Medico Guides 3rd Block Gross Anatomy Guidelines

by

Prepared by:

                            Harram Sameer (G15)

Compiled by:

                            Muhammad Ahmed Bhatti (G14)

Reference Books:

  • Snell’s Clinical Anatomy by Regions 10th edition
  • BD Chaurasia Human Anatomy 8th edition 

THORAX

Important Note:

  •  This part of Anatomy is easy when done in a proper way. Visualization and Revisions are the keys of mastering Gross Anatomy .
  •  First of all use Snell as main book for thorax. However there are several points and LOs in the curriculum which are not in Snell or not properly written in Snell. For them go for BD
  •  For thorax , you have to do chap 4&5 of Snell
  •  For clinicals use TH Clinicals but must give a good read to clinicals from Snell as many lines of Snell were asked as it is in our proff 
  • For mcqs practice use Chapter 1 & BRS gross anatomy (scenario MCQs) 
  • Nerve supply of diaphragm, structures passing through diaphragm, bronchopulmonary segment, root of lung , mediastinal syndrome it’s symptoms and effects (clinical v.v.imp). Guidelines are mentioned according to your LOs 

CARDIOVASCULAR SYSTEM

(Module No 4)

CV-A-001 

Mediastinum :

Lecture: Anatomy Zone ,Dr Hasna or Johri 

  • Definition, boundaries , compartments & contents of Mediastinum from BD chap 17  (complete) . Its schematic diagram is given below for your understanding:
  • Also do all the clinicals of Mediastinum from Snell or TH clinicals , Mediastinal syndrome is vvimp

Superior Vena Cava:

 Lecture: Taim Talks Med

  • Formation, Tributaries and Termination of Superior vena cava (imp) from BD chp 19  

Aorta:

 Lecture: Dr Hasna , TCML or About Medicine 

  • Formation , Branches and Distribution of Ascending Aorta, Aortic Arch and Descending Aorta in reference to their branches  from Snell chap 5  (imp)
  • Must Do relations of Aortic arch from BD chp 19 (also try to do relations of ascending and descending aorta but relations of aortic arch are most imp)

Azygous Vein : 

 Lecture: Essentials of Medical Sciences  or Taim Talks Med

  • Formation, course and tributaries of Azygous + Hemizygous + Accessory Hemizygous veins (extremely imp) from BD chp 14
  • Do it completely as they are frequently asked in exams (skip relations) 

Nerve supply of Heart : 

 Lecture: Dr Hasna , Kenhub , Dr Adel Bondok or Johri

  • Course , Relations and Distribution of Vagus Nerve and thoracic splanchnic nerves in relation to Nerve Supply of Heart from Snell chap 5 (under the topic extrinsic nerve supply)

CV-A-002

Pericardium:

      Lecture: Dr Azam 

  • Pericardium and its parts with emphasis on their nerve supply from Snell Chap 5 
  • Blood supply: Internal Thoracic Artery + Musculophrenic Artery + Descending Aorta 

Pericardial cavity and sinuses:

      Lecture : Dr Azam

  • Pericardial cavity ,  Transverse and oblique sinuses their Boundaries and clinical significance from BD chap 18 (v.v.imp)

Clinical Correlates:

  • Pericardial rub, pericardial pain , pericarditis, pericardial effusion, cardiac tamponade , paracentesis from Snell chap 5 

CV-A-003:

External Features of Heart:

      Lecture: Dr Azam

  • External features of heart , chambers of heart their features and openings  (just give a good read to this topic from Snell chp 5) They are mainly asked in Ospe and viva especially on model. So try to do its practice on heart model alongwith its diagram from Snell chap 5  and study all landmarks written in text 
  • Moderator Band is imp for written 

Arterial supply of Heart: 

      Lecture: Dr Azam

  • Coronary arteries (v.v.imp) complete from Snell chp 5 
  • Left and Right coronary artery branches + their  distribution + variations in coronary arteries+ sites of  anastomosis between right and left coronary artery + table 5.3 from Snell chap 5 (vvimp)
  • Anatomical correlates of cardiac Arterial supply from Snell chap 5

Clinical Correlates:

  • ECG , Cardiac referred pain , angioplasty and coronary grafts from Snell chap 5
  • Features of Angina Pectoris and MI from Snell chap 5 or TH clinicals

Venous Drainage of Heart:

      Lecture: Dr Azam

  • Venous drainage of heart & Alternative venous routes to heart from Snell chap 5 
  • Vessels supplying the heart with their origin and Termination from Snell chap 5

Cardiac plexus:

Lecture: Dr Hasna , Johri MBBS 

  • Formation, relations and distribution of Cardiac Plexus from BD chap 18 (imp)

Fibrous Skeleton & Cardiac Valves: 

  • Components and significance of Fibrous Skeleton of heart + valves from Snell chp 5 (imp)
  • Valvular Heart diseases from Snell chap 5
  • Surface marking, perform  percussion , auscultation and CT scan /MRI of heart and great vessels for OSPE

RESPIRATORY SYSTEM

(Module No 5)

Re-A-001

Thoracic Apertures:

 Lecture : Dr Hasna , Johri MBBS 

  • Superior thoracic aperture / Inlet of Thorax from BD chap 12
  • Inferior thoracic aperture ( also called as DIAPHRAGM) from Snell chap 4  (don’t skip any point and also do all clinicals) 
  • Do the table of openings and structures passing through these openings of diaphragm from BD chap 12 table 12.1 .Memorize  it completely as it is always asked either in written or in Viva (vvimp). Its pic is shared below:

Thoracic Outlet Syndrome:

  • Do it from Snell chap 4 (vvimp) 

Re-A-002 & Re-A-004:

Ribs:

Lecture: Dr Hasna , Johri or  Byte Sized Med 

  • Diff b/w typical and atypical rib (vvvvimp) from BD chap 13 or AI (While explaining the ribs in Ospe , you must know whether it’s typical or atypical rib)
  • Anatomical features of ribs from Snell chap 4 or BD chap 13 , Do 1st and 2nd ribs completely
  • Supernumerary cervical rib from Snell chap 4
  • Articulations of ribs are actually the joints . Do Classification of Articulations of ribs , Anatomical features of these Articulations and movements with Muscles producing articulations from BD chap 13 ( under the heading of joints of thorax) . You must also know the category of each rib ( vertebrosternal, vertebrochondral, typical, atypical etc )
  • Effects of fracture to neck of rib from Snell chap 4
  • Flail chest from Snell chap 4

Vertebra:

Lecture: Dr Hasna , Johri or Byte Sized Med 

  • Anatomical features of typical and atypical vertebrae and difference between them (vv imp) from BD chap 13 ( You should be able to differentiate between vertebrae in Ospe , For Ospe , you just have to do the bony features of vertebra)
  • Must know the difference of thoracic vertebrae from the other vertebrae 
  • Thoracic part of vertebral column ( normal curvature, intervertebral joints ) from BD chap 13 and do  fascia of back , blood supply, lymphatic drainage and nerve supply of back from any short book or AI
  • Kyphosis, Scoliosos  (vvimp) 

Re-A-003:

  • Thoracotomy (imp clinical) from Snell chap 4

Intercostal muscles:

  • Do intercostal muscles from Snell cha p 4 complete (imp)
  • Completely cover the headings of intercostal muscles + their actions+ nerve supply (main things asked are their actions , nerve supply and also their difference like direction of fibers etc) All this will be covered from Snell chap 4 , Also do table 4.1

Intercostal space :

    Lecture: Dr Azam

  • Intercostal space and its contents from  Snell chap 4 
  • In the topic of Intercostal space, 7 layers are written memorize these 7 layers in sequence and make mnemonic (v.v.imp mcq) 
  • Question is usually asked that if we have to perform lung biopsy, which layers will be pierced , the answer is these 7 layers
  • Contents of Intercostal space: Intercostal (Vein+ Artery+ Nerve) Mnemonic: VAN (imp)

Re-A-005 & Re-A-006:

Sternum:

Lecture: Dr Hasna , Johri MBBS

  • Do bony features of Sternum from Snell chap 4 or BD chap 13
  • Sternal biopsy , sternotomy and sternal fractures from Snell chap 4 or TH clinicals 

Endothoracic Fascia & Sibson’s fascia:

Lecture: Dr Azam

  • Endothoracic Fascia from Snell chp 4 
  • Suprapleural membrane (Sibson’s Fascia)  with attachments from Snell chap 4 ( imp)

Re-A-007 & Re-A-008: 

Joints of Thorax: 

Lecture: Taim Talks Med or Mina MedEase

  • Joints of Thorax from BD chap 13
  • For ligaments just do their names
  • You can revise the joints from the pic shared below:

Mechanics of Respiration:

 Lecture: Byte Sized Med 

  • Mechanics of Inspiration and Expiration from Snell chap 5 or BD 13 (vvvimp)
  • Vertical Diameter (Piston Pump Mechanism) from the pic shared below
  • Anteroposterior diameter (pump handle mechanism) , Transverse diameter (bucket handle mechanism) and  Vertical Diameter , All are vvimp
  • Muscles involved in respiratory movements from picture shared below

Intercostal Nerves and Vessels: 

      Lecture: Dr Azam

  • Origin, Course , Relation and Distribution of Intercostal Nerves from Snell chap 4
  • Origin , Course , Relation and Distribution of Intercostal Vessels (arteries and veins) from BD chap 14 (vvimp)
  • Posterior intercostal arteries from BD chap  14 
  • Anterior intercostal arteries from BD chap 14 
  • Intercostal veins from BD chap  14 complete (must do table 14.2 from BD) 
  • Alternate routes of Venous drainage in blockage of superior/ inferior Vena Cava  from Snell chap 5 , pic is shared below:

Re-A-009 & Re-A-010: 

Dermatomes :

  • Cutaneous Innervation and Dermatomes of Thorax from any short book or AI (not imp)

Diagram of cutaneous innervation is given below:

Clinical Correlates: 

  • Herpes Zoster Infection on thoracic wall and Intercostal Nerve block from Snell chap 4

Trachea:

  • Anatomical features, extent , relations, neurovascular supply and lymphatics of trachea from Snell chap 5

Re-A-011:

Diaphragm:

  Lecture : Dr Hasna , Johri MBBS

  • Parts of Diaphragm, their attachments and neurovascular supply from Snell chap 4
  • Role of Diaphragm in Respiration from Snell chap 4
  • Diaphragmatic apertures from BD table 12.1 (vvimp)

Re-A-012:

Pleura:

Lecture: Dr Azam

  • Parts, Layers , neurovascular supply  of pleura from Snell chap 5 (vvimp)
  •  Blood supply and Lymphatic drainage from picture shared below:
  • Difference between parietal and visceral pleura from BD chap 15  table 15.1 :

Pleural cavity:

  • Pleural cavity, its recesses and lines of reflection from Snell chap 5 ( under the heading of pleura)
  • Pleural reflections ( clinical) from Snell chap 4

Clinical Correlates:

  • Pleural pain , pleurisy, pneumothorax, pleural effusion from Snell chap 5 

Lungs:

 Lecture: Dr Azam 

  • Anatomical features and relations of lungs from Snell chap 5
  • Lobes and Fissures of lungs from Snell chap 5  +  table 5.1 v.imp. 

Re-A-013:

Lungs:

     Lecture: Dr Azam

  • Neurovascular supply and Lymphatic drainage of lungs from Snell chap 5
  • Difference between Anatomical features of right and left lung from BD table 16.2: 

Root of lung:

 Lecture: Dr Azam

  • Pulmonary Ligament (covered in topic of Pleura from Snell chap 5) 
  • Root of lung from BD chap 16  (vvvimp)
  • In root of lung cover following headings from BD: Contents+ arrangement of structures in root+ Relations of root 

Bronchopulmonary Segments:

Lecture: Dr Azam

  • Bronchopulmonary segments complete (extremely imp) from Snell chap 5 (don’t skip anything) , Also do its diagram from the pic shared below:
  • Blood supply, Nerve Supply, Lymphatic drainage and clinical significance of bronchopulmonary segments from Snell chap 5

Clinical Correlates:

  • Chest tube intubation, Thoracentesis, bronchoscopy from Snell chap 5 or TH clinicals
  • Anatomical basis for medicolegal significance of lungs in determining viability of new born from any short book or AI
  • Anatomical landmarks on chest X-rays, CT , MRI for Ospe 

Note: 

  • Do all the clinicals of Thorax from Snell or TH clinicals 

Apparently guidelines seem  switching between Snell and BD — but it is to cover every topic in a proper and in an understandable way. So, when you study thorax, study Snell and BD side by side according to guidelines.

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