Human anatomy

A.Y. 2020/2021
Overall hours
Learning objectives
The aim of the Course of Neuroanatomy is to:
- Provide an overview of the ultrastructure of neurons and glia and the major cytoarchitectural features of the connections between neurons (brain barrier);
- Describe the difference between grey matter (e.g. nuclei, cortex and basal nuclei/ganglia) and white matter;
- Provide the morphological basis of the impulse transmission of neurons;
- Provide the basic features of the topography and structural organization of the forebrain (cerebral hemispheres), the midbrain (amygdala, thalamus, hypothalamus, hippocampus, pituitary gland), the brainstem/hindbrain (pons, medulla oblongata and cerebellum), with definition of sensitive and motor tracts and cortical areas;
- Describe the morphological features and the blood supply and venous drainage of the different organs so to deduce the impact of rupture and occlusion of the vessels;
- Describe the anatomical basis of the reflexes (myotatic, tendon an those involving cranial nerves), that are critical for clinical diagnosis and for the basic understanding of the principles of motor control;
- Describe the basic features of development of the nervous system and of the common malformations that occur in the nervous system;
- Obtain an understanding of the functional anatomy of sensory and motor processing and higher cerebral functions such as language and emotions and to be able to apply this knowledge to the clinical situation.
Expected learning outcomes
At the end of the Course of Neuroanatomy, the student should be able to:
- Demonstrate the knowledge and the understanding of the basic anatomy of the nervous system, also by using the radiological imaging;
- Have clearly understood the complexity and interconnectedness of the central nervous system;
- Apply the basic mechanisms of the development of the nervous system to the interpretation of the common malformations;
- Apply the knowledge of the neuroanatomy to the sensory and motor processing and higher cerebral functions such as language and emotions and also to apply this knowledge to the interpretation of the clinical situation, embracing imaging technology and especially the resulting images,
- Understand that the knowledge of the normal functions of nervous system components make possible that, when malfunction is observed, to work backward and determine which structure or structures are affected.
Course syllabus and organization

Single session

The lessons of the first semester will take place in mixed mode:
- in presence in the classroom with a limited number of students, who have booked themselves using Google Form and at the same time in synchrony through the "Teams platform" for students not present;
- the student is obliged to wear the surgical mask for the entire duration of his stay in the classroom and to sit in the free seats respecting the alternation of one occupied seat, one free seat, one occupied seat per single row;
- the lessons will also be video-recorded to allow students unable for documented needs to follow them in sync and made available on the teacher's Ariel / Teams website;
- the lessons will take place at the Vialba center as usual

Students must enter from the main atrium of the Lita Vialba teaching pavilion and undergo body temperature measurement using a Thermo-scanner. The entry / exit routes are differentiated and marked
Course syllabus
The third semester takes place in the second academic year and it focuses on central and peripheral nervous system, organs of special senses and corresponding embryology.
Description of the general features of nervous tissue, the spinal cord and the brain stem.
Introduction to the fundamentals of neural development.
Fundamental concepts, organizational principles, structure, connectivity, and how these relate to function and behavior are considered, with a strong emphasis on the clinical application of "traditional" neuroanatomical knowledge.
The forebrain (cerebral hemispheres), the midbrain (amygdala, thalamus, hypothalamus, hippocampus, pituitary gland, pineal gland and crus cerebri), the brainstem/hindbrain (pons, medulla oblongata and cerebellum).
Characteristics of the grey matter (e.g. nuclei, ganglia, cerebellar and cerebral cortex and basal nuclei/ganglia) and white matter (association, commissural and projection fibers, and the corpus callosum).
Cortical topography: frontal, parietal, temporal and occipital lobes and the major sulci/landmarks that separate them. Description of the cerebral cortex in relation to its functions, namely: motor, sensory, visual, auditory, speech; memory and emotion, decision making, social behavior.
Describe the organization of the internal capsule.
Basal ganglia (the caudate nucleus, putamen, and globus pallidus, their relationship with each other and with the lateral ventricle and internal capsule).
Description of the cerebellar anatomy (anatomic division and evolutionary terms neocerebellum, paleocerebellum and pontocerebellum).
Description of the cerebellar cortex and nuclei, afferents, internal circuitry, efferents and blood supply.
Identify the major structures of the limbic system (limbic lobe, hypothalamus, hippocampus, amygdala.
Describe and identify the anatomic features of the hypothalamus, the efferent connections of the hypothalamus with the autonomic nervous system and compare neuroendocrine secretion and control in the anterior and posterior pituitary.
Description of the structure of the spinal cord, a typical spinal nerve and a reflex arc, and its relation to the vertebral column.
Spinal and dorsal column-medial lemnisci, trigeminal lemniscus (proprioception i.e., joint position, tactile discrimination, vibration sense and form recognition).
Motor tracts: pyramidal [the corticobulbar and corticospinal tracts) and extrapyramidal (i.e., reticulospinal, vestibulospinal, tectospinal, rubrospinal including the basal ganglia (caudate, putamen, and globus pallidus), and the subthalamic nucleus].
Description of the 12 cranial nerves and their major functions in relation to innervation.
Description of the general organization of the outer, middle and inner ear.
Description of the structure of the visual system: eye, eyelid, conjunctiva and lacrimal gland.
Particular importance is given to central nervous pathways and to the anatomical basis of the reflexes (Moro reflex, abdominal reflexes, myotatic, tendon and those involving cranial nerves like as pupillary light reflex, the lacrimal reflex , the cough reflex, sucking and swallowing reflexes, the gag reflex, salivation, accommodation and corneal reflexes, vestibulo-ocular reflex, baroreflex) that are critical for clinical diagnosis and also for the basic understanding of the principles of motor control.
Description of the structural differences between the three layers of meninges (dura, arachnoid and pia), their relationship to the brain and spinal cord and the ventricular system and the formation, circulation, drainage and role of cerebrospinal fluid.
Prerequisites for admission
Students must have got a basic knowledge of Cytology, Histology and Cellular Biology.
To take the oral exam, the student must have passed the exam of Histology and Microscopic Anatomy.
Teaching methods
The course of anatomy takes place in a 6-year-degree course and it is organized in three semesters. Two semesters take place in the first academic year, the third in the second academic year.
- Lectures on concepts, anatomical organization, surface anatomy, sectional anatomy, variations. Lectures focus on a general introduction to anatomy and its terminology. A mixed topographical-systemic anatomy approach is applied to the limbs, head and neck, and to the organs of the thorax, abdomen, pelvis, and perineum (respiratory, endocrine, circulatory, gastrointestinal, and urogenital systems). Neuroanatomy is a fully developed unit.
- Use of plastic models in the anatomy class to show internal organ relationships and to allow students to repeatedly study a specimen. During these the students work in peer groups and are supported by the Anatomy teacher and by peer teaching or near-peer teaching assistants (i.e., medical students who have already passed the anatomy program, and are still in their medical school training). Although plastic models associated to low-fidelity, they teach three-dimensional comprehension and anatomical reasoning, by showing the spatial relationship of the structures, which strongly correspond to the human body.
- Video acquisitions during classic or laparoscopic surgery have been introduced to underline anatomical concepts and to transpose them into a clinical setting. Each video is followed by a discussion with the students involving surgeons, endoscopists and anatomy teacher.
- During the course, groups of students (five to eight students) are solicited to elaborate under anatomy teacher supervision a presentation on an anatomical topic relevant to lecture content and derived from an article featured in scientific literature, focused around both clinical and scientific problems and to present them as lecture to the rest of the class (i.e., power point presentation). Anatomy teacher supervised the elaboration of students' lectures, in order to provide an appropriate guidance and motivation to students on how to improve their performance (quality of the report, level and fluency of oral presentation and ability to carry out literature search).
- We have developed a dissection program that we carried out during the second semester. Students participate in small groups (three to four students) to dissection laboratory of selected animal organs (heart, kidney, lung, liver) under the supervision by fourth/fifth-year tutors, who have already passed the anatomy exam. Every dissection is preceded by a brief introduction drawn up by the tutors to get the attraction of the students on the critical anatomical features that have been given during the lectures. After this peer-teaching dissection, students performed a personal dissection on similar organs. To ensure continuity in the didactic activities, the same tutors are also involved in the exercitations on physical models.
- We have started a pilot study with a selected group of first and second-year medical students where they learn to explore and create 3D visceral organ reconstruction alongside various CT cross-sectional slices of the neck, thorax and abdomen to describe patient specific anatomy. During this pilot study, the students: 1) apply their basic anatomy knowledge to identify anatomical structures in the radiological image; 2) learn to use open-source software for imaging elaboration. Lastly, 3D scenes will be loaded in a Immersive Virtual Reality setting on an App that we have developed using head-mounted displays with tracker and coupled with a Smartphone.
Teaching Resources
- Anatomia del Gray - Le basi anatomiche per la pratica clinica - di Gray - Susan Stranding · 2017
- Trattato di Anatomia Umana e Anatomia Topografica - Anatomy Bag e Risorse Digitali su Piattaforma Virtual Campus di Anastasi et al, Ed 2019
- Lo sviluppo prenatale dell'uomo. Embriologia ad orientamento clinico (Italiano X Ed.) 2017 di Keith L. Moore, T. V. Persaud, Mark G. Torchia
- Neuroanatomia nel contesto clinico - Atlante Strutture, sezioni, sistemi e sindromi 9a Edizione americana, Autore/i Duane E. Haines, Edizione italiana a cura di Maurizio Vertemati
- Fitzgerald - Neuroanatomia con riferimenti funzionali e clinici (VII Ed), Mtui E., Gruener G., Dockery P.
- Netter Atlante di Anatomia Umana VI Ed, di Netter F.H.
Assessment methods and Criteria
During the three semesters of the Course of Anatomy, eight multiple choice tests on specific topics are submitted to the students to assess the basic knowledge and the preparation of the students on the key concepts of the different subjects.
Each multiple choice test (MCT) is based on forty questions with five possible answers for every question.
The correction of the MCT is a machine-readable and fully-automated procedure.
After each test, students receive formative feedback for their overall score (positive or negative), including a detailed breakdown of their performance.
At the end of the course:
- the student who passed all the eight multiple choice tests will be directly admitted to an oral exam including the arguments of the Course. This "major bonus" can be exploited only time during the exam dates of the corresponding academic year. If the student fails in the oral exam, he/she should attend a new MCT including all the arguments of the program Course
- the student who have not passed only one MCT should attend a new MCT including the arguments related to the failed test. This "minor bonus" can be exploited only time during the exam dates of the corresponding academic year, even in the case of a period of multiple exam session.
- the student who have not passed two (or more) MCT should attend a new MCT including all the arguments of the program Course to be admitted to the oral exam.
Oral exam:
- it consists of an oral interview on the whole program. The oral exam must be carried out at the same time of the session in which the preliminary written test is taken.
BIO/16 - HUMAN ANATOMY - University credits: 5
Lessons: 60 hours