A Guide to Human Anatomy
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i A GUIDE TO HUMAN ANATOMY Emmanuel N. Obikili ii A GUIDE TO HUMAN ANATOMY The aim of this guide is to help students know the course content, anatomical terminologies, and the type of questions to expect and how to prepare for examinations in Anatomy. Lecture notes on selected topics have been included as a guide. Although the guide is primarily meant for students preparing for examinations in Anatomy, it will also be useful to clinical students and resident doctors. I am very grateful to Dr. C. O. Ohaegbulam for painstakingly going through the manuscripts and for preparing one of the lecture notes. I also wish to express my gratitude to Dr. W. C. Mezue, Rev Dr. T. C. Awuzie, Dr. C. Okpalike, E. O. Ewunonu and the other members of staff of Anatomy Department for their encouragement. Finally, I wish to thank Prof. F. C. Akpuaka who prompted me to write this guide. This guide is dedicated to my past, present and future students. All rights reserved. No part of the lecture notes may be reproduced in any form without the written permission of the author. Emmanuel N. Obikili Senior Lecturer Department of Anatomy University of Nigeria, Enugu Campus 8th December, 1996. Reprinted, 25 January 2007 E-book, 2 April 2019 Email: [email protected] iii TABLE OF CONTENTS PREFACE .............................................................................................................................................. ii TABLE OF CONTENTS ...................................................................................................................... iii 1. INTRODUCTION. ANATOMICAL TERMS ................................................................................... 1 2. CLASSIFICATION OF BONES ........................................................................................................ 8 3. CLASSIFICATION OF JOINTS ...................................................................................................... 10 4. OSSIFICATION OF BONES (in collaboration with Dr C.O. Ohaegbulem) ................................... 12 5. THE BREAST .................................................................................................................................. 19 6. THE BRACHIAL PLEXUS ............................................................................................................. 22 7. THE RADIAL NERVE .................................................................................................................... 25 8. THE ARTERIES OF THE UPPER LIMB ....................................................................................... 27 9. THE LYMPHATIC DRAINAGE OF THE UPPER LIMB ............................................................ 32 10. THE MEDIASTINUM ................................................................................................................... 34 11. TRACHEA, LUNGS AND PLEURA ............................................................................................ 36 12. THE AUTONOMIC NERVOUS SYSTEM IN THE THORAX ................................................... 41 13. THE INGUINAL CANAL AND HERNIAS ................................................................................. 44 14. SPLEEN AND COELAC TRUNK ................................................................................................ 47 15. STOMACH ..................................................................................................................................... 50 16. DUODENUM ................................................................................................................................. 53 17. LIVER ............................................................................................................................................ 55 18. THE PORTAL VENOUS SYSTEM .............................................................................................. 59 19. DIAPHRAGM ................................................................................................................................ 61 20. THE KIDNEYS .............................................................................................................................. 64 21. RECTUM AND ANAL CANAL ................................................................................................... 67 22. PELVIS ........................................................................................................................................... 71 23. UROGENITAL TRIANGLE .......................................................................................................... 74 24. THE HIP JOINT ............................................................................................................................. 77 iv 25. THE ARCHES OF THE FOOT ...................................................................................................... 80 26. THE LYMPHATIC DRAINAGE OF THE LOWER LIMB ......................................................... 83 27. THYROID GLAND........................................................................................................................ 84 28. LARYNX ........................................................................................................................................ 87 29. FORAMINA OF THE SKULL AND THE STRUCTURES THAT PASS THROUGH THEM .. 92 30. THE PTERYGOPALATINE FOSSA ............................................................................................ 97 31. FACIAL NERVE .......................................................................................................................... 100 32. VAGUS NERVE .......................................................................................................................... 102 33. STELLATE OR CERVICOTHORACIC GANGLION ............................................................... 104 34. THE CAVERNOUS SINUS ......................................................................................................... 105 35. TEMPOROMANDIBULAR JOINT ............................................................................................ 107 36. VISUAL PATHWAY AND VISUAL REFLEXES .................................................................... 109 37. INTERNAL CAPSULE ................................................................................................................ 113 38. FUNCTIONAL COMPONENTS OF THE CRANIAL NERVES ............................................... 114 39. RECOMMENDED TEXTBOOKS .............................................................................................. 118 40. LECTURE AND PRACTICAL TOPICS (FROM THE DEPARTMENT) ................................. 119 41. PAST ESSAY QUESTIONS ........................................................................................................ 128 42. ESSAY-TYPE QUESTIONS ....................................................................................................... 136 43. OBJECTIVE - TYPE QUESTIONS (FROM THE DEPARTMENT) ......................................... 141 44. APPENDIX I: VERTEBRAL LEVELS ....................................................................................... 165 45.APPENDIX II: DIMENSIONS OF SOME STRUCTURES IN THE BODY .............................. 167 1 1. INTRODUCTION. ANATOMICAL TERMS TIT BITS ON HOW TO STUDY ANATOMY Anatomy is very interesting. However, it is voluminous and volatile. When you stop studying it, it leaves you. It does not waste time on those who do not have time for it. You have to bear with it. It is the foundation of medicine. Below are pieces of advice which you may find useful. 1. Sleep for about 7 hours everyday. If you do not have enough sleep, even if you read a lot, you are likely to remember very little. 2. Prepare for the lectures by reading up the topics in advance. 3. At the end of the day or at least within the week, read the same topics in your textbooks, correct and enrich the notes you took during the lectures. DISSECTION: 4. Study in advance the areas that you are going to dissect. 5. You have to train your hands in dissection. The first time you dissect, you may do it awkwardly. Do not worry even if your group mates cajole you. With time your dissection will improve. The group mates should take turns to dissect. Otherwise the good student who does the dissection most of the time will become much better while the bad student will remain bad. It is extremely easy to get stuck in a cycle where you do not dissect because you are not good at it, which of course only gets worse. 6. Learn to identify with reasons the structures you come across. For example, if it is an important muscle you should know its origin, insertion, nerve supply, relations to other structures etc. During dissection, refer to the gross atlas frequently. 7. Periodically, during lunch break or at any other free period, go to the dissection room with a colleague of yours who is 'hot' to have a closer look at the regions you have dissected. Compare the structures you identify in your cadaver with the same structures in other cadavers. In this way, you will get used to normal variations in structures. 8. HISTOLOGY PRACTICAL: Identify the slides with reasons. Draw and label the slides you have studied. 9. OSTEOLOGY: A good knowledge of osteology facilitates the understanding of anatomy. Borrow bones from your friends or from the Department and study them regularly. Have them in front of you when you are studying certain topics like muscle attachments, venous sinuses, fossae and foramina in