1^st week

General anatomy

I. Introduction

a) General remarks – structure of the department, contact points, ethics of anatomical and medical teaching and studying

b) Structure of the anatomical teaching – lectures, practical trainigs, dissection courses, integrated seminars and lectures, consultations, examinations, credit conditions

c) Study tools – textbooks, web site materials, white coats, dissection instruments

d) Anatomical terminology – review of its history, actual state, basic terminology – main planes and directions in the body, basic anatomical vocabulary for the fisrt practical training (web site)

II. Morphological structure of the human body

Basic scheme of the morphological teaching:

Cell → tissues → organs → organ complexes (systems) → organism

Tissues:

a) epithelial

b) muscular – smooth muscle cells, cardiomyocytes, cross striated muscle fibres

c) nervous – neurons and glial cells

d) connective tissues – 2 main structures, e.g. basic cells and matrix

- connective tissue proper (fibrocyte, - blast; according to the quality of the fibrills: collagenous, elastic, fibrous and reticular; dense and loose connective tissue)

- cartilage (chondrocyte, - blast; hyaline cart. – on the contact surfaces of most joints, fibrous – intervertebral discs, and elastic – auricle)

- osseous (osteocyte, - blast, -clast /osteoclas belongs to the macrophage family/)

e) [blood]

III. Osseous tissue, bone as an organ

1. Kinds of osseous tissue: primary (fibrilar - in onotgenesis, then only in tendon and ligament attachments, close to the skull sutures and around the inner ear) and secondary (lamellar = haversian→ osteons). Attention – the ability of osseous tissue to REGENERATE → healing of fractures!
2. Bone as an organ:

a) types of bones – short, flat, long, irregular, pneumatized, sesamoid

b) basic description of long bone: diaphysis, metaphysis, epiphysis, apophysis; compact, cortical and spongy bone, bone marrow

c) bone strucutre – bony part (compact = long bones, cortical = short bones, spongious = both underneath)

- cartilaginous part (epiphysial plate, joint cartilage)
- fibrous part (periosteum = 2 layers, endostium)

d) blood supply of the bones – nutritional vasa, periostal vessels

e) growth of the bone into the length and thickness

f) bony age

2^nd week

Joints; Articular system

I. Synarthrosis (connection using connective tissue)

Division according to the qualitiy of connective tissue in:

a) Fibrous joint (Junctura fibrosa)

a. syndesmosis (extra-articular ligaments, membrana interossea)

- gomphosis (teeth)

b. sutura (skull sutures)

b) Cartilaginous joints (Junctura cartilaginea)

a. synchondrosis (hyalinne cartilage – epiphysial (=growth) plate, skull, ribs)

b. symphysis (fibrocartilage – intervertebral discs, pubic symphysis)

c) Bony union = synostosis (bone – fading of skull sutures, sacral bone, hip bone)

II. Diarthrosis = Synovial joints = Junctura synovialis = Articulatio

1. general arthrology (articular surfaces, joint capsule, joint cavity, synovial membrane, joint ligaments, vessels and nerves of joint – proprioception!)
2. diarthrosis divisions according to:
1. element number:

i. simple /art. simplices/ - 2 bones

ii. complex /art. compositae/ - more than 2 bones, 2 bones + disc or menisc

2. movement extension:

i. amphiarthrosis

ii. more movable – other joints

3. shape of articular surfaces – plane, cylindrical (pivot, hinge), bicondylar, saddle, elipsoid, ball-and-socket (cotyloid)
3. basic schema for joint description:

a. name

b. type

c. descripiton - joint head + fossa

d. articular capsule attachment (close by the articular surfaces – several important exceptions clinically!)

e. special joint structures (labrum, disc, menisc, fibrocartilage, ligaments, synovial bursae, fat pads (= corpus adiposum intraarticulare))

f. basic and loose position

g. pasive mechanism and active movements

4. movements:
1. basic: flexion x extension, abduction x adduction, internal, medial rotation x external, lateral rotation, (ulnar x radial duction)
2. other: pronation x supination – special type of rotation of the radius around the ulna, opposition x reposition – special movements of thumb to position facing the other fingers, elevation x depression + protraction x retraction – temporomandibular joint, scapula (functional joint only!)
3. combined: circumduction – cone surface movement, each side always faces the same direction, inversion x eversion – foot movement as a whole, further: e.g.. hyperadduction (depends on the joint)

3^rd week

Introduction into the myology, muscles of the upper extremity

I. General structure of the skeletal muscle

The skeletal muscles represent approximately 40% of the total body mass, have a rich vascular supply

Basic construction of the skeletal muscle: origin (origo), insertion (insertio) / head (caput), belly (venter), (tail - cauda)

Structure of the muscle fibres: extra- and intrafusal fibres and their innervation [α and γ motoneurons], the motor and movement unit, bundles of motor fibres

Muscle shapes: m. fusiformis (fusiform), rectus (straight), triangularis (triangular), quadratus (quadrate), biventer (two-bellied), biceps (two-headed), triceps, quadriceps, semipennatus, pennatus, orbicularis, cutaneus (cutaneous)

Muscles groups: agonists and antagonists, synergists, neutralising muscles, principal and auxilliary, mono-, bi- and polyaxial muscles

Function: corresponds to joint movements; sphincter x dilator

Fascie), flat tendon (= aponeurosis), synovial sheath (= vagina synovialis tendinis), retinaculum, bursa

Blood vessels of the muscle, clinical importance of the muscular and myocutaneous flaps, compartment syndrom, physiotherapy

II. Review of the muscles of the upper extremity

1. Muscles of the pectoral girdle
2. Muscles of the arm – anterior and posterior group
3. Muscles of the forearm – anterior, posterior and lateral group
4. Muscles of the hand – muscles of the thenar, hypothenar and of the middle space
5. Basics of the topography of the upper extremity: axilla, clavipectoral trigone, cubital fossa, palm of the hand, carpal canal, synovial sheaths of extensors and flexors of the hand

4^th week

Muscles of the lower extremity

1. Pelvic muscles

a) anterior group – iliopsoas m. (iliopectineal bursa)

b) posterior group (2 layers)

2. Muscles of the thigh

a) anterior group

b) medial group

c) posterior group

3. Crural muscles

a) anterior group

b) lateral group

c) posterior group (2 layers)

4. Muscles of the foot

a) muscles of dorsum

b) plantar muscles:

- muscles of the big toe

- muscles of the middle plantar space

- muscles of the small toe

Furthermore: muscular and vascular space (lacuna musculorum and vasorum), femoral septum, canalis obturatorius, greater and lesser sciatic foramen, supra- and infrapiriform foramen, trochanteric bursa, femoral triangle and iliopectineal fossa, fascia lata (saphenous opening and cribriform fascia), iliotibial tract, adductor canal of Hunter (hiatus adductorius), lamina vastoadductoria, popliteal fossa, bursae of the knee joint, arcus tendineus of soleus muscle, fibular canal, retinacula and synovial sheats of the flexors, extensors and of the fibular muscles, malleolar canal, musculofibular canal of Hyrtl, Kager´s triangle

5^th week

Vertebral column, sternum, ribs

1. General description of the vertebrae

2. Different shapes of C1,C2, C7, L5 vertebrae, sacral and coccygeal bone

3. Junctures of the vertebral column:

a) syndesmoses

b) synchondroses

c) synostoses

d) synovial joints

4. Curvatures of the vertebral column

5. Sternum

6. Ribs

6^th week

Pelvis

1. Basic description of the pelvic bone

2. Pelvic planes and their diameters

3. Sexual differences of the pelvis

4. Pelvic foramina

7^th week

Skull I

1. Review of the development
2. Bones of the neuro- and splanchnocranium
3. Internal base of skull – anterior, middle and posterior cranial fossa
4. Orbit
5. Osseous nasal cavity

8^th week

Skull II

1. Temporal bone
2. External base of skull: infratemporal fossa, pterygopalatine fossa
3. Skull of the newborn
4. Craniometric points of the skull
5. Temporomandibular joint