College of Medical and Dental Sciences M3-CSA-Y18 Clinical Core 2 Clinical Skills Anatomy Handbook 2018-2019 CC2 This course guide has been written to provide outline course content and some elements of background reading to the clinical skills anatomy course at the beginning of Year 3. It is intended as a guide only, to supplement learning within a clinical context at the Teaching Academies as part of Clinical Core 2 component of the course. It is not intended as a replacement for texts on the subject of anatomy and provides the main context rather than the whole content of the course. Any comments about its contents should be directed towards [email protected] Course Guide Version 1 Prepared by Jamie Coleman, David Morley, and Joanne Wilton August 2014 Updated August 2017 CSA 2 CC2 CONTENTS Introduction .............................................................................................................. 4 Background and Context ........................................................................................ 4 What is the Clinical Skills Anatomy course? ........................................................... 4 The course includes ............................................................................................... 4 Lectures ................................................................................................................. 4 SGT ........................................................................................................................ 4 PBL CSA eCases ................................................................................................... 5 Workbook ............................................................................................................... 5 What this handbook intends to do .......................................................................... 5 Background to Clinical Skills .................................................................................. 6 Basic concepts ......................................................................................................... 7 Thorax ....................................................................................................................... 9 Thorax Knowledge ................................................................................................. 9 Thoracic Anatomy in detail ................................................................................... 10 Abdomen and Pelvis .............................................................................................. 15 Abdomen / Pelvis Knowledge ............................................................................... 15 Abdominal / Pelvis Anatomy in detail .................................................................... 16 The Spine ................................................................................................................ 19 Spine Knowledge ................................................................................................. 19 Spine Knowledge in detail .................................................................................... 20 The Upper Limbs .................................................................................................... 22 Upper Limb Knowledge ........................................................................................ 22 Upper Limb in detail ............................................................................................. 22 The Lower Limbs .................................................................................................... 25 Lower Limb Knowledge ........................................................................................ 25 Lower Limb in detail ............................................................................................. 25 Head and Neck / Central Nervous System ............................................................ 28 Central Nervous System Knowledge .................................................................... 28 Central Nervous System in detail ......................................................................... 29 Head and Neck Anatomy Knowledge ................................................................... 31 Head and Neck Anatomy in detail......................................................................... 32 PBL on Thoracic Trauma (Thorax) ........................................................................ 37 PBL on Acute Abdominal Pain (Abdomen and Pelvis) ........................................ 40 PBL on Wrist Trauma (Upper Limb) ...................................................................... 43 PBL on Knee Trauma (Lower Limb) ...................................................................... 46 PBL on Neck Pain (Head and Neck) ...................................................................... 49 PBL on Facial Palsy (Central Nervous System) ................................................... 52 Bibliography ........................................................................................................... 54 CSA 3 CC2 Introduction An overview of the Clinical Skills Anatomy course including the course objectives and general procedure of the sessions. Background and Context A course on ‘Clinical Skills Anatomy’ is included in the third year to allow students to revise information from the first two years and apply this existing knowledge to clinical skills in medicine and surgery. It will contain elements of regional anatomy but will provide a new perspective and contextualise the anatomy content of the first two years of study. What is the Clinical Skills Anatomy course? With recent changes to the curriculum you have had lots of regional anatomy taught alongside systems based anatomy so you have already have an excellent grounding. The following pages highlight some of the key points that will help you revise the parts of anatomy that are essential to the clinical skills you will learn over not just the 3rd year, but the rest of the programme. The course includes 1 hour lecture during your academic in days (September) 2 hour SGT Series of interactive online cases A CSA “workbook” to complete before the SGT This handbook as a supporting resource Lectures The lecture slot during your academic in-days will cover the following: The Anatomy of Procedural Skills Introduction to the CSA SGT – what to expect and how to get the most out of the session SGT During this 2 hour practical, demonstrators will facilitate your exposure to surface anatomy and radiological imaging in order to help you learn how to apply the anatomy you know to clinical examination, procedural skills and the interpretation of radiological imaging. The intention is that you use this time to focus on moving your knowledge from the page to the patient. To do this, we have created a number of brief clinical cases and small exercises for you to work through. CSA 4 CC2 There will be lots of opportunity to get hands on by using markers and body “painting” using wash-off pens. Please come prepared to examine and be examined - wearing shorts and t-shirt if comfortable. Bring your stethoscope please. Clinical content will be covered; but this will only be at a depth to allow the context of the subject to be understood. This course does not replace the in depth teaching of clinical skills that takes place at patients’ bedsides in the teaching Trusts. PBL CSA eCases We have prepared a number of online interactive cases for you to work through. These eCases include a number of carefully chosen links and signposts to additional materials. They have been developed with student input and also include a few bonus MCQ format questions too. You get feedback as you go and can also save or print your completed cases. A version of these cases is also available at the end of this handbook. Workbook As a reference tool to support your clinical skills there are a number of carefully selected images for you to label and brief exercises to complete. To get the most out of your SGT we recommend you work though it before your SGT session. What this handbook intends to do This course guide has been written to supplement the suggested texts in both applied anatomy and clinical skills that students will be expected to study. It is not intended to be a replacement for attending the SGT or studying the relevant texts, it does however aim to provide: Further context about the importance of anatomical knowledge for clinical skills (including diagnoses) and practical procedures Preparatory material / PBLs to allow students to revise anatomical concepts from previous anatomy teaching prior to the SGT sessions, and throughout the academic year. CSA 5 CC2 Background to Clinical Skills This CSA course is designed to refresh your knowledge of the essential anatomy necessary to facilitate your entry into clinical studies. You have already spent two years of formal anatomy studies and should therefore have a good understanding of the subject. It is not the intention, nor would it be possible in the time available, to revisit all of the anatomy curriculum and this course must of necessity, therefore, be selective and focused. As Stanley Monkhouse puts it in his book Clinical Anatomy, it covers the anatomy “you need to know” rather than that which is “nice to know”. Clinical examination and the practice of procedural skills rely heavily on a good knowledge of surface anatomy including bony landmarks and surface markings, as well as a sound knowledge of sensory