Anatomy
A.Y. 2023/2024
Learning objectives
The course addresses the organization of the human body from the cellular and tissue level to the organ/system level, including how this organization comes into being during development. The systematic and topographic approaches are integrated in light of the clinical practice. The course provides the comprehensive fundamental background to understand the functions and pathologies of the different organs and systems. Some specific contents are provided in other integrated courses of the curriculum (cytology in Cells, molecules and genes I, part of Neuroanatomy and of Anatomy of the Head and Neck in Functions, Head and Neck and Neurobiology, human behaviour and clinical neuroscience) "Functional drops" are introduced in the lectures to exemplify the relationships between morphology and its functional correlates. "Diagnostic and Clinical drops" are introduced in the lectures to exemplify how disruption of normal development and structure leads to pathology, so to underline the relevance of anatomy in clinical practice.
Expected learning outcomes
Students are expected to be able to: -Describe cells, cell ultrastructure, and tissues and their functional aspects in relation to the morphological organization. -Describe gametogenesis, fertilization, the early stages of embryonic development, and the key mechanisms leading to organogenesis. -Illustrate the main morphological events and the relevant related molecular aspects characterizing the development of the body and its various organ systems in order to acquire the vision of the adult anatomy through a dynamic developmental view and understand the basis of congenital defects -Illustrate the structural principles underlying the functions of organs and systems -Illustrate the general principles of the body plan at both the systematic (organs and systems) and the topographic levels (regions of the body and corresponding deep spaces)and systems). - Possess sufficient anatomical information to proficiently attend the subsequent courses.
Lesson period: Second semester
Assessment methods: Esame
Assessment result: voto verbalizzato in trentesimi
Single course
This course cannot be attended as a single course. Please check our list of single courses to find the ones available for enrolment.
Course syllabus and organization
Single session
Responsible
Course syllabus
ORGAN STRUCTURE AND SYSTEM DEVELOPMENT
During this module some major topics in organogenesis will be discussed as to understand the main morphological events and the related molecular aspects characterizing the development of the body and its various organ systems. On this basis, the morphological and structural features of mature organs will be described stressing functional aspects.
Topic 1. Principles of organ architecture.
· Describe the general architecture of organs.
Topic 2. Heart and pericardium.
· Describe the external morphology of the heart.
· Describe the internal cavities of the heart.
· Describe the organization of the heart skeleton.
· Describe the structure of the heart wall and the organization of the myocardium.
· Describe the morphology of cardiac valves. · Describe the organization of the conductive system.
· Describe the vascularization of the heart.
· Describe the morphology and structure of the pericardium.
Topic 3. Structure of blood vessels and lymphatic vessels.
· Describe the structure of arteries and vein in relation to their function.
· Describe the different types of capillaries in relation to their function.
· Describe the structure of lymphatic vessels. Topic 4. Layout of the vascular system.
· Describe the general layout of the arterial, venous and lymphatic system.
Topic 4. Lymphoid organs (lymphnodes, spleen, thymus, tonsils).
· Describe the structure of the lymph node and how it accommodates its function.
· Recognize the structure of the spleen and how it accommodates its function.
· Recognize how the structure of the thymus accommodates its function.
· Describe the structural and functional organization of the MALT.
Topic 5. Digestive system part I: overview of the oral cavity and of the pharynx; macroscopic aspects, functional architecture and structure of the esophagus and the stomach.
· Illustrate the general structural organization of the digestive system in relation to the functions of digestion and absorption.
· Describe the general organization of the oral cavity and illustrate the pharynx.
· Illustrate the morphology of the pharynx in relation to its dual function (respiratory and digestive tracts).
· Describe the external and internal morphology of the esophagus and stomach and their histological structure.
· Describe the cell types of the stomach glands and their function.
· Describe the distribution of gastric enteroendocrine cells and their role.
Topic 6. Digestive system part II: macroscopic aspects, functional architecture and structure of the small and large intestine.
· Describe the external and internal morphology of the small and large intestine and their histological structure.
· Describe the structure of the intestinal villi and crypts and the major cell types of their epithelial lining.
· Describe the organization of the lymphoid tissue in the intestinal wall: the GALT (gut-associated lymphoid tissue). · Describe the basic organization of the enteric nervous system.
· Describe the internal morphology of the rectum and anal canal.
Topic 7. Digestive system part III: Macroscopic aspects, functional architecture and structure of the salivary glands, exocrine pancreas and liver.
· Describe the organization of salivary glands parenchyma.
· Describe the macroscopic aspect of the liver and to discuss the organization of its parenchyma in relation to the different types of hepatic lobules.
· Describe the gallbladder and the intrahepatic and extrahepatic biliary tracts.
· Describe the macroscopic aspect of the pancreas and discuss the organization of its parenchyma in relation to its endocrine and exocrine function.
Topic 8. Lower respiratory tract: macroscopic aspects, functional architecture and structure.
· Illustrate the outline of the respiratory pathways.
· Describe the morphology and the main structural aspects of the larynx.
· Describe the organization of the tracheo-bronchial tree.
· Illustrate the histological features of the conductive portion and of the respiratory portions of the tracheobronchial tree. · Describe the macroscopic aspects of the lungs and their lobes.
· Describe the morpohofunctional aspects of the pulmonary lobule and acinus. Clinical drops: asthma. Clinical drops: emphysema. · Describe the microcirculation of the lungs.
· Describe the structure of the alveoli and the structure of the gas-exchange barrier.
Clinical drops: Acute Respiratory Distress Syndrome (ARDS).
Topic 9. Urinary system: macroscopic aspects, functional architecture and structure of the kidney, ureters and lower urinary tract.
· Describe the macroscopic aspect of the kidney.
· Describe the structural organization of the kidney parenchyma and its vascular supply in relation to process of blood filtration and urine production.
· Describe the morpohofunctional description of the different segments of the nephron and collecting ducts, the structural aspects of the filtration barrier.
· Describe the juxtaglomerular apparatus.
· Describe the macroscopic aspect and the general structure of the excretory pathways: calyxes, pelvis, ureters and urinary bladder.
· Describe the male and female urethra.
Topic 10. Reproductive system: macroscopic aspects, functional architecture and structure of the male and female reproductive system. · Describe the different components of the female reproductive system.
· Describe the morphology of the ovary, uterine tubes, uterus and vagina.
· Describe the structure of these organs and their cyclic changes.
· Describe the different components of the male reproductive system.
· Describe the morphology of the testicle, epididymis, spermatic pathways and accessory glands.
· Describe the main structural aspects of the epididymis, spermatic pathways and accessory glands.
· Describe the different portions of the male urethra.
Topic 11. Endocrine system
· Describe the general aspect and function of endocrine glands.
· Describe and recognize the structure of the pituitary gland and the functional role of the hypophyseal portal circulation in the regulation of pituitary secretion.
· Describe and recognize the structure of the pineal gland.
· Describe and recognize the structure of the thyroid gland.
· Describe and recognize the structure of the adrenal gland.
· Describe and recognize the islets of Langerhans.
· Describe the unicellular endocrine glands and the interstitial glands.
EMBRYOLOGY
Topic 12. The 4th week: establishing the body plan.
· Illustrate the concept of organogenesis.
· Describe the destiny of the three embryonic layers.
· Illustrate the concept of segmentation.
· Describe the outcome of the folding of the embryo: formation of the intestinal tube, formation of the body cavities, formation of the body wall.
Developmental defects: gastroschisis and omphalocele.
· Describe the formation and general organization of the embryonic circulation.
Topic 13. Topic: Development of the cardiovascular system, fetal circulation, neonatal circulation.
· Illustrate the contribution of the heart fields and other sources to the heart formation.
· Describe the formation of the heart tube and its looping.
· Describe the basic events leading to the formation of the heart chambers and outflow tract.
· Describe the general organization of the embryonic circulation and how it evolves into the fetal circulation.
· Describe how the fetal circulation changes at birth. Developmental defects: patent ductus arteriosus.
Developmental defects: main congenital malformation of the heart and outflow tract.
Topic 14. The primordial pharynx and the pharyngeal apparatus.
· Describe the pharyngeal apparatus and its relation to the primordial pharynx.
· Illustrate how the different components of the pharyngeal apparatus contribute to the formation of various structures of the head and neck.
· Describe the development of the thyroid gland.
· Describe the development of the thymus.
Developmental defects (DiGeorge syndrome, craniosynostosis, first arch syndrome, Cleft lip/ palate).
Topic 15. Development of the lower respiratory tract.
· Illustrate the formation of the tracheobronchial tree and its segmental pattern. Developmental defects: tracheo-esophageal fistulas. Developmental defects: congenital diaphragmatic hernia.
· Describe the stages of lung maturation and their relation to breathing capacities.
· Illustrate the mechanisms contributing to lung maturation.
· Illustrate the basis of the most common malformations of the respiratory system.
Clinical drops: premature birth and respiratory distress syndrome.
Topic 16. Development of the digestive system.
· Illustrate how the different portion of the digestive system develop from the primitive gut.
· Describe the formation of the peritoneum.
· Illustrate the basis of the most common malformations of the digestive system.
Developmental defects: stenosis, atresia, abnormal rotations, fistulae.
Topic 17. Development of the urogenital system.
·Illustrate the formation of the three successive forms of the embryonic kidney and their destiny.
·Describe the formation of the uriniferous tubule.
Developmental defects: renal agenesia.
·Describe the positional changes of the kidney and related structures.
Developmental defects: defects in migration and rotation of the kidneys.
·Describe the formation of the bladder and urethra.
Developmental defects: exstrophy of the bladder, epispadia and hypospadia.
·Illustrate the development of the gonads and the establishment of their gender.
Developmental defects: abnormalities of sexual differentiation.
·Describe the formation of the sexual duct system.
Developmental defects: Malformations of the uterus.
·Describe the positional changes of the gonads.
Developmental defects: cryptorchidism, congenital inguinal hernia.
·Describe the formation of the external genitalia.
Practicals
Practical/Microscopic Anatomy topic 1: Practical at the virtual light microscope: Digestive system: hollow organs.
Practical/Microscopic Anatomy topic 2: Practical at the virtual light microscope: Digestive system: solid organs.
Practical/Microscopic Anatomy topic 3: Practical at the virtual light microscope: Respiratory and urinary system. Blood vessels.
Practical/Microscopic Anatomy topic 4: Practical at the virtual light microscope: Reproductive system and endocrine glands.
Practical/Microscopic Anatomy topic 5: Practical at the light microscope: revision of all organs.
Observe, recognize and compare the different organs.
Practical/Microscopic Anatomy topic 6: Practical at the virtual light microscope: interactive revision of all organs and compare the different organs.
GENERAL ANATOMY
Topic 1. From tissues to body: organs and systems. Anatomical nomenclature
·Define and describe the terms relative to the anatomical position.
Describe the anatomical planes.
·Define and describe the terms used to describe the movements of the limbs and vertebral column.
Functional drops: general body growth and development.
Diagnostic drops: medical imaging.
Topic 2. From outside to inside: topographical hints
Define and describe the various parts of the human body and their general content and arrangement.
Clinical drops: peritonitis and mesotheliomas.
Topic 3. Intercommunication between the body and the environment (skin and its appendages).
·Define and describe the skin and its appendages and their regional characteristics.
Diagnostic drops: dermatoglyphics.
·Illustrate how we can interact with the environment.
·Illustrate how we can protect ourselves from the environment.
Functional drops: thermoregulation and UV protection.
Functional drops: human skin varies in space and time.
Clinical drops: skin and burns.
Clinical drops: pressure wounds.
Clinical drops: psoriasis.
Topic 4. Bones: support, movement and protection.
·Understand how the various bones, their components, growth, remodelling and repair, contribute to the general
framework of human body.
Functional drops: microgravity and bed rest.
Functional drops: principal stresses and bone morphology.
·Learn the morphofunctional bases of the support, movement and protection functions of the bones in the trunk and limbs.
Diagnostic drops: bone age.
Clinical drops: fracture healing and distraction osteogenesis.
Topic 5. Joints: support and movement.
·Understand how joints can link bones together permitting and/ or limiting their reciprocal movements.
·Learn the morphofunctional bases of the movement and support functions of the various joints in the trunk and limbs.
Clinical drops: joint endoprostheses.
Topic 6. Skeletal muscles: support, movement and protection.
·Understand how the various skeletal muscles and their components contribute to the general construction of human
body.
Functional drops: thermoregulation.
·Learn the morphofunctional bases of the movement and support functions of the various muscles in the trunk and limbs.
Functional drops: levers.
Functional drops: sports champions.
Topic 7. The skull: bones, fossae and general architecture.
·Describe the position and main characteristics of the major bones of the skull, and their reciprocal joints.
·Describe the boundaries, walls and floors of the cranial fossae.
·Identify the external and internal features of the cranial foramina and list the structures that each transmits.
Practical/General anatomy topic 1: The skull
·Observe, describe and recognize the position and main characteristics of the major bones of the skull, and their reciprocal
joints.
·Observe, describe and recognize the boundaries, walls and floors of the cranial fossae.
·Observe, describe and recognize the external and internal features of the cranial foramina and list the structures that each transmits.
REGIONAL ANATOMY
During the course a description of regional anatomy in relation to the clinical practice will be made. The anatomical structures of the back, thorax, abdomen and limbs will be analyzed in their relations and reciprocal interdependence together with the
principal methods for non-destructive clinical image analysis. In the 4th year/second semester the same approach will be used for Head and Neck.
Topic 1. Trunk: the back.
·Describe the anatomical relations between the vertebrae, the spinal cord, and the spinal nerves.
Functional drops: spinal curvatures.
·Describe the cervical, brachial, lumbosacral, and pudendum plexuses, their position, anatomical relations and
significance.
Clinical drops: brachial plexus lesions.
Clinical drops: sciatic nerve pain.
Topic 2. Trunk: the thorax.
·Describe the main anatomical characteristics of the thorax and its surface anatomy.
Diagnostic drops: sentinel lymph node.
·Describe the topographical and anatomical divisions of the thoracic cavity, the surface markings of the main thoracic
organs, and their anatomical relations.
Diagnostic drops: endoscopy and medical imaging.
Clinical drops: thoracic inlet syndrome.
·Understand the position of the heart, great vessels and oesophagus in the mediastinum.
Functional drops: organ perfusion vs. oxygen consumption
·Understand the position and relations of the pleura, lungs, trachea and bronchi.
Clinical drops: pneumothorax.
·Understand the position and relations of the diaphragm, and its role in respiratory movements.
Clinical drops: phrenic nerve lesions.
Topic 3. Trunk: the abdomen and pelvis.
·Describe the main anatomical characteristics of the abdomen and pelvis, and their surface anatomy.
Functional drops: endoabdominal pressure variations.
Clinical drops: feto-pelvic relationship and childbirth.
·Describe the topographical and anatomical divisions of the abdominal cavity, the surface markings of the main abdominal
organs, and their anatomical relations.
·Understand the position of the gastrointestinal tract, abdominal viscera, and urogenital system in the abdomen.
·Describe the peritoneum, its ligaments, and the peritoneal cavity.
Clinical drops: hernia.
·Understand the position and relations of the various organs with the peritoneal cavity.
Clinical drops: portal hypertension.
Topic 4. Pectoral and pelvic girdles, upper and lower limb.
·Describe the main anatomical characteristics of the upper and lower limbs, thoracic and pelvic girdles, and their surface anatomy.
·Describe the fascial compartments delimiting the major muscle groups of the upper and lower limbs, and to explain the functional importance of those compartments and their contents.
·Describe the movements of the pectoral and pelvic girdles, and of upper and lower limbs; to identify and describe the muscles responsible for the movements and summarize their main attachments and somatic motor nerve supply.
Clinical drops: rotator cuff lesion.
Clinical drops: hip dysplasia.
Clinical drops: Trendelenburg gait.
Clinical drops: free flaps.
Functional drops: plantar arches.
Clinical drops: flat foot.
·Describe the origin, course and distribution of the major arteries and veins of the upper and lower limbs and their
branches; classify and contrast the functions of the deep and superficial veins.
Diagnostic drops: arterial pulses and blood pressure measurement.
Clinical drops: saphenous varices.
·Describe the origin, course and function of the principal nerves of the upper and lower limbs.
Clinical drops: radial nerve and humeral shaft fractures.
Clinical drops: carpal tunnel syndrome.
Practical/Regional anatomy topic 1: Trunk & the back.
·Observe, describe and recognize the main anatomical features of vertebrae and their joints.
·Observe, describe and recognize the structures, regions, functions and movements of the vertebral column.
·Observe, describe and recognize the principal muscle groups and ligaments of the vertebral column.
·Observe, describe and recognize the anatomical relations between the vertebrae, the spinal cord, and the spinal nerves.
·Observe, describe and recognize the cervical, brachial, lumbosacral, and pudendum plexuses, their position, anatomical relations and significance.
Practical/Regional anatomy topic 2: Trunk: the thorax.
·Observe, describe and recognize the main anatomical characteristics of the thorax and its surface anatomy.
·Observe, describe and recognize the main anatomical skeletal, cartilaginous and ligamentous features of thorax.
·Observe, describe and recognize the joint and movements of the thorax.
·Observe, describe and recognize the principal muscle groups of the thorax.
·Observe, describe and recognize the position and relations of the diaphragm.
·Observe, describe and recognize the position of the heart, great vessels and oesophagus in the mediastinum.
·Observe, describe and recognize the position and relations of the pleura, lungs, trachea and bronchi.
Practical/Regional anatomy topic 3: Trunk: the abdomen and pelvis.
·Observe, describe and recognize the anatomical characteristics of the abdomen and pelvis, and their surface anatomy.
·Observe, describe and recognize the main anatomical skeletal, cartilaginous and ligamentous features of abdomen and
pelvis.
·Observe, describe and recognize the joint and movements of the abdomen and pelvis.
·Observe, describe and recognize the principal muscle groups of the abdomen and pelvis.
·Observe, describe and recognize the position and anatomical relations of the gastrointestinal tract, abdominal viscera, and
urogenital system in the abdomen.
Practical/Regional anatomy topic 4: Upper and lower limb.
·Observe, describe and recognize the main anatomical characteristics of the upper and lower limbs, thoracic and pelvic
girdles, and their surface anatomy.
·Observe, describe and recognize the main anatomical skeletal, cartilaginous and ligamentous features of the upper and
lowe limbs.
·Observe, describe and recognize the joints and movements of the upper and lower limbs.
·Observe, describe and recognize the major muscle groups of the upper and lower limbs, and their relations with the
vessels and nerves.
·Observe, describe and recognize the major arteries and veins of the upper and lower limbs and their branches.
·Observe, describe and recognize the principal nerves of the upper and lower limbs.
NEUROANATOMY
The neuroanatomy course is divided into three modules. The first module takes place during the second semester of the first year. Its general learning goal is to understand, starting from a developmental perspective, the macroscopic anatomy and internal architecture of the central nervous system and to know the organization of the peripheral nervous system.
Topic 1. Phylogenesis and general organization.
·Describe the phylogenesis of nerve cells and primitive neural circuits.
·Describe the process of centralization and cephalization of nerve cells.
·Describe the formation of the tubular nervous system and brain vesicles.
·Illustrate the general morpho/functional organization of the nervous system in relation to its phylogenesis.
·Describe the general organization of the grey and white matter.
·List the most common neurotransmitters/neuromodulators.
Topic 2. Development of the nervous system.
·Describe the different phases of neurulation.
Developmental defects: defects of closure of the neural tube, cyclopia.
·Describe the process of histogenesis in the neural tube.
·Describe the fundamental cross sectional organization of the developing neural tube.
· Describe the process of myelination.
·Describe the development of the spinal nerve and of the peripheral nervous system.
·Describe the basic macroscopic events through which the neural tube undergoes to form the different portions of the
central nervous system and the ventricular system.
·Illustrate the events that lead to the organization of the gray and white matter in the different portions of the central
nervous system: spinal cord, brainstem and brain.
·Understand the basic prenatal and postnatal steps characterizing the morpho-functional maturation of the nervous
system.
Developmental defects: holoprosencephaly, fetal alcohol spectrum disorders & syndrome
Topic 3: Spinal cord, spinal nerves.
·Describe the relation of the spinal cord with the vertebral canal.
·Describe the spinal segment, the ventral and dorsal roots and their level of exit.
·Describe the meninges, the meningeal spaces and their content.
·Describe the lumbar cistern and the composition of the cerebrospinal fluid.
Clinical drops: lumbar punctures (diagnosis and treatment).
·Describe the macroscopic aspect of the spinal cord and its vascularization
·Illustrate the general organization of the grey and white matter.
Functional drops: spinal reflexes.
Topic 4. Peripheral nervous system: spinal plexuses.
·Describe the formation of the spinal nerve and the destiny of its terminal and collateral branches.
·Illustrate the formation of spinal plexuses.
·Describe the position and composition of the spinal plexuses and their territory of innervation.
·Highlight the main aspects of the course and territory of innervations of the most important peripheral nerves.
Clinical drops: injuries of the brachial and lumbosacral plexuses.
Topic 5. Peripheral nervous system: Autonomic nervous system.
·Illustrate the general organization of the autonomic nervous system.
·Describe the organization of the enteric nervous system.
Clinical drops: referred pain
Topic 6. Brainstem and cerebellum.
·Illustrate the content and organization of the posterior cranial fossa.
·Describe the organization of the meninges in relation to the suvratentorial and infratentorial compartments of the neurocranium and to the formation of the venous sinuses.
Clinical drops: herniations.
·Describe the surface anatomy of the brainstem, the origin of the cranial nerves and their exit points with respect to the
skull foramina.
·Describe the surface anatomy of the cerebellum and its division in lobes.
·Describe the relation of the cerebellum to the brainstem and 4th ventricle.
·Describe the morphology of the 4th ventricle and its communications.
·Describe the structure of a choroid plexus and the formation and circulation of the cerebrospinal fluid.
Clinical drops: hydrocephalus.
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Topic 7. Telencephalon and diencephalon.
·Describe the surface anatomy of the telencephalon and its subdivision in lobes and gyri.
·Identify the position of the primary and secondary motor and sensory areas in the lobes.
·Illustrate the general organization of the white matter of the cerebral hemispheres into projecting, association and
commissural fibers.
·Describe the position and relations of the basal ganglia.
·Describe the diencephalon and name its subdivisions
·Describe the third ventricle.
·Describe the morphology of the lateral ventricles.
·Describe the position and function of circumventricular organs.
Clinical drops: vomiting.
Practical/Neuroanatomy: topic 1, macroscopic organization of nervous system.
Learning goals:
·Observe, describe and recognize the main anatomical features of the CNS organs, their position and anatomical relations.
·Observe, describe and recognize the anatomical relations between the vertebrae, the spinal cord and meninges, the spinal
nerves and sensory ganglia.
·Observe, describe and recognize the macroscopical location of the PNS organs (somatic and visceral).
·Observe, describe and recognize the cervical, brachial, lumbosacral, and pudendum plexuses, their position and
anatomical relations.
SEMINARS
To be reorganized--
· People from Bones. Prof. Cristina Cattaneo
· 3D reconstruction of human movement. Prof. Manuela Galli
· Clinical aspects of knee joint pathology. Prof. Giuseppe Peretti
· Clinical aspects of shoulder joint pathology. Prof. Pietro Simone Randelli
During this module some major topics in organogenesis will be discussed as to understand the main morphological events and the related molecular aspects characterizing the development of the body and its various organ systems. On this basis, the morphological and structural features of mature organs will be described stressing functional aspects.
Topic 1. Principles of organ architecture.
· Describe the general architecture of organs.
Topic 2. Heart and pericardium.
· Describe the external morphology of the heart.
· Describe the internal cavities of the heart.
· Describe the organization of the heart skeleton.
· Describe the structure of the heart wall and the organization of the myocardium.
· Describe the morphology of cardiac valves. · Describe the organization of the conductive system.
· Describe the vascularization of the heart.
· Describe the morphology and structure of the pericardium.
Topic 3. Structure of blood vessels and lymphatic vessels.
· Describe the structure of arteries and vein in relation to their function.
· Describe the different types of capillaries in relation to their function.
· Describe the structure of lymphatic vessels. Topic 4. Layout of the vascular system.
· Describe the general layout of the arterial, venous and lymphatic system.
Topic 4. Lymphoid organs (lymphnodes, spleen, thymus, tonsils).
· Describe the structure of the lymph node and how it accommodates its function.
· Recognize the structure of the spleen and how it accommodates its function.
· Recognize how the structure of the thymus accommodates its function.
· Describe the structural and functional organization of the MALT.
Topic 5. Digestive system part I: overview of the oral cavity and of the pharynx; macroscopic aspects, functional architecture and structure of the esophagus and the stomach.
· Illustrate the general structural organization of the digestive system in relation to the functions of digestion and absorption.
· Describe the general organization of the oral cavity and illustrate the pharynx.
· Illustrate the morphology of the pharynx in relation to its dual function (respiratory and digestive tracts).
· Describe the external and internal morphology of the esophagus and stomach and their histological structure.
· Describe the cell types of the stomach glands and their function.
· Describe the distribution of gastric enteroendocrine cells and their role.
Topic 6. Digestive system part II: macroscopic aspects, functional architecture and structure of the small and large intestine.
· Describe the external and internal morphology of the small and large intestine and their histological structure.
· Describe the structure of the intestinal villi and crypts and the major cell types of their epithelial lining.
· Describe the organization of the lymphoid tissue in the intestinal wall: the GALT (gut-associated lymphoid tissue). · Describe the basic organization of the enteric nervous system.
· Describe the internal morphology of the rectum and anal canal.
Topic 7. Digestive system part III: Macroscopic aspects, functional architecture and structure of the salivary glands, exocrine pancreas and liver.
· Describe the organization of salivary glands parenchyma.
· Describe the macroscopic aspect of the liver and to discuss the organization of its parenchyma in relation to the different types of hepatic lobules.
· Describe the gallbladder and the intrahepatic and extrahepatic biliary tracts.
· Describe the macroscopic aspect of the pancreas and discuss the organization of its parenchyma in relation to its endocrine and exocrine function.
Topic 8. Lower respiratory tract: macroscopic aspects, functional architecture and structure.
· Illustrate the outline of the respiratory pathways.
· Describe the morphology and the main structural aspects of the larynx.
· Describe the organization of the tracheo-bronchial tree.
· Illustrate the histological features of the conductive portion and of the respiratory portions of the tracheobronchial tree. · Describe the macroscopic aspects of the lungs and their lobes.
· Describe the morpohofunctional aspects of the pulmonary lobule and acinus. Clinical drops: asthma. Clinical drops: emphysema. · Describe the microcirculation of the lungs.
· Describe the structure of the alveoli and the structure of the gas-exchange barrier.
Clinical drops: Acute Respiratory Distress Syndrome (ARDS).
Topic 9. Urinary system: macroscopic aspects, functional architecture and structure of the kidney, ureters and lower urinary tract.
· Describe the macroscopic aspect of the kidney.
· Describe the structural organization of the kidney parenchyma and its vascular supply in relation to process of blood filtration and urine production.
· Describe the morpohofunctional description of the different segments of the nephron and collecting ducts, the structural aspects of the filtration barrier.
· Describe the juxtaglomerular apparatus.
· Describe the macroscopic aspect and the general structure of the excretory pathways: calyxes, pelvis, ureters and urinary bladder.
· Describe the male and female urethra.
Topic 10. Reproductive system: macroscopic aspects, functional architecture and structure of the male and female reproductive system. · Describe the different components of the female reproductive system.
· Describe the morphology of the ovary, uterine tubes, uterus and vagina.
· Describe the structure of these organs and their cyclic changes.
· Describe the different components of the male reproductive system.
· Describe the morphology of the testicle, epididymis, spermatic pathways and accessory glands.
· Describe the main structural aspects of the epididymis, spermatic pathways and accessory glands.
· Describe the different portions of the male urethra.
Topic 11. Endocrine system
· Describe the general aspect and function of endocrine glands.
· Describe and recognize the structure of the pituitary gland and the functional role of the hypophyseal portal circulation in the regulation of pituitary secretion.
· Describe and recognize the structure of the pineal gland.
· Describe and recognize the structure of the thyroid gland.
· Describe and recognize the structure of the adrenal gland.
· Describe and recognize the islets of Langerhans.
· Describe the unicellular endocrine glands and the interstitial glands.
EMBRYOLOGY
Topic 12. The 4th week: establishing the body plan.
· Illustrate the concept of organogenesis.
· Describe the destiny of the three embryonic layers.
· Illustrate the concept of segmentation.
· Describe the outcome of the folding of the embryo: formation of the intestinal tube, formation of the body cavities, formation of the body wall.
Developmental defects: gastroschisis and omphalocele.
· Describe the formation and general organization of the embryonic circulation.
Topic 13. Topic: Development of the cardiovascular system, fetal circulation, neonatal circulation.
· Illustrate the contribution of the heart fields and other sources to the heart formation.
· Describe the formation of the heart tube and its looping.
· Describe the basic events leading to the formation of the heart chambers and outflow tract.
· Describe the general organization of the embryonic circulation and how it evolves into the fetal circulation.
· Describe how the fetal circulation changes at birth. Developmental defects: patent ductus arteriosus.
Developmental defects: main congenital malformation of the heart and outflow tract.
Topic 14. The primordial pharynx and the pharyngeal apparatus.
· Describe the pharyngeal apparatus and its relation to the primordial pharynx.
· Illustrate how the different components of the pharyngeal apparatus contribute to the formation of various structures of the head and neck.
· Describe the development of the thyroid gland.
· Describe the development of the thymus.
Developmental defects (DiGeorge syndrome, craniosynostosis, first arch syndrome, Cleft lip/ palate).
Topic 15. Development of the lower respiratory tract.
· Illustrate the formation of the tracheobronchial tree and its segmental pattern. Developmental defects: tracheo-esophageal fistulas. Developmental defects: congenital diaphragmatic hernia.
· Describe the stages of lung maturation and their relation to breathing capacities.
· Illustrate the mechanisms contributing to lung maturation.
· Illustrate the basis of the most common malformations of the respiratory system.
Clinical drops: premature birth and respiratory distress syndrome.
Topic 16. Development of the digestive system.
· Illustrate how the different portion of the digestive system develop from the primitive gut.
· Describe the formation of the peritoneum.
· Illustrate the basis of the most common malformations of the digestive system.
Developmental defects: stenosis, atresia, abnormal rotations, fistulae.
Topic 17. Development of the urogenital system.
·Illustrate the formation of the three successive forms of the embryonic kidney and their destiny.
·Describe the formation of the uriniferous tubule.
Developmental defects: renal agenesia.
·Describe the positional changes of the kidney and related structures.
Developmental defects: defects in migration and rotation of the kidneys.
·Describe the formation of the bladder and urethra.
Developmental defects: exstrophy of the bladder, epispadia and hypospadia.
·Illustrate the development of the gonads and the establishment of their gender.
Developmental defects: abnormalities of sexual differentiation.
·Describe the formation of the sexual duct system.
Developmental defects: Malformations of the uterus.
·Describe the positional changes of the gonads.
Developmental defects: cryptorchidism, congenital inguinal hernia.
·Describe the formation of the external genitalia.
Practicals
Practical/Microscopic Anatomy topic 1: Practical at the virtual light microscope: Digestive system: hollow organs.
Practical/Microscopic Anatomy topic 2: Practical at the virtual light microscope: Digestive system: solid organs.
Practical/Microscopic Anatomy topic 3: Practical at the virtual light microscope: Respiratory and urinary system. Blood vessels.
Practical/Microscopic Anatomy topic 4: Practical at the virtual light microscope: Reproductive system and endocrine glands.
Practical/Microscopic Anatomy topic 5: Practical at the light microscope: revision of all organs.
Observe, recognize and compare the different organs.
Practical/Microscopic Anatomy topic 6: Practical at the virtual light microscope: interactive revision of all organs and compare the different organs.
GENERAL ANATOMY
Topic 1. From tissues to body: organs and systems. Anatomical nomenclature
·Define and describe the terms relative to the anatomical position.
Describe the anatomical planes.
·Define and describe the terms used to describe the movements of the limbs and vertebral column.
Functional drops: general body growth and development.
Diagnostic drops: medical imaging.
Topic 2. From outside to inside: topographical hints
Define and describe the various parts of the human body and their general content and arrangement.
Clinical drops: peritonitis and mesotheliomas.
Topic 3. Intercommunication between the body and the environment (skin and its appendages).
·Define and describe the skin and its appendages and their regional characteristics.
Diagnostic drops: dermatoglyphics.
·Illustrate how we can interact with the environment.
·Illustrate how we can protect ourselves from the environment.
Functional drops: thermoregulation and UV protection.
Functional drops: human skin varies in space and time.
Clinical drops: skin and burns.
Clinical drops: pressure wounds.
Clinical drops: psoriasis.
Topic 4. Bones: support, movement and protection.
·Understand how the various bones, their components, growth, remodelling and repair, contribute to the general
framework of human body.
Functional drops: microgravity and bed rest.
Functional drops: principal stresses and bone morphology.
·Learn the morphofunctional bases of the support, movement and protection functions of the bones in the trunk and limbs.
Diagnostic drops: bone age.
Clinical drops: fracture healing and distraction osteogenesis.
Topic 5. Joints: support and movement.
·Understand how joints can link bones together permitting and/ or limiting their reciprocal movements.
·Learn the morphofunctional bases of the movement and support functions of the various joints in the trunk and limbs.
Clinical drops: joint endoprostheses.
Topic 6. Skeletal muscles: support, movement and protection.
·Understand how the various skeletal muscles and their components contribute to the general construction of human
body.
Functional drops: thermoregulation.
·Learn the morphofunctional bases of the movement and support functions of the various muscles in the trunk and limbs.
Functional drops: levers.
Functional drops: sports champions.
Topic 7. The skull: bones, fossae and general architecture.
·Describe the position and main characteristics of the major bones of the skull, and their reciprocal joints.
·Describe the boundaries, walls and floors of the cranial fossae.
·Identify the external and internal features of the cranial foramina and list the structures that each transmits.
Practical/General anatomy topic 1: The skull
·Observe, describe and recognize the position and main characteristics of the major bones of the skull, and their reciprocal
joints.
·Observe, describe and recognize the boundaries, walls and floors of the cranial fossae.
·Observe, describe and recognize the external and internal features of the cranial foramina and list the structures that each transmits.
REGIONAL ANATOMY
During the course a description of regional anatomy in relation to the clinical practice will be made. The anatomical structures of the back, thorax, abdomen and limbs will be analyzed in their relations and reciprocal interdependence together with the
principal methods for non-destructive clinical image analysis. In the 4th year/second semester the same approach will be used for Head and Neck.
Topic 1. Trunk: the back.
·Describe the anatomical relations between the vertebrae, the spinal cord, and the spinal nerves.
Functional drops: spinal curvatures.
·Describe the cervical, brachial, lumbosacral, and pudendum plexuses, their position, anatomical relations and
significance.
Clinical drops: brachial plexus lesions.
Clinical drops: sciatic nerve pain.
Topic 2. Trunk: the thorax.
·Describe the main anatomical characteristics of the thorax and its surface anatomy.
Diagnostic drops: sentinel lymph node.
·Describe the topographical and anatomical divisions of the thoracic cavity, the surface markings of the main thoracic
organs, and their anatomical relations.
Diagnostic drops: endoscopy and medical imaging.
Clinical drops: thoracic inlet syndrome.
·Understand the position of the heart, great vessels and oesophagus in the mediastinum.
Functional drops: organ perfusion vs. oxygen consumption
·Understand the position and relations of the pleura, lungs, trachea and bronchi.
Clinical drops: pneumothorax.
·Understand the position and relations of the diaphragm, and its role in respiratory movements.
Clinical drops: phrenic nerve lesions.
Topic 3. Trunk: the abdomen and pelvis.
·Describe the main anatomical characteristics of the abdomen and pelvis, and their surface anatomy.
Functional drops: endoabdominal pressure variations.
Clinical drops: feto-pelvic relationship and childbirth.
·Describe the topographical and anatomical divisions of the abdominal cavity, the surface markings of the main abdominal
organs, and their anatomical relations.
·Understand the position of the gastrointestinal tract, abdominal viscera, and urogenital system in the abdomen.
·Describe the peritoneum, its ligaments, and the peritoneal cavity.
Clinical drops: hernia.
·Understand the position and relations of the various organs with the peritoneal cavity.
Clinical drops: portal hypertension.
Topic 4. Pectoral and pelvic girdles, upper and lower limb.
·Describe the main anatomical characteristics of the upper and lower limbs, thoracic and pelvic girdles, and their surface anatomy.
·Describe the fascial compartments delimiting the major muscle groups of the upper and lower limbs, and to explain the functional importance of those compartments and their contents.
·Describe the movements of the pectoral and pelvic girdles, and of upper and lower limbs; to identify and describe the muscles responsible for the movements and summarize their main attachments and somatic motor nerve supply.
Clinical drops: rotator cuff lesion.
Clinical drops: hip dysplasia.
Clinical drops: Trendelenburg gait.
Clinical drops: free flaps.
Functional drops: plantar arches.
Clinical drops: flat foot.
·Describe the origin, course and distribution of the major arteries and veins of the upper and lower limbs and their
branches; classify and contrast the functions of the deep and superficial veins.
Diagnostic drops: arterial pulses and blood pressure measurement.
Clinical drops: saphenous varices.
·Describe the origin, course and function of the principal nerves of the upper and lower limbs.
Clinical drops: radial nerve and humeral shaft fractures.
Clinical drops: carpal tunnel syndrome.
Practical/Regional anatomy topic 1: Trunk & the back.
·Observe, describe and recognize the main anatomical features of vertebrae and their joints.
·Observe, describe and recognize the structures, regions, functions and movements of the vertebral column.
·Observe, describe and recognize the principal muscle groups and ligaments of the vertebral column.
·Observe, describe and recognize the anatomical relations between the vertebrae, the spinal cord, and the spinal nerves.
·Observe, describe and recognize the cervical, brachial, lumbosacral, and pudendum plexuses, their position, anatomical relations and significance.
Practical/Regional anatomy topic 2: Trunk: the thorax.
·Observe, describe and recognize the main anatomical characteristics of the thorax and its surface anatomy.
·Observe, describe and recognize the main anatomical skeletal, cartilaginous and ligamentous features of thorax.
·Observe, describe and recognize the joint and movements of the thorax.
·Observe, describe and recognize the principal muscle groups of the thorax.
·Observe, describe and recognize the position and relations of the diaphragm.
·Observe, describe and recognize the position of the heart, great vessels and oesophagus in the mediastinum.
·Observe, describe and recognize the position and relations of the pleura, lungs, trachea and bronchi.
Practical/Regional anatomy topic 3: Trunk: the abdomen and pelvis.
·Observe, describe and recognize the anatomical characteristics of the abdomen and pelvis, and their surface anatomy.
·Observe, describe and recognize the main anatomical skeletal, cartilaginous and ligamentous features of abdomen and
pelvis.
·Observe, describe and recognize the joint and movements of the abdomen and pelvis.
·Observe, describe and recognize the principal muscle groups of the abdomen and pelvis.
·Observe, describe and recognize the position and anatomical relations of the gastrointestinal tract, abdominal viscera, and
urogenital system in the abdomen.
Practical/Regional anatomy topic 4: Upper and lower limb.
·Observe, describe and recognize the main anatomical characteristics of the upper and lower limbs, thoracic and pelvic
girdles, and their surface anatomy.
·Observe, describe and recognize the main anatomical skeletal, cartilaginous and ligamentous features of the upper and
lowe limbs.
·Observe, describe and recognize the joints and movements of the upper and lower limbs.
·Observe, describe and recognize the major muscle groups of the upper and lower limbs, and their relations with the
vessels and nerves.
·Observe, describe and recognize the major arteries and veins of the upper and lower limbs and their branches.
·Observe, describe and recognize the principal nerves of the upper and lower limbs.
NEUROANATOMY
The neuroanatomy course is divided into three modules. The first module takes place during the second semester of the first year. Its general learning goal is to understand, starting from a developmental perspective, the macroscopic anatomy and internal architecture of the central nervous system and to know the organization of the peripheral nervous system.
Topic 1. Phylogenesis and general organization.
·Describe the phylogenesis of nerve cells and primitive neural circuits.
·Describe the process of centralization and cephalization of nerve cells.
·Describe the formation of the tubular nervous system and brain vesicles.
·Illustrate the general morpho/functional organization of the nervous system in relation to its phylogenesis.
·Describe the general organization of the grey and white matter.
·List the most common neurotransmitters/neuromodulators.
Topic 2. Development of the nervous system.
·Describe the different phases of neurulation.
Developmental defects: defects of closure of the neural tube, cyclopia.
·Describe the process of histogenesis in the neural tube.
·Describe the fundamental cross sectional organization of the developing neural tube.
· Describe the process of myelination.
·Describe the development of the spinal nerve and of the peripheral nervous system.
·Describe the basic macroscopic events through which the neural tube undergoes to form the different portions of the
central nervous system and the ventricular system.
·Illustrate the events that lead to the organization of the gray and white matter in the different portions of the central
nervous system: spinal cord, brainstem and brain.
·Understand the basic prenatal and postnatal steps characterizing the morpho-functional maturation of the nervous
system.
Developmental defects: holoprosencephaly, fetal alcohol spectrum disorders & syndrome
Topic 3: Spinal cord, spinal nerves.
·Describe the relation of the spinal cord with the vertebral canal.
·Describe the spinal segment, the ventral and dorsal roots and their level of exit.
·Describe the meninges, the meningeal spaces and their content.
·Describe the lumbar cistern and the composition of the cerebrospinal fluid.
Clinical drops: lumbar punctures (diagnosis and treatment).
·Describe the macroscopic aspect of the spinal cord and its vascularization
·Illustrate the general organization of the grey and white matter.
Functional drops: spinal reflexes.
Topic 4. Peripheral nervous system: spinal plexuses.
·Describe the formation of the spinal nerve and the destiny of its terminal and collateral branches.
·Illustrate the formation of spinal plexuses.
·Describe the position and composition of the spinal plexuses and their territory of innervation.
·Highlight the main aspects of the course and territory of innervations of the most important peripheral nerves.
Clinical drops: injuries of the brachial and lumbosacral plexuses.
Topic 5. Peripheral nervous system: Autonomic nervous system.
·Illustrate the general organization of the autonomic nervous system.
·Describe the organization of the enteric nervous system.
Clinical drops: referred pain
Topic 6. Brainstem and cerebellum.
·Illustrate the content and organization of the posterior cranial fossa.
·Describe the organization of the meninges in relation to the suvratentorial and infratentorial compartments of the neurocranium and to the formation of the venous sinuses.
Clinical drops: herniations.
·Describe the surface anatomy of the brainstem, the origin of the cranial nerves and their exit points with respect to the
skull foramina.
·Describe the surface anatomy of the cerebellum and its division in lobes.
·Describe the relation of the cerebellum to the brainstem and 4th ventricle.
·Describe the morphology of the 4th ventricle and its communications.
·Describe the structure of a choroid plexus and the formation and circulation of the cerebrospinal fluid.
Clinical drops: hydrocephalus.
.
Topic 7. Telencephalon and diencephalon.
·Describe the surface anatomy of the telencephalon and its subdivision in lobes and gyri.
·Identify the position of the primary and secondary motor and sensory areas in the lobes.
·Illustrate the general organization of the white matter of the cerebral hemispheres into projecting, association and
commissural fibers.
·Describe the position and relations of the basal ganglia.
·Describe the diencephalon and name its subdivisions
·Describe the third ventricle.
·Describe the morphology of the lateral ventricles.
·Describe the position and function of circumventricular organs.
Clinical drops: vomiting.
Practical/Neuroanatomy: topic 1, macroscopic organization of nervous system.
Learning goals:
·Observe, describe and recognize the main anatomical features of the CNS organs, their position and anatomical relations.
·Observe, describe and recognize the anatomical relations between the vertebrae, the spinal cord and meninges, the spinal
nerves and sensory ganglia.
·Observe, describe and recognize the macroscopical location of the PNS organs (somatic and visceral).
·Observe, describe and recognize the cervical, brachial, lumbosacral, and pudendum plexuses, their position and
anatomical relations.
SEMINARS
To be reorganized--
· People from Bones. Prof. Cristina Cattaneo
· 3D reconstruction of human movement. Prof. Manuela Galli
· Clinical aspects of knee joint pathology. Prof. Giuseppe Peretti
· Clinical aspects of shoulder joint pathology. Prof. Pietro Simone Randelli
Prerequisites for admission
There are no specific pre-requirements for the Human Body course.
Teaching methods
Synchronous learning: video conferences, interactive webinars, chat-based online discussions, seminars and lectures; tutorial activities at the light microscope and using virtual digital slides, tutorial and small group activities with human organs and models of human organs. Asynchronous learning: audio-video based (pre-recorded, multimedia platforms); text-based (e-mail, electronic documents, discussion boards, blogs); tutorial activities at the light microscope.
Teaching Resources
TEXTBOOKS: (more recent editions can be used as well)
· Ross and Pawlina Histology A Text and Atlas - With Correlated Cell and Molecular Biology. Lippincott Williams & Wilkins, 6th Edition, 2010
· Wheater's Functional Histology: A Text and Colour Atlas. Barbara Churchill Livingstone, 2006
· Moore & Dalley Clinically Oriented Anatomy. Lippincott Williams & Wilkins, 2009
· Gray's Anatomy The Anatomical Basis Of Clinical Practice. Churchill Livingstone, 2008
· Langman's Medical Embryology. Lippincott Williams & Wilkins; 12th Edition, 2011
· Larsen's Human Embryology. Churchill Livingstone, 2008
· Moore, Persaud, Torchia The Developing Human: Clinically Oriented Embryology. Elsevier, 9th Edition, 2011
SUPPLEMENTAL LEARNING MATERIAL: Additional material, in particular to online content, will be made available during the course.
· Ross and Pawlina Histology A Text and Atlas - With Correlated Cell and Molecular Biology. Lippincott Williams & Wilkins, 6th Edition, 2010
· Wheater's Functional Histology: A Text and Colour Atlas. Barbara Churchill Livingstone, 2006
· Moore & Dalley Clinically Oriented Anatomy. Lippincott Williams & Wilkins, 2009
· Gray's Anatomy The Anatomical Basis Of Clinical Practice. Churchill Livingstone, 2008
· Langman's Medical Embryology. Lippincott Williams & Wilkins; 12th Edition, 2011
· Larsen's Human Embryology. Churchill Livingstone, 2008
· Moore, Persaud, Torchia The Developing Human: Clinically Oriented Embryology. Elsevier, 9th Edition, 2011
SUPPLEMENTAL LEARNING MATERIAL: Additional material, in particular to online content, will be made available during the course.
Assessment methods and Criteria
Assessment methods: multiple question choice test (MCQT) and oral assessment, slide diagnosis.
Multiple choice test covering the whole program and slide diagnoses. In case of failure of the oral exam, the test will be kept valid through the session (summer, fall or winter session). Slide diagnoses will remain always valid.
Attendance is required to be allowed to take the exam. Unexcused absence is tolerated up to 34% of the course activities. University policy regarding excused illness is followed.
Registration to both written and oral exams through SIFA is mandatory.
Multiple choice test covering the whole program and slide diagnoses. In case of failure of the oral exam, the test will be kept valid through the session (summer, fall or winter session). Slide diagnoses will remain always valid.
Attendance is required to be allowed to take the exam. Unexcused absence is tolerated up to 34% of the course activities. University policy regarding excused illness is followed.
Registration to both written and oral exams through SIFA is mandatory.
BIO/16 - HUMAN ANATOMY - University credits: 12
Practicals: 48 hours
Lessons: 72 hours
: 36 hours
Lessons: 72 hours
: 36 hours
Professor(s)
Reception:
By appointment via e-mail
Department of Biomedical Sciences for Health, V. Mangiagalli, 31 - Milan
Reception:
appointment by e-mail
Dept of Biomedical Sciences for Health - via Mangiagalli 31 - Milano - via Microsoft Teams
Reception:
Appointment via e-mail
Dept. of Biomedical Sciences for Health - via Mangiagalli 31, Milan