University of Balamand

Faculty of Medicine & Medical Sciences

Human Gross Anatomy (HGAN 457) Syllabus
Fall 2010-2011

COURSE OBJECTIVES:

Anatomy is concerned with the structure and function of the body. In this course, we approach
anatomy from gross structural perspective. The students will use this knowledge to recognize
normal variations and clinically relevant abnormalities during their medical careers. The major
educational objectives of the course are to

• learn correct anatomical vocabulary so that the student can communicate effectively
with medical colleagues
• learn the gross morphology of the body, particularly the structural relationships which
permit understanding of anatomical variation, clinical radiology and the spread of
disease
• learn and appreciate that the various structures of the human body form an integrated
whole, without which proper function is impossible
• understand anatomy in three-dimensions and use this knowledge to analyze medical
images such as CT scans, MR images, ultrasound and 3D images.

Great emphasis is on learning normal structural and functional relationships. To accomplish

these goals, students acquire information through lectures, cadaver dissections, organ models,
video tapes, anatomical websites, and interactive software. Clinical presentations and problem
sets emphasize the clinical relevance of learning anatomical structure and its relation to
function.

In addition to learning the structure, function and context of anatomy, the gross anatomy
experience provides students an opportunity to acquire and hone many of the professional
skills needed throughout their medical careers. In particular, this course will allow you to

• strengthen your sense of compassion and respect for the patient (cadaver), especially
under difficult circumstances
• strengthen your commitment to and respect for colleagues
• strengthen and refine the skills necessary to work effectively with others in solving
problems and achieving goals
• reinforce the value and necessity of arriving to all professional meetings and situations
on time and fully prepared

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 By the end of this course, the student will have learned to function as a cooperative
participant of a medical team and have acquired a life-long basic understanding of the dynamic
gross structure of the human body based on the factual and conceptual information covered in
the course.

Textbooks:

Required texts: (latest edition)

Name of Books Author Publisher

1- Clinically Oriented Anatomy Moore, Dalley & Agur Lippincott

2- Grant’s Atlas of Anatomy Agur & Dalley Williams & Wilkins
3- Grant’s Dissector Tank Williams & Wilkins
4- Medical Dictionary (Stedman’s or Dorlands)

RECOMMENDED TEXTS: (latest edition)

Name of Books Author Publisher

1- Gray’s Anatomy for Students Drake, Vogl & Mitchell Elsevier

Churchill Livingstone

2- Cunningham’s Textbook of Anatomy Romanes Oxford

3- Clinical Anatomy for Medical Students Snell Little, Brown

4- Color Atlas of Anatomy Rohen & Yokochi Igaku-Shoin

Medical publisher

5- Anatomy: A Regional Atlas of the C.D. Clemente Urban &

Human body Schwarzenberg

6- Atlas of Human Anatomy Netter – Ciba Geigy Corporation

7- Imaging Atlas of Human Anatomy Weir & Abrahams Mosby

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FACULTY
Course Director : Jihad Hawi
E-mail : jihad.hawi@balamand.edu.lb
Cell Phone : 03-601558

Anatomy Youssef Bassim, M.D. Orthopedic Surgery, Lecturer

Lab Teaching
Team Jamil Halabi, M.D. General Surgery, Lecturer

Houssam Jourdi, Ph.D Human Morphology , Lecturer

Ghassan Nabbut, M.D. General Surgery, Lecturer

Clinical Lecturers Clinical Topics

Imad Hajj, M.D., General Surgery Axilla & Breast
Alexander Nehme, M.D., Orthopedic Surgery Upper Limb
Alexander Nehme, M.D., Orthopedic Surgery Back
Chawki Cortbawi, M.D., Orthopedic Surgery Lower Limb
Fouad Fata, M.D., Otolaryngology Ear
Jihad Khoury, Otolaryngology Face, Nasal Cavities & Neck
Ibrahim Dunia, M.D., Ophthalmology Orbit
Bassam Abou Khalil, M.D., Cardiothoracic Surgery Thorax
Amir Abdelnour, M.D., General Surgery Abdomen
Ziad Rassi, M.D., General Surgery Liver & Gall Bladder
Michel Daher, M.D., General Surgery Proctology
George Ghazal, M.D., Urology Male Pelvis, Urogenital Region
& Perineum
George Kehdy, M.D., Obstetrics and Gynecology Female Pelvis & Perineum
Mitri Achram, M.D. Radiology
Rami Chemali, M.D. Radiology
Raja Achou’, M.D Radiology
Carmen Adem, M.D. Radiology

STAFF

Mr. Elias Dahdouh, Research and Laboratory Assistant.

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Lecture Reading Assignments

Textbook: Clinically Oriented Anatomy

Moore, Dalley & Agur (Sixth Edition)

Topic Page #
Introduction 1-70
Breast; Axilla 98-106, 697-699, 713-731

Upper Limb 670-712, 731-819

Back
- Overview & Vertebral Column 439-453, 456-482
- Posterior Axioappendicular & Scapulahumeral Muscles 700-713
- Muscles of the Back 482-488
- Suboccipital Region 492-495
- Spinal Cord 496-507

Skull, Face and Scalp 820-865

Cranial Meninges and Brain 865-880, 882-888

Eye, Orbit, Orbital Region and Eyeball 889-914

Neck 981-1020
Summary of Cranial Nerves 1053-1082
Parotid & Temporal Regions, Infratemporal Fossa & 914-928
Temporomandibular Joint
Ear 966-980

Oral Region 928-930

Palate, Tongue and Salivary Glands 934-951
Pterygopalatine Fossa 951-954
Nose 955-965
Pharynx 1032-1038
Larynx & Trachea 1022-1032
Thorax 71-79, 83-97, 106-180

Abdomen
- Overview 181-184
- Anterolateral Abdominal Wall 184-202
- Inguinal Region 202-206
- Peritoneum & Abdominal Viscera 217-290
Kidneys, Ureters & Suprarenal Glands 290-305

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 Diaphragm 306-309
Posterior Abdominal Wall 309-325
Male/Female Pelves & Perineum 326-438
Spermatic Cord, Scrotum & Testis 206-216

Lower Limb 508-669

Lab Reading Assignments

Textbook: Grant’s Dissector, 14th Ed.

Topic Page #

Week 1 Introduction; 1-4

Pectoral Region; Axilla 19,20,24-28; 28-32

Axilla
Superficial Veins and Cutaneous Nerves 19-21
Arm ( Anterior Compartment) and 32-35
Week 2 Cubital Fossa

Flexor Region of Forearm 36-40

Palm of Hand 40-46
Extensor Region of Forearm and
Week 3 Dorsum of Hand 47-49
Arm (Posterior Compartment) 35-36

Back (Superficial Muscles) and

Scapular Region 5-11; 22-24
Back (Intermediate and Deep Muscles)
Suboccipital Region 12-14
Week 4 Vertebral Canal; Spinal Cord and Meninges 15-18

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 Face 199-206
Scalp 208-210
Interior of skull 215-227
Week 5
227-234

Orbit
Posterior Triangle of Neck 186-190
Anterior Triangle of Neck 190-194
Week 6

Thyroid and Parathyroid Glands and

Root of Neck 195-199
Parotid, Temporal, and Infratemporal 206-208; 210-214
Regions
Week 7 Carniovertebral Joints, Disarticulation,
Bisection of the Head, and
Pre-and Lateral Vertebral Regions 234-236

Pharynx 236-240
Nose & Nasal Cavity 240-244

Week 8 & 9 Hard Palate and Soft Palate 244-249

Oral Region 249-252
Larynx 252-255

Intercostal Space and Muscles 54-59

Pleural Cavities and Lungs 59-64
Middle Mediastinum and Heart 64-73
Week 10 & 11 Superior and Posterior Mediastinum 73-77

Anterolateral Abdominal Wall 78-87

Peritoneum and Peritoneal Cavity 88-105
Posterior Abdominal Viscera 105-109

Week 11, 12 & 13 Posterior Abdominal Wall and

Diaphragm 109-112

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 Male External Genitalia and
Perineum(Scrotum, Spermatic Cord, Testis) 117-119

Male Pelvic Cavity in Hemisection 124-133

Female Pelvic Cavity in Hemisection 137-147

Week 14, 15 & 16 Anterior and Medial Compartments of Thigh 148-159

Gluteal Region 159-163
Posterior Compartment of Thigh 163-167
Male Urogenital Triangle 119-124
Female Urogenital Triangle 134-137

The Leg and Foot as a Functional Unit 167-180

The Knee Joint 182-183

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 GROSS ANATOMY SURVIVAL GUIDE

In medical school, you need to use your time wisely. In this course particularly, where the
cadaver is your primary instructor, you need to take time in the laboratory in learning the
material. If you do not come to anatomy class prepared, you will find yourself just
“completing the assigned list of tasks”. Here are the keys to success in anatomy:

• Complete the PRE-LABORATORY OBJECTIVES before each class. This will provide
the background information you need in order to learn from the dissection. Note: The
textbook contains many details that you do not need to learn (more in some areas than in
others). Some students say they benefit from repetition, especially since a lot of the language
is new.

• Read the dissection instructions before class and become familiar with the new
vocabulary, the structures for dissection, and the dissection approach. Consult these images
as you read through the exercise.

• Take full advantage of all scheduled meetings. Pre-labs will give you a “heads-up” on
what to expect in lab. Post-labs are designed to insure that you understand what you saw in
dissection, and to provide you with an opportunity to ask any questions related to the
anatomy or clinical applications. You will benefit from these discussions even if you are not
the one asking the questions.

• Do not hesitate to ask questions at any time. We want you to understand the material, and
we will be happy to answer as many questions as necessary. Nobody was born knowing this
material, and despite our best efforts, we do not imagine that the cadaver, the lab manual and
the textbook are perfect.

• Use your scheduled time in lab wisely. During the dissection, you will generally work in
pairs on one side of the body. One individual in the group should be a “reader” - a person
who reads the steps in the dissection manual and finds the appropriate atlas pages - while the
others are dissecting. It is a good idea to switch roles frequently, both to avoid getting tired
and because most people find that, they remember things better if they dissect them. If you
are dissecting an area that does not have sides, e.g. the heart, those of you not dissecting
should spend the time discussing the objectives with your lab partners, studying other
material (bone specimens, articulated skeletons, cross-sections, models and prosections) or
reviewing – there is always plenty to do. You can then switch with your dissection partners
later in the lab.

• Do not rush, and do not let your lab partners rush you. .Dissecting the cadaver is a
unique opportunity, one that most of you will never have again, so you should take full
advantage of it. Take a few minutes at the end of the period to review the dissection.

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• Help each other. You are not competing with your classmates. Your learning experience
will be more collegial and much more efficient if you work together. Group learning is very
effective in anatomy. You can use the first few minutes of lab to quiz your partners on the
previous dissection(s), for example pointing to structures with a probe and asking group
members to identify them. This will make a big difference in your practical exam scores,
with a minimal amount of time and effort. If something is confusing to you, ask your lab
partners. One person in the group may understand a particular concept and can explain it to
the others. Most importantly, discussing the material tells you what you know: If you can
explain the material to someone else, you own it. If you cannot, you know what you need to
study. Most students find a study partner or two that they work with regularly. You should
spend at least a few hours each week together reviewing the dissections, quizzing each other
on dissections, discussing lecture material, integrating material over the whole unit,
discussing clinical cases, etc.

• Study other cadavers. There is a tremendous amount of variation between cadavers (and
patients!) in many of the structures you will dissect. Trading tours of the dissection with
other groups regularly will make you much more adapt at identifying structures by their
relations, not by their visual appearance in your cadaver. This will benefit everyone, not least
on the practical exam. This can also be a good way to take a break from dissection and do a
little review if you get tired (see below). N.B. You may not dissect any cadaver other than
your own, but you do have access to all of the cadavers for study. You should arrange in
advance with other groups to examine their cadavers at a time that will not interfere with
their work.

• Keep up with the material. We expect you to behave professionally and treat the
opportunity to dissect a cadaver with the respect it deserves by showing up prepared. You
should expect to spend about 1 hour of quality time studying for every scheduled hour of
class/lab time. You should spend at least one of those hours before lab, completing the pre-
lab objectives and reading the dissector, and as much time as necessary before the following
meeting to complete the post-lab objectives. Add in a little time each week for review – post-
lab objectives are a great place to start. The pace and content being what they are, you will
not be able to cram for anatomy. DO NOT get behind, you will not be able to catch up (ask
the second years if you doubt this).

. Have Fun!

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 THE CADAVER
The following rules of conduct are mainly a matter of common sense, but they are below as a
reminder:

1. Approach each dissection as a professional (i.e., be prepared and focused).

2. Work at developing your skills as dissectors. Dissection is NOT mutilation.
3. Take pride in your work and always respect your "silent teacher."
4. The dissection room does not have to be a morbid place to work and study. Instead, the constant
thrill of discovery permeates its atmosphere. Animated conversation should be an inevitable
consequence.
5. Do not invite guests to the lab.
6. There will be no photographs in the Laboratory.
7. Inappropriate comments or actions made with reference to the cadaver are intolerable. This is
grounds for dismissal.
8. Do not take any anatomical material outside of the laboratory. This constitutes a criminal
offense.
9. Remember -- this is your lab and you are responsible for its proper operation and maintenance.
10. Lighten up and be happy! You are about to learn more in a shorter period than you ever have
before. That is exciting.

When the bodies are prepared by an anatomical embalmer they will last for a millennium with
routine maintenance. These solutions will kill every known pathogen including the AIDS
virus. NOTE: Formaldehyde and phenol are known carcinogens but the concentration of these
two compounds within the total fixative solution is low and well within safety limits. Phenol is
also a powerful anesthetic and can cause numbness of the fingers. Latex gloves of surgical
quality are therefore required.

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 LABORATORY POLICY
1. Each student should wear a lab coat while working in the laboratory. Students are responsible for
keeping their lab coats clean in accordance with standards of professional conduct.
2. When handling cadaveric material, make sure you wear Latex surgical gloves.
3. Caps or similar headwear is unacceptable attire. This applies to the lecture hall as well as the
laboratory. Medical schools prohibit such disrespectful informality.
4. There will be No eating, drinking or smoking in the laboratories. Such activities may be
hazardous to your health.
5. The dissecting table and its environs are in a neat and orderly fashion pursuant to professional
standards of cleanliness. DO NOT allow paper towels, cadaver remains, and fluids to
accumulate on the table or floor. DISCARD small cadaver scraps in the bucket provided to
each dissection table. Paper waste goes in the receptacle next to the sinks. DISCARD sharp
instruments, such as scalpel blades, in the containers on each sink marked for such instruments.
You must NEVER mix these items. Sharp instruments in the waste paper receptacle pose a
serious health hazard.
6. DO NOT remove skeletons, models, instruments, etc. from the laboratory! DO NOT
disarticulate skeletons! DO NOT disassemble models. Clean the instruments and return it
to their proper storage after use.
7. DO NOT remove any body parts, tissues, or prosthetic appliances found in the cadavers from the
laboratory. Violation of this rule is punishable by fine, jail sentence, or both AND failure of
the course.
8. Write down your names on the lab coat.
9. Do not block open the laboratory doors. If you are cold, put on more clothing! The lab is kept as
cool as possible to reduce the volatility of the fluids and to retard microbial growth and
corrosion.

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 ABOUT DISSECTION
1. How to Dissect: Before the first day of actual dissection carefully read pages 1-4, 19, 20 and 24-
28 of your dissector.
2. Equipment: Professional dissections require professional instruments. It is only necessary to have
two sets of instruments per tank table, one set per side. The instruments are available in the lab.
3. Safety Tips: Ordinarily the gross anatomy lab is a safe environment. However, there are some
hazards to avoid:
A. Never use a dull scalpel blade. Always put on a new blade when cutting becomes difficult.
B. Never remove a scalpel blade from its handle with your fingers; always use forceps. The
same advice applies to putting on a new scalpel blade.
C. If you can, remove soft, gas-permeable contact lenses before entering lab. The lenses absorb
and concentrate the noxious vapors emanating from the cadaver, leading to irritated eyes.
D. Some people are very sensitive to the preservative fumes, to the extent that they get
headaches, feel faint, or even pass out. This is a very rare event.
E. If you cut or puncture yourself with an instrument, seek first aid from an instructor or TA.
F. If a small piece of tissue flies into your eye, go over to a sink and flush it out.
G. Watch out for jagged edges of bone (e.g., cut ends of ribs). When using a saw, try to cut the
bone clean through. Try to trim off jagged edges with a bone cutter so that the risk of a cut or
puncture minimizes.
H. Pregnant women may wish to speak to their physicians about possible hazards presented by
the preservatives. As far as is known, none of the preservatives is mutagens.

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 HOW ANATOMY IS STUDIED?
The most frequently asked question in gross anatomy courses is -- "How can I possibly learn
all this stuff?" However, the answer is disappointingly simple -- by daily study! The subject
matter of anatomy is not particularly difficult, but there is a lot of it and students cannot
afford to get behind. It is not possible to cram for anatomy exams. Moreover, contrary to
popular belief anatomy cannot be mastered by rote memorization. Anatomy is one of the most
logical of sciences and therefore must be "thought through". Facts quickly memorized are as
quickly forgotten. Facts understood will stay with you. While there are at least 1,786 different
methods of studying (and learning!) anatomy the following 8-step method has been thoroughly
tested and time proven to be a very successful approach. Try it - and if you do not like it, see
one of your instructors early in the course so we can get you on the right track. Remember --
you cannot afford to get behind.

1. BEFORE each lecture read or at least PREVIEW the suggested text and SYLLABUS/CLASS
NOTES pages.
2. Focus on the study questions! Try to answer them before coming to class. They are the crux of
the course. We will try to answer as many as time permits during the lecture but even if we miss
a few you are still responsible for all of them. That is why God invented books!
3. PREVIEW the next day's topics. Preview, THINK, and Review. Get the idea!
4. The same approach applies equally, if not more so, to the lab. BEFORE each lab read or at least
preview the day's dissection in your dissection manual by referring to the designated plates in
your atlas. In short, perform the dissection mentally....
5. . . . before you perform it physically. Follow each day's instructions carefully and professionally.
Never leave the lab before you have identified all of the designated structures. Your lab
instructors will be delighted to check you out.
6. During each evenings study session, REVIEW the day's dissection (and all preceding ones!) For
the lab, your atlas is your very best friend. Get used to living with it. Moreover sleep with it
under your pillow (it will also ward off evil demons!).

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Grade Computation
Examinations:

Written : Four exams 50%

Oral : Four over-the-cadaver exams 40%

Evaluation : Dissection effort, cleanliness and performance 10%

Exam attendance is mandatory. If for any reason, the student were not able to attend the exam, he
or she must justify the absence to the course director and to the Dean before a make-up exam may
be assigned. Make-up exams are graded by Pass or Fail. One make-up exam will be allowed in
the course upon validation of the circumstance that prevented the student from attending the
scheduled exam.

Attendance:

Lectures:
• Attendance is MANDATORY to all lectures sessions. Attendance policy is in
accordance with the Faculty of Medicine Rules and Regulations.

Labs:
• Attendance is MANDATORY to all lab sessions.
• If you come to the lab unprepared, you will be dismissed
• If you are dismissed for two lab sessions, you will take an INCOMPLETE grade
for that given Part

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 Human Gross Anatomy
Medicine I Students
Monday November 01, 2010

• Classes will start on Monday at 8:30 A.M. Fares 226

• Read the Introduction in textbook (Moore & Dalley)

• Read Pages 1-4 and 19, 20, 24-28 in the Grant’s

dissector, 14th edition.

• Bring Grant’s atlas, Grant’s dissector and a long, white

laboratory coat to the laboratory session on Tuesday
November 02.

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I the Undesigned, have read the syllabus and will abide by the rules and
regulations mentioned in it.

Signature---------------------

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