SECTION – I(Course Content)

ABDOMEN, PELVIS, PERINEUM

SCHEDULE­1

ANTERIOR ABDOMINAL WALL AND EXTERNAL GENITALIA.

Lecture: 03 hrs

Dissection/ Prosection: 10 hrsTutorials: 01 hr

LECTURES:

Planes and regions of the abdomen. Inguinal canal, spermatic cord, testis­ coverings and descent. Rectus sheath

DISSECTION/ PROSECTION: Relevant morphological features:­ linea alba; umbilicus; linea semilunaris;

midaxillary line; posterior axillary line.Subcutaneous structures:­ anterior and lateral cutaneous branches of lower intercostal nerves; subcostal nerve; iliohypogastric nerve;ilioinguinal nerve; superficial epigastric artery; dartos muscle; fatty and membranous layers of the superficial fascia.Muscles:­ obliquus externus abdominis; obliquus internus abdominis; cremastermuscle; transversus abdominis; rectus abdominis; pyramidalis.Nerves:­ muscular branches of lower intercostal; subcostal; iliohypogastric; ilioinguinal; genitofemoral.Arteries:­ lower posterior intercostal; subcostal; lumbar; superior epigastric; inferior epigastric; deep circumflex iliac.Veins:­ veins accompanying the above arteries.External genitalia:

Male:­ testis and its coverings; spermatic cord and contents.Female:­ round ligament.

Surface anatomy:­ superficial inguinal ring; deep inguinal ring; inguinal canal.Applied anatomy:­ surgical incisions of the anterior abdominal wall; vasectomy; inguinal hernia; hydrocoele; undescented testis.

TUTORIAL TOPICS FOR THE WEEK Relevant osteology. Relevant radiological anatomy. Relevant living anatomy. Relevant cross­sectional anatomy.

SCHEDULE­2.

ABDOMINAL CAVITY, STOMACH AND INTESTINES.

Lecture: 03 hrsDissection/ Prosection: 10 hrs

Tutorials: 01 hr

LECTURES:

Peritoneum, Stomach, jejunum and ileum Caecum and appendix.

DISSECTION/ PROSECTION:Planes of abdomen:­ vertical; subcostal; transtubercular; transpyloric.Regions of abdomen:­ epigastric; umbilical; hypogastric, right and left hypochondriac; right and left lumbar; right and left iliac.Peritoneum:­ parietal; visceral; greater sac; lesser sac; foramen of Winslow; median umbilical fold; medial umbilical folds; lateralumbilical folds; falciform ligament; left triangular ligament; lesser omentum; greater omentum; gastro­splenic ligament; lieno­renal

liganment; mesentry; meso­appendix; transverse mesocolon; phrenico­colic ligament.Viscera:­ Liver­ lower margin; fissure for ligamentum teres; fissure for ligamentum venosum; porta hepatis; caudate lobe; Gall bladder­fundus, neck, body; Stomach­ fundus; body; pyloric part; greater and lesser curvatures; incisura angularis; sulcus intermedius; stomachbed; interior of the stomach; arterial supply; venous drainage; lymphatic drainage; nerve supply; jejunum and ileum­ extent; differencesarterial supply; venous drainage; lymphatic drainage; nerve supply; appendix­ position, arterial supply; caecum­ posterior relations; colon­ ascending, transverse, descending; pelvic; arterial supply; venous drainage; lymphatic drainage; nerve supply.Portal vein:­ formation, location.Surface anatomy:­ fundus of gall bladder; cardiac and pyloric orifices of the stomach; caecum and appendix.Applied anatomy:­ referred pain over the umbilical region and pain over the right iliac fossa in appendicitis.

TUTORIAL TOPICS FOR THE WEEK Relevant osteology. Relevant radiological anatomy. Relevant living anatomy. Relevant cross­sectional anatomy.

SCHEDULE­3

LIVER, PANCREAS, DUODENUM AND SPLEEN.

Lecture: 03 hrsDissection/ Prosection: 10 hrs

Tutorials: 01 hr

LECTURES:

Duodenum and pancreas Liver and extrahepatic biliary apparatus Portal vein

DISSECTION/ PROSECTION:

Liver:­ surfaces and margins; lobes; relations; structures passing through porta hepatis; bare area; common bile duct.Gall bladder:­ parts; cystic duct; arterial supply.Duodenum:­ subdivisions; relations; arterial supply; venous drainage; lymphatic drainage; opening of the bile duct.

Pancreas:­ subdivisions; relations; arterial supply; venous drainage; openings ofthe pancreatic ducts.Spleen:­ position; relations.Portal vein:­ Formation and its tributaries; porto­systemic anastomoses.Surface anatomy:­ liver; gall bladder; common bile duct; duodenum; spleen.Applied anatomy:­ portal obstruction; biliary colic.

TUTORIAL TOPICS FOR THE WEEK Relevant osteology. Relevant radiological anatomy. Relevant living anatomy. Relevant cross­sectional anatomy.

SCHEDULE­4

KIDNEY, SUPRARENAL AND POSTERIOR ABDOMINAL WALLLecture: 03 hrs

Dissection/ Prosection: 10 hrsTutorials: 01 hr

LECTURES:

Kidneys, ureters, suprarenals

Abdominal aorta; Inferior venacava; posterior abdominal wall Diaphragm

DISSECTION/ PROSECTION:Kidney:­ coverings; relations; arterial supply; venous drainage; hilum.Ureter:­ course; constrictions; arterial supply; nerve supply.Suprarenal:­ relations; arterial supply; venous drainage.

Posterior abdominal wall.

Muscles:­ diaphragm; psoas; quadratus lumborum; tranversus abdominis; iliacus.Nerves:­ subcostal; lumbar plexus and branches; sympathetic trunk; coeliac, renal, intermesenteric and hypogastric plexuses.Arteries:­ Aorta and its branches.Veins:­ subcostal; inferior venacava and its tributaries; azygos.Lymphatics:­ cisterna chyli.Surface anatomy:­ kidney; ureter; spleen; aorta; inferior venacava.Applied anatomy:­ inferior venacaval obstruction; renal infarction; polycystic kidneys; ureteric colic.

TUTORIAL TOPICS FOR THE WEEK Relevant osteology. Relevant radiological anatomy. Relevant living anatomy. Relevant cross­sectional anatomy.

PELVIS

SCHEDULE­5

PELVIC VISCERA.

Lecture: 03 hrsDissection/ Prosection: 10 hrs

Tutorials: 01 hr

LECTURES:

Uterus and adnexa. Rectum. Urinary bladder and prostate.

DISSECTION/ PROSECTION:Identification of relevant skeletal features:­hip bones ­ ilium; ischium; pubis;sacrum ­ ala; anterior sacral foramina.coccyx ­ coccygeal vertebrae; sacro­coccygeal articulation.bony pelvis ­ inlet, oulet; diametres; ligaments.Peritoneum:­ Male: pelvic mesocolon; rectovesical pouch Female: pelvic mesocolon; recto­uterine puch; uterovesical

pouch; broad ligament of the uterus; mesovarium;uterosacral folds.

Rectum:­ flexures;ampulla; relations; arterial supply; venous drainage; supports.Uterus:­ position; parts; cavity; arterial supply; venous drainage; supports; transverse cervical ligament; uterosacral ligament; roundligament.Fallopian tube:­ intramural part; isthmus; ampulla; infundibulum; fimbriae; abdominal ostium.Ovary:­ attachments; relations; arterial supply; venous drainage; nerve supply; lymphatic drainage; ligament of ovary.Vagina:­ fornices; relations.Urinary bladder:­ shape; surfaces; relations in both the sexes; arterial supply; venous drainage; lymphatic drainage; nerve supply.Ureter:­ pelvic part ­ course; termination; arterial supply in both the sexes.Ductus deferens:­ course; termination.Seminal vesicle:­ shape, position, ducts.

Prostate:­ shape; size; position; subdivisions; capsules; prostatic venous plexus; prostatic urethra; opening of the ducts.Surface anatomy:­ fundus of the urinary bladder.Applied anatomy:­ prolapse of the uterus;prolapse of the rectum; enlargement of the prostate; spread of cancer from pelvic viscera.

TUTORIAL TOPICS FOR THE WEEK Relevant osteology. Relevant radiological anatomy. Relevant living anatomy. Relevant cross­sectional anatomy.

SCHEDULE­6

BLOOD VESSELS, NERVES AND MUSCLES OF THE PELVIS.

Lecture: 02 hrsDissection/ Prosection: 10 hrs

Tutorials: 01 hr LECTURES:

Internal iliac artery and its branches.and lymphatics of the pelvis.

Pelvis diaphragm.

DISSECTION/ PROSECTION:Arteries:­ internal iliac; divisions and branches; median sacral.Veins:­ internal iliac and its tributaries.Nerves:­ sacral plexus; coccygeal plexuses; autonomic plexuses.Muscles:­piriformis; obturator internus; coccygeus; levator ani and its subdivisions; pelvic diaphragm.Applied anatomy:­ pelvic diaphragm and mechanics of labour.

TUTORIAL TOPICS FOR THE WEEK Relevant osteology. Relevant radiological anatomy. Relevant living anatomy. Relevant cross­sectional anatomy.

SCHEDULE­7

PERINEUM

Lecture: 01 hrsDissection/ Prosection: 10 hrs

Tutorials: 01 hr

LECTURE:

Ischiorectal fossa.

DISSECTION/ PROSECTION:Anal triangle:­ rectum and anal canal­ sphincters; relations; mucous membrane; arterial supply; venous drainage; portosystemicanastomoses; nerev supply.Ischiorectal fossa:­ boundaries and contents.Urogenital triangle:­ superficial perineal pouch and its contents; deep perineal pouch and its contents.

Nerves:­ pudendal nerve and its branches.Arteries:­ internal pudendal artery and its branches.Veins:­ internal pudendal vein and its tributaries.Lymphatics:­ superficial inguinal lymph nodes.Surface anatomy:­ pudendal canal.Applied anatomy:­ rectal examination; vaginal examination; pudendal block anaesthesia.

TUTORIAL TOPICS FOR THE WEEK Relevant osteology. Relevant radiological anatomy. Relevant living anatomy. Relevant cross­sectional anatomy.

SECTION – II(Course Content under Level – I, II, III)

LECTURES

OUTLINE OF LECTURES

S.No TOPIC MUST KNOW SHOULD KNOW COULD KNOW1. ANTERIOR

ABDOMINAL WALL

1. Regions of the abdomen and theviscera in relation. Landmarks Joints Muscles Nerves­ Dermatomes 2. Superficial fascia & itsattachments3. Muscles & their actions5. Dermatomal distribution 6. Blood Vessels7 a. Portal obstruction b. Caval obstruction c. Lymph. Drainage d. Surface anatomy of superficialand deep inguinal rings e. Renal angle f. Murphy’s point

3. Holden's line 7. Attachment of themuscles8 a. Striae gravidarum& albicantesb. Extravasation of

urine11. Abdominal incisions

1. Langer's lines 4. Suspensory lig of penis

2. RECTUS SHEATH

1. Formation at three levels2. Arcuate line3. Contents of rectus sheath4. Linea alba5. Linea semicircularis

6. Functional aspects

of rectus sheath 5 g. Retraction ofrectus muscle laterally

5. a . Divarication of recti b. Umblical hernia c. Incisional hernia d. Faecal fistula e. Urinary fistula f. Meckel’sdiverticulum

3. INGUINAL CANAL 1. Descent of testis & processus

vaginalis2. Topography(location /surf

projection)3. Boundaries, extent & contents 4. a. Indirect & direct inguinal

herniab. Types of indirect hernias

4(i)Mechanisms ofinguinal canal4(ii)Interfoveolar lig 7. Anatomicalconsideration of herniarepair

8. Canal of Nuck

4. TESTIS & SPERMATICCORD

1. Coverings of spermatic cord andtestis

2. Contents in males & females3. Spermatic cord vis­à­vis hernial

sac in direct and indirect inguinalhernias

4. Tunics of testis5. Gross structure of testis6. Blood supply, lymphatics7. Nerve supply8. Applied anatomy

a. Hydroceleb. Vasectomyc. Cremaster reflexd. Scrotum – nerve supply

8 e. Varicocele f. Undescended testis g. Ectopic testis

8.h. Torsion of testis i. Appendix of testis j. Appendix of epididymis

5. PERITONEUM 1. Vertical disposition of peritoneuma. to the right of gall bladderb. to the left gall bladder2.Horizontal disposition ofperitoneum at:a. at epiploic foramenb. at umblicus c. in the pelvis2. Greater Sac4. Lesser sac (Omental bursa) andepiploic foramen2Applied anatomy: a. Hepatorenal pouch b. Pouch of Douglas6. Nerve supply of the peritoneumand referred pain

6(iv) Peritoneal recesses& bands5. Functions ofperitoneum6. (I) Ascitis6 (ii) Various spaces ­supracolic, infracolic,pelvis6(iii) Peritoneal fossae­ lesser sac,duodenalfossae,intersigmoidal recess

Peritoneal recesses andbands

6. STOMACH

1.Gross features 3. Relations & Stomach bed5. Blood supply6. Lymphatic drainage7. N. supply8. (I) Gastric ulcer and vagotomy

2. Musculature ­magenstrausse gastriccanal 7(ii) Endoscopy7(iii) Barium meal

7(iv) Ca stomach­Trosier'ssign7(v) Traube's space7(vi) congenital anomalies

7. DUODENUM I & II 1. Gross features including relations 4. Interior : Openings and bile ductand pancreatic duct5.a. Blood supply 6 a. Duodenal ulcer &cap b. Paraduodenal fossa 7. Difference between small & largeintestine

2.Prepyloric vein ofmayo 6 c. Endoscopy &Endoscopic retrogradecholangio pancreaticography(ERCP)

1. Lig. of Treitz 5 b. Supraduodenal arteryof wikie c. Retrodoudenal artery

8. CAECUM, APPENDIX and COLON Ascending Transverse Descending Sigmoid

CAECUM: 1. Gross featuresincluding relations 2. Blood supply 3. Interior APPENDIX: a.. Difference fromlarge intestine b. Gross features including relations c. Blood supply d. PositionsCOLON:a. Gross features including relationsb. Blood supplyc. Interior

4. Shapes of caecum 7. Clinical relevance of

positions8. McBurneys' point

5 a. Recesses aroundcaecum b. Lump in right iliacfossa 9. Appendicitis vs

Salpingitis /oophoritis10. Anatomical

considerations &surgical incisions

9 LIVER 1. Gross features including relations2. Blood supplyLobes of the liver and vascularsegments3. Lymphatic drainage

10. EXTRAHEPATICBILIARY APPARATUS

1. Components2. Gross features of G.B.3. Blood supply of G.B4. CBD­Parts & relations 6. Applied ­gall stones

5. Sphincter of Oddi 7. Cholecystography

8. Callot's triangle11. Endoscopic retrograde

cholangiopanereatcography(ERCP)

12. Hartmann's pouch13. Phygian cap

11. PANCREAS 1. Gross features of individualcomponent including relations

2. Blood supply3. Lymphatic drainage4. Duct system5. Sphincter of Oddi6. Duodenal papillae

7. Splenectomy vis­à­vis tail of pancreas

8. CA head pancreas

12. PORTAL VEIN 1. Definition of portal system2. a. Formation & tributaries3. Parts & relations4. Porto­caval anastomosis:

common sites & clinical bearing;haemorrhoids & esophageal.

2.b. Laminar blood flow

Varices.5. Caput medusae

7. Porto ­caval shunt.

S.No TOPIC MUST KNOW SHOULD KNOW COULD KNOW

13. KIDNEYS

2. Gross features includingrelations3. Coverings 5. a. Blood supply

b. Vascular segments 7. Coronal section withinternal feature

1. Morrison'sparallelogram

4. Supports 8. Applied: a. Nutcrackereffect on Lt. Renal vein b. Renal angle c. Exposure ofkidney from back d. Pyelography

6. Pattern of divisionof renal artery 8 e. Floating kidney f. HorseshoeKidney g. Abberent renalA h. Renal transplant i. Lithotripsy

14. URETERS 1. Extent, course &terminations2. Constrictions3. Relations4. Blood supply5. Lymphatic drainage6. Ureteric colic

7. Anomalies of theureter

15. DIAPHRAGM 1. Attachment2. Openings3. Nerve supply5. Function

6. Applied anatomy: a. Diaphragmatichernia b. Reflex arc forhiccups

6 c. Foramen ofBochdalek d. Phrenic crush

16. 17.

A. AORTA &INFERIOR VENA CAVA andB. POSTERIORABDOMINAL WALL

A. 1. Extent, course &termination

2. Relations2. Tributaries

5. Porto­cavalanaatomosis6. Thoraco­epigastricVn in block of IVC

4. Spread ofcarcinoma throughsystemic veins tovertebral venousplexus

18. PERINEUM

1. Boundaries2. Subdivisions3. Colle's fascia &perineal

membrane4. Urogenital diahragm5. Perineal body6. Levator ani7. Perineal pouches:

Boundaries, contents8. Nerve supply of theperineum

9. Rupture of urethra&extravasation ofurine10. Perineal tear11. Episiotomy

19. ISCHIORECTALFOSSA

1. Location2. Boundaries & contents3. Pudendal canal

4. Course ofinf.rectal vessels &pudendal N5. Recesses of IRFossa6. Applied:

6(I) Ischiorectalabscess6(ii) Fistula in ano &Goodsall's rule

6(iii) Hiatus ofSchwalbe

20. URINARY BLADDER 1. Gross features & relationsin male and female

2. Interior3. N. supply4. Blood supply: In male and

female5. Lymphatic drainage

6. Suprapubic

cystostomy7. Neurogenic

bladder8. Cystoscopy

9. Ectopia vesicae10. Patent urachus

21. A. PROSTATE &MALE URETHRAB. SEMINAL VESICLE

1.Gross features & relations2. Internal structure3. Blood supply4. Age changes

5. Capsule vis­a­viaprostatectomy6. Benign prostatichypertrophy7. Symptoms & itsanatomicalconsiderations inBPH8. Per rectalexamination9. Urethralcatheterisation

10. TURP­Transurethralresection of prostate11. Ca­prostate &spread

22.OVARY, UTERUS andADNEXA:

1. Gross features & relations 3. Position; Tubectomy4. Blood supply5. Lymph drainage6. Supports of uterus ­ Broadligament7. Nerve supply and referredpain of ovary8. Rectouterine fistula.

2. Rectouterinepouch &vesicouterine pouch 7. Prolapse of uterus8. Hysterectomy

Uterine anomalies 9. Recurrent abortionsin retroverted uterus

23. SIGMOID COLON andRECTUM

1. Goss anatomy includingrelations and flexures2. Sigmoid mesocolon and theureter2. Internal features3. Blood supply with venousdrainage4. Lymphatic drainage5Applied anatomy:a. Imperforate anusb. Per rectal examinationc. Fascia of Denonviller'sd. Haemorrhoidse. Proctoscopy

4. Applied

anatomy:f. Hirschsprung’sDiseaseg Prolapse of therectum

5 Applied anatomy:h. Ca­rectum

24. ANAL CANAL

1.Gross features; Anorectaljunction2. Internal features of analcanal:2(i)White line2(ii) Pecten2(iv) Anal columns3. Internal & externalsphincters and nerve supply 4. Blood supply includingvenous drainage5. Puborectalis – Anorectalring

6(I) Internal &external haemorrhoids6(ii) Porto­cavalanastomosis6(iii)Fissure ­in ­ano6(iv)Fistula ­ in­ano

6(v) Perianalabscesses vis­à­visischio and abscesss

6(vi) Goodsall's rule7. Embryological &surgical anal canal8. Imperforate anus

25. PELVIC DIAPHRAGM, FASCIA, VESSELSand NERVES

Pelvic diaphragm:Components1. Attachments2. Relations3. Actions4. N.upply:

Sacral plexus andlumbosacral trunk

5. Internal iliac artery

6. Tear of lev. Ani­childbirth episiotomy

7. Branches ofexternal and internaliliac arteries8. Role of levator ani

in chilbirth 9. Urinary stressincontinence due toweakening of pelvicdiaphragm

26. JOINTS ANDLIGAMENTS OF THEPELVIS

A. Pubic symphysis:Classification andfunction

B. Sacroiliac joints:1.Classification2. Ligaments3. Relations4. Applied anatomy

SECTION – II(Course Content under Level – I, II, III)

DISSECTION­INCISIONS

DISSECTION

Learning Objectives of Dissection

S.No

TOPIC

DISSECTION

STEPS

WHAT IS EXPECTED FROM THE STUDENTS

SUMMARY

MUST KNOW SHOULDKNOW

COULDKNOW

IDENTIFY UNDERSTAND

1. ANTERIORABDOMINALWALL

Place thebody in asupineposition &give incisions3,4,8 & 9.

While giving

Various planes,their levels &variousabdominalregions.

Pubicsymphysis,

Muscles ofAnteriorAbdominalWall

Superficialinguinalring.

Actions of thesemuscles.Various planes &their levels(drawyourself)Name abdominalregions & abdominal

incisions 8encircle theumbilicus

Extendincision 9posteriorlyalong theiliac crest

Reflect theskin flapsleaving thesup.fascia onAAW

Transverse.sectionthroughsuperficialfascia fromASIS tomedian plane

Separatememb layerfrom E.O.aponeurosis.

Divide sup.Fasciavertically inmedianplanes & inline ofpost.axillaryfold

Separatesup.fascia bybluntdissection.

Note thedirection offibres of EO.& define itsattachments

Divide EOfrom costalmargin toiliac crest &reflect itmedially.Notedirection offibres of IO.

Divide IOfrom costalmargin toiliac crest,reflect itmedially &separate itfromTransversusabdominis.

Pubic tubercle,Anteriorsuperior iliacspine

Supf. Fascia:its two layers(fatty andmembranous)in theinfraumbilicalregion.

Superficial Inguinal ring(superolateralto PubicTubercle) inEOA.

Structuresemergingthrough it: ­Spermatic cordin male.­ Roundligament ofuterus infemale

Ext. oblique Int. oblique Transversus

abdominis Conjoint

tendon Veins of the

anteriorabdominalwall.

Attachmentsof AAWmuscles

Ant. Cut.br.of IHNpiercingE.O.A. a shortdistance sup.To supf.Inguinal ring. Lat. cut

Nerves Cut. Veins

Spermaticcord.

viscera occupyingthem.

APPLIED ASPECTS

Paracentesis abdominis Caput medusae SVC blockade ­ Lateral thoracic

vein Ultrasonography Abdominal incisions

S.No

TOPIC

DISSECTIONSTEPS

WHAT IS EXPECTED FROM THE

STUDENTS

SUMMARY

MUST KNOW SHOULDKNOW

COULDKNOW

IDENTIFY UNDERSTAND

2. RECTUSSHEATH

Open anteriorlayer ofRectussheathmediallyalong middle

Anterior Layerof RectusSheath.

Rectus sheath Rectus

abdominis Sup. & inf.

Epigastric vs.

Formation of R.Sat different levels

Tendinousintersections

Actions of RA

of R.ectusAbdominismuscle

Detach itfrom thetendinousintersections.

Reflect ant.Layer of R.S.medially &laterally.

Lift R.A. &identifyintercostalNs. &subcostal Ns.

Divide R.A.transvereslyat the middle& turn theparts sup. &inf. Andidentify

Rectusabdominis

Pyramidalis, ifpresent

Posterior layer

of RectusSheath.

Superior &inferior.Epigastric veins.

Arcuate line Linea alba Linea

semilinaries Linea

semicircularis

Intercostal

Ns. Subcostal

nerve

Arcuate line Linea

semilunaris

APPLIED ASPECTS

Umblical hernia Paraumblical hernia Epigastric hernia Rationale of ant. Abdo.wall incisions. Reflection of R.A. laterally Divarication of recti Abdominal paracentesis

S.No

TOPIC

DISSECTION

STEPS

WHAT IS EXPECTED FROM THE STUDENTS

SUMMARY

MUST KNOW SHOULD KNOW COULD KNOW IDENTIFY UNDERSTAND 3. TESTIS AND

SPERMATICCORD

Make a longincisionextending fromsupfl. Ringthroughanterolateralaspect ofscrotum

Reflect thedartos from theskin

Reflect dartosfrom loosearticular tissuedeep to it.

Lift testis &spermatic cordfrom thescrotum.

Cut thespermatic cordat the sup, ring& remove italong withtestis.

Clean and traceblood vs. intotestis

Free tail andbody ofepididymis fromthe testis.

Make atransverseincision throughthe testisexamine it witha hand lens &identify

Spermatic cord &structures in itesp. ductusdeference &testicular artery.

Epididymis Dartos Scrotum and its

nerve supply Epididymis and

its various parts Sinus of

epididymis(opens laterally)

Mediatinumtestis

Penis­ parts Vessels and

nerves of thepenis

Penile urethra TS of the penis

Coverings of

spermatic cord& testis.

Testicular vein

formation Genitofemoral

nerve andcremastericreflex

Testis and its

normalorientation & sidedetermination

Sinus ofepididymis

Spermatic cord Ductus

deferens Testis Epididymis

Coverings ofspermaticcord andtestis

Descent oftestis

APPLIED ASPECTS

Hydrocoele Incomplete descent of testis Ectopic testis Vasectomy Torsion of the testis

S.No

TOPIC

DISSECTIONSTEPS

WHAT IS EXPECTED FROM THE STUDENTS

SUMMARY

MUST KNOW SHOULDKNOW

COULD KNOW IDENTIFY UNDERSTAND

4. INGUINAL Study the Boundaries of Inguinal Coverings of

CANAL formation ofthe inguinalcanal

inguinal canal­ Ant. wall­ Post. wall­ Floor­ Roof.

Openings:Inguinal ring inEOA superolat.To P.T­Deep ing. Ring inF.T. Structures

passingthroughsuperficialinguinal ring:

­ spermatic cordin males

­ round lig. ofuterus infemale

Fasciatransversalis

Ilioinguinal N Iliohypogastric

nerve Umbilical

hernia

Compareinguinalhernia withfemoralhernia

Hasselbach'striangle

Ventral

incisionalhernia

ligament Sup. Ing.

Ring Deep

ing.ring Spermatic

cord inmales

Round lig.in females

Conjointtendon

different typesof hernia

Direct VsIndirectinguinal hernia

Factors

preventinginguinal hernia

APPLIED ASPECTS

Inguinal herniae Anatomical consideration in

repair or hernia

S.No

TOPIC

DISSECTIONSTEPS

WHAT IS EXPECTED FROM THE STUDENTS

SUMMARY

MUST KNOW SHOULD KNOW COULDKNOW

IDENTIFY UNDERSTAND

5. DISSECTIONOF THE LOIN:EXPOSURE OFTHE KIDNEYFROM THEBACK

Place the body inthe proneposition

Follow inf. partof lat. Dorsi toiliac crest

Expose free post.border of ext.oblique & notethe intervalbetween the twomuscles

Reflect the lat.Dorsi nf. AndExt. obliqueanteriorly.Exposeint.oblique (post.part) andthoracolumbarfascia.

Remove remainsof lat. Dorsi &detach serr. Postfrom T.L fascia(post layer)

Cut verticallythrough postlayer from 12thrib to iliac crestand transverse atupper and lowerends. Reflect thelayer and exposeerector spinae

Pull erectorspinae medially& follow middlelayer of theT.L.F ant to themuscle

Define

Lat dorsi Ext. oblique Lumbar triangle

of petit Int. oblique Erector spinae Quadratus

lumborum Subcostal Iliohypogastric Ilioinguinal

Thoracolumbar

fascia(post.layer)

Thoracolumbar

fascia (postlayer)

Subcostal N Iliohypogastric

N Ilioinguinal N

Muscles­Lat dorsi­Int. oblique­Eretor spinae­Q. lumborum Fascia ­ TLF Nerves­Subcostal­Iliohypogastric­Ilioinguinal Triangle­Lumbar triangle Lower pole

of kidney

Arrangement& attachmentsof ThoracoLumbar fascia

APPLIED ASPECTS

attachments ofmiddle layer ofthoracolumbarfascia and cutthrough its sup.Med. & & inf.Attachments &reflect it laterally

Push Quadlumborummedially & feelpost surface ofant. layer byfinger

Divide ant. layer& expose lowerpart of kidney &nerves runningover postr.Surface ofkidney.

Renal angle: incision pleura Bimanual palpation of kidney Lumbar hernia through lumbar

triangle

S.No

TOPIC

DISSECTION STEPS

WHAT IS EXPECTED FROM THE STUDENTS

SUMMARY

MUST KNOW SHOULDKNOW

COULDKNOW

IDENTIFY UNDERSTAND

6. PERITONEUMANDDISPOSITIONOF THEVISCERA INSITU

Cut parietalperitoneumtransversely atumbilicus and turnupper and lowerparts sup. & inf.Respectively

Examine and

identify ligamentsin infraumbilicalportion from deeperaspects.

Identify various

abdo. Organs insitu,

Identify Pull stomach down

& to left and liverup and to right.

Ientify epiploicforamen. Pass indexand middle fingersof left hand throughit.

Parietalperitoneum

Verticaldisposition Rt.Of GB. Lt of GB

Horizontaldisposition E.foramen. Umb.Pelvic .

Ligamentumteres

Falciformligament.

Greater sac Lesser sac Compartments­ Supracolic­ Infracolic Greater omentum Lesser omentum

­ parts Epiploic foramen

& its boundaries Omental bursa

and parts Transverse

mesocolon

Median umb.

Lig.

Medial umb.

Lig Lat. Umb.

Lig Internal

hernias

Parietalperitoneum

Peritonealligs.Falciform

Lig. teres Peritoneal

reflections­Gr. Omentum &parts­Lesser omentum& parts Abdo. Organs

in situSupracoliccompt

Epiploic for.

Peritoneum &its reflections

Def. &examples of­Ometum

­ Mesentry ­ Ligaments

APPLIED ASPECTS

Peritoneal efusion Paracentesis Peritonitis H.R. pouch Peritoneal spaces Peritoneal recesses Pouch of douglas

S.No

TOPIC

DISSECTIONSTEPS

WHAT IS EXPECTED FROM THE STUDENTS

SUMMARY

MUST KNOW SHOULD KNOW COULDKNOW

IDENTIFY UNDERSTAND

7. SPLEEN Palpate the spleenin the lefthypochondrium

Push stomach toright and identifyupper part ofgreater curvature.

Spleen Anatomical

position Impressions on

visceral surface Ligaments of

Gastrosplenic

ligament(GSL).

Spleen and itsanatomicalposition

Impressions onits visceralsurface

Hilum of

Peritonealreflections oforgan

Ligaments ofspleen

Blood circulationthrough it

Identify fold ofperitoneumextending fromthere to hilum ofspleen.

Identify Vs. inGSL

Push Tr. Colondownward on theleft side includingleft colic flexureand push spleenupward towardleft dome ofdiaphragm &note fold ofperitoneumextendingbetween spleenand Lt. Kidney

Study the organin situ. And noteits relations

Cut ligaments athilum of spleenand remove theorgan & study itsgross features

spleen Blood supply

Linorenal

ligament TS at L1 showing

epiploic foramen& lesser sac

Short

gastricVeins

spleen

Functional aspectsof the organ

APPLIED ASPECTS

Palpation of spleen Splenomegaly ­ direction, costal arch. Referred pain in splenic rupture : Kehr's

sign Splenectomy Accessory spleen Splenic puncture

S.No

TOPIC

DISSECTIONSTEPS

WHAT IS EXPECTED FROM THE

STUDENTS

SUMMARY

MUST KNOW SHOULDKNOW

COULDKNOW

IDENTIFY UNDERSTAND

8. COELIACTRUNK

Push liverupwards &trace theperitonealreflection fromliver to lessercurvature ofstomach

Cut and removeboth layers oflesseromentum &identify bloodVessels.

Trace Lt.

Gastric vessels,coursing alonglesser curvature

Trace rt.Gastric vs.coursing alonglower part oflesser curvature

Follow Rt.Gastric art. Tohepatic art

Identifystructures inlesseromentum(in itsrt. Free margin)& note theirpositions

Trace these

Lesser omentum Coeliac trunk and

its three branches­Lt. Gastric­Hepatic­Splenic Lt. Gastric Vs. Rt. Gastric Vs. Hepatic Art.

Proper Three structures­Common hepaticart.­Portal vein­Bile duct Tortuous splenic

art Common hepatic

art Gastroduodenal

art Rt. Gastric art.

Coeliac

ganglion

Coeliac trunkand its threebranches

Branches ofhepatic art.

Splenic Vs.behindstomach

Area supplied bycoeliac trunk & itsanatomical basis

Course of hepatic art.

APPLIED ASPECTS

oesophageal varices

structures toporta hepatis &note theirrelations

Identify splenicvs. behindstomach

Clean anddefine branchesof hepatic artproper

S.No

TOPIC

DISSECTION

STEPS

WHAT IS EXPECTED FROM THE STUDENTS

SUMMARY

MUST KNOW SHOULD KNOW COULD KNOW IDENTIFY UNDERSTAND 9. STOMACH Identify the

organ in situ &note its grossfeatures

Identifyperitoneal foldsof stomach

Note Vs in thegreateromentum

The 2 ligaturesto right ofpyloricsplincter(somedistance apart)

Turn stomachalong rt. Gastricand Rt.GastroepiploicVs to left sideand thenidentify.

Strip offperitoneumalong lessercurvature &identify.

Pull cardiac enddown and tie 2ligatures somedistance apartand cut inbetween the 2ligatures.

Cut at pyloricend & remove

Greateromentum

Lesseromentum

Structuresformingstomach bed

Parts: Fundus,body & pylorus

Omental

bursa Coeliac trunk

and itsbranches

Left kidneyand thesuprarenal

Gross features Internal

features:Mucosalfolds:

Rugae. Blood supply

and nervesupply

Lymphaticdrainage

Gastroepiploic

Vs. (Rt & Lt) Rt. & Lt. Vagi Lt.

Gastroepiploicart

Coeliac

ganglia Short gastric

arteries (5­7 inno.)

Organ & itsgrossfeatures

Cardiac &pyloric ends& theirdifferences

Structuresformingstomach bed.

Anatomicaldisposition

Peritonealrelations

Blood supply Lymphatic

drainage

APPLIED ASPECTS

Gastro colic reflex Gastirc ulcers Barium meal study Endoscopy Anatomical basis of vagotomy &

types Ca. Stomach and its spread

S.No

TOPIC

DISSECTIONSTEPS

WHAT IS EXPECTED FROM THE STUDENTS

SUMMARY

MUST KNOW SHOULDKNOW

COULDKNOW

IDENTIFY UNDERSTAND

10. MESENTERICVESSELS

Turntransversecolon & itsmesocolonupwards

Expose andidentifymesentery ofsmallintestine

Trace obliqueattachment ofmesentery on

Tr. Colon &mesocoln

Mesentery ofsmallintestine

Sup.

Mesenteric

Sup.Mesentric art.& its branches

Inf. Mesentricart. & itsbranches

Marginal art Mesenteric

group oflymph nodes

Portion of gutsupplied bySMA onembryologicalbasis

Portion of gutsupplied byIMA onsmbryologicalbasis

Anastomosisbetween brs. ofSMA & IMA

the post. abdowall

Turn smallintestine tothe left

Cut throughRt. Layer ofperitoneum ofmesentery &expose sup.MesentericVs.

Identify SMVto the right ofthe artery

Turn smallintestine & itsmesentery tothe right.

Removeperitoneum &fat on post.abdo. Wallbetweenmesentery &descendingcolon &expose inf.MesentericVs.

Identify inf.Mesentericvein to theleft of art.

Trace and

identifymarginalartery

Vs. Inf.

MesentericVs.

Branches fromSMA

­Inf. Pancreatico­­duodenal.­Jejunal & ileal(12­15)­Ileocolic(cont)­Rt. Colic ­middlecolic Branches from

IMA­Left colic­Sigmoidal (2­3)­Sup rectal Marginal

artery ofDrummond

Mesenteric

group oflymph nodes

APPLIED ASPECTS

Marginal art. Of drummond Resection of L.intestine and end to

end anastomosis of arteries Critical point of Sudeck

S.No

TOPIC

DISSECTIONSTEPS

WHAT IS EXPECTED FROM THE STUDENTS

SUMMARY

MUST KNOW SHOULD KNOW COULDKNOW

IDENTIFY UNDERSTAND

11. LARGEINTESTINE

Study largeintestine insitu & note itscardinalfeatures

Note the

peritonealcovering oflargeintestine

Clean &definecaecum &turn itupwards

Identifyappendix &note itsposition

Noteconvergenceof all taeniato base ofcaecum

Cut. Lat wall

Large intestine& its variousparts:

Caecum & appendixAsc. ColonTr. ColonDesc. ColonSigmoid/pelvic colonRectumAnal canal Tr. Mesocolon

sigmoidmesocoln

Caecum Appendix & its

position Ileocaecal

orifice Appendicular

orifice

Post relations

of caecum Mesoappendix Appendicular

`artery Structures

behind apexLeft ureterDiv. of lt. CI artery

Largeintestine & itsvarious parts

Post.relations ofcaecum

Appendix &its position

Peritonealcoverings

Tr. Mesocolon.Sigmoidmesocolon

Embryological basis ofblood supply of largeintestine

Peritoneal relations oflarge intestine

Vertical disposition Horizontal disposition

of caecumwash &identify

Divideperitoneumalong lateralmargin ofdescendingcolon & turncolonmedially.Noteattachment ofsigmoidmesocolon

Tie twoligatures atjunction ofdesc.colon &sigmoidcolon. Dividecolonbetweentheseligatures

Removelargeintestine &wash it

Take about 6" piece oflargeintestine &open itlongitudinally& examine itsinterior.

APPLIED ASPECTS

Differential diagnosis of lump in Rt. Iliacfossa

Appendicitis & Mcburney's point Muscle cutting and muscle splitting

incisions for appendicectomy Ca.colon &resection of colon Gastro­colic reflex Meckel's diverticulum Blood supply of appendix (tip)

S.No

TOPIC

DISSECTIONSTEPS

WHAT IS EXPECTED FROM THE STUDENTS

SUMMARY

MUST KNOW SHOULDKNOW

COULDKNOW

IDENTIFY UNDERSTAND

12. SMALLINTESTINE

Pullduodenojejunalflexuredownwards

Tie twoligatures at theDJ flexuresome distanceapart(1")

Cut smallintestinebetween twoligatures 2inchesproximal toiliocaecaljunction & cutthe smallintestine

Cut along themesenteryalong itsattachment onpost.abdo.wall.

Remove thesmall intestineand flush itslumenthoroughly

Cut a piece ofjejunum &ileum alongwithmesentery

Duodenojejeunaljunction

Small intestine­Jejunum­Ileum Arterial supply

patternArterial arcadesArterial windows Pliaca circularis Payer's patches

in ileum

Fat

distributionin theirmesenteries

Suspensorylig. ofTreitz.

D.J junction. Jejunum Ileum Mesentery of

small intestine Arterial supply

­pattern ofjejunum &ileum

Differencesbetween jejunum& ileum­Extramural­Mural­Intramural

Proximal /distalend of a loop ofintestine ­ comingout of the incisionsite by tracing themesentery

Functional aspectof arterial supply& differences

APPLIED ASPECTS

Paralytic ileum Meckel's diverticulum

(about 6 incheslength)

Study bothparts and notetheirdifferences

Open jejunum& ileum alongtheir antimesentericborder & studythe interior.

S.No

TOPIC

DISSECTION

STEPS

WHAT IS EXPECTED FROM THE STUDENTS

SUMMARY

MUST KNOW SHOULDKNOW

COULDKNOW

IDENTIFY UNDERSTAND

13. PANCREASANDDUODENUM

Turn tail andbody of pancreasto right

Strip splenicvessels from itspost. surface

Divide bileduct near sup.Part ofduodenum &removeduodenum &pancreas as onepiece

Make 2 cutson post. surfaceparallel to sup.& inf. margins ofthe body ofpancreas

Tease awaylobules of glandbetween the cutsto exposegreyish whitemain pancreaticduct & note itstributaries (herring bonepattern)

Expose acc.Duct & itstributaries inhead ofpancreas.

Follow bothducts duodenum.Cut open theduodenum alongits Rt. Wallvertically &wash it. Identifythe openings onthe internalsurface ofposteromedialpart of II part ofduodenum

Identify theduodenum &pancreas insitu.

Differentparts ofduodenum &post. relationsof III part.

Differentparts ofpancreas

Duodenalfossae

Main

pancreaticduct. (ofWirsung)

Major

duodenalpapilla

Acc.

Pancreaticduct (ofSantorini)

Minorduodenalpapilla

Duodenum (allparts)

Pancreas Major

pancreatic duct Major

duodenalpapilla

Peritoneal relationsof duodenum &pancreas

Blood supply ondevelopmentalbasis.

APPLIED ANATOMY

Duodenal ulcer Duodenal cap in barium meal supply Acute & chronic pancreatitis Varicocoele ERCP ­ Endoscopic visualisation of the

openings of the bile duct and thepancreatic ducts.

Cpommon sites of cancer

S.No

TOPIC

DISSECTIONSTEPS

WHAT IS EXPECTED FROM THE STUDENTS

SUMMARY

MUST KNOW SHOULD KNOW COULDKNOW

IDENTIFY UNDERSTAND

14. PORTALVEIN

Lift tail ofpancreas fromspleen &

Pancreas

Veins ­Inf. Mesenteric ­Splenic

Formation of portalvein

Portal system of

separate bodyof pancreasfrom posteriorabdominalwall

Identifysplenic veinover posteriorsurface ofpancreas

Clean & tracesplenic vein tothe junctionwith SMVbehind theneck ofpancreas &note thebeginning ofportal vein

Follow IMV &note itstermination

Trace varioustributaries ofportal vein

Splenic vein. Sup.

Mesentericvein

Portal vein

Termination of

IMV Tributaries of

portal vein

­Sup.Mesenteric­Portal Tributaries

of portalvein

circulation Portal hypertension

APPLIED ASPECTS

Portocaval anastomosis & its appliedanatomy

­Esophageal varices ­Caput medusae ­Haemorrhoids Portocaval shunts

S.No

TOPIC

DISSECTIONSTEPS

WHAT IS EXPECTED FROM THE STUDENTS

SUMMARY

MUST KNOW SHOULDKNOW

COULDKNOW

IDENTIFY UNDERSTAND

15. LIVER &GALLBLADDER

Identify andfeel

Pull liverdown andcut layersof lefttriangular &coronaryligaments

Cut thestructures atthe portahepatis

Identify &feel IVC &cut it above& belowthe liver

Remove theliver alongwithsegment ofIVC

Liver & gallbladder in situ

Ligaments ofliver

Lig.teresCoronary lig.Rt. & lt triangularlig. Anatomical

position Anatomical

lobes Physiological

lobes Fissures for Lig. teres Lig. venosum Gall bladder

and its variusparts

Porta hepatis &groove for IVC

Arrangement ofatructures atporta hepatis.

Bare area Fossa for the

gall bladder

Structures

related toinf. Andpost. surface

Vascular

segments Hepatic

circulation

Liver and itsparts

Gall bladder Various

components ofextrahepatic biliaryapparatus

Peritonealreflection on theliver 1

Bare area ofliver

Veins of Retzuis Supports of

liver

APPLIED ASPECTS

Hepatomegaly Palpation of the liver Liver biopsy Hepatorenal pouch Gall stones (Predisposing factors) Calot's triangle

S.No

TOPIC

DISSECTIONSTEPS

WHAT IS EXPECTED FROM THE STUDENTS

SUMMARY

MUST KNOW SHOULD KNOW COULDKNOW

IDENTIFY UNDERSTAND

16. KIDNEYS ANDSUPRARENALS

Remove fatand fasciafrom ant.

Kidneys &suprarenals insitu.

Kidneys andsuprarenals

Renal fascia 7other coveringsof kidneys

surface ofkidneys andsuprarenals

Clean & trace

ureters Mobilise both

the kidneys &turn themmedially

Separate

suprarenalsfrom renalfascia & notetheir relations

Removesuprarenalsand note.

Cut ureter atlower pole ofkidneys &renal vessels2cm from thehilum andremove them

Study post.relations

Cut one

kidney alongits lateralborder intotwo equalhalves(ant. &post) andstudy the cutsection withthe help ofdiagram

Renal vessels Termination of

Lt. Suprarenal& Lt gonadalveins in Lt.Renal vein

Kidneys:position,coverings andrelations

Ureter: Course,relations,normalconstrictionsand bloodsupply

Lymphaticdrainage of thekidneys and theureter

Relations ofsuprarenals insitu

Differences inshapes ofsuprarenals

Determine theside &anatomicalposition

Coronal section:Cortex,medulla,pyramid,calyces, pelvisof ureter

Branch to Lt.

Suprarenal Suprarenal

arteries Positions of

suprarenal veins Vascular

segments

Branch to

ureter Brodal's

line

Sidedeterminationof kidney

Differencesbetweensuprarenals

Post. relationsof kidneys

Supports ofkidneys.

Anatomicalbasis of:

­Floating kidney­Polycystic kidney­Pelvic kidney­Horseshoe shaped kidney

APPLIED ASPECTS

Renal angle Palpation / percussion of the kidney

(bimanual) Differentiation of renal enlargement

from splenic enlargment Surgical approach to kidney & ureter Pyelography & its indications Renal / ureteric coli Varicocoele. Renal infarction Polycystic kidney

S.No

TOPIC

DISSECTIONSTEPS

WHAT IS EXPECTED FROM THE STUDENTS

SUMMARY

MUST KNOW SHOULD KNOW COULD KNOW IDENTIFY UNDERSTAND 17. POSTERIOR

ABDOMINALWALL

Clean thepost. abdo.Wall &denude itfrom allfascia andidentify

Clean

muscles ofpostr.abdo.wall &identify them

Clean &

trace nerveson posteriorabdominalwall

Dissect the

lumbar

IVC & itstributaries

Abdo.aorta & itsbranches

Sympathetictrunk on eitherside of aorta

Quadratus

.lumborum Psoa major &

minor Iliacus Subcostal

iliohypogastric Ilioiniguinal Femoral Obturator Lumbosacral

Azygos vein Hemiazygous

vein Genitofemoral

Cisterna chyli

&continuationupwards asthoracic ducts

Lat.cut.N of

thigh

Structures inpost.abdo.wall.

Muscles: Q.lumborum P. major Iliacus Nerves Symp. Trunk Femoral Obturator Aorta & its

branches IVC & its

tributaries

Arrangement ofabdominopelvicfascia on post.abdo. wall

APPLIED ASPECTS

Caries spine Psoas abscess Meralgia parasthetica IVC obstruction

plexus

trunk Cysterna chyli

S.No

TOPIC

DISSECTIONSTEPS

WHAT IS EXPECTED FROM THE STUDENTS

SUMMARY

MUST KNOW SHOULDKNOW

COULD KNOW IDENTIFY UNDERSTAND

18. RESPIRATORYDIAPHRAGM

Strip parietalperitoneumfrom theundersurface ofdiaphragm &identify variousparts &openings ofdiaphragm

Clean & define

attachments ofcrura

Clean and

define arcuateligaments

Clean and

define majoropenings indiaphragm withstructurespassing throughthem

Work out their

levels inrelation tothoracic spines

Explore

various otherminor openings& structurespassing throughthem

Respiratorydiaphragm & itsrt. & lt. Domesand centraltendon

Crura of

diaphragm Med. & lat.

Arcuateligaments

IVCopening (in

central tendon) Oesophageal

opening (in rt.Crura)

Aortic opening (behind medianarc. Lig)

IVC ­T8 Oesophagus ­

T10 Aortic ­ T12

Structures

passingthrough them

Opening for

sup.Epigastricvessels

Subcostal Vs.& N

Symph trunk Splanchnic

nerves

Median arcuate

ligament Opening for

musculophrenicVs.

Lower 5intercostal N

Hemiazygous v.

Respiratorydiaphragm andits variouscomponents

Majoropenings indiaphragm

Actions ofdiaphragm

Developmentalanatomy ofdiaphragm

Nerve supply

APPLIED ASPECTS

Diaphragmatic herniae Paralysis of diaphragm: injury to phrenic

nerve

S.No

TOPIC

DISSECTIONSTEPS

WHAT IS EXPECTED FROM THE STUDENTS

SUMMARY

MUST KNOW SHOULDKNOW

COULDKNOW

IDENTIFY UNDERSTAND

19. UROGENITALTRIANGLE:ISCHIORECTALFOSSA; ANALTRIANGLE ANDANAL CANAL;PERINEALPOUCHES (PROSECTIONONLY)

Place the cadaverin prone position

Expose lowerborder of Gluteusskin fascia fromperineum.ext.analsphincter.anococcygeal lig.& margins of anus

Trace & defineboundaries ofischioanal fossa

Expose & cleanpost. margin ofperineal memb. &

Gluteus

maximus Sacrotuberous

lig. Location &

extent ofischioanalfossa

Inf. Rectal

N & Vs inthe fossa

Post.scrotal/labial N &

Gluteal

branchesof PCN ofthigh

Perineal

branch ofS4

Boundariesextent &locations ofischioananlfossa

Inf. rectal N& Vs

Fascial arrrangementin ishchioanal fossa

Formations ofpudendal canal

Hiatus of schwalbe

APPLIED ASPECTS

identify Trace inf. Rectal N

& Vs to lat. Wallof fossa

Remove all fatfrom the fossa

Clean and definepudendal canal onlat. Wall of fossa

Remove all fatfrom the fossa

Clean and definepudendal canal onlat. Wall of fossa

Vs Pudendal

canal Pudendal

nerve Internal

pudendal vessels.

Ischioanal abscess Pain Drainage Ischiorectal hernia

S.No

TOPIC

DISSECTIONSTEPS

WHAT IS EXPECTED FROM THE STUDENTS

SUMMARY

MUST KNOW SHOULDKNOW

COULDKNOW

IDENTIFY UNDERSTAND

20. URINARY BLADDERANDPROSTATE

Defineperitonealreflection in relation to UB& identify

RemoveperitoneumfromSup.surface ofbladder

One table ineach row

Median incisionthrough pubicsymphysis andsacrum &coccyxThis will divide

Bladder &rectum in males

Bladder, uterus& rectum infemales

(Male cadavers) On other tablesremove bladderalong withprostate,separating it allaround andperineum.Separatestructures allaroundpreferably byhand or byblunt dissection

Open bladderby incisionalong thejunction of sup.& inferolat.Surfaces onboth sides &identify

Clean fasciaaround it &study

Open prostateby incising itthrough pros.Urethra and

UB in situ. Rectovesical

pouch in male Rectouterine &

uterovesicalpouches infemale

Shape andposition

Study grossfeatures of UB

Trigone ofbladder

Opening ofureters

Int. urethralmeatus

Gross featuresof prostate &capsules

Lobes of

prostate Uvula vesicae Urethral crest Prostatic sinus Blood supply &

lymphaticdrainage of theurinarybladder,prostate,seminalvesicles

Vas deferens

Identify &

study post.relations ofbladder inboth sexes

Prostatic

utricle Colliculus

seminalis Openings of

ducts ofprostate inprostaticsinuses

Openings

ofejaculatoryducts

Urinary bladder& prostate

Gross featuresof both together

Trigone ofbladder

Openings ofureters

Int. urethralmeatus

Peritoneal reflectionsover urinary bladder

Prostatic venous plexus Ejaculation

APPLIED ASPECTS Benign hypertrophy of prostate, symptoms

with anatomical explanation­ Frequency,urgency, hesitancy, precepitancy, feeblestream

Ca. Prostate an its spread Anatomical considerations in prostatectomy ­

abdominal /transurethral Cystoscopy Cystotomy Retrograde ejaculation after prostatectomy,

patient is sterile but potent Stricture of the urethra Rupture of th urethra Functionally abnormal bladder

identify

S.No

TOPIC

DISSECTION

STEPS

WHAT IS EXPECTED FROM THE

STUDENTS

SUMMARY

MUST KNOW SHOULDKNOW

COULDKNOW

IDENTIFY UNDERSTAND

21. REMOVALOF UTERUS

Clean andidentifyfemalegenitalorgans insitu

Traceperitonealreflections inpelvis &identify

Identifystructures inrelation tobroad lig

Separate

sides andback ofcervix andidentify

Separatevagina fromthe perineum

Removeuterus alongwithfallopiantube &ovaries aftercutting broadligaments

Uterus: partsand position

Cervix of theuterus

Fallopian tubes Ovary Rectouterine

pouch Uterovesical

pouch Broad ligament Ligaments of

ovary Round lig. of

uterus Uterine artery Uterus and the

adnexa. Blood supply,

lymphatics andnerve supply ofthe uterus,fallopian tubeand the ovary.

Transversecervicalligaments

Uterosacralligaments

Female genitaloragans

Uterus Fallopian

tubes Ovary Vagina Peritoneal

folds Pouches &

ligaments Broad

ligaments Lig. of ovary Round lig. of

uterus Rectouterine

pouch Uterovesical

pouch Contents of

broad lig.

Peritonealreflections overuterus in pelvis

Normal positionanteversionanteflexionsupports of uterus

APPLIED ASPECTS

Prolapse of uterus Tubectomy Krunkenberg tumour Pap smear Gravid uterus /involution Douglas's pouch, podt, fornix ­

drainage, IVF (Visualisation of ovary) Laproscopy

SECTION – II(Course Content under Level – I, II, III)

TUTORIALS

OUTLINE OF TUTORIALS

S.No TOPIC MUST KNOW SHOULD KNOW COULD KNOW1. LUMBAR VERTEBRAE

1. Distinguishing features ­ Body,

vertebral arch (Transverseprocess, Spinous process,superior and inferior articularprocess, vertebral canal)

3. Feweet's method of identifyinglumbar vertebrae 5. Identifying features of L5 vertebraand muscle attachments

2. Mamillary process

and accessoryprocess

4 Muscle attachments­ Psoas, quadratuslumborum , Crus ofdiaphragm, Lamella ofthoracolumbar fascia,Erector spinae,Supraspinousligaments, Interspinousligaments 6. Lumbar puncture

2. SACRUM 1. Normal anatomical position

2. Parts, Surfaces3. Sacral foramina4. Sacral crest 7. Sex differences

5. Muscle attachments

­ Pyriformis,Iliacus, coccygeus,gluteus maximus,Sacrotuberousligament

6. Course of ventraland dorsal rami ofsacral spinal nerves

8. Sacral index

3. VERTEBRAL COLUMN 1. Identifying features of lumbar,thoracic and cervical vertebra.

2. Length of column in males andfemales.

3. Functions4. Primary and secondary

curvatures 6. Movements of vertebral column invarious regions 10. Intervertebral disc­Number, partsof disc, constituents of disc,functions

5. Causes of Primary

and secondarycurvatures

11. Disc prolapse

7. Abdominal curvaturesof ­Kyphosis, Lordosis,Scoliosis8. Spondylolisthesis9. Line of weighttransmission

4. PELVIS 1. Bones forming pelvis2. Normal anatomical position3. Greater pelvis/ Lesser Pelvic4. Pelvic Inlet /pelvic outlet5. Pelvic inclination6. Structures crossing pelvic brim7. Structures passing throughgreater and lesser sciatic notch

11. Sex differences

8. Pelvimetry ­Obstetrical conjugatediameter

9.contracted Pelvis10. Types of pelvis

RADIOLOGICAL ANATOMY: Plain X­Rays , Contrast X­Rays showing parts of GIT and Urinary systems.CT scans of the abdomen at the epiploic foramen, transpyloric plane and L4