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  • Computerized Gross anatomy Practical
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Electronic Book- A truly Interactive Electronic Book (TIEB) with companion :  Computerized Medicine Practical  500 pp.


 


 

 

 

 

 

 

Computerized Gross Anatomy Practical

An electronic manual of museum dissections and workbook for the anatomy medical student

 

 

 

 

 

 

 

 

 

 

Oluwole Ogunranti

 

Visiting Professor of Anatomy, Imperial College London and

Member, Wolfson College, Cambridge, UK

 

 

 

 

 

 

 

Electronic School of Medicine [ESM] Publications

____________________________________________________

www.oluwoleogunranti.com


 

 

 

 

 

Computerized Gross Anatomy Practical

An electronic manual of museum dissections and workbook for the anatomy medical student

 

 

 

 

© Electronic School of Medicine Publication 2012

 

 

ISBN 978-2756-26-1

 

  

All Rights Reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise for sale, without the prior permission of ESM Publications. 

Other related titles by ESM Publications

Computerized Practical Manuals

Computerized Neuroanatomy Practical

Computerized Histology & Cell Biology Practical

Computerized Osteology Practical and Tutorial

Computerized Living and Clinical Anatomy Practical

Computerized Gross Anatomy Practical

Computerized Surgery Practical etc
 


Other advanced books published by ESM

Degree Anatomy
Reproductive biology, Technology and Medicine
Recombinant DNA and Genetic Medicine 

 

Printed by

Davworld Prints - +234 803 970 7008

  

 

 

 

 

 

 

 

 

 

 

PREFACE

 

Gross anatomy was the subject that made medicine scientific in the early parts of European renaissance. Unfortunately because of the scarcity of cadavers for dissection, several medical schools have stopped practical anatomy and prefer the use of imaging devices such as ultrasound etc. This book is actually designed for this category of students whose medical school does not dissect cadavers. Dissections have been made for them and the pictures placed on internet solely by the author. This workbook can then be followed along with the internet dissections. For those who still dissect, the workbook can serve as revision material for professional examinations. Dissections are in layers so that the user can follow the location of organs and structures with or without the help of digital locator and with the help of electronic dissectors. Computer dissectors are divided into two types- elementary and advanced dissectors. For professional examination the elementary is good enough. Again, like other computerized manuals, this workbook is designed in such a way that the actual materials such as cadavers may not be needed for study. But if they are available, they should be used with the computer which is internet enabled in the dissecting room. For those who dissect, the most important function of this workbook to them would be to use it to locate structures they have inadvertently removed during their dissections, and/or assist in location or identification of structures dissected with the use of the program digital locator.

 

As in previous electronic texts, stupendous illustrations are provided and many modalities of image display are used in this electronic book. They include animations, scan, simulations, morphing, rollover, alternate displays etc, to include audios and videos, to enable the learner to study in a modified environment which is learning friendly with well written learning objectives. It is supported by the resource base at the world wide web- Human anatomy Museum, http://www.hamj.org  which contains dry and wet dissected specimen and at  Electronic School of Medicine.

 

This book is another of the TIEB (totally interactive electronic books) series under the Electronic School of Medicine Publications on the World Wide Web in which the hard book is the literature and the actual book is electronic. It is mainly designed for self instructional learning but can also be used in a class room setting, e.g. a digital classroom, or practical laboratory. When used as an electronic workbook for practical learning it is completely computer enabled so that the student can choose to submit his/her assignments electronically by email or by hand. He/she can generate the image he/she needs electronically and then either color and/or label electronically before submitting by email or simply print and then label manually before submission. This feature is however disabled in gross anatomy workbooks where diagrams of specimen are available as in this particular workbook. The user is therefore advised to use the electronic book very often since it contains lots of interactive materials which cannot be displayed on a hard book with access to materials that fill a whole Library of Medicine, and to use the literature as companion/revision and secondary to it. The electronic book contains mainly internet TIEB links. It also has a teacher’s page.

 

I am grateful to Imperial College London for giving me an opportunity for Sabbatical in the Human Anatomy Unit and for giving me the time to write this book and others. It is hoped that this little electronic book with its stupendous library access will find use in the area of modern learning and assimilation.

 

John Oluwole Ogunranti

London

14 July 2011

 

 Use AM browser and JAVA to read

 

 

 

 

CONTENTS

 

SECTION A

SECTION A- UPPER EXTREMITY

 

Chapter 1

Pectoral region and anterior aspect of Upper arm

 

Chapter 2

Scapular region and posterior aspect of Upper arm

 

Chapter 3

Anterior aspect of Forearm and Hand

 

Chapter 4

Posterior aspect of Forearm and hand

 

Chapter 5

Palm

 

Chapter 6

Dorsum of Hand

 

Chapter 7

Cross section of Upper extremity

 

Chapter 8

Joints of upper Extremity

 

SECTION B

 LOWER EXTREMITY

 

Chapter 9

Anterior aspect of Thigh

 

Chapter 10

Posterior aspect of Thigh

 

Chapter 11

Anterior aspect of leg and Dorsum of foot

 

Chapter 12

Posterior aspect of Leg and sole

 

Chapter 13

Sole

 

Chapter 14

Cross sections of Lower extremity

 

Chapter 15

Joints of Lower extremity

 

SECTION C

THORAX

 

Chapter 16

Thoracic and Abdominal walls

 

Chapter 17

Lung

 

Chapter 18

Heart

 

Chapter 19

Joints of Thorax

 

SECTION D

ABDOMEN

 

Chapter 20

Peritoneal cavity

 

Chapter 21

Abdominal viscera

 

Chapter 22

Back

 

SECTION E

PELVIS

 

Chapter 23

Male Pelvis

 

Chapter 24

Female Pelvis

 

Chapter 25

Joints of Pelvis

 

SECTION F

 HEAD AND NECK

 

Chapter 26

Head and Neck

 

Chapter 27

Skull and Brain

 

SECTION G

MYOLOGY

 

Chapter 28

Muscles of the Human Body

 

SECTION H

ATLAS OF FRESH CADAVER AND IMAGING

 

Chapter 29

Upper extremity Atlas and Imaging

 

Chapter 30

Lower Extremity Atlas and Imaging

 

Chapter 31

Thoracic Atlas and Imaging

 

Chapter 32

Abdominal Atlas and Imaging

 

Chapter 33

Head, Neck and Back Atlas and Imaging

 

 

Teacher’s Page

 

 

Human Anatomy Museum List

 

 

Subject Index

 

 

 

 

 

HOW TO USE THIS BOOK FOR ALL ITS WORTH

 

/

 

You have just acquired a unique book which is also the first of its kind. It is a dream of a moving library in which information can be checked out on a larger resource base as quickly as it is possible, which in this case is the World Wide Web. Do not USE THIS BOOK LIKE ANY OTHER OR READ IT THE WAY OTHER BOOKS ARE READ. It is an Electronic Book which means it is a book to be read or used on the computer. Open your CD/DVD and copy all the items into your computer in case the CD is lost. Then use the links on the computer and store your CD/DVD in a safe place.

 

Prelab

Your teacher may use the link on the Teachers page to introduce the Practical for the day by digital projection in the laboratory.

 

Lab

The actual literature or hard book is meant for revision or, using the language of the Electronic School of Medicine, for postlab. For laboratory activity the actual Electronic Book should be used. In the classroom or laboratory the electronic book must be hooked unto internet via a modem on a laptop or any other internet link. Then use the computer to perform instructions and answer all questions on the workbook. Each chapter is a single laboratory schedule. Take time to check the links with other colleagues in a practical group of 2 or more other students. It is preferable to have the practical item on the tray or trolley during the use of the book. But if not available, use the illustrations on the book and then label or color the diagrams (just like for the actual practical material) which may be generated automatically using the computer or manually. You then have the option of either submitting manually after the practical session or digitally through email to your learning instructor/teacher.

 

During the period of your practical class try to open links that would make you as a group understand the laboratory schedule you are performing, which will include links to  images, videos, or audios, which are played to the hearing of everyone in your group.

 

Postlab

In the comfort of your own home you can perform postlab or revision. Again it is wise to begin with the Electronic Book itself. Check it out on internet and make sure it assists you in understanding the subject matter of the practical. After then you can safely use only the literature for revision which will include studying your own labelled diagrams and/or comments together with the comments found in the book. You can perform quizzes after every chapter and these are themselves interactive, or do revision at http://www.oluwoleogunranti.com/elab/anatomy/anatomy/anatomy/NEH/embryology/erc.htm .

 

 

Check the link http://www.oluwoleogunranti.com/tiebs.htm on internet to obtain more information on what your Truly (or totally) Interactive Electronic Book you have just purchased can do for you.

 

 

 


 

 

INSTRUCTIONS

 

 

General

Color and label all unlabelled specimen. The coloring code is as follows. Color all nerves yellow, arteries red and veins blue only.

Label all fresh cadavers.

Draw all specimen that have no diagrams

 

 

 

 

 

 

SECTION A

UPPER EXTREMITY

 

 

 

 

 


 

 

1

Dictionaries: Anatomy Bible   Anatomy Items Search  Medical Dictionary   Clinical anatomy   Search page

Imaging anatomy: Xray imaging   CT scan  MRI   Ultrasound imaging    

Museums:   Gross anatomy Museum  Table 1 Museum    Gross anatomy Museum’s List   Gross anatomy Videos

Items: Organs of the body   Regions of  the body  Muscles of the body  Joints of the body  Arteries of the body  Veins of the body  Nerves of the body    Ligaments of the body   Lymphatics of the body  Tissues of the body      Clinical megaexaminer   Palpation anatomy  Anatomy Game 1  Game 2

Lectures: Summary   Lessons [extended summary]  Full Lectures  Chapter Quiz

Programs: Digital Locator  Elementary dissector  Advanced dissector

Clinical anatomy: Orthopedic anatomy  Endoscopic anatomy  Imaging anatomy  Anesthetic anatomy   Surgical anatomy  Medical anatomy  Obstetrical anatomy Gynecological anatomy  ENT anatomy  Ophthalmological anatomy  Dermatological anatomy  Neurological anatomy  Living anatomy

AtlasesElementary Atlas   Advanced Atlas

 

Pectoral region & breast and anterior aspect of upper arm    e-dissector     d-locator
Cognate identification learning

 

Learning objective

Outline the steps involved in the dissection of the pectoral region and anterior aspect of upper arm and identify/recognise the structures there in.

 

 

Pectoral region

The pectoral region is that part of the upper extremity, which is placed in front of the chest wall. It carries the breast or mammary gland

It also has the following structures

 

Arteries

 

11 axillary artery 2 axillary vein 3 highest thoracic artery 4 thoracoacromial artery 5 lateral thoracic artery 6 anterior circumflex humeral artery 7 posterior circumflex humeral artery 8 brachial vessels 9 median nerve 10 subscapular artery 11 pectoralis minor

 


Veins

Corresponding veins of the branches of the arteries or their venae comitantes. They have the same course

 

1 axillary artery (removed 2 axillary vein 3 highest thoracic vein 4 thoracoacromial vessels 5 lateral thoracic vein 6 anterior circumflex humeral vein 7 posterior circumflex humeral vein 8 brachial vein 9 median nerve 10 subscapular vessels 11 pectoralis minor

 

 

Nerves

 

Bones

  1. 1. Clavicle

  2. 2. Scapula

  3. 3. Upper part of humerus

Others

 

 

Breast

 

The breast is expanded in the female in order to accommodate the mammary gland which produces milk during lactation but it functions mostly as secondary sexual characteristics and therefore more available in the young or nulliparous as a symbol of romance. It consist of fat or areolar tissue in which is embedded the mammary gland. These glands contain about 15-20 lactiferous ducts which produce milk and transport same to the areola of the breast. The areola is darkened part of the external surface in which is implanted the middle placed nipple that juts out of the surface of the areola. The areola is dark because it contains pigment cells and becomes darker permanently after the first pregnancy. Ligaments of Cooper are attached to the skin of the breast and to the deep fascia. They are responsible for keeping the nulliparous breast to be firm and slightly elastic as opposed to the pendulous and flat breast of the multiparous woman.

The breast is supplied by the lateral thoracic artery, thoracoacromial artery and perforating branches of intercostal arteries. It is drained by the corresponding veins.

Radical mastectomy is performed when the breast is diseased as in formation of cancer. This is because the cancer  cells may spread to other parts of the body making it impossible for cure to take place.

 Arteries

*       Thoracic branches of axillary artery

*       Mammary branches of internal thoracic artery

*       Mammary branches of intercostal arteries

*       Lateral thoracic artery,

*       Thoracoacromial artery and

*       Perforating branches of intercostal arteries.

Veins

From circulus venosus which drain into

*       Axillary vein

*       Internal thoracic vein

Nerves

*       Anterior cutaneous branches of the T4-T5-T6 nerves

*       Lateral cutaneous branches of T4-T5-T6 nerves

Others

*       Ligaments of Cooper

 

Other features

*       Breast pain

*       Lymphatics

 

Imaginary and Electronic layers of pectoral region

Skin layer of pectoral region: Layer 1

Skin: The skin is lax and contains Langer’s lines running transversely. Suspensory ligaments (or ligaments of Astley Cooper; or  ligaments of Cooper) of the breast run from the deep fascia, which covers the muscle to the skin.

 

1 nipple 2 anterior axillary fold 3 armpit 4 shoulder 5 sternum  6 Biceps brachii 7 posterior triangle of neck 8 trapezius 9 midline of neck 10 sternocleidomastoid 11 jugular notc

 

Layer theory
Automatic dissector of pectoral region

Click to dissect

Remove/dissect: skin to expose levator scapulae,   acromioclavicular joint, nipple, clavicle, pectoralis major and serratus anterior


 

Superficial fascial layer of pectoral region: Layer 2

Superficial fascia: This underlies the skin and covers the whole mammary gland for the whole of the gland is embedded in the superficial fascia.

 

 

1 chest vein 2 cephalic vein 3 medial supraclavicular nerve 4 intermediate supraclavicular nerve 6 lateral supraclavicular nerve 7 branches of medial cutaneous nerve of forearm 8 branches of medial cutaneous nerve of arm 9 anterior cutaneous branches of intercostal nerves

Layer theory
Automatic dissector of pectoral region
Advanced Atlas

Click to dissect

Remove/dissect: cephalic vein  pectoral region  shoulder region  scapular region

Breast

Draw and color and label
Remove/dissect: Langer’s lines  nipple  breast

 

Deep fascia layer of pectoral region- pectoral fascia: Layer 3

Deep fascia: This is called pectoral fascia and it covers the external surface of the pectoralis major. It is continuous with deep investing fascia of neck superiorly and with the Scarpa's fascia of anterior abdominal wall inferiorly. The part between the pectoralis minor and the clavicle, which completely invests the subclavius is the clavipectoral fascia. It is pierced by four structures as follows

 

1 axillary vein 2 lateral pectoral nerve 3 thoracoacromial artery

Layer theory
Automatic dissector of pectoral region
Advanced Atlas

Click to dissect

Remove/Dissect: 1 trapezius 2 rhomboideus minor 3 clavicle 4 perforating vessels 5 latissimus dorsi 6 biceps brachii 7 ulnar nerve 8 serratus anterior 9 pectoralis major 10 deltoid 11 deltopectoral groove 12 cephalic vein 13 median nerve 14 brachial veins 15 triceps brachii 16 brachialis 17 brachioradialis

Layer of superficial muscles of pectoral region: Layer 4

Muscles

 

1 deltoid 2 clavicular head of pectoralis major 3 sternocostal head of pectoralis major 4 remnant of pectoral fascia 5 serratus anterior 6 thoracodorsal nerve 7 cephalic vein 8 median nerve 9 brachial artery 10 deltopectoral groove 11 trapezius 12 biceps brachii 13 ulnar nerve 14 armpit

 

Layer theory
Automatic dissector of pectoral region
Advanced Atlas

Click to dissect

Remove/Dissect: trapezius rhomboideus minor clavicle  perforating vs  latissimus dorsi  biceps brachii  ulnar nerve serratus anterior  pectoralis major deltoid  deltopectoral groove  cephalic vein  median nerve  brachial veins  triceps brachii brachialis  brachioradialis to  expose layer 5.

 

 

Layer of intermediate muscles of pectoral region:  Layer 5

Muscles

 

1 trapezius 2 thoracoacromial artery 3 clavipectoral fascia 4 pectoralis minor and fascia 5 serratus anterior  6 thoracodorsal nerve 7 ulnar nerve 8 brachial artery 9 cut part of pectoralis major 10 head of humerus 11 long head of biceps brachii tendon 12 cut and reflected distal end of pectoralis minor 13 median nerve 14 medial cutaneous nerve of forearm 15 biceps brachii belly 16 clavicle  17 deltoid (cut)

Layer theory
Automatic dissector of pectoral region
Advanced Atlas

Click to dissect

Remove/dissect: 1 trapezius 2 clavicle 3 deltoid muscle 4 coracoacromial ligament 5 head of humerus 6 long head of biceps brachii

7 coracobrachialis 8 pectoralis major 9 coracoid process of scapula 10 conjoint tendons of coracobrachialis and short head of biceps brachii 11 brachial artery 12 musculocutaneous nerve 13 median nerve 14 medial cutaneous of forearm 15 ulnar nerve 16 axillary nerve 17 pectoralis minor 18 thoracodorsal nerve 19 medial pectoral nerve 20 pectoralis major 21 thoracoacromial vessels 22 clavipectoral fascia 23 infraspinatus and teres minor 24 serratus anterior 25 posterior circumflex humeral artery 26 lateral head of triceps brachii 27 pectoralis minor  (reflected) and expose layer 6.

 

Layer of intermediate muscles: Layer  6

1 clavicle  2 subscapularis 3 lower subscapular nerve 4  radial nerve 5 anterior circumflex humeral artery 6 posterior circumflex humeral artery 7 axillary nerve  8 circumflex scapular artery 9 upper subscapular nerve  10 brachial artery 11 subscapular artery 12 deep branch of transverse cervical nerve 13 median nerve 14 ulnar nerve  15 lateral head of triceps brachii  16 suprascapular artery 17 subclavius 

 

 

 

Layer theory
Automatic dissector of pectoral region
Advanced Atlas

Click to dissect

Remove/dissect:

1 subscapularis 2 thoracoacromial vessels 3 coracoclavicular ligament 4 clavicle 5 highest thoracic artery 6 axillary artery 7 thoracoacromial vessels 8 circumflex humeral vessels 9 lateral thoracic artery 10 subscapular artery 11 radial nerve 12 axillary nerve 13 ulnar nerve 14 median nerve 15 brachial artery venae comittantes 16 dorsal scapular nerve 17 posterior cutaneous nerve of forearm 18 lower lateral cutaneous nerve of arm 19 upper lateral cutaneous nerve of arm 20 circumflex humeral vessels 21 acromion 22 acromioclavicular joint 23 supraspinatus 24 suprascapular vessels 25 capsule of shoulder joint 26 teres minor 27 infraspinatus 28 long head of triceps brachii 29 lateral head of triceps brachii 30 teres major 31 lateral thoracic artery 32 rhomboideus major 33 coracoacromial ligament 34 coracoid process of scapula 35 long head of biceps brachii  To expose layer 7

 

 

 

Layer of joints of pectoral region:  Layer 7

1 subscapular fossa of scapula 2 suprascapular ligament 3 conoid ligament 4 trapezoid ligament 5 coracoacromial ligament 6 coracohumeral ligament 7 coracoid process 8 clavicle 9 coracohumeral ligament

 

 

 

 

Layer theory
Automatic dissector of pectoral region
Advanced Atlas

Click to dissect

Remove/Dissect: to layer 8

 

Layer of bones of pectoral region:  Layer 8

1 humerus 2 coracoid process 3 acromion 4 clavicle 5 1st rib 6 2nd rib 7 3rd rib 8 4th rib 9 5th rib 10 6th rib 11 7th rib 12 8th rib 13 9th rib 14 10th rib 15 scapula 16 lumbar vertebra

 

 

 

 

 

 

 

 

 

Layer theory
Automatic dissector of pectoral region
Digital locators of pectoral region
Advanced Atlas

Click to dissect

Remove:

a sternal end of clavicle b coracoid process of scapula c acromion d greater tuberosity of humerus e radial fossa f capitulum g coronoid fossa h trochlea

i surgical neck of humerus j intertubercular sulcus k anatomical neck of humerus 1 deltoid muscle 2 biceps brachii 3 omohyoid 4 triceps brachii 5 subscapularis 6 supraspinatus 9 teres major 10 latissimus dorsi 11 pectoralis minor 12 serratus anterior 18 pectoralis major 21 brachialis 22 brachioradialis

23 extensor carpi radialis longus 24 common extensor origin 25 pronator teres 26 common flexor origin 28 coracobrachialis 29 supraspinatus

 

Assignments

     
     
     
     

Draw and color and label

 

Anterior compartment of arm

This compartment is bounded by two intermuscular septa

bullet

bullet

It contains muscles, arteries, veins, nerves of the body as followss

Muscles of anterior compartment are

bullet

Biceps brachii

bullet

Brachialis

bullet

Coracobrachialis

Arteries of the anterior compartment are

bullet

Brachial artery only and it has the following branches in the anterior compartment

bullet

Profunda brachi, which passes immediately to the posterior compartment

bullet

Superior ulnar collateral artery  

bullet

Nutrient humeral artery 

Veins of the anterior compartment accompany their arteries in most cases as venae comitantes of the artery

bullet

Brachial veins and tributaries

Nerves of the anterior compartment

bullet

Musculocutaneous nerve. This give muscular branches to all anterior compartment muscles.

bullet

Median nerve. This has no branches in the upper arm

bullet

Ulnar nerve. This has no branches in the upper arm

 

Dissector

Other features

*       Lymphatics  

 

bullet

Embryology

bullet

Histology

 

 

 

 

 

 

 

 

 

 

 

 

 

 


 

 

 

 

 

Arm

The upper arm is that part of the upper extremity that extends from the shoulder to the elbow.

It also has the following structures

Skin: The skin is lax and contains Langer’s lines running transversely.

Superficial fascia: This underlies the skin and covers the entire surface of the upper arm below the skin. It contains some cutaneous structures

Brachial veins

bullet

Basilic vein

bullet

Cephalic vein

bullet

Medial cutaneous of forearm

bullet

Upper lateral cutaneous of arm

bullet

Lower lateral cutaneous of arm

bullet

Posterior cutaneous of arm

Deep fascia: Does not present with any special features.

Joint

bullet

Shoulder joint complex

bullet

Elbow joint

Dissector

 

 

These books are provided on CDs/DVDs and also on internet for interactive learning. When their CDs are installed, they function either as internet TIEB or CD-ROM TIEB

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

History taking  
Learn clinical examination  
Long cases  
Short cases   
Clinicopathological cases  
Female examination 
Electronic clinical demonstrations  
Electronic clinical conferences  
Electronic clinicopathological conferences  
Integrated Organ examination 
Heart sounds  
Lung sounds

 


Electronic School of Medicine. Creator: Oluwole Ogunranti
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