Glossary
Define the terms:

• Achalasia
• Agenesis
• Anastomosis
• Anhydrosis
• Ascites
• Atresia
• Borborygmi
• -centesis (Thoracocentesis, Pericardiocentesis, Amniocentesis)
• Cephalalgia
• Cholecystolithiasis
• Choledocholithiasis
• Cirrhosis
• Cyanosis
• Cyst
• Deglutition
• Dysphagia
• Dyspnea
• -ectomy (Appendectomy, Prostatectomy, Cholecystectomy, Tonsillectomy)
• Edema
• Epistaxis
• Fistula
• Hemothorax
• Hernia
• Hypertrophy
• Hypoplasia
• Hypertension
• Hyperplasia
• -itis (Cholecystitis, Pancreatitis, Peritonitis, Pleuritis, Pericarditis)
• Ileus (dynamic versus adynamic)
• Infarction
• Intussussception
• Ischemia
• Labyrinthine hydrops (Meniere disease)
• Pleural effusion
• Pneumothorax
• Quinsy
• Somatic
• Spondylolysis
• Spondylolisthesis.
• Stenosis
• Valgus
• Varus
• Varicosity
• Visceral/splanchnic
• Volvulus

(Underlined Text are Clinical Objectives)

GENERAL EMBRYOLOGY

Ovulation, Fertilization and Implantation

• Describe the ovarian and menstrual cycles, explaining how they are linked.
• Explain how the date for delivery is calculated from the last menstrual cycle.
• Describe the clinical significance of the sperm count.
• Describe the phases and results of fertilization.
• Discuss cleavage of the zygote and formation of the blastocyst.
• Describe early implantation of the blastocy

Bilaminar Embryo, Gastrulation, Somites, and Folding of the Embryo

• Describe implantation of the blastocyst,
• Describe ectopic pregnancy including placenta previa.
• Discuss the differentiation of the trophoblast, formation of lacunar networks and the establishment of a primordial uteroplacental circulation.
• Trace the development of the amniotic cavity, bilaminar embryo, umbilical vesicle (yolk sac), extraembryonic mesoderm, chorionic villi, and connecting stalk.
• Describe the process of gastrulation and formation of the three germ layers.
• Describe the development of the notochord and its induction of the neural plate.
• Describe the fate of the intraembryonic mesoderm, including the development of the somites and intraembryonic coelom.
• Describe the formation of early embryonic blood vessels.
• Describe the folding of the embryo.
• Describe the development of sacrococcygeal teratoma
• Describe hydatiform mole and its association with choriocarcinom

Placenta and Fetal Membranes

• Describe the formation of the placenta.
• Describe the fetomaternal junction.
• Describe the placenta circulation.
• Describe how the amniotic fluid is produced and its circulation.
• Compare and contrast oligohydramnios versus polyhydramnios and describe their associated conditions.
• Describe the development of allantois and fetal membranes.
• Describe the cause of hemolytic disease in a newborn (erythroblastosis fetalis)
  

Pharyngeal Arch Arteries; Fetal Circulation

• Summarize the major events in the transformation of the pharyngeal arch system into the adult arterial pattern.
• Discuss the relatively common aortic arch anomalies, especially patent ductus arteriosus and coarctation of the aorta.
• Outline the embryologic basis of double aortic arch, right aortic arch, and retroesophageal subclavian artery.
• Describe the course of the fetal circulation and the changes that normally occur at birth.
• Explain how coarctation of the aorta results in difference between femoral and radial pulses and notching of the ribs.
• Describe the embryologic origin of coarctation of the aorta.
• Describe the development of the branchial sinuses, fistulas, cysts and vestiges.
• Describe the development and clinical picture of the following syndromes: Treacher Collins, Pierre Robin, DiGeorge.

Molecular embryology

• Describe the mechanism responsible for congenital anomalies induced by the following: cigarette smoke, alcohol ingestion, tetracyclines, retinoic acid.
• Describe the developmental anomalies induced by thalidomide.
• Describe the developmental anomalies induced after infection by rubella virus, varicella virus, cytomegalovirus, toxoplasma gondii, treponema pallidum.
• Describe the five genes responsible for signaling pathways during development.
• Describe the association between Sonic Hedgehog and holoprosencephaly
• Indicate the places of expression of fibroblast growth factor in association with phocomelia and thalidomide.

 

BACK

Superficial Back

• Define a dermatome, a myotome and a spinal nerve.
• List the major bony landmarks of the scapula and clavicle.
• Describe the general difference in function between the superficial (extrinsic) and deep (intrinsic) muscles of the back.
• Describe the general attachments, innervations, functions and major blood supply of the five superficial muscles of the back.
• Describe the cutaneous innervation of the back.
• Describe the location of the lymph nodes into which the lymphatics of the skin of the back drain.
• Describe the signs and symptoms of a lesion to the spinal accessory, dorsal scapular, long thoracic, thoracodorsal and axillary nerves.
• List the borders of the triangle of auscultation and define its clinical significance.

Deep Back

• Describe the general attachments, innervations, functions and major blood supply of the erector spinae muscles.
• Describe the general location, innervations and actions of the transversospinalis muscles.
• Explain how the above muscles function unilaterally and bilaterally.
• Describe the general extent of the thoracolumbar fascia and how it encloses the intrinsic muscles of the back.
• Explain the functional loss of the deep muscles of the back resulting from nerve lesions to these muscles.
• Describe the triangle of Petit and its clinical significance.

Vertebral Column and Spinal Cord

• List the major features of typical cervical, thoracic and lumbar vertebrae.
• List the major features of the sacrum and coccyx.
• Describe the distinguishing features of the atlas and the axis.
• Describe the joints between the atlas, axis and skull.
• Describe the movements between the atlas, axis and skull.
• Describe the function of the transverse and alar ligaments of the atlas.
• Describe the five ligaments that support the vertebral column.
• Describe the joints found between typical vertebrae.
• Describe the movements between typical vertebrae.
• Describe the normal curvatures of the vertebral column and their development.
• Describe scoliosis, kyphosis and lordosis
• Describe the general anatomy of a cross section of the spinal cord.
• Describe the difference between spinal gray matter and spinal white matter.
• List the spinal cord segments where the dorsal (posterior) horn is found.
• List the spinal cord segments where the lateral horn is found.
• List the spinal cord segments where the ventral (anterior) horn is found.
• Describe the functional modalities associated with the ventral, dorsal and lateral horns.
• Describe the extent, attachments and spaces of the spinal meninges.
• Describe the extent and the contents of the dural sac (lumbar cistern).
• Describe the extent and the attachments of filum terminale and denticulate ligaments.
• Describe the changes in vertebral level of the conus medullaris from 8 weeks to 24 weeks to newborn to adult.
• Describe between which vertebrae a lumbar puncture (spinal tap) should be performed in an infant and in an adult, and why.
• List the structures the needle would pierce in a lumbar puncture (spinal tap).
• Describe the blood supply of the spinal cord and its clinical significance.
• Describe the location and function of the internal vertebral venous plexus (of Batson) and its role in the spread of infections and/or cancer.
• Describe the nerve impingements, and their consequences, resulting from disc herniations in the cervical, thoracic and lumbar regions.
• Describe the major anatomical features of the vertebral column, spinal cord, nerves and meninges in CT, MRI and Radiographic images.
• Describe the anatomical landmarks used for lumbar and sacral epidural anesthesia.
• List the neurological signs and symptoms of spondylolysis and spondylolisthesis of the L5 vertebra.
• Describe the structure of the intervertebral disc.
• Describe the embryological origin of the vertebrae and intervertebral discs.
• Describe the location of the primary and secondary ossification centers of a typical vertebra.
• Describe the formation of the neural plate and define the term neuroectoderm.
• Describe the major steps in formation of the neural tube and neural crest.
• List the derivatives of the neural tube.
• List the nervous system derivatives of the neural crest cells.
• Describe the three zones which form in the neural tube.
• Explain how each of these zones contributes to formation of the spinal cord.
• Outline the embryological origin of the cellular components of the spinal cord.
• Describe the development of the meninges.
• List common causes of neural tube defects.
• Describe the basic anatomy, mechanisms and severity of spina bifida occulta, spina bifida with meningocele, spina bifida with meningomyelocele and spinal bifida with myeloschisis.
• Describe the embryological origin of chordoma
• Outline the embryological bases for the development of brevicollis (Klippel-Feil), hemivertebra (with scoliosis) and rachischisis.
• List the two most common locations of accessory ribs and their clinical significance.
• Define a lumbarized sacral and sacralized lumbar vertebra.
• Describe the anatomical location and mechanism of a Jefferson (burst) fracture.
• Describe the anatomical location and mechanism of a Hangman’s fracture.

Spinal Nerves and Somatic Plexus

• Provide a general definition of spinal nerves and cranial nerves.
• Define the terms: sensory / afferent, motor / efferent, somatic / parietal, visceral / splanchnic, ganglion and nucleus.
• Explain the terms somatic afferent, visceral afferent, somatic efferent, and visceral efferent as they apply to nerve fibers found in spinal nerves.
• List the “targets” of each of the nerve fiber types found in spinal nerves.
• Compare and contrast visceral afferents versus somatic afferents.
• Compare and contrast visceral efferents versus somatic efferents.
• Describe the formation and branches of a typical spinal nerve, including communicating branches to/from the sympathetic chain.
• Explain the differences between dorsal / ventral roots and dorsal / ventral rami of typical spinal nerves, and list the sensory and motor fibers contained in each of these structures.
• Describe a dorsal root ganglion and a typical afferent neuron.
• Describe the anatomical sites of formation of somatic and visceral motor, and sensory, neurons from neuroblasts.
• Describe the basic process of myelination and list the cell types responsible for myelination in the CNS versus the PNS.
• Describe the distribution of a typical spinal nerve and its branches, including cutaneous branches.
• Explain the relationship between dermatomes and the emergence/appearance of herpes zoster (shingles).
• Explain how spinal nerves exit the vertebral canal in cervical, thoracic, lumbar, sacral and coccygeal regions
• Describe a posterolateral herniation of the nucleus pulposus and predict the specific spinal nerve most likely to be injured/compressed by such a herniation in the cervical, thoracic and lumbar regions.
• Describe the organization and composition of a somatic nerve plexus.
• List the nerve fiber types found in a typical nerve branch of a somatic plexus.
• Explain the different consequences of an injury to a mixed spinal nerve versus an injury to a peripheral nerve branch of a somatic plexus.

 

PECTORAL REGION AND UPPER LIMB

Pectoral Region and Breast

• List the general attachments, innervations, blood supply and actions of the muscles of the anterior chest wall.
• Explain the effects of a lesion to the nerves innervating the muscles of the anterior chest wall.
• Describe the cutaneous innervation of the anterior chest wall.
• Explain why blocking a single thoracic spinal nerve would not result in any loss of sensation.
• Describe the location, innervation, blood supply and lymphatic drainage of the mammary gland.
• Explain the clinical importance of the lymphatic drainage of a cancerous mammary gland.
• Explain the symptoms and signs of “peau d‘orange.”
• Describe polythelia and polymastia and their clinical significance.
• Describe the “milk line” and explain its clinical significance.
• Explain what clinical impairments could be caused by the presence of a cervical rib.
• Describe the developmental anomalies in a child with Poland syndrome.

Axilla and Brachial Plexus

• Describe the location of the axilla and what constitutes its medial, lateral, anterior and posterior boundaries (walls), and its apex.
• Describe the apex of axilla and the cervicoaxillary sheath and explain how the contents of the axilla are continuous with structures found in the neck and in the upper limb.
• List the general attachments, innervations and actions of the muscles that contribute to the walls of the axilla.
• Describe the functional loss of the muscles of the axillary walls resulting from lesions to the nerves innervating these muscles.
• Define the extent of the axillary artery and axillary vein.
• Describe the three parts of the axillary artery, their branches and distribution.
• List the arteries involved in anastomosis around the scapula, and describe the importance of this anastomosis for collateral circulation.
• Describe how blood may reach the upper limb if the 2nd part of the axillary artery is ligated.
• Describe the clinical significance of the axillary sheath in local anaesthesia.
• Describe the anatomical relationships that are important for successful insertion of a catheter for central venous access (infraclavicular subclavian venipuncture).
• Describe the signs and symptoms of “thoracic outlet” syndrome.
• Describe the lymphatic drainage of the walls of the axilla.
• Describe the pattern of lymphatic drainage of the upper limb.
• List the areas for examination in both males and females with enlarged axillary lymph nodes.
• Describe the organization of the brachial plexus from its roots to its terminal branches.
• Define the terms pre-fixed and post-fixed brachial plexus.
• List the fiber types that are present in the branches of the brachial plexus.
• Describe the signs and symptoms of an upper brachial plexus nerve lesion.
• Describe the signs and symptoms of upper brachial plexus lesions when the C7 ventral ramus is involved.
• Describe the signs and symptoms of a lower brachial plexus nerve lesion.
• Explain how a cervical rib may contribute to the development of a lower brachial plexus lesion.
• Describe the signs and symptoms of lesions of the medial, lateral and posterior cords of the brachial plexus.
• Explain why lymphedema may result from breast cancer surgery.

Shoulder and Arm

• Describe the cutaneous innervation of the shoulder and arm
• List/identify the major anatomical features of the humerus.
• Identify, name and correctly orient the bones forming the shoulder girdle and the shoulder joint.
• Identify the bones of the shoulder girdle and the shoulder joint in CT, MRI and X-ray images.
• List the major ligaments that contribute to the stability of the shoulder (glenohumeral) joint.
• Describe the location of the subacromial and subscapular bursae at the shoulder joint.
• List the attachments, innervations and actions of the muscles that act on the shoulder joint.
• Describe the rotator cuff muscles and their function in maintaining the stability of the shoulder joint.
• Explain the functional loss of the muscles of the shoulder and arm resulting from nerve lesions to these muscles.
• Explain why the shoulder joint can be easily dislocated.
• Describe shoulder dislocation injuries, particularly antero-inferior dislocations, and explain the nerve injuries that might accompany shoulder dislocations.
• Describe the ligamentous injuries in acromioclavicular (shoulder) separation.
• Describe the signs of acromioclavicular separation.
• Describe the signs of calcific supraspinatus tendonitis.
• Describe the compartments of the arm and the contents of each.
• List the attachments, innervations, blood supply and actions of the muscles that act on the elbow joint.
• Describe the origin and distributions of the nerves that course through the arm.
• Describe the course of the brachial artery and its branches.
• Describe the arterial anastomosis of the elbow.
• Explain the potential clinical consequences of fractures at the surgical neck, midshaft, supracondylar, and medial epicondylar regions of the humerus.
• Describe the cause and signs of Volkmann’s ischemic contracture.
• Describe the bony and ligamentous anatomy of the elbow joint.
• Describe the borders of the cubital fossa, its contents and their relationships.
• Describe the superficial venous drainage of the arm.
• Explain which nerves are at risk during intravenous access of the basilic or cephalic veins in the cubital fossa.
• Identify the bones of the arm and elbow joint in CT, MRI and X-ray images.
• Describe the motor and sensory deficits resulting from lesions of the musculocutaneous, radial, median and ulnar nerves in the arm.
• List the sites commonly used for venipuncture in the upper limb.
• Describe the basic mechanism of radial head subluxation  (“nursemaid’s elbow”) in small children.

Forearm and Hand

• Describe the cutaneous innervation of the forearm and hand.
• Explain how a nerve with cutaneous distribution in the hand can provide cutaneous supply to “½“ of a digit.
• Describe the superficial venous and lymphatic drainage of the forearm and hand.
• Identify the bones of the forearm and hand in CT, MRI and X-ray images.
• Describe the movements that occur at the radioulnar joints and at the wrist joint.
• Describe the articulations between the distal radius and the proximal row of carpal bones.
• Describe the general arrangement of articulations between the distal row of carpal bones and the metacarpals (4 distal carpals, 5 metacarpals).
• List the general attachments, innervations, blood supply and actions of the muscles in the flexor and extensor compartments of the forearm.
• Describe the course of the median, ulnar and radial nerves in the forearm and hand.
• Describe the boundaries and contents of the “anatomical snuff box”.
• Describe the course of the radial and ulnar arteries in the forearm and hand.
• Describe the landmarks used when taking the radial pulse.
• Describe the contribution, and clinical significance, of the superficial and deep palmar arterial arches in the blood supply of the hand.
• List the attachments, innervations, blood supply and actions of the intrinsic muscles of the hand.
• Describe the movements of the thumb and of digits 2-5.
• Describe the tendon sheaths / bursae in the hand and fingers and their importance in the spread of infections.
• Explain the anatomical mechanism of “carpal tunnel syndrome” .
• Describe the signs and symptoms of ”carpal tunnel syndrome”.
• Explain the importance of the Allen Test.
• List the steps in performing an Allen Test.
• Describe the functional tests for integrity of the median, ulnar and radial nerves in the forearm.
• Describe functional tests for the integrity of the median and ulnar nerves in the hand.
• Recognize and describe mallet finger, Swan neck deformity and Boutonniere deformity on a radiograph.
• Describe the signs and symptoms of lesions of the radial, median and ulnar nerves in the forearm.
• Describe the signs and symptoms of lesions of the median and ulnar nerves at the wrist.
• Describe the signs and symptoms of recurrent median nerve injury in the proximal palm.
• Explain why radial nerve injury at/above the elbow decreases grip strength.
• Recognize and describe Colle’s fracture, Smith fracture and boxer’s fracture on a radiograph.
• Describe the presentation of Dupuytren’s contracture and “trigger finger” (stenosing tenosynovitis).
• Describe the cause of ulnar “claw-hand” deformity.
• List the commonly fractured and most commonly dislocated bones in the carpus.
• List the most commonly fractured bone of the upper limb.

THORAX

Thoracic Wall

• Describe the dermatomes of the thoracic wall.
• Describe the skeletal framework of the thoracic wall.
• Describe the boundaries of the superior thoracic aperture (thoracic inlet) and the inferior thoracic aperture (thoracic outlet).
• Describe the costovertebral, sternocostal and sternoclavicular joints.
• List general attachments, innervations and actions of the intercostal muscles.
• List the muscles that act in forced expiration.
• List the accessory muscles of respiration.
• List the layers of the thoracic wall from skin to the parietal pleura.
• Describe the arterial supply, venous drainage and lymphatic drainage of the thoracic wall.
• Describe the course of the intercostal neurovascular bundle in relation to thoracocentesis, or in relation to administering a local anesthetic for a rib fracture.
• Identify the major anatomical features of the thoracic wall in radiographic imagery.

Pleura and Lungs

• Describe the locations of the parietal and visceral pleura and the areas where they meet.
• List the recesses formed by the pleural reflections.
• Differentiate between the thoracic cavity and the pleural cavity.
• Describe the relationship of the lungs to the pleural cavity.
• Describe and differentiate the surface projections (rib level) of the visceral pleura and those of the parietal pleura.
• Explain the importance of the pleural recesses in thoracocentesis.
• Differentiate between the bucket-handle and pump-handle movements of the ribs during respiration. 
• Describe the arterial supply, venous drainage and innervation of the parietal pleura.
• List the identifying features of the right and left lungs and their surface projections.
• List the surfaces and borders of the lungs.
• Describe the surface projections (rib level) of lobes and fissures of the lungs.
• Differentiate between the root and hilum of a lung.
• Describe the relationship of the structures in the root of each lung.
• Describe the typical branching pattern of the bronchial tree.
• Define a bronchopulmonary segment and understand its clinical importance.
• Describe the arterial supply, venous and lymphatic drainage, and innervation of the lungs and the bronchial tree.
• Identify the major anatomical features of the lungs in radiographic images such as CT and X-ray.
• Compare and contrast the mechanism underlying a spontaneous versus a tension pneumothorax.
• Explain how diaphragmatic pain may be referred to the shoulder as shoulder tip pain, and list the possible sites of the origin of the pain.
• Explain the distribution of herpes zoster eruptions on the thoracic wall.
• List the intercostal spaces where thoracocentesis can be safely performed at the midclavicular, midaxillary and paravertebral lines.
• Explain why pleurisy (pleuritis) causes localized (somatic) pain.
• Describe the location of pleural effusion versus pulmonary edema.
• Explain why an aspirated foreign body would usually pass into the right bronchus.
• List the germ layers contributing to the formation of the respiratory tract.
• Describe the development of the larynx, trachea, bronchial tree and lungs.
• Describe the stages of lung development.
• Name the site of production, and the role of, surfactant.
• Summarize the changes that occur in the respiratory system at birth.
• Explain the embryological basis for laryngeal atresia, tracheoesophageal fistula, tracheal stenosis and atresia, respiratory distress syndrome and esophageal atresia and stenosis.
• Describe the parts of the diaphragm.
• Describe the development of the diaphragm.
• Explain the embryological mechanism for all types of congenital diaphragmatic hernia and eventration
• Describe the division of the embryonic coelom into pleural, pericardial and peritoneal cavities.

Introduction to Autonomics

• List the three target tissues of visceromotor (ANS) fibers.
• Differentiate between a nucleus and a ganglion.
• Define the terms preganglionic (presynaptic) and postganglionic (postsynaptic).
• List the four cranial nerves that contain preganglionic parasympathetic fibers.
• List the segments of the spinal cord that containing the neural cell bodies of preganglionic sympathetic fibers.
• List the segments of the spinal cord that contain the neural cell bodies of preganglionic parasympathetic fibers.
• Describe the course of a preganglionic parasympathetic fiber from its origin to the parasympathetic ganglion in the walls of thoracic viscera.
• Describe the location and extent of the sympathetic trunk.
• Describe the course of a preganglionic sympathetic fiber from its origin to its synapse in the sympathetic trunk or a preaortic ganglion.
• Describe the pathways of sympathetic fibers innervating the body wall, thoracic viscera, and abdominopelvic viscera.
• Describe the course of visceral sensory fibers traveling with sympathetic nerves, and the location of their cell bodies.
• Describe the mechanism of referred pain.

 Heart and Pericardium

• Describe the location of the heart in the mediastinum.
• List the pericardial coverings of the heart.
• Describe the extent, and attachments, of the fibrous pericardium (pericardial sac).
• Describe the arterial supply of the fibrous pericardium.
• List the surfaces and margins of the heart and the chambers/structures that contribute to them.
• Describe the anatomy of the heart chambers and their relationships to one another and to adjacent structures.
• Describe the arterial supply and venous drainage of the heart.
• Describe the pattern of the venous blood flow from the upper limb to the right atrium.
• Describe the innervation of the heart.
• Describe the course of the pain fibers from the  heart to the CNS
• Differentiate between the pathways used by the two types of visceral afferent fibers (carrying pain versus physiologic sensation) from the heart to the CNS.
• Explain why the pain of a myocardial infarction maybe referred to the upper limb.
• Explain how cardiac pain differs from intercostal pain.
• Describe the surface projections of the heart and the heart valves.
• Identify the auscultation sites for heart valve sounds and explain why these auscultation points differ from the anatomic location of the valves.
• Describe the path of blood flow through the heart.
• Explain which part of the myocardium will be affected if any of the coronary arteries is occluded. How this sounds? Identify the parts of myocardium affected by occlusion of any of the coronary arteries.
• Differentiate between the systemic and the pulmonary circulation.
• Identify the major anatomical features of the heart and great vessels in radiographic images, CT and MRI.
• Describe the clinical significance of the transverse pericardial sinus.
• Describe the importance of the aortic sinuses (of Valsalva) for continuous myocardial perfusion.
• Define cardiac tamponade.
• Describe pericardiocentesis for the alleviation of cardiac tamponade.
• Describe the anatatomical expalanation of the three cardinal signs of cardiac tamponade
• Explain why a paraxiphoid approach is used to alleviate cardiac tamponade and list the structures that the needle will pierce.
• Explain why swallowing a sharp object might pierce the heart and into what chamber it could enter.
• Describe the formation of the oblique and the transverse pericardial sinus.
• Describe the partitioning of the atrioventricular canal.
• Describe the partitioning of the bulbus cordis and truncus arteriosus by the aorticopulmonary septum.
• Describe the fate of the sinus venosus.
• Describe the formation of the right and left atria.
• Describe the development of the interatrial septum.
• Describe the partitioning of the common ventricle.
• Describe the development of the heart valves.
• Explain the fate of vitelline, umbilical and cardinal vessels.
• discuss the changes that occur at birth.
• Describe the two types of ventricular septal defect.
• Describe the four types of atrial septal defects.
• List the most common heart defects in Down’s syndrome.
• Describe the difference between dextrocardia and situs inversus.
• Describe the developmental mechanisms underlying ectopia cordis, persistent truncus arteriosus, transposition of the great arteries, tetralogy of Fallot, patent ductus arteriosus
• List left-to-right shunts in congenital heart defects and explain why they are generally acyanotic.
• List right-to-left shunts in congenital heart defects and explain why they are generally cyanotic.

Mediastinum

• Describe the subdivisions of the mediastinum and their boundaries.
• List the structures found in the superior, anterior, middle and posterior mediastinum and their relationships to one another.
• Describe the relationships of the esophagus, trachea and thoracic duct in the superior mediastinum.
• Describe the typical branching pattern of the aortic arch in the superior mediastinum.
• Describe the relationships of the phrenic nerves to the aortic arch and the root of the lung.
• Describe the relationships of the vagus nerves to the aortic arch, the root of the lung and the esophagus.
• Describe the course of the right and left recurrent laryngeal nerves in the thorax.
• List the structures that are found at the plane of Ludwig.
• Describe the four normal constrictions of the esophagus.
• Describe the arterial supply, innervation, venous and lymphatic drainage of the thoracic and abdominal portions of the esophagus.
• Describe the azygos system of veins and their typical pattern of drainage.
• Describe the origin of the greater, lesser and least splanchnic nerves.
• Identify, in radiological images, the major anatomical structures found in the subdivisions of the mediastinum.
• List the normal openings in the diaphragm and their approximate vertebral level. 

ABDOMEN

Anterior Abdominal Wall

• Describe the bony boundaries of the anterolateral abdominal wall.
• Describe the division of the anterolateral abdominal wall into four clinical quadrants and nine anatomical regions.
• Describe the location of major abdominal organs and vessels in the four quadrants and in the nine regions of the abdomen.
• Describe the blood supply, lymphatic drainage and cutaneous innervation of the abdominal wall.
• List the layers of the superficial fascia and describe their locations.
• List the general attachment, blood supply, innervations, and function of the muscles of the anterolateral abdominal wall.
• Explain how venous blood may reach the right atrium when the IVC is obstructed.
• Describe how the aponeuroses of these muscles contribute to the anterior and posterior layers of the rectus sheath.
• Describe the inguinal ligament and its attachment sites.
• Explain the surgical significance of the intersection of the right linea semilunaris and the costal margin.
• Explain the surgical significance of "McBurney’s point".
• Explain the surgical approach through the layers of the abdominal wall to approach an inflamed appendix and the surgical significance of the muscle fiber orientation.
• Describe the anatomy of the superficial and deep inguinal rings.
• Describe the process of testicular descent into the scrotal sac. 
• Describe the structure and contents of the spermatic cord.
• Describe the boundaries of the inguinal triangle (of Hesselbach) and its clinical significance.
• Explain the difference between a direct and an indirect inguinal hernia.
• Describe the fate of the processus vaginalis and its contribution to an indirect inguinal hernia.
• Explain why pain from an inguinal hernia occurs at the site of the hernia.
• Define cryptorchidism and explain the problems associated with the condition.
• Explain the advantage of performing vertical surgical incisions on the midline.
• Compare and contrast the location of an epigastric versus an umbilical hernia.
•  Describe the cremasteric reflex arc following stimulation of the anterior scrotal sac.
• Explain why a blow to the testis is felt around the umbilicus.
• Explain why the initial pain of appendicitis is felt around the umbilicus.
• List the dermatomes which overlie the xiphoid process, umbilicus and pubis.
• is referred to the abdominal wall. 
• Describe the development and clinical picture of gastroschisis.

Peritoneal Cavity

• Describe parietal and visceral peritoneum.
• Describe the extent of the peritoneal cavity, the greater and lesser sacs, and the omental (epiploic) foramen (of Winslow).
• Describe the location of the paracolic gutters, the vesicouterine pouch, the rectouterine pouch (of Douglas) and the hepatorenal pouch (of Morrison) within the peritoneal cavity.
• Describe the following peritoneal mesenteries and the abdominal organs they enclose/suspend: “the mesentery”, transverse mesocolon and sigmoid mesocolon.
• Describe the following peritoneal ligaments and the abdominal organs they enclose/suspend: falciform, round ligament of the liver (ligamentum teres hepatis), coronary, triangular, median, medial and lateral umbilical, greater omentum, gastrocolic, gastrosplenic, splenorenal ligaments, lesser omentum (hepatoduodenal and hepatogastric ligaments) and suspensory ligament of the duodenum (Treitz).
• Describe the difference between intraperitoneal and retroperitoneal abdominal organs.
• Explain where free air in the peritoneal cavity can accumulate.

Gastrointestinal Tract

• Describe the stomach, and identify its parts and curvatures.
• Describe the relationships of the stomach to the spleen, pancreas, liver, ascending and descending colon.
• Describe the blood supply and the venous and lymphatic drainage of the stomach.
• Describe the location of the duodenum and its relationship to surrounding organs.
• Describe the blood supply and the venous and lymphatic drainage of the duodenum.
• Describe the location of the jejunum and ileum.
• Describe the blood supply and the venous and lymphatic drainage of the jejunum and ileum.
• Describe the location of the large intestine and its relationship to surrounding organs.
• Describe the blood supply and the venous and lymphatic drainage of the large intestine.
• Describe the sympathetic, parasympathetic and sensory innervation of the foregut, midgut and hind gut.
• Describe the anastomotic communications between vessels of the foregut and the midgut and between midgut and hindgut.
• Explain why surgical resection of the ascending or descending colon should be done in the lateral paracolic gutters.
• Compare and contrast where stomach contents from a perforation of the posterior, versus the anterior, stomach wall will initially accumulate.
• List the blood vessels which may be eroded in ulceration of the posterior wall of the stomach.
• Determine the large artery at risk for injury/hemorrhage by a perforated ulcer in the posterior wall of the duodenal bulb (1st part of dudenum).
• Determine the lymph nodes that may drain tumors in various parts of the small and large intestine.
• Explain which parts of the GI tract may become involved in volvulus.
• Explain how the hind gut receives its blood supply after repair of an abdominal aortic aneurysm since the inferior mesenteric artery is usually sacrificed during the procedure. 
• Describe the development of an ileal (Meckel) diverticulum.
• Describe the contents of the hepatoduodenal ligament which will be gripped during a Pringle maneuver.
• Describe the mechanism for development of megacolon (Hirchsprung’s disease).
• Describe the importance of the ligamentum venosum and its significance in fetal circulation
• Describe the derivatives of the embryonic foregut, midgut and hindgut.
• Explain the development of an omphalocoele.
• Compare and contrast the development and clinical picture of congenital hypertrophic pyloric stenosis versus duodenal stenosis.
• Describe the development and clinical picture of duodenal atresia.
• Describe the nerve pathways for pain in a patient with gastroesophageal reflux disease (Barrett’s esophagus)

Liver, Pancreas, Spleen

• Describe the location of the liver and its relationship to surrounding structures.
• Describe the four anatomical lobes of the liver.
• Describe the functional (physiological) lobes of the liver.
• List the structures entering / leaving the liver at the porta hepatis.
• List the branches of the celiac trunk and their area of supply.
• Describe the arterial supply of the liver, gall bladder and cystic duct.
• Describe the “the bare area” of the liver.
• Describe the location of the gall bladder and its relationship to the liver.
• Describe the anatomy of the biliary tree.
• Describe the blood supply, and the venous and lymphatic drainage of the liver and gall bladder.
• List the 3 common sites where gall stones can be impacted (lodged) and explain the effects of each on the bile flow.
• Explain how the visceral pain from an inflamed gallbladder can refer to the shoulder.
• Explain the pathway taken by an endoscope from mouth to the biliary tree during Endoscopic Retrograde Cholangio Pancreatography (ERCP) to remove a gallstone.
• List the borders of the triangle of Calot and state the importance of this triangle when performing laparoscopic surgery for gallbladder disease.
• Describe the location of the pancreas and its relationship to the surrounding structures. 
• Describe the blood supply, venous and lymphatic drainage of the pancreas.
• Describe how pancreatic enzymes flow to the duodenum.
• Describe the location of the spleen and its relationship to surrounding structures.
• Describe the blood supply, and the venous and lymphatic drainage of the spleen.
• List the areas of porto-caval anastomosis, and describe how these areas may decompress (alleviate) portal hypertension.
• Explain how portal hypertension can create varicosities, and where those varicosities can occur.
• Explain which caval vein can be anastomosed with the splenic vein to create a portocaval shunt to decompress portal hypertension.
• Identify, in radiological images, the liver, pancreas and spleen, their blood supply and other adjacent abdominal structures.
• Describe the rotation of the foregut and midgut during development.
• Describe how jaundice can occur with respect to drainage through the extrahepatic biliary system.
• Describe the contents of a liver segment and its importance in surgery of the liver.
• Describe the embryologic mechanism responsible for an anular pancreas.

Posterior Abdominal Wall

• Describe the boundaries of the posterior abdominal wall.
• Describe the attachment sites and the peritoneal lining of the diaphragm.
• Describe the innervation and blood supply of the diaphragm.
• List the innervations, blood supply, general attachments and actions of the muscles of the posterior abdominal wall.
• Describe the origin of the lumbar plexus and list its branches and their distributions.
• Describe the abdominal aorta and its parietal and visceral branches.
• List the approximate vertebral levels of the visceral branches of the abdominal aorta and its bifurcation into the common iliac arteries.
• Describe the inferior vena cava and its tributaries, and list the vertebral level where it begins from the common iliac veins.
• Describe the cisterna chili, and the course and termination of the thoracic duct.
• Describe the location of the kidneys and their relationship with surrounding organs and ribs 11 and 12.
• Describe the relationship of the kidneys to the diaphragm, psoas major, quadratus lumborum and transversus abdominis aponeurosis.
• Describe the kidneys in relation to the renal fascia, perirenal and pararenal fat.
• Describe the anatomy of the cortex and medulla of the kidney.
• Describe the flow of urine from the renal papillae to the ureter and to the urinary bladder.
• Identify the structures in the hilum of the kidney and their relationship to one another.
• Identify the course, relationships, blood supply and innervation of the ureters.
• Describe the blood supply, innervation and venous drainage of the kidney.
• Describe the development, location, blood supply, innervation and venous drainage of the suprarenal glands.
• Describe the location and the nerve fiber types contained in the superior hypogastric plexus.
• Identify, in radiological images, the structures in the posterior abdominal wall.
• List the sites of constriction of the ureters and explain their relationship to kidney stones.
• Describe the development of the kidney from the metanephric diverticulum and the metanephric mass of mesoderm.
• Explain the distribution of pain from kidney stones that are impacted (lodged) in the ureter. 
• Describe the layers that would be cut when harvesting a donor kidney using a posterior approach.
• Describe the development of a discoid (pancake) and a horseshoe kidney.
• Describe the development of a bifid or double ureter.
• Describe the embryologic mechanism responsible for renal agenesis.
• Describe the “psoas sign” and explain why it can be positive during appendicitis (psoas sign is not always positive depending on the location of the appendix).
• Describe how a kidney may have more than one renal artery and how an accessory renal artery may causes hydronephrosis.
• Describe the development of adrenal hyperplasia.
• Describe the development of cystic kidney disease.

PELVIS AND PERINEUM

Pelvic Wall and Pelvic Cavity

• List the bones of the pelvic girdle.
• List the components of the hip bone.
• Identify the bony landmarks of the pelvis which can be palpated on the body surface or palpated per vagina or per rectum.
• Describe the main features of the sacrum.
• Describe the sacroiliac joints and their ligamentous support.
• Explain the importance of the sacrospinous and sacrotuberous ligaments in preventing rotation of the sacrum at the sacroiliac joints.
• List the openings in the bony pelvis, major structures passing through these openings, and with which spaces these openings communicate.
• Describe the major differences between the male and female bony pelvis.
• Describe the following dimensions of the birth canal: pelvic inlet, conjugate (antero-posterior) diameter, interspinous distance and pelvic outlet.
• Describe the boundaries of the “true” and “false” pelvis.
• Describe the general attachments, innervations and actions of the muscles of the pelvic wall.
• List the muscles that make up the pelvic diaphragm.
• List the attachments, innervations, blood supply and general function of the levator ani muscle.
• Describe the puborectalis muscle and explain how fecal incontinence could result from injury of this muscle.
• Describe the urogenital hiatus in the pelvic floor and list the major structures passing through the hiatus in males and females.
• Describe the peritoneal reflections from the abdominal wall down to the pelvic cavity and the pouches of the peritoneal cavity in the male and female pelvis.
• Explain how bleeding in the upper abdomen (such as from liver or spleen lacerations) can reach the pelvic peritoneal pouches.
• Identify, in radiological images, the major parts of the bony pelvis.

 

Pelvic Organs

In Both Males and Females

• Describe the course of the ureter along the posterior abdominal wall to the bladder.
• Explain what is meant by “water under the bridge”.
• Describe the retropubic space.
• Describe the structures which support the urinary bladder.
• Explain why the empty bladder is a pelvic organ in adolescents and adults, but a partially abdominal organ in infants and small children.
• Explain how a needle inserted through the lower abdominal wall over the pubic symphysis can enter a distended bladder without entering the peritoneal cavity.
• Describe the internal anatomy of the urinary bladder.
• Compare the innervation of the internal and external urethral sphincters.
• List the divisions of the male urethra.
• Compare and contrast the male versus female urethra.
• Explain why lower urinary tract infections are more common to females than in males.
• Describe the muscles and nerves (visceral afferent, somatic efferent, sympathetic, parasympathetic) involved in normal micturition and urinary continence.
• Compare voluntary micturition / urinary continence in adults with reflex voiding in children prior to “potty training”.
• Describe the location, arterial supply, and the venous and lymphatic drainage of the rectum and anal canal.
• Compare and contrast the embryologic origin, lymphatic drainage and sensory innervation of the anal canal above and below the pectinate line.
• Compare the internal and external submucosal venous plexus of the anal canal.
• Compare the location and symptoms of internal versus external hemorrhoids.
• Compare the location and innervation of the internal and external anal sphincters.
• Describe the basic process of defecation.
• Identify, in radiological images, major anatomical structures of the male and female pelvis.
• Describe the developmental mechanism of imperforate anus, anal agenesis, anal stenosis, membranous atresia of the anus, rectal agenesis, and anorectal agenesis.
• Describe the development of a urachal cyst, sinus and fistula and explain their clinical significance.
• Compare and contrast the visceral pain pathways for structures above the peritoneal floor of the pelvis versus structures below the peritoneal floor.

Male Pelvic Organs

• Describe the relationships of the bladder, prostate gland, ductus deferens, seminal vesicles, ejaculatory ducts and rectum in the pelvic cavity.
• Describe the relationship of the prostate gland and ampulla of the ductus deferens and seminal vesicles to the wall of the rectum.
• Describe the nervous pathways for control of erection, emission and ejaculation.
• Describe the anatomical lobes of the prostate gland and the relationship of the median lobe and posterior lobe to the ejaculatory ducts.
• List the lobes of the prostate and the symptoms most commonly involved in benign prostatic enlargement.
• Explain why prostate cancer usually is leading to erectile and urinary dysfunction. Identify the nerves involved in this process.
• Describe the surgical procedure called TURP (Trans-Urethral Resection of the Prostate) and common postoperative complications resulting from this procedure.
• Describe the nerves that might be compromised during open prostatectomy and the consequence on sexual functioning and urinary continence.
• List the common sites of prostate cancer metastasis and explain how prostate cancer cells can travel to the central nervous system.

Female Pelvic Organs

• Describe the relationships of the bladder, uterus, uterine tubes, ovaries, vaginal canal and rectum in the pelvic cavity.
• Describe the reflections of the peritoneum over the bladder, uterus, uterine tubes, ovaries, vaginal canal and rectum in the pelvic cavity.
• Describe the fornices of the vagina.
• Explain the clinical importance of the relationship of the posterior fornix to the rectouterine pouch.
• Explain the differences in sensory innervation of the pelvic part of the vagina versus the perineal part of the vagina.
• Describe the parts of the uterus and uterine tubes.
• Describe the ovaries and ovarian ligaments.
• Describe the typical relationship of the cervix to the vaginal canal.
• Describe the typical relationship of the body of uterus to the cervix.
• Define the terms anteverted, anteflexed, retroverted, and retroflexed with respect to the position of the uterus.
• Describe the broad ligament of the uterus and its subdivisions in relationship to the body and fundus of the uterus, the uterine tubes and their fimbriated ends, the ovaries, the ovarian ligament, and the round ligament of the uterus.
• Explain how lower genitourinary infections in females, such as gonorrhea and Chlamydia, can gain access to the pelvic peritoneal spaces.
• Explain how/where the female ureter is at risk during ligation of uterine vessels.
• Describe the transverse cervical (cardinal), pubocervical and uterosacral ligaments and explain their relative importance in uterine support.
• Describe the course of the uterine arteries across the pelvic floor.
• Recognize anatomical structures of the uterus and uterine tubes on a salpingogram and explain the purpose of the procedure.
• Define the term “ectopic pregnancy” and list the sites of occurrence and the most common site.
• Define the term “uterine prolapse” and explain why it is more common in multiparous (multiple vaginal deliveries) women.
• Define the term “cystocele” and explain why it is more common in multiparous women.
• Define the term “stress urinary incontinence” and explain which structures may be injured during vaginal delivery to lead to this condition.
• Describe the development of a double and a bicornuate uterus and their clinical significance.
• Discuss the importance of vaginal and rectal examinations and “pap smears” in relation to the detection and prevention of uterine and ovarian cancer.

Pelvic Vessels and Nerves

• Describe the areas of supply of the branches of the internal iliac artery in males and females.
• Describe the course of the internal pudendal artery and pudendal nerve in the pelvis and perineum.
• Describe the course of the obturator nerve, artery and vein.
• List the ventral rami contributing to the sacral plexus and describe the relationship of this plexus to the piriformis muscle.
• List the terminal branches of the sacral plexus.
• Explain how inflammation or a tumor near the lateral wall of the pelvis (such as a ruptured ovarian cyst or ovarian cancer) might cause pain in the medial thigh.
• Describe the origin, and type of nerve fibers, found in the superior and inferior hypogastric plexuses.
• Describe the lymphatic drainage of the urinary bladder, prostate gland, ductus deferens and seminal vesicles, testes, scrotum, penis, ovaries, uterine tubes, uterine fundus, body and cervix of uterus, pelvic part of vagina, vaginal vestibule, anal canal above the pectinate line and anal canal below the pectinate line.
• Describe the bony landmarks used for determining the position of the pudendal nerve during a transvaginal pudendal nerve block and list the areas anesthetized.
• Compare and contrast the areas into which urine can be extravasated following an intrapelvic versus an extrapelvic rupture of the urethra.
• Contrast the nerves blocked when using lumbar versus sacral epidural anesthesia during childbirth.
• Compare and contrast the structures cut when performing an oblique versus a midline episiotomy.
• List the boundaries of the superficial perineal pouch. Explain why extravasated urine will not pass into the thighs or the ischioanal fossa.
• Describe a varicocele.
• Explain the developmental mechanism responsible for the formation of hypospadias and epispadias.

LOWER LIMB

Overview

• Describe the line of weight in relationship to the hip, knee and ankle joints.
• Identify, in radiological images, structures of the hip joint, femur, knee joint, tibia and fibula, ankle joint and foot.

Gluteal Region

• Describe the cutaneous innervation of the gluteal region.
• Describe the general attachments, innervation and actions of the muscles of the gluteal region.
• Describe the arterial supply and venous drainage of the gluteal region.
• Explain how the hip abductor muscles function during gait.
• Describe and explain the safe and unsafe areas for gluteal intramuscular injections.
• Differentiate between a Trendelenburg Sign and a Trendelenburg Test.
• Explain a “waddling gait” and what anatomical problems may cause it.

Thigh

• Describe the cutaneous innervation of the thigh.
• Describe the general attachments of the fascia lata and the iliotibial tract (band).
• Describe the cutaneous innervation of the thigh.
• List/identify the major anatomical features of the femur.
• Describe the hip joint and list its ligamentous support.
• Describe the general attachments, innervations and actions of the muscles of the thigh.
• Describe the arterial supply, and the venous and lymphatic drainage of the thigh.
• Describe the blood supply of the hip joint and the clinical implications of its changing blood supply with age.
• Describe the clinical significance of an intracapsular versus an extracapsular fracture of the femoral neck.
• Describe the boundaries of the femoral triangle, the adductor canal and the relationship of their contents.
• Describe the structures in the femoral sheath and their relationship to one another.
• Describe the lymphatic drainage into superficial and deep inguinal lymph nodes.
• Describe the course of a femoral hernia and how it differs from an inguinal hernia.
• Describe the consequence of nerve lesions of the lumbosacral plexus on lower limb function and sensation.
• List the areas for examination in both male and female with enlarged inguinal lymph nodes.
• Determine which nodes will first receive lymph drainage from a testicular carcinoma, and how this differs from drainage from an infected scrotum.
• Describe the nerve impingements and their consequences resulting from lumbosacral disc hernations.

Leg

• Describe the cutaneous innervation of the leg.
• List the boundaries and the contents of the popliteal fossa.
• Describe the crural fascia.
• List the major anatomical features of the tibia and fibula.
• Describe the knee joint, its cartilage and its ligamentous support.
• Describe the patellar tendon reflex.
• Describe the blood supply of the knee joint.
• Describe the general attachments, innervations and actions of the muscles of the leg.
• Describe the arterial supply and the venous and the lymphatic drainage of the leg.
• Describe the significance of the prepatellar, suprapatellar and infrapatellar bursae.
• Describe the function of the anterior and posterior cruciate ligaments.
• Describe a “Baker’s Cyst”.
• List the nerves involved in the patellar tendon reflex.
• Describe the “unhappy triad” of the knee joint injuries.
• Describe the anterior and posterior drawer signs and the ligament they are testing.
• Explain the consequence of a lesion of the common fibular nerve at the neck of the fibula.
• Explain the consequence of a lesion of the superficial and deep fibular nerves just distal to their origin.
• Explain the consequence of a lesion of the tibial nerve in the popliteal fossa.
• Describe the consequence of “anterior compartment syndrome”.
• Describe the development of varicose veins.

Ankle and Foot

• Describe the cutaneous innervation of the foot.
• Describe the ankle joint, and its ligamentous support.
• List the bones of the foot and their relationships to one another.
•  Describe the innervation and actions of the muscles in the sole of the foot.
• Describe the blood supply and venous and lymphatic drainage of the foot.
• List the muscles that function during dorsiflexion, plantarflexion, inversion, eversion.
• List the two ligaments most commonly damaged during an inversion sprain.
• Describe hallux valgus and hallux varus.
• Describe the tarsal tunnel and its contents.
• Describe congenital talipes (clubfoot), amelia / meromelia, cutaneous syndactyly, osseous syndactyly, brachydactyly, polydactyly, ectrodactyly (cleft hand or partial adactyly) and limb deformities caused by amniotic bands.

HEAD & NECK

Skull

• Identify the bones that constitute the viscerocranium of the skull and the foramina found in this part of the skull.
• Identify the bones that constitute the neurocranium of the skull and the foramina found in this part of the skull
• Identify the foramina through which the cranial nerves, arteries and veins enter and leave the skull.
• Identify in radiological images the individual bones, foramina, fissures, canals, paranasal sinuses.

Posterior Triangle of the Neck

• Describe the investing fascia of the neck.
• Describe the general attachments, innervation and actions of the muscles that define the borders of the triangle.
• Describe the general attachments, innervations and actions of the muscles that are found in the floor of the triangle.
• List the nerves found in the triangle, their fiber type and their areas of distribution.
• Describe the borders of the occipital and subclavian (supraclavicular and omohyoid) triangles.
• List the arteries found in the triangle and their origin.
• Describe the cervical plexus, its cutaneous branches and their distribution.

Anterior Triangle of the Neck

• Describe the general attachments, innervation and actions of the muscles that define the borders of the triangle.
• Describe the general attachments, innervation and actions of the muscles that define the borders of the submental, carotid, muscular and submandibular triangles.
• List the major structures found in each of the subtriangles.
• Describe the branches of the external carotid artery and their areas of distribution.
• List the structures within the carotid sheath and their relationship to each other.
• Describe the relationship of the carotid sheath to the prevertebral and pretracheal fasciae, the cervical part of the sympathetic trunk and the phrenic nerve.
• Describe the ansa cervicalis, its origin and its fiber types.
• Describe the course of the hypoglossal nerve and its relationship to the carotid arteries, C1 nerve, the hyoglossus muscle and the posterior belly of digastric.
• List the muscle in the floor of the submental triangle, its attachment, innervation and action.
• Describe the boundaries of the scalene gap and list its contents.
• Describe the relationship of the subclavian artery and vein to the anterior scalene muscle.
• Describe the branches of the 1st, 2nd and 3rd parts of the subclavian artery and their areas of distribution.
• Identify major anatomical structures found in this region in appropriate radiological imaging.
• Describe the relationship of the hyoid bone, the thyroid and cricoid cartilages and the thyroidhyoid and the cricothyroid membranes.
• Describe the location and structure of the thyroid gland.
• Identify the tracheal rings.
• Describe the relationship of the recurrent laryngeal nerve to the tracheoesophageal groove and to the inferior thyroid artery.
• Describe the location of the sympathetic trunk and the cervical ganglia.
• Compare and contrast the structures incised during a tracheotomy versus a cricothyrotomy procedure.
• Describe the prevertebral fascia and its clinical significance.
• Describe the development of a thyroglossal duct cyst and its clinical presentation.
• Describe the development of normal and ectopic parathyroid glands.
• Describe the development of normal and ectopic thyroid gland.
• Describe the development and the clinical picture of torticollis.

Face and Scalp

• Describe the sensory innervation of the face and scalp by the three divisions of the trigeminal nerve, the cervical plexus and cervical dorsal rami.  
• List the locations, innervations and actions of the major muscles of facial expression.
• Describe the course of the facial artery and vein.
• Describe the course of the facial nerve and its relationship to structures as it passes from the stylomastoid foramen through the parotid gland, and its terminal branches on the face.
• Describe the location, innervation and blood supply of the parotid gland.
• Describe the clinical significance of the buccal fat pad.
• Describe the course of the parotid duct and its opening in the oral vestibule.
• Describe the five layers of the scalp, its innervation, blood supply and venous return.
• Describe the “danger zone” of the scalp and its clinical significance.
• Describe how infections of the scalp and the face may spread into the cranial cavity.
• Explain the clinical importance of the pterion.
• List the layers of the calvaria and explain which layer is more prone to fractures and give the clinical significance of the diploic layer.
• Describe the development, and the closure times, of the fontanelles.
• Describe the developmental failures resulting in the various forms of cleft lip and cleft palate.
• Describe the time of development of the paranasal sinuses.

Infratemporal Fossa

• List the bony boundaries of the infratemporal fossa.
• Describe the general attachments, innervations and actions of the muscles of mastication.
• Describe the course of the maxillary artery in the infratemporal fossa and the areas supplied by the middle meningeal, inferior alveolar and posterior superior alveolar arteries.
• Describe the pterygoid venous plexus and list its intra- and extracranial connections.
• Describe the mandibular nerve, giving its entrance foramen into the fossa, its branches, the nerve fiber content and distribution of each branch.
• Describe the course of the chorda tympani nerve from the middle ear cavity, its fiber types, its connections to the lingual nerve, its target ganglion and final distribution.
• Describe the structure, innervation and movements of the temporomandibular joint.
• Identify, in radiological images, major anatomical structures in this region.

Cranial Cavity and Brain

• Describe the anterior, middle and posterior cranial fossae, listing the bones that form each fossa.
• Identify the major foramina, fissures, canals and openings in each fossa, and list the structures traversing them.
• Describe the location of the cranial meninges and the meningeal spaces.
• Describe the causes and locations of epidural (extradural), subdural and subarachnoid hematomas.
• Describe the dural venous sinuses, how they are connected, and their locations.
• Describe the relationship of the structures within the cavernous dural sinus.
• Describe how blood from the scalp can flow to the dural sinuses.
• Describe the arterial contributions to, and the components of, and branches of the circle of Willis.
• Describe the origin of the anterior inferior cerebellar artery and its relationship to the abducens nerve.
• Describe the origin of the posterior inferior cerebellar artery and its relationship to the vagus and spinal accessory nerves.
• Describe the origin of the superior cerebellar and posterior cerebral arteries and its relationship to the occulomotor and trochlear nerves.
• Identify, in radiological images, major arteries to the brain.
• Describe the development of scaphocephaly, brachycephaly, plagiocephaly and trigonocephaly, microcephaly and cranium bifidum.
• Describe the lobes, the fissures and major sulci and gyri of the brain.
• Describe the ventricular system of the brain.
• Describe cerebrospinal fluid production, circulation and absorption.
• Compare and contrast the cause of communicating versus non-communicating hydrocephalus.
• Describe the development of meroencephaly, exencephaly, microcephaly and holoprosencephaly.
• Describe the development of the Arnold-Chiari malformation.

Orbit and Eye

• Describe the lacrimal apparatus and how tears flow from the lacrimal gland to the medial canthus of the eye.
• List the bones forming the orbit and the orbital margin.
• List the structures that pass through the optic canal and the superior orbital fissure to enter or leave the orbit.
• Describe the attachments, innervations and functions of the 6 muscles of eye movement.
• Describe the H– test to test the function of the extraocular muscles and their innervation.
• Compare and contrast the attachments, innervations and functions of the levator palpabrae superioris and superior tarsal muscles.
• Describe the layers of the eyeball.
• Describe the branches of the ophthalmic nerve in the orbit and their distribution.
• Describe the nerves that carry general sensation from the eyeball.
• Describe the course of parasympathetic fibers from the brainstem to the eye.
• Describe the pathway of sympathetic fibers from their origin to the dilator pupillae muscle and the superior tarsal muscle.
• Describe the intraorbital course of the ophthalmic artery and name its branches and distribution.
• Describe how the ophthalmic veins communicate with the pterygoid venous plexus, facial vein and the cavernous sinus.
• Describe the cause of Cavernous Sinus syndrome, the nerves that may be affected and what consequences can occur.
• Explain how the orbital floor may be fractured and which muscle(s) can be entrapped
• Explain how increased intracranial pressure causes papilledema.
• Explain how a cataract results in visual impairment. 
• Explain the anatomical cause of glaucoma and its effect on the retina.
• Describe the cause of diplopia.
• Describe coloboma and the embryologic mechanisms responsible for this condition.
• List the nerves and muscles involved in ptosis and partial ptosis of the eyelid.
• List the nerves and muscles that may be affected by the loss of accommodation.
• List the nerves and muscles that may be affected in loss of the corneal reflex.
• List the nerves and muscles that may be affected in loss of the pupillary light reflex.
• List the nerves and muscles that may be affected in loss of the startle reflex.
• List the anatomical structures that may be affected in Horner’s syndrome.
• Describe the development and clinical picture of congenital retinal detachment.

Ear

• Describe the external ear.
• Describe the major innervation of the auricle and the external ear.
• Name the parts of the bone in which the three ear cavities are located.
• Describe the innervation of the external and internal surfaces of the tympanic membrane and explain ear-cough reflex. 
• List the structures found in the middle ear and their relationships to one another.
• List the structures found in the medial wall of the middle ear.
• Describe the function of the ossicles.
• Describe the attachments, innervations and actions of the tensor tympani and stapedius muscles.
• Describe the connections between the nasopharynx, pharygotympanic tube, middle ear cavity and the mastoid air cells.
• List the nerve fiber types in the tympanic nerve and the composition of the tympanic nerve plexus.
• List the areas that receive sensory fibers from the tympanic nerve.
• List the nerve fiber types in the chorda tympani nerve and its relation to the ossicles.
• Describe the components of the bony labyrinth.
• List the nerve fiber components of the vestibulocochlear nerve and their distribution.
• Describe the cone of light and its location on the tympanic membrane
• Explain the purpose of a myringotomy and where an incision should be placed.
• Compare and contrast the orientation of the external auditory meatus in a young child versus an adult and describe how it would affect the performance of an ear examination.
• Explain the difference between otitis externa and otitis media with regard to sensory innervation.
• Describe the branching of the facial nerve in the temporal bone and the nerve fiber type found in each branch.
• Describe the development of auricular appendages, microtia and preauricular sinuses and atresia of the external acoustic meatus.

Nasal Cavity  and Pterygopalatine Fossa

• List the bones that form the boundaries of the nasal cavity.
• List the bones and cartilage that form the nasal septum.
• Describe the paranasal sinuses, the bones in which they are found and where each opens into the nasal cavity.
• Describe the sensory and parasympathetic innervations of the paranasal sinuses.
• Describe the location of the pterygopalatine fossa, and the openings related to it.
• Describe the relationship of the pterygopalatine ganglion to the maxillary nerve.
• List the fiber types in the nerve of the pterygoid canal.
• Describe the distribution of nerves from the pterygopalatine ganglion and list their functional components.
• Describe the course and distribution of the sphenopalatine and infraorbital arteries.
• Identify major anatomical structures found in this region in appropriate radiological imaging.
• Explain the clinical significance of Kiesselbach’s area during epistaxis.

Mouth, Tongue and Palate

• Describe the boundaries of the vestibule and the oral cavity proper.
• Describe the sensory innervation of the vestibule.
• Describe the sensory innervation of the oral cavity proper.
• Describe the course of the submandibular duct and its termination under the tongue.
• Describe the location of the sublingual gland and the openings of this gland.
• Differentiate between the oral and pharyngeal parts of the tongue.
• List the nerves that carry general sensation and taste sensation from the tongue.
• List the general attachments, innervations and actions of the extrinsic muscles of the tongue.
• Describe how the tongue and palate function during deglutition.
• List the general attachments, innervations and actions of the muscles that are found in the floor of the mouth.
• List the general attachments, innervations and actions of the muscles that are found in the soft palate.
• Describe the arterial supply and its venous and lymphatic drainage of the tongue.
• Identify major anatomical structures found in this region in appropriate radiological imaging.
• List the consequences of a lingual nerve transection just distal to its junction with the chorda tympani nerve.
• List the consequences of a lingual nerve was transection at its origin from the mandibular nerve.       
• List the consequences of a chorda tympani transection.
• Describe the typical site of injection of anesthetic for dental work of the mandibular teeth.
• Describe the cause of ankyloglossia and explain why any corrective measures need to be performed in early childhood.
• Compare and contrast the deciduous and permanent dental formulae.

Pharynx

• Delineate the borders between the naso-, oro- and laryngopharynx.
• List the general attachments, innervations and functions of the muscles of the pharynx.
• List the contributions to the pharyngeal nerve plexus.
• Describe the location and function of the buccopharyngeal fascia.
• Explain the sensory and motor innervation of the nasopharynx, oropharynx and laryngopharynx.
• Describe the afferent and efferent limbs of the gag reflex and its purpose.
• Explain how the pharynx functions during deglutition.
• Describe the location of the pharyngeal, palatine and lingual tonsils.
• Describe the piriform fossa and its innervation.
• Describe the arterial supply of the pharynx, and its venous and lymphatic drainage.
• Describe the lymphatic tonsillar ring of (Waldeyer) and its clinical significance.
• Describe the location of the valeculae.
• Identify major anatomical structures found in this region in appropriate radiological images.
• Describe the three stages of deglutition.
• List the nerves and muscles that may be affected by loss of the gag reflex.
• Descibe the afferent and efferent limbs the gag reflex

Larynx

• Identify the hyoid bone and the cartilages that form the larynx.
• Identify the thyrohyoid and cricothyroid membranes.
• Define the boundaries and extent of the larynx.
• Describe the true and false vocal folds, ventricle, vestibule and rima glottidis.
• List the attachments, innervation and functions of the muscles of the larynx.
• Describe the sensory and mucous innervation of the larynx.
• Describe the afferent and efferent limbs of the cough reflex.
• Describe the arterial supply of the larynx, and its venous and lymphatic drainage. 
• List the nerves and muscles that may be affected by loss of the cough reflex.
• Describe the afferent and efferent limbs of the cough reflex
• Explain the clinical significance of the space between the true vocal folds.
• Compare and contrast the clinical picture of a patient with loss of recurrent versus the internal versus the external laryngeal nerves.

General Clinical Objectives of the Head and Neck

• Describe the signs and symptoms of Bell’s palsy (facial paralysis).
• Describe the signs and symptoms of Horner’s syndrome.
• Describe the signs and symptoms of trigeminal neuralgia.
• Describe the consequence of intracranial lesions of each of the 12 cranial nerves.
• Describe the consequence of lesions in each of the 4 parasympathetic brain nuclei.
• Describe the consequence of lesions in each of the 4 parasympathetic ganglia in the head.
• Describe the consequence of lesions affecting the sensory ganglia of cranial nerves.
• Explain the consequence of extracranial lesions affecting each of the cranial nerves.
• Describe the tests performed for each of the 12 cranial nerves.