Regional Anatomy I - Thorax, Abdomen, Pelvis, Perineum
Code
11110
Academic unit
NOVA Medical School|Faculdade de Ciências Médicas
Department
CMH
Credits
3
Teacher in charge
Prof. Doutor Diogo Pais
Teaching language
Portuguese
Objectives
General Objectives
The Regional or Topographical Anatomy is an additional area of Morphological Sciences complimentary to General Human Anatomy and Descriptive Anatomy General or Systemic. While these provide the students with the fundamental building blocks for knowledge of language and anatomical terminology,as well as descriptive aspects of the various organs and systems, Regional Anatomy addresses the structure of the human body in a topographical perspective. The human body is now divided into anatomical regions that are studied by defining its limits, its different plans, relations between different structures, feeling the different textures of tissues and organs and becoming aware of the possibility of change from the normal that every individual and every structure can present.
The teaching of Anatomy, as we see it, will be to promote a sound knowledge of Normal Anatomy, essential in preparing the student for future learning in other curricular units of the MSc in Medicine. Only an extensive and solid background in Normal Human Anatomy, which includes the regional knowledge of anatomy, can allow students to understand issues such as Anatomy of Development, Functional Anatomy, Imaging anatomy, Ultrasound Anatomy, Endoscopic Anatomy, Pathological Anatomy and Clinical Anatomy (from both the medical and surgical areas).
This optional Course Unit is also the response to a challenge posed by students during the first semester of the first year: looking for more! The theoretical and practical knowledge of Normal Anatomy opened the door and will allow the study of Regional or Topographical Anatomy. The challenge of learning the Anatomy, essential to the formation of any physician, is also to accept this invitation to learn to be more.
Specific learning objectives
Considering that the key areas of learning are: cognitive, psychomotor, affective or attitudes, these are also the specific objectives of teaching and learning of the Curricular Units of Regional Anatomy:
a) In the field of knowledge:
- Identify and describe all the features of anatomical structures, as well as their relationship with neighboring structures, based on the cadaver.
- Know and use the correct nomenclature of the structures that make up the systems of the human body, as well as other terminology required for their description in which students should base their technical expression as a future health professionals.
- Understand and explain the functions of the structures and systems that make up human body.
b) In the area of abilities or performance:
- Development of the dissection technique - being able to perform adequately, the set of techniques inherent to cadaveric dissection. The preparation of the body parts by careful and thorough dissection of cadaveric material is one of the objectives of the practical course. The comparison between the results obtained by dissection of the corpse and the content of descriptions of textbooks, and observation of the presence of anatomical variations is fundamental in the practical course.
- Manual dexterity - being able to properly handle the surgical tools used in dissection.
- Observation - being able to identify the various morphological structures of the normal human body in the body.
- Projection of deep structures on the surface of the human body - being able to orally describe making use of visual memory, the most important structures that
are placed deep, for every skin region.
- Integration of knowledge - being able to integrate the various anatomical structures and the relations they establish among themselves in a regional or topographical and functional perspective.
- Description - being able to describe orally the anatomical structures, using a clear, fluent, accurate and complete language, showing also the ability to perform systematization and synthesis.
- Structuring and laying out knowledge - being able to sort knowledge in well-defined descriptive schemes. similar for the various structures of the same type.
- Critical thinking - being able to disentangle the essential from the accessory and criticize the sources of knowledge, not tacitly accepting everything they read or hear.
- Autonomous Learning - being able to develop appropriate methods of individual study, the cornerstone for continuing medical education or permanent.
- Group work - being able to develop the capacity for teamwork, which is necessary to practice medicine in modern times.
- Bibliographic Research - being able to search and select the information needed for an updated discussion of a given subject, as well as for planning a dissection.
- Ability to Participate in Corporis Fabrica (annual exhibition) developing the ability to plan and implement a project to develop a model of a three-dimensional poster or multimedia presentation in which is illustrated a simplified the result of experience in dissecting a given anatomic region.
c) With respect to attitudes and values:
- Increasing consideration for the Man - having respect for the human cadaver as a first step for respecting patients.
- Recognizing the important role played by Anatomy in the training of a doctor.
- Developing and demonstrating interest in knowing and learning.
- Developing and demonstrating scientific curiosity to stimulate interest in research.
- Taking the responsibility of the physician (and therefore the medical student) before the society.
- Tolerance - promoting intellectual flexibility, open mind to new ideas, acceptance of diversity in human nature.
Prerequisites
Subject matter
Introduction to the Course Unit.
Goals. Methods of evaluation.
Introduction to Regional Anatomy.
Context of Cadaveric Dissection in the History of Teaching and Studying of Human Anatomy and in he Birth of Medicine
Cadaveric dissection at the Faculty of Medical Sciences.
The importance of dissection in the Pre and Post Graduate Training in Medicine.
Instrumental dissection.
General Methodology of Dissection - theoretical approach.
Risk and Safety.
Ethical and Legal Aspects.
Report of a dissection: a scientific record.
General Methodology for dissection - a practical approach.
Getting acquainted with embalming techniques.
Concepts and Basic Training of sutures: the key to closure of cavities dissected at the end of each session.
The approach of the Corpse: Surface Anatomy.
Regional Anatomy of the Chest I (Parietal Regions, including Breast and Diaphragmatic regions)
Regional Anatomy of the Chest II (Thoracic Cavity and its content):
Regional Anatomy of the Chest III (Conclusion):
Regional Anatomy of the Abdomen and Pelvis I (Parietal Regions, including inguinal-abdominal or Inguinal Canal):
Regional Anatomy of the Abdomen and Pelvis II (Abdominal Cavity, including Peritoneum and Peritoneal Spaces, and its content)
Anatomy of the Abdomen and Pelvis Region III (Retroperitoneal Region):
Regional Anatomy of the Abdomen and Pelvis IV (Pelvic Cavity, including the lower pelvis and its contents):
Regional Anatomy of the Abdomen and Pelvis V (Conclusion):
Regional Anatomy of the Perineum I (Male Perineum and Female Perineum):
Regional Anatomy of the Perineum II (Conclusion):
Summary of Learning.
Bibliography
Core Bibliography
- Anatomia Humana dos Órgãos - J.A. Esperança Pina - Lidel, Edições Técnicas.
- Anatomia Humana do Coração e Vasos - J.A. Esperança Pina - Lidel, Edições Técnicas.
- Anatomia Humana da Locomoção - J.A. Esperança Pina - Lidel, Edições Técnicas.
- Anatomia Humana da Relação - J.A. Esperança Pina - Lidel, Edições Técnicas.
- Anatomia Geral e Dissecção Humana - J.A. Esperança Pina et al. Lidel, Edições Técnicas.
- Anatomia Humana (Descriptiva, Topográfica e Funcional) - H. Rouvière (A. Delmas)
- Tratado de Anatomia Topográfica - L. Testut & O. Jacob.
- Anatomy in Surgery - P. Thorek, C.T. Linden and N. Swan - Springer.
- Anatomia Humana - L. Testut (A. Latarjet)
- Anatomie de I' Abdomen - C. Couinaud - G. Doin & Cie.
- Atlas de Anatomia Humana - F. Netter
Complementary Bibliography (recommended)
- Clinically Oriented Anatomy - K. Moore - Williams and Wilkins.
- Atlas of Human Anatomy with integrated text - J.A. Gosling e colbs. - Churchill Livingstone.
- Anatomy for Surgeons - W.H. Hollinshead (3 volumes).
- Sectional Human Anatomy - Han M-C. & Kim C-W. - Igaku-Shoin.
- Color Atlas of Anatomy - J. Rohen & C. Yokochi
- Sobottal / Becher Atlas of Human Anatomy - H. Ferner & J. Staubesand
Teaching method
1) Theoretical Component:
The course consists of theoretical lectures (three times expected), given the universe of course, with lessons of 90 minutes duration, in which the development of issues is preceded by the presentation of the summary of the lesson, and followed by a period for clarifying doubts in class.
The lecture should have as auxiliaries of exposure: an updated iconography illustrated with appropriate media resources, leaving to the discretion of the teacher whether or not to transfer the teaching material to students.
The end of the lecture should contain a summary of the topic, addressing the most important aspects, proceeding then to answer questions submitted by students.
For each lecture it is expected to:
- Identify and contact the teacher;
- General objectives of the lesson;
- Specific objectives of the lesson;
- Summary;
- Detailed bibliography.
The organization of the theoretical component is the responsibility of the Regent Professor - Professor Diogo Pais.
Theoretical Teaching Evaluation: All theoretical teaching is monitored by questionnaires of evaluation of the theoretical knowledge, to be completed online by all students. To this end, students should access the institutional Faculty of Medical Sciences site, log in with their personal identification in Students/Forms/evaluation forms of disciplines and proceed to the filling in, which is strictly anonymous. The data handling is the responsibility of the Information of Technology Division of the Faculty of Medical Sciences, and the data analysis and feedback to teachers is the responsibility of Medical Education Department of the Faculty of Medical Sciences.
2) Practical Component:
The Practical Component is integrated in the first two teaching periods of the Theoretical Course, consisting essentially of Teaching and Learning of Regional Anatomy through the Teaching and Practice of Human Dissection.
Parameters to be considered in the structuring of Practical Sessions, by each Faculty member, will be among others:
a) Tutorial Education open to students participation.
b) Laboratory Work with cadaveric material
c) Work of Bibliographic Research
d) Project Work
e) Work of Self-Assessment of Learning
a) Teaching Tutorial open to students participation
This is the method used to at the beginning of the practical sessions, in which a Theoretical Review of the proposed Anatomical Region for work in that class is presented. The content of the practical session, as well as this tutorial approach, should include the relevant summary, according to the program of the course.
The management and time distribution of the tutorial component depends on the nature of the teaching subject and should include a period of exposure of the material by the teaching assistant and / or students, after which follows a period to answer questions.
It should be taken into account, what is the incentive to give to students so that they can overcome their natural inhibitions about speaking before a group.
During this act of exposure the teacher must be particularly attentive to the rigor of the scientific and sequential structure of the descriptive elements.
The teachers should correct the description, adding new descriptive elements and other elements derived from their experience as physicians, this contribution being possible due to the fact that all teachers of the Course Unit of Regional Anatomy I are provided with activity and different degrees of experience in clinical practice.
The teachers must foster an environment that contributes to the creation of a spirit of mutual help among the students.
Thefore, it will be possible to maintain and stimulate students' motivation, helping them to continuously increase their knowledge of Anatomy.
b) Laboratory Work with anatomical models and cadaveric material
The attempt to replace human cadaveric parts by their respective plastic models or by models of other nature is always a choice of lower reliability, because, however perfect the execution of models is, models do not accurately represent anatomical reality, nor contemplate what is normal anatomy or the anatomical variations. Nothing replaces the human cadaver fresh or embalmed.
It is essential to instill the respect due to human body and the selfless attitude that results from living donation of the body to study and dissection should be emphasized. Cadaveric dissection leads the student of Anatomy to the knowledge of the ultimate end of man as matter, allowing a true and scientific contact with the end of a biological life cycle.
However, the experience of dissection without knowledge of Normal Anatomy, would alter its essence. Dissecting without prior learning would truly be a disregard of the corpse. Thus, our perception is that most students can only be fully prepared to the experience of dissection after completion of the Course Unit of Anatomy.
Thus, the Curricular Units of Regional Anatomy aim to achieve in their teaching scope the initiation to cadaveric dissection: a critical element in the Practical Anatomy Courses. The cadaveric dissection in anatomy courses, should not be seen as merely an attempt to identify the previously studied corpse structures. It must be remembered that the dissection of a corpse is one of the first experimental acts performed by students, training them for the proper handling of instruments useful for their future as a doctor, in addition to stimulate the development of learning in the realm of attitudes and values.
To achieve this objective in the course of Anatomy, commitment, existence of good will and human and technical resources are not enough, being essential the existence of human cadavers.
It is here, during the practical training of Anatomy that students must learn to dissect and only later, as a result of the course, to begin their surgical practice, and not the reverse.
c) Work of Bibliographic Research
Time for the training in bibliographic research on the anatomical areas in study or on a particular subject, and the results late applied in the practice of Dissection, presented and / or discussed with the teacher.
Students must turn to other sources of bibliography recommended or other sources of recognized scientific value that they come across, namely in the Library of the Department of Anatomy, the Library of the Faculty of Medical Sciences or websites or publications in the area medical knowledge or the morphological sciences.
The work in this kind of class can be conducted outside the room usually attributed to practical sessions - Anatomical Theatre - but the Teachers should however meet the students in the class, to register the attendance and to guide work for the allotted time for class.
d) Project work
The practical work by student groups, should be encouraged, as it represents a mode of group study. Among the works to be done, each student should have at least one work project that will count for the final evaluation of the student in the course. This work should be based on the work of Human Dissection performed and can be presented in the form of posters, anatomical models, multimedia presentation or other support, if previously accepted by the Faculty.
e) Work Self-Assessment of Learning
Teaching Periods for the execution of activities of self-evaluation of knowledge and learning. Students are challenged to answer questions (written or oral, that may go through the identification of structures in the body dissected) from a database created by the various teachers and available equally to all teachers.
Thus, students can monitor the knowledge they acquired or not, by answering the questions, which seek to assess the ability of the student to accomplish the proposed goals for the Curricular Unit and its syllabus.
Assessment of the Practical Teaching: Questionnaires will be applied to Evaluate the Practical Teaching, aimed at each teacher. These questionnaires will be validated by the Department of Medical Education. Data analysis and feedback to teachers is the responsibility of the Direction of the Department of Anatomy and the Department of Medical Education in the Faculty of Medical Sciences - NOVA University of Lisbon.
Evaluation method
In Anatomy, the evaluation of students should be based on different parameters that assess not only the real level of knowledge but also their thinking skills, skills in dissection technique, innovative capacity, adaptability to new situations and novel issues presented.
It is necessary, albeit indirectly, to assess the future physicians. Therefore, their ethical and human capacities should be taken into account, being the students prepared from the first year of the course, to approach the patient from a scientific and human perspective.
1) Practical assessment
The practical assessment is the responsibility of teachers of the practical course and will take place in all classes and can involve evaluation of the following items:
a) The student must face human dissection as an act which implies theoretical preparation, training of technical capacity for analysis, interpretation, discussion and conclusion. All these points should be the target of evaluation in each class, accepting at the outset that this Optional Course Curricular Unit initiates students in the practice of Dissection and that technical prowess is something that students will acquire gradually.
b) The students should be asked by the teacher to expose issues, detailing this or that detail, and may on their own initiative address the description of an issue intimately related to the purpose of the class in which they participate.
c) The practical assessment must also evaluate the overall characteristics of students, with regard not only to their level of knowledge but also to attendance and punctuality, ability to promote group work and relationship with teachers and fellow students, their respect and humanism to the corpse and compliance with health and safety rules during class dissection.
d) The group work or individually prepared themes, eventually required, should be presented orally in a succinct and clear manner by the group or student that performed the work. The faculty should evaluate not only exposure and scientific rigor, but also the commitment, dedication and effort put into the study and literature search for realization of the theme.
This assessment is quantitative, from 0 to 20 and:
With a grade lower than 10 the student will not have final approval on the Course Unit.
With a rating higher than 10 the student is admitted to the Final Examination.
2) Final Examination - Single Season
This will be held at a date still to determine in the amphitheaters or other facilities of the Home Building of the Faculty of Medical Sciences - New University of Lisbon and will have two components:
Oral Component (O): it is the oral presentation (poster, three-dimensional model, multimedia presentation and / or other support accepted) of a work resulting from human cadaveric dissection before a jury composed of the teaching staff. This assessment is quantitative, ranging from from 0 to 10.
Written Component (W): it is a multiple choice test composed of a True/False questions, legending of images and/or short answer questions. This test aims to evaluate in a general manner the knowledge taught in the Lectures and in the Theoretical Reviews of the Practical Sessions, and others resulting from the practical application of the former. This assessment is quantitative, ranging from from 0 to 10.
The Classification obtained in the Final Examination is the result of the sum of (O) and (W) and:
With a classification under 10 (or if the student missed (O) and/or (E)) the student will not pass the Final Examination of the Curricular Unit
With a classification above 10 the student will pass the Final Examination of the Curricular Unit.