Gross Anatomy (ANAT 210)

Course Director Frank J. Slaby, Ph.D. The George Washington University School of Medicine and Health Sciences 2300 I Street NW, Ross Hall 212 Washington, DC 20037 Tel: 202-994-8813 Fax: 202-994-8885 Email: anafxs@gwumc.edu

Faculty

F. Slaby, Ph.D. - Course Director
R. Bohn, Ph.D.
R. Bernstein, Ph.D.
R. Jurjus, M.D.
P. Lucas, Ph.D.
S. McFarlin, Ph.D.
B. Wood, Ph.D.
R. Walsh, Ph.D.

Objectives for Students

1. Acquire a broad perspective of the structural organization of the body. For example, know the actions and innervation of the most important muscles of the limbs, the general features of synovial joints, the sites of key regions of certain dermatomes, the division of the thorax into the mediastinum and the pleural spaces about the lungs, the spatial relationships among mediastinal viscera, the mechanics of respiration, the peritoneal relationships of the abdominal viscera, the association of the arterial supply of the abdominal organs with their nerve supply and lymphatic drainage, and the general distribution of the cranial nerves.
2. Understand the anatomical basis of physical diagnosis. For example, know the sites of cardiac and pulmonary auscultation, the distinction between pleuritic pain and visceral chest pain, the distinction between rebound tenderness and visceral abdominal pain, the regions where the pulsations of superficial arteries can be assessed, the locations of all palpable lymph nodes, the spinal cord levels tested by the deep tendon reflex tests of the upper and lower limbs, and how to test the cranial nerves.
3. Understand the anatomical basis of radiological images. For example, be able to identify the major normal structures imaged in radiographs and CT scans of the chest and abdomen.
4. Understand the anatomical basis of the signs and symptoms of common or severe injuries, diseases, and conditions. Injuries, diseases, and conditions we cover include:

For the upper limb - shoulder separation, subacromial impingement syndrome, shoulder dislocation, fractures of the surgical neck, mid-shaft and supracondylar region of the humerus, pulled elbow, Colles fracture, carpal tunnel syndrome, and scaphoid fracture;

For the lower limb - hip fracture, intermittent claudication, injury to the ligaments and cartilages of the knee joint, foot drop, and inversion ankle sprains;

For the thorax - rib fracture, stable angina, acute pericarditis, left ventricular hypertrophy resulting from aortic stenosis, congenital aortic coarctation, pulmonary embolism, tension pneumothorax, primary pulmonary hypertension, and reflux esophagitis;

For the abdomen and pelvis - inguinal and femoral hernias, perforation of a gastric ulcer, acute cholecystitis, acute appendicitis, passage of a renal calculus, abdominal aortic aneurysm, pelvic inflammatory disease (Fitz-Hugh-Curtis syndrome), metastatic cancer of the prostate, and herniation of lumbar intervertebral discs;

For the head and neck - otitis media, meningitis, thoracic outlet syndrome, cavernous sinus thrombophlebitis, epiglottitis, and herniation of cervical intervertebral discs.

Instructional Methods

Three instructional methods are utilized to present the course material:

1. Laboratory dissection of the human body. 6 students participate in the dissection of a human cadaver. One group of 3 students dissects the upper limb and thorax as the other group of 3 students dissects the lower limb, abdomen, pelvis, and perineum. All students participate in the dissection of the head and neck. The laboratory setting provides for small group teaching.
2. Lecture-based instruction. Lectures are used to present the gross anatomy of the head and neck, upper and lower limbs, thorax, abdomen, pelvis, and perineum.
3. Computer-assisted instruction. A web-based, interactive program titled NetAnatomy (developed by Raymond Walsh, Ph.D., and Stephen Raskin, M.D.) is used to introduce the students to radiological images. NetAnatomy is provided free of charge for home use through the Himmelfarb Library.

A CD-based program titled Virtual Lectures on the Clinical Anatomy of the Upper and Lower Limbs (developed by Frank Slaby, Ph.D.) provides virtual lectures in which animated drawings are synchronized with the lecturer’s remarks. A CD-based program titled Clinical Anatomy Reviews of the Upper and Lower Limbs (developed by Frank Slaby, Ph.D.) uses a question-and-answer format for a quick review of upper and lower limb clinical anatomy. The CD-based programs can be purchased through the website LearningAnatomy.

Finally, we use a clinically-oriented gross anatomy textbook titled Gray’s anatomy for Students (written by Richard Drake, Ph.D., Wayne Vogel, Ph.D., and Adam Mitchell. MBBS) ) to emphasize the anatomical basis of the signs and symptoms of common or severe injuries, diseases, and conditions.

The course is divided into three parts:

1. The first part spans 5 weeks, consists 19 lecture and 20 lab hours, and covers the upper and lower limbs.
2. The second part spans 5 weeks, consists of 19 lecture hours, 18 lab hours, and a 3 hour clinical demonstration, and covers the thorax and abdomen.
3. The third part spans 5 weeks, consists of 26 lecture and 26 lab hours, and covers the head, neck, pelvis, and perineum.

Evaluation Process

Students are evaluated on the basis of their performance on 6 exams: 3 multiple-choice exams and 3 practical exams. The practical exams require identification of cadaveric structures or structures displayed in radiological images (one-fifth of the questions in the practical exams cover radiological images). The gross anatomy course also includes a lecture series on human embryology that covers fetal membranes; the placenta; gametogenesis; fertilization and cleavage; implantation; gastrulation; neurulation; establishment of the body plan; formation of body cavities, development of the musculoskeletal, cardiovascular, pulmonary, gastrointestinal, urinary, and reproductive systems; the pharyngeal arches; eye and ear development; mechanisms of sex determination; and congenital birth defects.