Anatomy

HUMAN ANATOMY

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 5. Lymphoid organs (lymphnodes, spleen, thymus, tonsils). -see histology course
- · Describe the structure of the lymphoid organs how it accommodates their function.

Topic 6. 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 7. 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 8. 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 9. 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 morphofunctional 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 10. 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 morphofunctional description of the different segments of the nephron and collecting ducts, the structural aspects of the filtration barrier.
· Describe the iuxta-glomerular 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 11. 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 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.
Developmental defects: craniosynostosis, Crouzon and Apert syndromes
Developmental defects: first arch syndrome
Developmental defects: 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
lower 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

EXPECTED LEARNING OUTCOMES
Students are expected to be able to:
-Describethe 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.

HUMAN ANATOMY - FIRST YEAR

GENERAL OBJECTIVES OF THE COURSE:
This course addresses the organization of the human body integrating the organ/system (systematic anatomy) and regional (topographic anatomy) approachesin relation to the clinical practice, including how this organization comes into being during development. The core of knowledge acquired during this course is fundamental to understand the functions and pathologies of the different organs and systems
Part of Neuroanatomy and of Anatomy of the Head and Neck regions will be integrated in courses of the second (Functions) and, fourth year (Head and Neck) years.

Learning goals:
- to know 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
- to understand the structural principles underlying the functions of organs and systems
- to acquire the general principles of the body plan at both the systematic (organs and systems) and the topographic level (regions of the body and corresponding deep spaces)

System development and organ structure:
General purposes
At the end of the Course the student should:
- Know the most important developmental aspects characterizing the body systems in relation to their adult structure and
location
- Be able to describe the organ composition of the body systems
- Know the macroscopic aspects, architectural organization and cellular features of organs
- Be able to relate the structural aspects to organ function

System Embryology: organogenesis
The student should be able to:
1. Describe how the basic body plan of the embryo is established by
a. Knowing how the three germ layers and the neural crest will develop
b. Understanding the process of folding and the ensuing formation of the intraembryonic celomatic cavity, intestinal tube,
and body wall
c. Understanding the process of segmentation in the neural tube and intermediate mesoderm
d. Knowing the basic events leading to the formation of the heart and primitive circulation

2. Describe the development of the digestive system by
a. Knowing how the primitive intestinal tube forms
b. Understanding the behavior of the splanchnopleura and somatopleura and the ensuing formation of the mesenteries
and the peritoneal cavity
c. Knowing the relative contribution of the endoderm and splanchnic mesenchyme to the formation of the intestinal wall
d. Understanding the position of organs with respect to the peritoneum (intraperitoneal, retroperitoneal, secondarily
retroperitoneal)
e. Knowing the regionalization of the gut tube, the organs that originate from each region and the main vascular supply to
each of the latter
f. Understanding the process of occlusion and recanalization of the intestinal tube and the histogenesis of the different
layers of its wall
g. Understanding the positional shifts of organs that lead to their definitive location in the abdominal cavity
h. Understanding the major events that lead to the development of the liver, biliary tree and pancreas
i. Understanding the major developmental defects of the digestive system

3. Describe the development of the respiratory system by
a. Understanding the evolutionary need to develop a respiratory dry diverticulum
b. Understanding the formation of the respiratory diverticulum from the primitive intestine and its relationwith the
primitive pharynx
c. Understanding the formation of the laryngeal inlet
d. Knowing the relative contribution of the endoderm and splanchnic mesenchyme to the formation of the airways wall
e. Knowing how the primitive diverticulum evolves into the tracheobroanchial tree and determines the final subdivisions of
the lungs
f. Knowing the basic structural/molecular events driving the branching mechanism
g. Knowing how the lung parenchyma mature with respect to its respiratory functions
h. Knowing the main morpho-functional processes relevant to lung development and the events characterizing the
transition at birth
i. Understanding the formation of the pleural cavities
j. Understanding the formation of the diaphragm
k. Knowing the main abnormalities related to lung/respiratory function development

4. Describe the development of the urogenital system by
a. Understanding why the urinary and genital system are embryologically and anatomically interwoven
b. Understanding the evolutionary needs that have driven kidney development
c. Understanding how the phylogenesis of the kidney is recapitulated during the ontogenesis of the human kidney and how
the primitive form of kidney contributes to the formation of the mature kidney and to the formation of the urinary
conduits and genital conduits
d. Knowing the relevant morphological and molecular events characterizing the interaction between the ureteric bud and
the metanephric mesenchyme
i. Development of the collecting system
ii. Development of the excretory unit (the nephron)
iii. Establishment of the definitive renal architecture
e. Understanding the process of migration of the kidney and related changes in vascularization
f. Understanding the division of the cloaca and the formation of the bladder and urethra from the urogenital sinus
g. Understanding how the urinary tract and genital tract become common at the level of the male urethra and separated at
the level of the female urethra
h. Knowing how the primitive gonad develops form the intermediate mesoderm and its colonization by germ cells
i. Understanding the relation of the primitive gonad with the mesonephric duct and tubules and paramesonephric duct
j. Knowing the morphological and molecular mechanisms through which the indifferent gonad develops into the male or
female gonad
k. Knowing how the mesonephric duct and tubules and the paramesonephric duct become incorporated and develop into
the male and female genital tract respectively
l. Understanding the formation of the inguinal canal, the migration of the gonads and the formation of the covering of the
testicle
m. Knowing the main aspect of the development of the external genitalia
n. Understanding the main congenital anomalies of the urinary and genital system
o. Knowing the basic aspects of the development of the adrenal gland

5. Describe the development of the pharyngeal apparatus by
a. Understanding how it develops around the primitive pharynx and its relation to the stomodeum
b. Knowing the composition of the pharyngeal arches and their derivatives
c. Understanding the contribution of the pharyngeal arch arteries to the mature vascularization
d. Understanding the formation of the pharyngeal pouches and knowing their derivatives
e. Understanding the formation of the pharyngeal grooves and membranes and their development
f. Knowing the main aspects of the development of the thymus
g. Knowing the main aspects of the development of the thyroid gland
h. Understanding the main congenital anomalies of the pharyngeal apparatus

6. Describe the development of the heart by
a. Knowing the basic outline of the primitive circulation
b. Knowing the primitive chambers of the heart tube and their contribution to the mature heart
c. Understanding the changes in position of the heart primitive chambers because of the folding of the heart tube
d. Understanding the evolution of the sinus venosus and how it contributes to the formation of the atria
e. Understanding how the atrioventricular canal is divided by the septum intermedium
f. Understanding the formation of the interatrial septum and the relevance of the components of this septum to the fetal
circulation
g. Understanding the formation of the muscular and membranous portion of the interventricular septum
h. Understanding the mechanism of septation of the outflow tract of the heart
i. Understanding the basic mechanisms leading to the formation of the atrio-ventricular and semilunar valves
j. Understanding the formation of the conduction system of the heart
k. Knowing the relevant aspect of the fetal circulation and how it changes at birth
l. Understanding the most common congenital defects of the heart

Organ structure
The student should be able to describe
1. the main external morphologic features (size, shape, division in parts, colour, weight, length )
2. the internal architecture (organization of the different compartments/tissues of hollow and parenchymal organs,
relevant vascular pattern)
3. the relevant microstructural aspects (main cell types in relation to their function, functional units) of the organs of the
following systems:
a. Digestive system: oral cavity, pharynx, oesophagus, stomach, small intestine, large intestine, liver and pancreas, salivary
glands
b. Respiratory system: larynx, trachea, lungs, tracheobronchial tree (conductive portion and respiratory portion, alveoli),
pleura
c. Urinary system: kidney, pelvicalyceal system, ureter, urinary bladder, male and female urethra
d. Male reproductive system: testicle, rete testis, ductuli efferentes, epididymis, ductus deferentes, ejaculatory ducts,
urethra, prostate, seminal vesicle, external genitalia
e. Female reproductive system: ovary, uterine tubes, uterus, vagina, external genitalia
f. Endocrine system: hypophysis, thyroid gland, parathyroid glands, adrenal gland, endocrine pancreas, diffuse neuroendocrine system
g. Cardiovascular system: heart (faces, cardiac chambers, fibrous skeleton, cardiac valves, organization of the musculature,
composition of the heart wall, conduction system, vascularisation, structure and organization of the pericardium), vessels
(general structural features of arteries and veins, specific features of the different kind of arteries/arterioles, classification
and structure of capillaries, mechanisms contributing to the control of microcirculation in the capillary bed, structure of
venules and veins
h. Lymphatic system: lymphatic vessels, lymph nodes, spleen, thymus, mucosal-associated lymphoid tissue

General Anatomy
General purposes
At the end of the Course the student should:
- Know the general organization of the human body
- Know the anatomical position and nomenclature, the anatomical planes and the terms used to describe body
movements
- Know bases of our interaction with the environment, as well as of how we can protect ourselves from the environment
- Know the general organization of the locomotor system as framework for further regional description
- Know the general layout of the circulatory system (pulmonary, systemic and lymphatic circulation)

Anatomical Terms
The student should be able to:
1. Define and describe the terms relative to the anatomical position (e.g.: medial, lateral, proximal, distal, superior, inferior,
deep, superficial, palmar, plantar, anterior/ ventral, posterior/ dorsal, rostral, caudal).
2. Describe the anatomical planes: axial/ transverse/ horizontal, sagittal and coronal/ frontal.
3. Define and describe the terms used to describe the movements of the limbs and vertebral column: flexion, extension,
lateral flexion, pronation, supination, abduction, adduction, medial and lateral rotation, inversion, eversion,
plantarflexion, dorsiflexion, protraction, retraction and circumduction.

Regional Anatomy
General purposes
At the end of the Course the student should:
- Be able to describe the regions of human body and corresponding deep spaces in relation to the clinical practice
- Be able to describe the anatomical structures of the back, thorax, abdomen and limbs, their position, anatomical
relationships, and the morphological bases of their function.
In the 4th year /2nd semester the same approach will be used for head and neck.

Vertebral Column
The student should be able to:
1. Describe the main anatomical features of a typical vertebra. Describe the atlas, axis, typical cervical, thoracic, lumbar
vertebrae and sacrum and recognise their characteristic features.
2. Describe the structures, regions and functions of the vertebral column. Describe the range of movement of the entire
vertebral column and its individual regions.
3. Describe the anatomy of intervertebral facet joints and intervertebral discs. Explain the role of the discs in weight
bearing by the vertebral column and detail their topographical relationships to spinal nerve roots and the spinal cord.
4. Describe the anatomy of a spinal nerve (e.g. as exemplified by a thoracic spinal nerve, including its origin from dorsal
and ventral spinal roots, its main motor and cutaneous branches and any autonomic component).
5. Describe the principal muscle groups and ligaments of the vertebral column and surface features in order to be able to
perform an examination of the back, discuss their functional role in stability and movement of the vertebral column.
6. Describe the anatomical relationships of the meninges and relevant meningeal spaces to the spinal cord and dorsal and
ventral nerve roots.

Upper Limb
The student should be able to:
1. Describe the main anatomical landmarks of the clavicle, scapula, humerus, radius and ulna. Illustrate the bones of the
wrist and hand and their relative positions.
2. Describe the close relations of the bones and joints (e.g. bursae, blood vessels, nerves ligaments and tendons), which
may be injured by fractures or dislocation and predict what the functional effects of such damage might be.
3. Describe the fascial compartments delimiting the major muscle groups of the upper limb. Explain the functional
importance of those compartments and their contents.
4. Describe the origin, course and distribution of the major arteries and their branches that supply the shoulder, arm and
forearm. Explain the importance of anastomoses between branches of these arteries at the shoulder and in the upper
limb.
5. Describe the sites at which pulses in the brachial, radial and ulnar arteries may be located.
6. Describe the courses of the main veins of the upper limb; classify and contrast the functions of the deep and superficial
veins. Identify the common sites of venous access and describe their key anatomical relations. Explain the relationship
between venous and lymphatic drainage channels.
7. Describe the organisation of the brachial plexus, its origin in the neck and continuation to the axilla and upper limb.
8. Describe the origin, course and function of the axillary, radial, musculocutaneous, median and ulnar nerves in the arm,
forearm, wrist and hand. Name the main muscles and muscle groups that these nerves supply as well as their sensory
distribution. Predict the consequences of injury to these nerves.
9. Describe the boundaries of the axilla. List its contents, including the major vessels, parts of the brachial plexus and
lymph node groups.
10. Describe the movements of the pectoral girdle; identify the muscles responsible for its movements and summarise their
main attachments and somatic motor nerve supply.
11. Describe the factors that contribute to the stability of the shoulder joint and explain the functional and possible
pathological consequences of its dislocation.
12. Describe the anatomy of the elbow joint. Explain the movements of flexion and extension, identify the muscles
responsible for these movements and summarise their main attachments and somatic motor nerve supply.
13. Describe the anatomy of the superior and inferior radio-ulnar joints. Explain the movements of supination and
pronation; identify the muscles responsible for these movements and summarise their main attachments and somatic
motor nerve supply.
14. Describe the anatomy of the wrist. Describe the movements at these joints and name and identify the muscle groups
responsible for the movements. Describe the relative positions of the tendons, vessels and nerves at the wrist in
relation to injuries.
15. Describe the movements of the fingers and thumb. Describe the position, function and nerve supply of the muscles and
tendons involved in these movements, differentiating between those in the forearm and those intrinsic to the hand.
16. Describe the anatomy of the axillary lymph nodes and explain their importance in the lymphatic drainage of the breast
and the skin of the trunk and upper limb.

Thorax
The student should be able to:
1. Describe the main anatomical landmarks of the thoracic vertebrae, ribs and sternum.
2. Describe the anatomy of the joints between the ribs and vertebral column, the ribs and costal cartilages and the costal
cartilages and sternum. Explain the movements made at those joints during ventilation and the differences between
ventilatory movements in the upper and lower chest.
3. Describe how the boundaries of the thoracic inlet and outlet are formed by the vertebrae, ribs, costal cartilages and
sternum.
4. Describe the surface projection, attachments and relationships of the diaphragm and the structures that pass through it.
Explain the movements it makes during ventilation and the motor and sensory nerve supply to it and its pleural and
peritoneal coverings.
5. Describe the anatomy of the intercostals muscles. Describe a neurovascular bundle in a typical intercostal space and
outline the structures its components supply.
6. Explain the movements involved in normal, vigorous and forced ventilation and describe the muscles responsible for
these movements.
7. Describe the surface markings of the heart and great vessels, the position and site of auscultation of the four major
valves, the margins of the pleura and the lobes and fissures of the lungs.
8. Describe the anatomy and the major relations of the trachea, bronchial tree and bronchopulmonary segments.
9. Describe the anatomy, the position and form of the lungs, their lobes and their key anatomical relations. Explain the
pleural reflections.
10. Describe the blood and nerve supply and lymph drainage of the lungs. Describe the structures in the hilum and the
mediastinal relations of each lung.
11. Describe the arrangement and contents of the mediastinum.
12. Describe the anatomy, the position and form of the heart, and its key anatomical relations. Explain the pericardial
reflections.
13. Describe the major anatomical features of each chamber of the heart and explain their functional significance.
14. Describe the structure and position of the atrio-ventricular, pulmonary and aortic valves and describe their role in the
prevention of reflux of blood.
15. Describe the origin, course and main branches of the left and right coronary arteries and discuss the functional
consequences of their obstruction.
16. Understand the anatomical course of the spread of excitation through the chambers of the heart.
17. Describe the arrangement of the fibrous and serous layers of the pericardium.
18. Describe the course of the ascending aorta, the arch of the aorta and the descending thoracic aorta. Name their major
branches and the structures they supply.
19. Describe the origins, course and relationships of the brachiocephalic veins, inferior and superior venae cavae and the
azygos venous system.
20. Describe the origin, course and distribution of the vagus nerve and its branches and the phrenic nerves on both the right
and left sides of the thorax. Explain the mechanism of referred pain and where pain is referred from thoracic organs.
21. Describe the composition and function of the sympathetic chains and splanchnic nerves.
22. Describe the course and major relations of the oesophagus within the thorax.
23. Describe the course and major relations of the thoracic duct and the other lymph systems within the thorax.

Abdomen
The student should be able to:
1. Describe the bony and cartilaginous landmarks visible or palpable on abdominal examination.
2. Describe the regions of the abdomen. Describe the surface projections of the abdominal organs.
3. Describe the anatomy, innervation and functions of the muscles of the anterior and posterior abdominal walls. Discuss
their functional relationship with the diaphragm and roles in posture, ventilation and voiding of abdominal/ thoracic
contents.
4. Describe the anatomy of the attachments of the inguinal ligament; the anatomy of the superficial and deep inguinal
rings and how the anterior abdominal wall muscles form the inguinal canal. Describe the contents of the inguinal canal
in both males and females.
5. Describe the relationship between the femoral canal and the inguinal ligament.
6. Describe the positions of the liver, pancreas, spleen, kidneys, stomach, duodenum, jejunum and ileum of the small
intestine, caecum, appendix, ascending, transverse, descending and sigmoid parts of the colon and the rectum.
7. Describe the organisation of the parietal and visceral peritoneum; its lesser and greater sacs, mesenteries and
peritoneal 'ligaments'.
8. Explain the nerve supply of the parietal and visceral peritoneum and the role of the visceral peritoneum in referred pain.
9. Describe the functional anatomy of the stomach, its position, parts, sphincters, blood and nerve supply and key relations
to other abdominal organs.
10. Describe the duodenum, its parts, position, secondary retroperitoneal attachment, blood supply and key relations with
other abdominal organs.
11. Describe the regions of the small and large intestine, including the anatomy of the appendix and the anatomical
variations in its position.
12. Describe the position and form of the pancreas and its relationships to other abdominal organs.
13. Describe the position and form of the liver, its lobes and their key anatomical relations. Explain the peritoneal reflections of the liver and its movement during respiration. Summarise the functional anatomy of the portal vein, the portal venous system and portal-systemic anastomosis and their significance in portal hypertension.
14. Describe the position and form of the gall bladder and biliary tree; their relations in the abdomen.
15. Describe the position and form of the kidneys and ureters. Describe their relationships to other abdominal and pelvic structures.
16. Describe the relations of the suprarenal (adrenal) glands and their functional anatomy.
17. Describe the position and form of the spleen and its key anatomical relationships with other abdominal structures.
18. Describe the origins, course and major branches of the abdominal aorta, celiac axis, superior and inferior mesenteric arteries and their major branches, the renal and gonadal arteries. Explain the significance of the blood supply from the abdominal aorta to the spinal cord. Describe the origins, course and major tributaries of the inferior vena cava.
19. Describe the anatomy of the lymph nodes involved in lymph drainage of abdominal viscera.

Pelvis
The student should be able to:
1. Describe the skeletal and ligamentous components of the pelvis, the anatomy of the pelvic inlet and outlet and recognise their normal orientation. Explain sex differences in pelvic skeletal anatomy and how these change during development.
2. Describe the anatomical landmarks of the iliac, ischial and pubic bones.
3. Describe the points of attachment of the muscles of the abdominal wall and those of levator ani.
4. Describe the functional importance of the pelvic floor musculature, its midline raphé and the structures passing through it in males and females.
5. Describe the anatomy of the bladder, its base and ureteric openings. Explain how its position changes with filling and pregnancy and its relationship to the overlying peritoneum.
6. Describe the anatomy of the urethra; explain the anatomy of its different parts in males and females in relationship to continence and catheterisation.
7. Describe the innervation of the bladder and its sphincters and the mechanism of micturition.
8. Describe the anatomy of the scrotum, testis, epididymis, and their arterial supply and venous and lymphatic drainage.
9. Describe the structure and course of the spermatic cord and vas deferens.
10. Describe the anatomy of the prostate gland, seminal vesicles and their anatomical relations.
11. Describe the position and form of the ovary, uterine tubes, uterus, cervix and vagina and their anatomical relationships, including any peritoneal coverings.
12. Describe the origin, course and relations of the uterine, ovarian and testicular arteries.
13. Describe the origin, course and branches of the pudendal nerves.
14. Describe the innervation and mechanisms involved in erection of cavernous tissue in male and female and emission and ejaculation in the male.
15. Describe the anatomy of the sigmoid colon and rectum and their anatomical relationships including peritoneal. Explain the anatomy of the anal canal, the functional anatomy of the anal sphincters and their role in faecal continence.
16. Describe the blood supply and venous drainage of the distal bowel; the supply from the superior rectal (inferior mesenteric), middle rectal (internal iliac) and inferior rectal arteries (from pudendal to anal canal only), and portal-systemic venous anastomosis.
17. Describe the anatomy of the ischio-anal fossa and explain its potential involvement in abscesses, anal glands and fissures.
18. Describe the structure of the penis, scrotum and its contents, the clitoris and vulva. Describe the arterial supply to and venous drainage from the penis. Explain the anatomy of the perineal membrane.
19. Describe the lymphatic drainage of the pelvis.

Lower Limb
The student should be able to:
1. Describe the major features and surface landmarks of the pelvis, femur, tibia, fibula, ankle and foot.
2. Describe the close relations of the bones and joints (e.g. bursae, blood vessels, nerves ligaments and tendons), which may be injured in fractures or dislocations and predict what the functional effects of such damage would be.
3. Describe the fascial compartments enclosing the major muscle groups and explain the functional importance of these compartments and their contents.
4. Describe the origin, course and branches of the major arteries that supply the hip, gluteal region, thigh, leg, ankle and foot. Explain the functional significance of anastomoses between branches of these arteries at the hip and knee.
5. Describe the locations at which the femoral, popliteal, dorsalis pedis and posterior tibial pulses can be felt.
6. Describe the course of the principal veins of the lower limb. Explain the role of the perforator vein connections between the superficial and deep veins and the function of the 'muscle pump' for venous return to the heart.
7. Outline the origin of the lumbosacral plexus and the formation of its major branches.
8. Describe the origin, course and function of the sciatic, femoral, obturator, common peroneal and tibial nerves, sural and saphenous nerves and summarise the muscles and muscle groups that each supply as well as their sensory distribution.
9. Describe the structure and movements of the hip joint. Summarise the muscles responsible for these movements, their innervation and main attachments.
10. Describe the structures responsible for stability of the hip joint and their relative contribution to maintaining the lower limb in different positions.
11. Describe the structures at risk from a fracture of the femoral neck or dislocation of the hip and explain the functional consequences of these injuries.
12. Describe the boundaries of the femoral triangle and the anatomical relationships of the femoral nerve, artery, vein and lymph nodes to each other and to the inguinal ligament.
13. Describe the anatomy of the gluteal (buttock) region and the course of the sciatic nerve within it. Explain how to avoid damage to the sciatic nerve when giving intramuscular injections.
14. Describe the structure and movements of the knee joint. Summarise the muscles responsible for these movements, their innervation and main attachments.
15. Describe the close relations of the knee joint including major bursae and explain which structures may be injured by trauma (including fractures and dislocation) to the knee.
16. Identify the factors responsible for maintaining the stability of the knee joint. Describe the menisci, ligaments and the locking mechanism close to full extension.
17. Describe the boundaries and contents of the popliteal fossa.
18. Describe the anatomy of the ankle joint. Explain the movements of flexion, extension, plantarflexion, dorsiflexion, inversion and eversion. Summarise the muscles responsible for these movements, their innervation and their main attachments.
19. Describe the factors responsible for stability of the ankle joint, especially the lateral ligaments, and explain the anatomical basis of "sprain" injuries.
20. Describe the arches of the foot and the bony, ligamentous and muscular factors that maintain them.
21. Describe the movements of inversion and eversion at the subtalar joint, the muscles responsible, their innervation and main attachments.
22. Describe the structures at risk to a fracture of the femoral neck or dislocation of the hip and describe the functional consequences of these conditions.
23. Describe the lymphatic drainage of the lower limb.

Head and Neck
The student should be able to:
1. Describe the position and main characteristics of the major bones of the skull, including the frontal, parietal, occipital, temporal, maxilla, zygoma, mandible, sphenoid, nasal and ethmoid bones. Describe the anatomy and position of the hyoid bone, thyroid and cricoid cartilages. Describe the major sutural joints and describe the fontanelles of the fetal skull.
2. Describe the boundaries, walls and floors of the cranial fossae.
3. Identify the external and internal features of the cranial foraminae and list the structures that each transmits.
4. Describe the walls of the orbital cavity.
5. Describe the walls of the nasal cavity.
6. Name and locate the paranasal sinuses.
7. Describe the location and anatomical relations of the thyroid and parathyroid glands.
8. Identify the major structures passing between the neck and the thorax. Describe the courses and important relationships of the subclavian arteries and veins.
9. Describe the arrangement of the dura mater, and its main reflections within the cranial cavity and their relationship to the major venous sinuses and the brain itself.
11. Describe the relationships between the brain and the anterior, middle and posterior cranial fossae.

Neuroanatomy (1st year, 1st module)
General purposes:
The neuroanatomy course is divided into two modules. The general purpose of the first module is to know the main aspects of the macroscopic and microscopic organization of the central nervous system starting from a developmental perspective, and to know the specific organization of the spinal nerves and spinal plexuses.

The student should be able to
1. Describe the general aspects of the evolution of the neural circuits and their organization
2. Describe the relevant embryological events characterizing the development of the nervous system
3. Define the terms rostral and caudal, anterior/ ventral and posterior/ dorsal in relation to the nervous system.
4. Define the terms grey and white matter, fasciculus, tract, commissure, pathway, chiasm, decussation, nucleus, ganglion, and cortex.
5. Describe the major divisions of the central nervous system: the cerebral hemispheres, diencephalons (thalamus, hypothalamus and epithalamus), midbrain, pons, medulla oblongata, cerebellum, and spinal cord
6. Describe the external morphological features (surface anatomy)
7. Illustrate the general internal organization of the grey matter and white matter
8. Describe the meninges and their compartmentalization of the neural spaces
9. Describe the position of the different structure of the central nervous system in relation to the bony structures
10. Describe the ventricular system and explain the formation, circulation and drainage cerebrospinal fluid.
11. Describe the general organization of the peripheral nervous system (receptors, fibres classification, sensory ganglia, visceral ganglia, nerves)
12. Describe the spinal nerves and the specific organization of the spinal plexuses
13. Describe the main aspects of the course and territory of innervations of the nerves originating from the spinal plexuses
14. Describe the composition of cranial nerves and their territory of innervations
15. Describe the blood supply to the spinal cord
16. Describe the structure of the brain blood barriers