the
    muscles of facial expression supplied by each branch and describe the consequences of
    injury to each branch.
    13. Describe the intracranial and intrapetrous course of the facial nerve and the
    relationships of its branches to the middle ear in relation to damage of the nerve
    within the facial canal.
    14. Describe the anatomy of the temporo-mandibular joint. Explain the movements that
    occur during chewing and describe the muscles involved including their innervation.
    Explain what occurs in anterior joint dislocation and relocation.
    15. Describe the origin, function and branches of the sensory and motor components of
    the trigeminal nerve.
    16. Describe the origins and summarise the courses and major branches of the facial and
    maxillary arteries, including the course and intracranial relations of the middle meningeal
    artery and its significance in extradural haemorrhage.
    17. Describe the relationship of the termination of the facial vein (draining into the internal
    jugular vein) and the mandibular branch of the retromandibular vein (supplying facial
    muscles controlling the angle of the mouth) to the submandibular gland and related upper
    jugular lymph nodes in relation to exploration of this area.
    18. Describe the key anatomical relations of the parotid, submandibular and sublingual
    salivary glands, the course of their ducts into the oral cavity and their autonomic
    secretomotor innervation. Appreciate the narrow points of the ducts in relation to salivary
    stone impaction.
    19. Demonstrate the features and boundaries of the oral cavity and describe its sensory
    innervation.
    20. Describe the functional anatomy of the tongue, including its motor and sensory
    innervation and the role of the extrinsic and intrinsic muscles. Explain the deviation of the
    tongue after hypoglossal nerve injuries.
    21. Describe the anatomical arrangement and functional significance of the lymphoid
    tissue in the tonsils, pharyngeal, and posterior nasal walls.
    22. Describe the muscles that compose the pharyngeal walls and move the soft palate;
    summarise their functions and nerve supply. Describe the components of the gag reflex.
    23. Describe the hyoid bone and cartilages of the larynx. Explain how these structures are
    linked together by the thyrohyoid, cricothyroid, and quadrangular membranes.
    24. Describe the intrinsic and extrinsic laryngeal muscles responsible for closing the
    laryngeal inlet, controlling vocal cord position and tension. Explain how these muscles
    function during phonation, laryngeal closure, the cough reflex and regulation of
    intrathoracic pressure.
    25. Describe the origin, course and functions of the motor and sensory nerve supply of the
    larynx and the functional consequences of injury to them.
    26. Describe the stages of swallowing and the functions of the muscles of the jaw, cheek,
    lips, tongue, soft palate, pharynx, larynx and oesophagus during swallowing.
    27. Describe the location, actions and nerve supply of the intrinsic and extra-ocular
    muscles and apply this knowledge to explain the consequences of injury to the nerve
    supply of these muscles.
    28. Describe the anatomy of the eyelids, conjunctiva and lacrimal glands. Explain their
    importance for the maintenance of corneal integrity.
    29. Describe the functional anatomy of the external auditory meatus, tympanic membrane,
    ear ossicles and auditory tube, together with their major anatomical relations.
    30. Describe the bones of the nasal cavity and the major features of the lateral wall of the
    nasal cavity. Describe the major arteries that supply the lateral wall and nasal septum in
    relation to nosebleeds.
    31. Name the paranasal sinuses, describe their relationships to the nasal cavities and sites
    of drainage on its lateral wall and explain their innervation in relation to referred pain.
    32. Describe the arrangement of the dura mater, and its main reflections within the cranial
    cavity and their relationship to the major venous sinuses and the brain itself.
    33. Describe the arrangement of the venous sinuses of the cranial cavity; explain the
    entrance of cerebral veins into the superior sagittal sinus in relation to subdural
    haemorrhage, and how connections between sinuses and extracranial veins may permit
    intracranial infection
    34. Describe the relationships between the brain and the anterior, middle and posterior
    cranial fossae.
    35. Describe the anatomy of the motor and sensory nerves to the head and neck and
    apply this to a basic neurological assessment of the cranial nerves and upper cervical
    spinal nerves.
    36. Describe the sympathetic innervation of the head and neck and the features and
    casual lesions in Horner’s syndrome.
    37. Demonstrate the positions of the external and internal jugular veins and the surface
    landmarks that are used when inserting a central venous line.
    38. Describe the arrangement of the lymphatic drainage of the head and neck, the groups
    of lymph nodes and the potential routes for the spread of infection and malignant disease.
    39. Interpret standard diagnostic images of the head and neck and be able to recognise
    common abnormalities.
    40. Describe the anatomical microscopical structure at light and electron microscopy level
    of all head and neck viscera

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