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2010-09-02 浏览次数:1123次

 

暨南大学

全日制本科课程教案

                             

  2005  -  2006  学年    学期 

 

 

          Systematic Anatomy            

          Required                      

          Huamn Anatomy                 

适用专业(方向)   Clinical Medicine              

           Medical Students outside Mainland

          Department of Anatomy          

          Sanqiang Pan                    

             Associate Professor             

 

 

 

 

暨南大学教务处 

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《暨南大学全日制本科课程教案》填写说明

一、用宋体、5号字填写,每项页面大小可按照规定格式自行添减。

二、一次课为一份教案(不包括封面)。

三、“课程性质”填必修课、专业选修课或公共选修课;“学生类别”填内招生,外招生或内、外招生;公共选修课的“适用专业(方向)”填写“全校各专业”。

四、“开课单位”填学院、学系和教研室(无教研室只填学院和学系)。

五、授课类型指理论课、讨论课、实验、社会实践、实习或见习课、其他等。

    六、“教学内容”应具体,而不应只填写教材章节名称或讲授主题的题目。

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

           Systematic Anatomy        课程教案

授课题目(教学章节或主题):

Introduction of Human Anatomy,

Introduction of Osteology,

Bones of Trunk

授课类型 

      Lecture

授课时间

20062 27

1周 星期一 第79

教学内容(包括基本内容、重点、难点三部分):

Objective:

Part one Introduction of Human Anatomy

1. To know about the definition of human anatomy.

2. To know about division of human anatomy.

3. To know about development of human anatomy.

4. To master descriptive terms of human body.

5. To know about definition of organs and systems of human body.

 

Part two Introduction of Osteology

1.To master the form , structure and function of bone.

2.To know about the physical and chemical properties of bone.

3.To know about the growth , ossification of long bone.

4.To know about the vessels and nerves of bone.

 

Part three  Bones of Trunk

1.To master the general structure of vertebrae and the special properties of cervical, thoracic and limbar vertebrae

2.To master the form and structure of ribs.

3.To know about the properties of the special ribs.

4.To master the general form and structure of the sternum.

 

Basic Content

一、Introduction of Human Anatomy

1. Human Anatomy (10 min)

 Deal with normal morphology and interrelations of structures of body.

2Nine Systems (10 min)

3.The Anatomical Position (5 min)

4.The Anatomical Planes (10 min)

 Sagittal, coronal and horizontal planes

5. The Terms(15 min)

 Anterior and posterior; Medial and lateral; Internal and external;Superficial and deep; Proximal and distal

二、Introduction of Osteology (50min)

1. Classification of Bones (10 min)

 longshortflat and irregular bonesAccording to their shape).

2The Structure of Bones (20 min)

consist of bony substance, periosteum and bone marrow, and are abundant in blood and nerve supply.

3The Chemical Composition and Physical Properties of Bones (20 min)

The organic component resilience and toughness

  The inorganic component hardness and rigidity

4. The Functions of Bones (10 min)

 

三、Bones of Trunk

1  The Vertebrae (30min)

(1) Number26 in adult3233 in a child

(2) General Featuresvertebral body and arch

(3) Intervertebral foramen

(4) The Main Characteristics of Vertebrae in Each Region

  The cervical vertebrae 

    a.transverse foramenb.bifid spinesexcept the first and the seventh

The thoracic vertebrae

a. costal facets (on each side of their bodies and  on their transverse processes )

    b. sloping caudaward spines

The lumbar vertebrae

  a. large body b. horizontal quadrilateral spines

2 The Ribs (10 min)

3 The Sternum (10 min)

consist of manubrium, body and xiphoid process

 

 

Emphasis:

 

The Anatomical Position, Planes and Terms; The Structure of Bones; General Features of Vertebrae;

The Main Characteristics of Vertebrae in Each Region;Sternal angle

 

Difficulty:

 

The Main Characteristics of Vertebrae in Each Region

 

教学手段与方法:

1.Multimedia assistant teaching

2.Network station:http://202.116.15.22:100/

3.Specimen,illustrations and anatomical models

 

思考题、讨论题或作业:

1.Describe the structure of bones.

2.Describe the general structure of vertebrae and the main characteristics of cervical, thoracic and lumbar vertebrae.

 

参考资料(包括辅助教材、参考书、文献等):

1Susan Standring .Gray’s anatomy (Thirty-ninth edition). Churchill Livingstone.London,UK.2004

2Keith L. Moore, Anne M. R. Agur.Essential clinical anatomy(Second edition). Lippincott Williams & Wilkins. Baltimore:USA. 2002

3Richard S. Snell. Clinical anatomy for medical students. (Sixth edition). Lippincott Williams & Wilkins. Baltimore:USA. 2000

 

 

 

 

 

 

       Systematic Anatomy           课程教案

授课题目(教学章节或主题):

Skull

授课类型 

     Lecture

授课时间

20063 6

2周 星期一 第79

教学内容(包括基本内容、重点、难点三部分):

Objective:

1.To master the composition and function of skull.

2.To master the position and division of bones of the skull.

3.To know about the form and structure of the calviria on the internal and external skull views.

4.To master the form and structure of skull on the lateral aspect.

5.To master the general form and structure of the base of skull on the internal and external surfaces.

6.To master the special characteristics of the orbits and the bony nasal cavity.

7.To master the position, openings and clinical application of the paranasal sinuses.

8.To know about the position and communication of pterygopalatine fossa.

9.To master characteristics of skull of a newborn infant

 

Basic Content

一.Introduction (10min)

Composition:cerebral cranium and facial cranium

 

二.Cerebral Cranium (40min)

Include one frontal, two parietal, two temporal, one occipital, one sphenoid and one ethmoid bones. 8 in number.

 

三.Facial Cranium (50min)

The paired bones are the maxillae, the palatine,the zygomatic, the nasal,the lacrimal bones and the inferior nasal conchae. The unpaired bones are the vomer, the mandile, and the hyoid. 15  in number.

 

四.The Skull as a Whole

 

1The Superior Aspect of the Skull (5 min)

 

2. The Internal Surface of the Base of Skull (15 min)

 

(1) The anterior cranial fossa

 

(2) The middle cranial fossa

the hypophysial fossa, the optic canal,  the superior orbital fissure, the foramen rotundum,the foramen ovale, the foramen spinosum ,the foramen lacerum,the sulcus for middle meningeal artery, the trigeminal impression, the tegmen tympani

 

(3) The posterior cranial fossa

   the foramen magnum,the hypoglossal canal ,the internal occipital protuberance, sulcus for transverse sinus,sulcus for sigmoid sinus, the jugular foramen,the internal acoustic pore

3The External Surface of the Base of Skull (10 min)

 

4The Lateral View of Skull (5 min)

the temporal fossa,the infratemporal fossa ,the pterion,the pterygomaxillary fissure, the pterygopalatine fossa

 

5The Front View of Skull (10 min)

1The orbits 

2The bony nasal cavity 

The lateral wall: the superiormiddle conchae and inferior nasal concha. the superior midde meatuses and  inferior meatus.

The paranasal sinusesThe frontal sinusesThe ethmoidal sinusesThe sphenoidal sinusesThe maxillary sinuses

 

 

五.The Skull at Birth (5min)

   Fontanelles:membranous tissue

 

Emphasis:

The names and positions of the cerebral and facial crania; The internal and external surfaces of the base of skull;The names, positions and openings of the paranasal sinuses.

Difficulty:

The internal and external surfaces of the base of skull.

 

教学手段与方法:

1.Multimedia assistant teaching

2.Network station:http://202.116.15.22:100/

3.Specimen,illustrations and anatomical models

 

思考题、讨论题或作业:

1.State the main foramina of the internal surface of the base of the skull.

2.Describe the positions and openings of the paranasal sinuses.

 

参考资料(包括辅助教材、参考书、文献等):

1.Susan Standring .Gray’s anatomy (Thirty-ninth edition). Churchill Livingstone.London,UK.2004

2.Keith L. Moore, Anne M. R. Agur.Essential clinical anatomy(Second edition). Lippincott Williams & Wilkins. Baltimore:USA. 2002

3.Richard S. Snell. Clinical anatomy for medical students. (Sixth edition). Lippincott Williams & Wilkins. Baltimore:USA. 2000

 

      Systematic Anatomy      课程教案

授课题目(教学章节或主题):

Introduction of Arthrology,

Joints of Trunk

授课类型 

     Lecture

授课时间

20063 13

3周 星期一 第79

教学内容(包括基本内容、重点、难点三部分):

Objective:

Part one Introduction of Arthrology

1.To know about function and type of joints.

2.To master the basic structure and movement of joints.

3.To know about the accessory structure of joints.

 

Part two Joints of Trunk

 

1.To master the form,structure and function of the intervertebral discs.

2.To master the positions and functions of the anterior ,posterior longitudinal ligaments and ligamenta flava.

3.To master the vertebral column as a whole and its movements.

4.To master the composition , form and function of the thorax.

5.To know about the costal joints.

6.To master the movements of the thorax.

7.To know about the aging change and the difference of sex of the thorax.

Basic Content

一.Introduction of Arthrology

1Definition (10 min)

     The bones are connected together by joints or articulations.

 

2Classification of joints (40 min)

1The synarthroses(immovable articulations)

2The diarthroses(movable articulations)

a. The basic structurearticular surfacearticular capsule and articular(joint) cavity

b.The accessory structure:

    ligaments; articular disk; articular labrum ; synovial fold and synovial bursa

c.The movement

    translation(gliding movement) flexion and extension adduction and abduction

rotation circumduction

 

二.Joints of Trunk

1. The vertebral column

1The vertebral joints

a. The joints of the vertebral bodies (20 min)

   The intervertebral disks:annulus fibrosus and nucleus pulposus

   The anterior and posterior longitudinal ligaments

b. The joints of the vertebral arches (20 min)

     Ligamenta flava; Interspinal ligament; Supraspinal ligament and ligamentum nuchae;

     Intertransverse lig. and zygapophyseal joint

c. The joints of the suboccipital region (10 min)

    The atlantooccipital joint and atlantoaxial joint

2  The vertebral column as a whole and its movements

1) The vertebral column as a whole (30 min)

  (1) Anterior aspect

  (2) Dorsal aspect

  (3) Lateral aspect:

   cervical and lumbar curvesforward

   thoracic and pelvic curves backward

2) The movement of the vertebral column (20 min)

 

Emphasis:

The basic structure of the diarthroses(movable articulations); The joints of the vertebral bodies; The intervertebral disks; Lateral aspect of the vertebral column

 

教学手段与方法:

1Multimedia assistant teaching

2Network station:http://202.116.15.22:100/

3Specimen,illustrations and anatomical models

 

思考题、讨论题或作业:

1. State the basic and accessory structures of the diarthroses

2. Talk about the composition, location and function of the intervertebral disks.

 

参考资料(包括辅助教材、参考书、文献等):

1Susan Standring .Gray’s anatomy (Thirty-ninth edition). Churchill Livingstone.London,UK.2004

2Keith L. Moore, Anne M. R. Agur.Essential clinical anatomy(Second edition). Lippincott Williams & Wilkins. Baltimore:USA. 2002

3Richard S. Snell. Clinical anatomy for medical students. (Sixth edition). Lippincott Williams & Wilkins. Baltimore:USA. 2000

 

 

      Systematic Anatomy      课程教案

授课题目(教学章节或主题):

Introduction of Myology,

Muscles of Head and Neck

授课类型 

     Lecture

授课时间

20063 20

4周 星期一 第79

教学内容(包括基本内容、重点、难点三部分):

Objective:

Part one Introduction of Myology

1.To know about the basic types of muscle.

2.To know about the form , structure and distribution of skeletal muscle.

3.To know about the origin, insertion and action of skeletal muscle.

4.To know about how to name the skeletal muscle.

5.To know about the supplementary structures of muscles.

Part two Muscles of Head and Neck

1.To know about the distributions and actions of the facial muscles.

2.To master the locations and actions of the masticatory muscles.

3.To identify the muscular landmarks: masseter, temporalis

4.To know about groups, layers and actions of muscles of neck..

5.To master the location, origin ,insertion and action of sternocleidomastoid.

6.To master the locations and actions of trapezius and infrahyoid muscles.

7.To know about the layers and distributions of the fasciae of neck..

8.To identify the muscular landmarks: sternocleidomastoid

Basic Content

一.Introduction of Myology

1The morphology of skeletal muscle (10 min)

1Composition: muscle belly and tendon

2Classification: according to shape long , short , flat and orbicular muscles

 

2Shape of muscles (10 min)

 

3Origin and insertion(10 min)

 

4The supplementary structures of muscles (20 min)

1Fascia : superficial fascia and deep fascia

2Synovial bursa

3The tendinous sheath : fibrous layer and synovial layer

二.Muscles of Head

1 The facial muscles 20 min

(1) The epicranius (the occipitofrontalis)

(2) The orbicularis oculi

(3) The muscles around the mouth

 

2The masticatory muscles (30 min)

1 The masster

2 The temporalis

3 The medial pterygoid

4 The lateral pterygoid

三.The muscles of neck

 

1 The superficial group 10 min

1 The platysma

2 The sternocleidomastoid

2The hyoid muscles (30 min)

1 The suprahyoid muscles : the digastric the mylohyoidthe stylohyoid the geniohyoid

2 The infrahyoid muscles: the sternohyoid the omohyoidthe sternothyroidthe thyrohyoid

3The deep cervical muscles (10 min)

1 Lateral group: scalenus anterior scalenus medius scalenus posterior

2 Medial group

 

Emphasis:

Composition, classification, origin and insertion of the skeletal muscle; Names of the facial muscles; Names of the masticatory muscles; Origin and insertion of the sternocleidomastoid; Names of the hyoid muscles; Scalenus fissure

Difficulty:

Origin and insertion of the sternocleidomastoid; Origin and insertion of the masticatory muscles

 

教学手段与方法:

1Multimedia assistant teaching

2Network station:http://202.116.15.22:100/

3Specimen,illustrations and anatomical models

 

思考题、讨论题或作业:

1. Explain the the tendinous sheath, synovial bursa and scalenus fissure.

2Describe the origin, insertion and function of the sternocleidomastoid.

 

参考资料(包括辅助教材、参考书、文献等):

1Susan Standring .Gray’s anatomy (Thirty-ninth edition). Churchill Livingstone.London,UK.2004

2Keith L. Moore, Anne M. R. Agur.Essential clinical anatomy(Second edition). Lippincott Williams & Wilkins. Baltimore:USA. 2002

3Richard S. Snell. Clinical anatomy for medical students. (Sixth edition). Lippincott Williams & Wilkins. Baltimore:USA. 2000

 

 

      Systematic Anatomy      课程教案

授课题目(教学章节或主题):

Muscles of Upper and Lower Limbs

授课类型 

     Lecture

授课时间

20063 27

5周 星期一 第79

教学内容(包括基本内容、重点、难点三部分):

Objective:

Part one Muscles of Upper Limbs

1.To know about the division and arragement of the muscles of the upper limb.

2.To master the arragements and actions of the muscles of shoulder.

3.To master the arrangements and composition of the muscles of arm.

4.To master the locations and actions of the deltoid, the biceps brachii and the triceps brachii.

5.To master the arrangements and actions of the muscles of forearm.

6.To know about the arrangements and actions of the muscles of hand.

 

Part two Muscles of Lower Limbs

 

1.To know about the division and arragement of the muscles of the lower limb.

2.To master the division, locations and actions of the muscles of hip.

3.To master the locations and actions of the anterior, posterior and lateral muscles of leg.

4.To know about the division of the muscles of foot.

5.To know about some structures formed by fascia of the lower limb.

Basic Content

一.Muscles of Upper Limbs

1The muscles of shoulder 20 min

1 The deltoid

2 The suparspinatus

3 The infraspinatus

4 The teres minor

5, The teres major

6 The subscapularis

2The muscles of arm (30 min)

 

1The anterior group

a. The biceps brachii: has two heads. Actions : Flexes elbow joint and supinates forearm.

b. The coracobrachialis

c. The brachialis

2The posterior group :

  The triceps brachii: has three heads. Action : Extends the elbow joint and its long head can also adduct the shoulder joint.

3The muscles of forearm (40 min)

 

1The anterior group ( nine in number)

a. The first layer :  from radial to ulnar The brachioradialis The pronator teres The flexor carpi radialis The palmaris longus The flexor carpi ulnaris

b. The second layer : The flexor digitorum superficialis

c. The third layer :

 Radial: The flexor pollicis longus

 Ulnar: The flexor digitorum profundus

d. The fourth layer : The pronator quadratus

 

2The posterior group (ten in number)

a. The superficial layer : from radial to ulnar

  The extensor carpi radialis longus and brevis The extensor digitorum The extensor digiti minimi and the extensor carpi ulnaris

b.The deep layer : from radial to ulnar

  The abductor pollicis longus The extensor pollicis brevis and longus The extensor indicis except the supinator

4The muscles of hand (10 min)

 

(1) The lateral group : thenar

(2) The medial group : hypothenar

(3) The intermediate group

a. The lumbricales (four in number)

b. The interosseous muscles (seven in number)

 

二.Muscles of Lower Limbs

 

1The muscles of hip (10 min)

(1) The anterior group

a. The iliopsoas : includes the psoas major and the iliacus

b. The tensor fasciae latae

2The posterior group

a. The gluteus maximus

b. The gluteus medius

c. The gluteus minimus

d. The piriformis

e. The obturator internus

f. The quadratus femoris

 

2Muscles of thigh (20 min)

 

(1) The anterior group

a. The sartorius

b. The quadriceps femoris : has four heads the rectus femoris the vastus medialis the vastus lateralis the vastus intermedius . Actions: Extends the knee joint and the rectus femoris also flexes the thigh

 

2The medial group

The pectineusthe adductor longusthe gracilisthe adductor brevis and the adductor magnus

(3) The posterior group

a. The biceps femoris

b. The semitendinosus

c. The semimembranosus

 

3The muscles of leg (15 min)

 

(1)The anterior group

 a. The tibialis anterior

 b. The extensor digitorum longus

 c. The extensor hallucis longus

Actions : dorsiflex the ankle joint and the tibialis anterior can invert the foot.

2The lateral group

 a. The peroneus longus

 b. The peroneus brevis

Actions: evert the ankle joint and plantar-flex

(3) The posterior group

a. The superficial layer ( triceps surae )

The gastrocnemius and the soleus

b.The deep layer

The flexor digitorum longusThe tibialis posteriorThe flexor hallucis longus and the popliteus

Actions : plantar-flexes the ankle joint and invert the foot.

 

4The muscles of foot (5 min)

 

Emphasis:

The name and function of anterior and posterior groups of the muscles of arm, The name and function of anterior group of the muscles of thigh, The name and function of the muscles of leg

Difficulty:

1. The name and function of the muscles of forearm,

2. The name and function of the muscles of hand

 

教学手段与方法:

1.Multimedia assistant teaching

2.Network station:http://202.116.15.22:100/

3.Specimen,illustrations and anatomical models

 

思考题、讨论题或作业:

1.Explain the rotator cuff (or shoulder cuff)and its function.

2.How many muscles can extense the leg?

 

参考资料(包括辅助教材、参考书、文献等):

1Susan Standring .Gray’s anatomy (Thirty-ninth edition). Churchill Livingstone.London,UK.2004

2Keith L. Moore, Anne M. R. Agur.Essential clinical anatomy(Second edition). Lippincott Williams & Wilkins. Baltimore:USA. 2002

3Richard S. Snell. Clinical anatomy for medical students. (Sixth edition). Lippincott Williams & Wilkins. Baltimore:USA. 2000

 

 

      Systematic Anatomy      课程教案

授课题目(教学章节或主题):

Introduction of Splanchology,

Alimentary Canal

授课类型 

     Lecture

授课时间

20064 3

6周 星期一 第79

教学内容(包括基本内容、重点、难点三部分):

Objective:

Part one Introduction of Splanchology

1.To know about the definition of viscera.

2.To know about the general form and structure of viscera.

3.To master the reference lines of thorax and abdominal regions.

Part two Alimentary Canal

1.  Oral cavity

1.1  To master the subdivision and boundaries of the oral cavity.

1.2  To master the constructions of the lips, cheeks, palate and isthmus of fauces.

1.3  To know about the dental formulae of the deciduous and permanent teeth.

1.4  To master the form and structure of the teeth.

1.5  To master the subdivision and structures on the mucous membrane of tongue.

1.6  To know about the general composition and actions of the muscles of tongue.

1.7  To master the locations and openings of the salivary glands.

 

2.   Pharynx

2.1  To master the location, form and structures of pharynx..

2.2  To master the locations and functions of tonsils.

 

3.  Esophagus

3.1  To master the subdivision, location, length and three constrictions of esophagus.

3.2  To know about X radiograph of esophagus.

 

4.  Stomach

4.1 To master the location, shape and subdivision of stomach.

4.2 To know about the structure of stomach wall and the X radiograph of stomach.

 

5.  Small intestine

5.1  To master the subdivision of small intestine.

5.2  To master the location, subdivision, form and mucuos characteristics of duodenum.

5.3  To master the locations, forms and mucuos characteristics of jejunum and ileum.

5.4  To know about the structure of small intestine wall.

 

6          Large intestine

6.1  To master the subdivision of large intestine.

6.2  To master the characteristics of form of colon.

6.3  To master the locations, forms and structures of cecum and vermiform appendix.

6.4  To master the surface projection of the root of vermiform appendix.

6.5  To master the subdivision of colon and location of each subdivision.

6.6 To master the location and form of rectum.

6.7 To master the form and structure of anal canal.

 

Basic Content:

一.Introduction of Splanchology

1.Conception (5 min)

 Study of viscera

2.Organs of viscera (10 min)

 include the organs of the alimentary system, respiratory system, urinary system and genital system.

3. Location of viscera (5 min)

 thoracic,abdominal and pelvic cavity

4. Function (5 min)

relates to metabolism and race extension.

5.Classify of organs (5 min)

Tubular visera and Parenchymatous organs

6.Reference lines and abdominal regions (20 min)

(1)The common used reference lines of the thorax

a.anterior

        Anterior median line

        Sternal line

        Midclavicular line

        Parasternal line

b.lateral

        Anterior axillary line

        Midaxillary line

        Posterior axillary line

c.posterior

        Scapular line

        Posterior median line

(2) Abdominal regionsfour lines, three parts and nine regions

a.Two horizontal lines

Upper horizontal plane or transpyloric plane

Lower horizontal plane or transtubercular  plane

b.Two longitudinal lines: Midinguinal lines

(3) Three parts and nine regions

 

二.Alimentary Canal

Include mouthpharynxesophagusstomachsmall intestine and large intestine.

1. The oral cavity (mouth) (20 min)

(1) Division: The oral vestibule and oral cavity proper.

(2) Oral cavity contents

a.Teeth

b.Tongue

c.Salivary glands

2. Pharynx (20 min)

(1)Location:

(2)Subdivisions :nasopharynx,oropharynx,Laryngolpharynx

(3)Pharyngeal muscles

3.Esophagus (10 min)

(1)Location and subdivision of esophagus

Begin at C6 inferior border, extend from pharynx to stomach, about 25cm long.

Subdivisions:

        Cervical part

        Thoracic part

        Abdominal part

(2) Narrows of esophagus

a.at its commencement, 15cm from the incisor

b.crossed by left principal bronchus, 25cm

c.passes through the diaphragm,40cm

4. Stomach (20 min)

(1)Location of stomach

Most in left hypochondriac region and epigastric region,minor in right hypochondriac region

(2) The shape and parts of stomach

Two orificesCardiac and Pyloric orifices

Two curvatures: Greater and lesser incisures

Four partsCardiac part,Pyloric part,Body and Fundus

(3)The musculature and inner surface

(4)Relationship of stomach

5. The small intestine (15 min)

(1) Duodenum

a.Location: 25cm, between pylorus and jejunum.

b.Subdivision:

Superior part,descending part,horizontal part and ascending part.

(2) Jejunum and ileum

  Difference in the location, length, calibre, circular fold, Arterial arcades and Lymphatic follicles between thejejunum and ileum

6.Large intestine (15 min)

(1) Introduction

a. Features of the colon: Colic bands,haustra of colon and epiploic appendices

b. Subdivision: Cecum,Colon,vermiform appendix,rectum and anal canal

(2) Cecum

a.Location: Right iliac fossa

b.Features:Ileocecal  valves

(3) Vermiform appendix

a. Attachment : spring from the posteromedial wall of the caecum, below the end of the ileum.

b. Shape: worm shape tube

c. Several Positions

d. McBurney’ point ( surface projection of the root of the appendix) : opposite junction of the lateral and middle thirds of the line joining the right anterior superior iliac spine to the umbilicus.

(4) Colon :Ascending colon,Transverse colon,Descending colon and Sigmoid colon

(5) Rectum

a.Location

b.FeatureSacral flexure and Perineal flexure on the saggital plane

c.StructureMucosa

(6) Anal canal

a.Morphology

Anal columns

Anal valves

Anal sinuses

Dentate line

Anal pecten

White line(of Hilton)

b.Sphincter muscles

 

Emphasis:

Reference lines and abdominal regions, Isthmus of fauces, The structure of the teeth, Morphology and subdivision of the stomach, Subdivision of the pharynx, Surface projection of the root of the appendix and Dentate line

Difficulty:

1. Periodeontal structure

2. Pharyngeal muscles

 

教学手段与方法:

1Multimedia assistant teaching

2Network station:http://202.116.15.22:100/

3Specimen,illustrations and anatomical models

 

思考题、讨论题或作业:

1. Describe the positions of salivary glands and openings of their ducts.

2. Describe the narrowes of the esohagus.

3. How to find the appendix on operation?

4. State the loaction, shape and subdivision of the stomach.

参考资料(包括辅助教材、参考书、文献等):

1.Susan Standring .Gray’s anatomy (Thirty-ninth edition). Churchill Livingstone.London,UK.2004

2.Keith L. Moore, Anne M. R. Agur.Essential clinical anatomy(Second edition). Lippincott Williams & Wilkins. Baltimore:USA. 2002

3Richard S. Snell. Clinical anatomy for medical students. (Sixth edition). Lippincott Williams & Wilkins. Baltimore:USA. 2000

 

      Systematic Anatomy      课程教案

授课题目(教学章节或主题):

Endocrine System,

Peritoneum

授课类型 

     Lecture

授课时间

20064 10

7周 星期一 第79

教学内容(包括基本内容、重点、难点三部分):

Objective:

Part one Endocrine System

1.To know the conception, function and action way of the endocrine system. To master the feature of the endocrine glands.

2.To master the morphology, position and function of the thyroid gland, parathyroid glands, hypophysis, suprarenal glands, pineal bodies and thymus.

Part two Peritoneum

1.To master the conception of the peritoneum and peritoneal cavity.

2.To master the relationship between viscera and peritoneum.

3.To master the position of the greater omentum, to know the composition and function of the greater omentum.

4.To master the position of the lesser omentum.

5.To master the conception of the omental bursa and the location of the omental foramen.

6.To know the names of the mensenteries and mesocolons.

7.To know the names of the ligaments of the liver, stomach and spleen.

8.To master the location of the hepatorenal recess, rectovesical and rectouterine pouches.

 

Basic Content:

一.Endocrine System

1Introduction (10 min)

1The composition of the endocrine system :the endocrine tissues and organs.

2The endocrine tissues : The islets of Langerhans of pancreas, the ovarian follicles and corpora lutea of the ovary and the interstitial tissue of the testes

3The endocrine organs : the hypophysis (pituitary), thyroid gland, parathyroid glands, adrenal (suprarenal) glands, the thymus and pineal body

4The endocrine glands: no ducts . secrete hormones .

5Function of the endocrine system : metabolism, development and growth , reproduction, et al.

2The hypophysis(pituitary gland) (15 min)

a.Location:in the hypophysial fossa of the body of sphenoid bone

b.Division: adenohypophysis and neurohypophysis

c.Function:secrete and store many hormones

3. The thyroid gland (15 min)

(1) Location: in the neck region with one lobe on either side of the larynx and trachea

(2) Structure : lateral lobes and isthmus

(3) Function: thyroxin

4.The parathyroid glands (10 min)

(1)Location: lie on the dorsal surface of the lateral lobes of the thyroid

(2) Function: parathyroidin

5. The suprarenal (or adrenal) glands (10 min)

(1)Location : on the medial part of the kidney behind the peritoneum

(2)Structure on the longitudinal section: outer cortex and inner medulla

(3)Functions: steroid hormones and epinephrine(adrenalin) ,norepinephrine

6. The pineal body (10 min)

(1) Location: protruding from the roof of the third ventricle of the diencephalon.

(2) Function: secret melatonin and serotonin.

7. The thymus (5 min)

located in the upper mediastinum posterior to the sternu.and secrete lymphopoietin.

8. The pancreas (10 min)

(1) Location

(2) The endocrine part of the pancreas : Langerkans (islets of pancreas)

(3) Function: produce insulin and glucagon.

9. The ovary (10 min)

(1) The ovarian follicle(the endocrine tissues): produce estrogen

(2) The corpus luteum :produce progesterone

10. The testis (5 min)

  interstitial tissue : produce testosterone

二.Peritoneum

1Introduction 10 min

(1) Division of the peritoneum : the parietal peritoneum and visceral peritoneum

(2) The peritoneal cavity

(3) The difference between the abdominal cavity and the peritoneal cavity

(4) Function: absorptive capacity , secretion, supportion and phagocytosis

2. The Relationship between viscera and peritoneum (20 min)

1 The intraperitoneal viscera : completely surrounded by peritoneum

2 The interperitoneal viscera :  not completely wrapped

3 The retroperitoneal viscera : covered by peritoneum only on their anterior surface. Such as: the kidneys, ureters, suprarenal glands, pancreas, the middle and inferior parts of rectum, et al.

3Structures formed by the peritoneum (15 min)

(1)The omentum

(2)The mesenteries and mesocolons

(3)The ligaments

(4)The peritoneal recesses, pouches , fossae and folds

4Subdivision of peritoneal cavity (5 min)

Supramesocolic compartment:suprahepatic space and subhepatic space

Inframesocolic compartment:right mesenteric sinus, left mesenteric sinus, right paracolic groove, and left paracolic groove

 

Emphasis:

Location and division of the hypophysis,Morphology,location and structure of the thyroid gland,

The peritoneal cavity, Greater and lesser omenta

 

Difficulty:

The ligaments formed by the peritoneum

 

教学手段与方法:

1.Multimedia assistant teaching

2.Network station:http://202.116.15.22:100/

3.Specimen,illustrations and anatomical models

 

思考题、讨论题或作业:

1.State features of the endocrine glands.

2.Describe the Morphology,location and structure of the thyroid gland

3.Describe the relationship between the retroperitoneal viscera and the peritoneum.

参考资料(包括辅助教材、参考书、文献等):

1.Susan Standring .Gray’s anatomy (Thirty-ninth edition). Churchill Livingstone.London,UK.2004

2.Keith L. Moore, Anne M. R. Agur.Essential clinical anatomy(Second edition). Lippincott Williams & Wilkins. Baltimore:USA. 2002

3.Richard S. Snell. Clinical anatomy for medical students. (Sixth edition). Lippincott Williams & Wilkins. Baltimore:USA. 2000

 

      Systematic Anatomy      课程教案

授课题目(教学章节或主题):

Male and Female Genital System

授课类型 

     Lecture

授课时间

20064 17

8周 星期一 第79

教学内容(包括基本内容、重点、难点三部分):

Objective:

Part one Male Genital System

1 Introduction

1.1  To master the composition of the male genital system.

 

2 The internal genital organs

2.1 To master the form and location of the testes.

2.2 To know the structure and function of the testes.

2.3 To master the form and function of the epididymis.

2.4 To master the course and division of the ductus deferens.

2.5 To master the formation and opening of the ejaculatory duct.

2.6  To know the form and location of the seminal glands.

2.7  To master the form, division and relationship of the prostate.

2.8  To know the prostate change with age.

2.9  To know the location of the bulbourethral glands and the opening of the gland duct.

 

3 The external genital organs

3.1 To know the form, structure and function of the scrotum.

3.2 To master the composition and course of the spermatic cord.

3.3 To know the coverings of the testes and spermatic cord.

3.4 To master the division and composition of the penis.

3.5 To master the feature of the skin of the penis.

3.6 To master the division, form, constrictions and curves of the male urethra.

Part two Female Genital System

1 Introduction

1.1  To master the composition of the female genital system.

 

2 The internal genital organs

2.1 To master the form, location and ligaments of the ovaries.

2.2 To know the structure and change with age of the ovaries.

2.3 To master the location, division and form of the uterine tube.

2.4 To master the location, from and division of the uterus.

2.5 To master the posture and ligaments of the uterus.

1.1 T know the structure of the wall of the uterus and the change with age of the uterus.

1.2 To master the form and location of the vagina.

 

3 The external genital organs

3.1 To master the composition of the female vulva.

3,2 To master the location of the vestibular gland and its opening.

 

4.Breast

4.1 To master the location, form and structure of the female breast.

 

Basic Content:

一.Male Genital System

1Introduction (5 min)

divided into two parts: internal and external genital organs.

2Testes (15 min)

(1) Location: in the scrotum

(2) Shape: oval-shape. Has two extremities, two surfaces and two borders

(3) Structure

a. Lobules testis

b.Contorted semniferous tubules

c.Rete testis

d.Efferent ductules of testis

(4) Function: produce sperm

3.The epididymis (10 min)

(1) Morphology head body and  tail

(2) StructureDuctus of epididymis

4The ductus deferens (10 min)

(1) Course

(2) Division:

a.The testicular part

b.The funicular part:vasectomy is performed here

c.The inguinal, part

d.The pelvic part

5Ejaculatory duct (5 min)
   Formed by the union of the end part of the dutus deferens and the seminal vesicle duct.

6. Spermatic cord (5 min)
(1)Contentsductus deferens, testicular artery, pampeniform plexus of vein, nervous plexus, lymphatic vessels and the remnants of the vaginal process.

(2) Course: extend from the upper extremity of the testis to the inguinal deep ring.

7Seminal vesicle (5 min)

(1) Locationbehind the urinary bladder , lateral to the ampulla ductus deferentis

(2)Function

8Prostate (10 min)

(1) Locationbetween the urinary bladder and the urogenital diaphragm.

(2) Division: base, body and apex

(3) Structuregland and muscles

(4) Five lobes:anterior ,left and right lobes as well as posterior lobes

(5) Capusle

9Bulbourethral gland (5 min)

  situated in the deep transverse muscle of perineum

10Scrotum (5 min)

(1) Locationposteroinferior to the penis

(2) Structureskin, dartos

(3) Function

11.The penis (10 min)

(1) Structuresone cavernous body of urethra, two cavernous bodies of penis

(2) DivisionHead(glans),Body and Root

(3) prepuce

12Male urethra (15 min)

(1) Course:

(2) Subdivision:The prostatic portion,The membranous portion and The cavernous portion

(3)Three narrowsinternal urethral orfice, the membranous portion and external urethral orifice

(4)Three expendsthe prostatic portion, bulbous portion of urethra and navicular fossa

(5) Two curvatures: the subpubic curvature and the prepubic curvature

二.Female Genital System

1Introduction (5 min)

Be composed of internal and external genital organs .

2Ovaries (10 min)

(1) Shapea pair of oval organs.has two surfaces, two borders and two extremities.

(2) Locationon the lateral wall of the pelvis.

(3) Ligaments: the proper lig. of ovary, the suspensory lig. of ovary.

(4) Functionproduce ova and secrete female hormones.

(5) Development:

3The uterine tube (5 min)

(1) Locationsituated on each side of uterus close to the lateral of wall of the lesser pelvis.

(2) Subdivision:

  a. Uterine part

  b. Isthmus of uterine tube : legation is performed here.

  c. Ampulla of uterine tube: fertilization occurs here.

d. Infundibulum of uterine tube

4The uterus (10 min)

(1) Location: in the centre of the pelvis, between the urinary bladder and the rectum.

(2) Division: Fundus, Body and  Cervix ( Supravaginal part and Vaginal part)

(3) Interior cavity

a.Cavity of uterus

b. Cervical canal of uterus: lower end is termed the orifice of uterus.

(4) Postur : Anteversion and anteflexion

(5) The supporting structures of uterus
   The normal position is maintained by the supporting ligaments of  uterus, the pelvic diaphragm, urogenital diaphragm, vagina and neighboring connective tissues. the supporting ligaments of  uterus as following:

a.Broad ligament

b.Round ligament

c.Cardinal  ligament

d.Uterosacral ligament

(6) The structure of uterus
5
The vagina (5 min)

(1) Function: copulation , birth canal and passage for the menstrual flow.

(2) Structuremuscular canal. The opening of the lower portion is called the vaginal orifice. The upper end forms the fornix of vagina.

6The external organs (5 min)

n    mons pubis

n    greater lipskin

n    lesser lipmucosa

n    vestibular fossa of vagina

n    glans of clitoris

n    hymen

n    Bulb of vestibule

n    Greater vestibular glands(barholins glands)

 

Attachment: Mamma(breast)(10 min)

1. Shape: Nipple, areola of breast

2. Locationbetween 3 -6 ribs vertically, from the parasternal line to midaxillary line transversely.

3. Structure

Mammary gland: 15-20 gland lobes and lactiferous duct.

Adipose tissue

4. The suspensory ligament

 

Emphasis:

Division of the the ductus deferens, Location and division of the prostate, Subdivision, narrows and expands of the male urethra, Subdivision of the uterine tube, Location, division, posture and

supporting structures of uterus.

 

Difficulty:

1Spermatic cord

2.  The supporting structures of uterus

 

教学手段与方法:

1.Multimedia assistant teaching

2.Network station:http://202.116.15.22:100/

3.Specimen,illustrations and anatomical models

 

思考题、讨论题或作业:

1Which part is performed in the vasectomy ?

2.Describe the Subdivision, narrows and expands of the male urethra.

3Describe the posture and ligaments of uterus.

参考资料(包括辅助教材、参考书、文献等):

1.Susan Standring .Gray’s anatomy (Thirty-ninth edition). Churchill Livingstone.London,UK.2004

2.Keith L. Moore, Anne M. R. Agur.Essential clinical anatomy(Second edition). Lippincott Williams & Wilkins. Baltimore:USA. 2002

3.Richard S. Snell. Clinical anatomy for medical students. (Sixth edition). Lippincott Williams & Wilkins. Baltimore:USA. 2000

 

 

 

 

 

      Systematic Anatomy      课程教案

授课题目(教学章节或主题):

Introduction of Angiology,

Heart

授课类型 

     Lecture

授课时间

20064 24

9周 星期一 第79

教学内容(包括基本内容、重点、难点三部分):

Objective:

Part one Introduction of Angiology

1. To master the composition of the cardiovascular system.

2. To know the structures of the arterys, veins and capillaries.

3. To master the conception of the systemic and pulmonary circulations.

4. To know the anastomoses, collateral vessels and collateral circulation.

Part two Heart

1. To master the location, external features of the heart.

2. To master the strucutures of the cardiac chambers.

3. To maaster the strucutres of the interatrial and interventricular septa.

4. To know the strucutre of the heart.

5. To master the composition of the conduction system of the heart. And know its function.

6. To master the origin, course, main branches and distribution of the left and right coronary arteries.

7. To know the boold supplies of the sinoatrial and atrioventricular nodes.

8. To master the location and opening of the coronary sinus. To know the courses of the great, middle and small cardiac veins.

9. To know the nerves supplying the heart.

10. To master the surface projection of the heart. To master the composition of the pericardium.

Basic content:

一.Introduction of Angiology

1Composition of the cardiovascular system (10 min)

   Heart and blood vessels ( arteries , veins and capillaries)

2The cardiovascular circuits (20 min)

(1) The systemic or greater circulation: The course of the blood from the left ventricle through the  whole body finally to the right atrium.

(2) The pulmonary or lesser circulation: Its passage from the right ventricle via the lung to the left atrium.

(3) The difference between the systemic circulation and pulmonary circution

3. Anastomoses (20 min)

(1) Forms

  In addition to artery-capillary-vein , the blood vessels may unite to form the arterial anastomoses ,  venous plexus or network , arteriovenous anastomoses.

(2) Collateral circulation

  The blood circulation is established by the collateral (accessory) vessels.

二.Heart

1Location (5 min)

   Occupies the middle mediastinum between the lungs and the pleurae, enclosed in the pericardium. Approximately 1/3 lies to right of the median plane and 2/3 to the left.

2The cardiac shape (10 min)

One apex , one base , two surfaces , three borders and four sulci

3. The chambers of heart (35 min)

(1) The right atrium

a Anterior part ( atrium proper) and posterior part (sinus venarum) separated by sulcus terminalis.

b Three vessel openings :

   orifice of the superior vena cava

   orifice of the inferior vena cava

   orifice of the coronary sinus

c The fossa ovalis

d The right auricle

(2)The right ventricle

a Inflowing part and outflowing part(infundibulum): separated by supraventricular crest

b The right atrioventricular orifice : attached by the tricuspid valvechordae tendineae (tendinouscords) the papillary muscle

c The pulmonary orifice : encircled by the ring of pulmonary valves

d other structures : trabeculae carneae , septomarginal trabecula

(3) The left atrium : a The left auricle;  b The orifices of the pulmonary veins

(4) The left ventricle

a Inflowing part and outflowing part : separated by the anterior cusp of the mitral valve

b The left atrioventricular orifice : attached by the bicuspid(mitral) valvechordae tendineae (tendinouscords) the papillary muscle

c The aortic orifice : encircled by the ring of aortic valves

4.Cardiac architecture (5 min)

(1) The wall of the heart: from inner to outer

   endocardium myocardium epicardium

(2) The interatrial septum

(3) The interventricular septum:the membraneous part and the muscular part

(4) The skeleton of the heart :include fibrous rings and fibrous trigones.

a fibrous rings : surround the atrioventricular and arterial orifices

b fibrous trigones : left fibrous trigone and right fibrous trigone (central fibrous body)

5. The conducting system (15 min)

(1) The sinoatrial node (SA node): normal pacemaker of the heart

(2) The atrioventricular node (AV node)

(3) The atrioventricular bundle (His bundle)

(4) Left and right bundle branches (limbs) Purkinje network

6Vessels of the heart (20 min)

(1) Arteries of heart

a The right coronary artery (main rami) post. interventricular branch

   post. branch of the left ventricle

b The left coronary artery (main rami)

   ant. interventricular brach

   circumflex A.

   diagonal A.

(2)Veins of heart

a The coronary sinus the great , middle and small cardiac veins

b The anterior cardiac veins

c The smallest cardiac veins

7. The pericardium (5 min)

(1) The fibrous pericardium

(2) The serous pericardium

 a Composition: parietal and visceral layers

 b Pericardial cavity:The transverse sinus of pericardium, The oblique sinus of pericardium

8. The cardiac surface projection (5 min)

(1) left superior dot

(2) right superior dot

(3) left inferior dot

(4) right inferior dot

 

Emphasis:

Collateral circulation, Loaction of heart, Cardiac apex, The chambers of heart, The conducting system of heart, Arteries of heart, The serous pericardium

 

Difficulty:

The chambers of heart

 

教学手段与方法:

1Multimedia assistant teaching

2Network station:http://202.116.15.22:100/

3Specimen,illustrations and anatomical models

 

思考题、讨论题或作业:

1. Which structures allow blood to flow the heart in one direction.

2. Describe the composition of the conducting system of heart

3. Describe the course and distribution of the coronary artery.

参考资料(包括辅助教材、参考书、文献等):

1Susan Standring .Gray’s anatomy (Thirty-ninth edition). Churchill Livingstone.London,UK.2004

2Keith L. Moore, Anne M. R. Agur.Essential clinical anatomy(Second edition). Lippincott Williams & Wilkins. Baltimore:USA. 2002

3Richard S. Snell. Clinical anatomy for medical students. (Sixth edition). Lippincott Williams & Wilkins. Baltimore:USA. 2000

 

 

 

 

 

 

 

 

      Systematic Anatomy      课程教案

授课题目(教学章节或主题):

Arteries of Abdomen,

Veins and Lymphatic System

授课类型 

     Lecture

授课时间

20065 8

11周 星期一 第79

教学内容(包括基本内容、重点、难点三部分):

Objective:

Part one Arteries of Abdomen

1.To master the course and branches of the abdominal artery.

2.To know the distribution of the inferior phrenic artery, lumbar artery and suprarenal artery.

3.To master the courses and branches and distribution of the celiac trunk, superior and inferior mesenteric arteries.

4.To master the courses and distribution of the renal artery, testicular artery and ovarian artery.

Part two Veins

1. To know the features of the vein.

2. To master the courses of the left and right pulmonary veins.

3. To master the formation and course of the superior vena cava. To master the formation and course of the brachiocephalic vein. To master the origin, termination,course and main tributaries of the internal jugular vein. To know the communication between the intracranial extracranial veins. To master the origin and course of the subclavian vein. To master the formation and course of the external jugular vein. To know the origins, terminations,and courses of the cephalic vein, basic vein and median cubital vein. To master the origin, termination and course of the azygos vein, To know the origins, terminations and courses of the hemiazygos and accessory hemiazygos veins. To master the position and communication of the vertebral venous plexus.

4. To master the origins, terminations, and courses of the inferior vena cava, common iliac vein, internal and external iliac veins. To know the tributaries of the inferior vena cava and external iliac vein. To know the origins, terminations and courses of the great and small saphenous veins.

5. To master the formation, course and tributaties of the hepatic portal vein. To master the anastomoses between the hepatic portal venous system and vena cava system and their clinical application.

Part three Lymphatic System

1. To master composition and feature of the lymphatic system.

2. To master the origin, termination,course and collection of the thoracic duct. To master the composition and collection of the right lymphatic duct.

3. To master the conception of the regional lymph nodes.

4. To master the distribution of the lymph nodes of the head and neck. To master the formation and collection of the jugular trunk.

5. To know the distribution and collection of the axillary lymph nodes. To master the formation and collection of the subclavian trunk.

6. To know the distribution of the lymph nodes of the thoracic wall and cavity. To master the location and collection of the bronchopulmonary lymph nodes. To master the formation and collection of the bronchomediastinal trunk.

7. To know the distribution and collection of the celiac lymph nodes, superior and inferior mesenteric lymph nodes. To master the distribution and collection of the lumbar and intestinal trunks.

8. To know the distribution and collection of the extrnal iliac lymph nodes. To master the distribution and collection of the internal iliac lymph nodes and sacral lymph nodes.

9. To master the distribution and collection of the superficial and deep inguinal lymph nodes. To know the distribution and collection of the popliteal lymph nodes.

10. To master the shape and location of the spleen. To know the function of the spleen.

 

Basic content:

一.Arteries of Abdomen

1Introduction 5 min

the parietal branches and the visceral branches

2. The parietal branches (10 min)

   inferior phrenic a., and lumbar a.

3. The visceral branches (35 min)

(1)The paired :

a. The middle suprarenal a.

b. The renal a.

c. The testicular a.(in the male)

   (the ovarian a.in the female)

(2) The three unpaired :

    celiac trunk, superior mesenteric a. and inferior mesenteric a.  

a. The celiac trunk:

The left gastric a.

The common hepatic a.

   proper hepatic a. cystic a. and right gastric a.

   gastroduodenal a. right gastroepiploic a.

  The splenic a.   left gastroepiploic a. and short gastric a.

b. The superior mesenteric a.

  The jejunal and ileal a.

 The ileocolic a. the appendicular a.

 The right colic a.

 The middle colic a.

c. The inferior mesenteric a.

 The left colic a.

 The sigmoid a.

 The superior rectal a.

二.Veins

1The pulmonary veins (5min)

four in number right superior and inferior pulmonary v. , left superior and inferior pulmonary v.

2. The systemic veins (45 min)

include three groups: the superior vena cava and its tributaries, the inferior vena cava and its tributaries, and the veins of the heart

(1) The superior vena cava and its tributaries

a. The superior vena cava

b. The brachiocephalic (innominate) veins

The internal jugular v.

The subclavian v. the external jugular v.

c.The veins of upper limb

  The superficial v.The cephalic v.basilic v. and median cubital v.

  The deep v. : accompany the arteries which are similarly named

d. The azygos v. the hemiazygos v. and the accessory hemizygos v.

(2) The inferior vena cava and its tributaries

a. The inferior vena cava

b. The common iliac v.: The internal iliac v. and the external iliac v.

c. The veins of lower limb

   1) The superficial v.

   The great saphenous v.

   The small saphenous v.

    2) The deep v. : accompany the arteries which are similarly named

d. The tributaries of the inferior vena cava

1) The parietal tributaries

2) The visceral tributaries

The testicular v. ( the ovarian v. in the female) the pampiniform plexus

The renal v.

The suprarenal v.

The hepatic v.

e. The hepatic portal venous system

1) Composition : hepatic portal v. and its tributaries

2) The hepatic portal v.

3) The tributaries of the hepatic portal v.

     The sup. mesenteric v.

     The inf. mesenteric v.

     The splenic v.

     The left and right gastric v.

     The paraumbilical v.

d. The anastomoses between the hepatic portal venous system and the vena cava

1Hepatic portal v. left gastric v. esophageal venous plexusesophageal v. azygos v. sup. vena cava

2Hepatic portal v. inf. mesenteric v. sup. rectal v. rectal venous plexus inf. rectal and anal v. internal iliac v. common iliac v. inf. vena cava

3Hepatic portal v. paraumbilical v. periumbilical venous network

thoracoepigastric and sup. epigastric v. sup. vena cava

superficial and inf. epigastric v. inf. vena cava

4) Hepatic portal v. small tributaries of the superior and inferior mesenteric v. small tributaries of the posterior intercostals v.,inferior phrenic v., renal v.and testicular v. sup. and inf. vena cavae

5) Hepatic portal v. small tributaries of the superior and inferior mesenteric v. vertebral venous plexussmall tributaries of the posterior intercostals v., lumbar v. sup. and inf. vena cavae

三.Lymphatic System

1Introduction (10 min)

1Composition : lymphatic vessels ,lymphatic tissue and lymphatic organs

2) The lymphatic vessels

(1) The lymphatic capillary

(2) The lymphatic vessels

(3) The trunks : nine trunks

   the right and left jugular trunks,

   the right and left subclavian trunks,

   the right and left bronchomediastinal trunks,

   the right and left lumbar trunks,

   the intestinal trunk

(4) The lymphatic ducts: the right lymphatic duct and the thoracic duct

3The lymphatic tissue

4The lymphatic organsInclude lymph nodes, thymus,spleen and tonsils

2The lymphatic ducts (5 min)

1) The thoracic duct(left lymphatic duct)

(1) Coures :arise from the cisterna chyli and ends by opening into the left venous angle.

(2) Collecting lymph vessels: receive six trunks. collect three-quarters of the body

2) The right lymphatic duct: receive three trunks. collect upper right quadrant of the body.

3The lymphatic drainage (25 min)

1)The lymphatic drainage of head

(1) Location : around the adjoining part of the head and neck.

(2) Lymph nodes

2The lymphatic drainage of neck
1 Anterior cervical lymph node

2 Lateral cervical lymph node

Superficial lateral cervical lymph nodes:lie along external jugular v.

Deep lateral cervical lymph nodes:lie along internal jugular v.

3The lymphatic drainage of upper limb

(1) Supratrochlear lymph nodes

(2) Infraclavicular nodes

(3) The axillary lymph nodes

   The anterior group(pectoral lymph nodes)

   The lateral group

   The posterior group(subscapular group)

   The central group

   The apical group

4) The lymphatic drainage of thorax

(1) Lymph nodes of thoracic wall

parasternal lymph nodes

intercostal lymph nodes

(2) Lymph nodes of thoracic viscera

anterior mediastinal lymph nodes

posterior mediastinal lymph nodes

lymph nodes of trachea, bronchus and lungs

pulmonary lymph nodes

bronchopulmonary lymph nodes

tracheobronchial lymph nodes

paratracheal lymph nodes

5) The lymphatic drainage of abdomen

(1) Lymph nodes of the abdominal wall

(2) Lymph nodes of the abdominal viscera

  paired visceralumbar lymph nodes

  unpaired viscerathe celiac lymph nodes , the superior mesenteric lymph nodes and inferior mesenteric lymph nodes

6) The lymphatic drainage of pelvis

(1) The common iliac lymph nodes

(2) The internal iliac lymph nodes

(3) The external iliac lymph nodes

7) The lymphatic drainage of lower limb

(1) Popliteal lymph nodes

(2) Superficial inguinal lymph nodes

(3) Deep inguinal lymph nodes

4. The spleen (10 min)

1) Location : in the left hypochondriac region, between the ninth rib and the eleven rib

2) Formation : splenic notch on the superior border

3) Accessory spleen

 

Emphasis:

Course and branches of the abdominal artery, Courses and branches and distribution of the celiac trunk, superior and inferior mesenteric arteries, the formation and course of the superior vena cava. Origins, terminations,and courses of superficial veins of the upper and lower limbs,The origins, terminations, and courses of the inferior vena cava, The formation, course and tributaties of the hepatic portal vein. The anastomoses between the hepatic portal venous system and vena cava system and their clinical application. The origin, termination,course and collection of the thoracic duct. The distribution and collection of the axillary lymph nodes.The distribution and collection of the superficial and deep inguinal lymph nodes.

 

Difficulty:

1Courses and branches and distribution of the celiac trunk.

2. The anastomoses between the hepatic portal venous system and vena cava system

3. The distribution and collection of the axillary lymph nodes.

4. The distribution and collection of the superficial inguinal lymph nodes.

教学手段与方法:

1Multimedia assistant teaching

2Network station:http://202.116.15.22:100/

3Specimen,illustrations and anatomical models

 

思考题、讨论题或作业:

1Describe the branches and distribution of the celiac trunk, superior and inferior mesenteric arteries.

2Describe the Origin, termination,and course of cephalic vein.

3Describe the formation, course and tributaties of the hepatic portal vein.

4.Describe the distribution and collection of the axillary lymph nodes.

参考资料(包括辅助教材、参考书、文献等):

1Susan Standring .Gray’s anatomy (Thirty-ninth edition). Churchill Livingstone.London,UK.2004

2Keith L. Moore, Anne M. R. Agur.Essential clinical anatomy(Second edition). Lippincott Williams & Wilkins. Baltimore:USA. 2002

3Richard S. Snell. Clinical anatomy for medical students. (Sixth edition). Lippincott Williams & Wilkins. Baltimore:USA. 2000

 

      Systematic Anatomy      课程教案

授课题目(教学章节或主题):

Vestibulocochlear Organs

授课类型 

     Lecture

授课时间

20065 15

12周 星期一 第79

教学内容(包括基本内容、重点、难点三部分):

Objective

1The external ear

1.1 To know the composition of the external ear.

1.2 To master the division and feature of the external acoustic meatus.

1.3 To master the location and division of the tympanic membrane.

 

2. The middle ear

2.1  To know the composition of the middle ear.

2.2  To master the location, division, structure and communication of the tympanic cavity. And to master the names of the six walls of the tympanic cavity.

2.3  To know the names, joints and function of the auditory ossicles.

2.4  To know the functions of the tensor tympani and the stapedius.

2.5  To master the location, division and function of the auditory tube. And to master the feature of the auditory tube in childhood.

2.6  To master the locations and clinical correlation of the mastoid cells and mastoid antrum.

 

3. The internal ear

3.1  To know the location and division of the internal ear.

3.2  To master the division, shapes and structures of the bony labyrinth and membranous labyrinth, and the relationship between the bony labyrinth and the membranous labyrinth.

3.3  To know the shapes and functions of the utricle, saccule, membranous semicircular ducts and cochlear duct.

3.4  To know the conduction of sound.

Basic content:

The external ear
 consists of the auricle, external acoustic meatus, and tympanic membrane

1The auricle 10 min

2The external acoustic meatus (20 min)

extends from the externa1 acoustic pore to the tympanic membrane

1) Two parts: lateral part : the cartilaginous part ( one-third )

medial part : the bony part (two-thirds )

2) Direction: passes medially, its lateral part runs forwards and upwards, and then backwards and the medial part runs forwards and downwards

3 The tympanic membrane (20 min)

1) Two parts: tense part (lower three fourths of tympanic membrane) and flaccid part(upper one fourth )

2) The umbo

3) Cone of light: lie anteroinferior to the tense part of umbo

 

二. The middle ear

    between the external and inner ears, and includes three parts: the tympanic cavity, the auditory tube and the mastoid cells.

1 The tympanic cavity (20 min)

l) The walls of the tympanic cavity six walls:

(1) The tegmental wall (superior wall)

(2) The jugular wall (inferior wall)

(3) The carotid wall (anterior wall)

(4) The mastoid wall (posterior wall)

(5) The membranous wall (lateral wall)

(6) The labyrinthine wall (medial wall)

2) The auditory ossicles

(1)Three ossicles: the malleus, incus and stapes

(2)The muscles of the tympanic cavity :the tensor tympani and the stapedius

2 The auditory tube (Eustachian tube) (20 min)

  the channel through which the tympanic cavity communicates with the nasopharynx.

3 The mastoid cells (10 min)

  spaces in the mastoid process of the temporal bone

 

The internal ear
  lies in the petrous part of the temporal bone and consists of two parts: the bony labyrinth and the membranous labyrinth.

1The bony labyrinth (10 min)

   three parts :the cochlea ,the vestibule and the semicircular canals.

2The membranous labyrinth (20 min)

  from before backwards, includes: the cochlear duct, the utricle and saccule, and

  the membranous semicircular ducts.

1) The cochlear duct

(1) Section of the cochlea:

   show three channels:  the scala tympani, scala vestibuli and the cochlear duct

(2) The cochlear duct(transverse section)

three walls :

superior wallthe vestibular membrane

lateral wallthe thickend endosteum

inferior wall the basilar membrane(spiral membrane) and the outer part of the lamina of modiolus . The spiral organ on the basilar membrane

2) The utricle and saccule

   The maculae are the organs of static balance

3) The semicircular ducts

   The ampullary crests are the organs of kinetic balance.

3The conduction of sound (15 min)

4The internal acoustic meatus (5 min)

 

Emphasis:

The division and feature of the external acoustic meatus, The location, division, structure and communication of the tympanic cavity, The division, shapes and structures of the bony labyrinth and membranous labyrinth.

 

Difficulty:

1. Six walls of the tympanic cavity.

2. Structures of the membranous labyrinth.

教学手段与方法:

1Multimedia assistant teaching

2Network station:http://202.116.15.22:100/

3Specimen,illustrations and anatomical models

 

思考题、讨论题或作业:

1Describe the communication of the tympanic cavity

2Describe the conduction of sound.

参考资料(包括辅助教材、参考书、文献等):

1Susan Standring .Gray’s anatomy (Thirty-ninth edition). Churchill Livingstone.London,UK.2004

2Keith L. Moore, Anne M. R. Agur.Essential clinical anatomy(Second edition). Lippincott Williams & Wilkins. Baltimore:USA. 2002

3Richard S. Snell. Clinical anatomy for medical students. (Sixth edition). Lippincott Williams & Wilkins. Baltimore:USA. 2000

 

      Systematic Anatomy      课程教案

授课题目(教学章节或主题):

Introduction of Nervous System

授课类型 

     Lecture

授课时间

20065 16

12周 星期二 第12

教学内容(包括基本内容、重点、难点三部分):

Objective

1.To know the function of the nervous system.

2.To master the division of the nervous system.

3.To master the basic structure and classification the neuron.

4.To master the neuroanatomical terms of the white matter, grey matter, cortex, medullary substance, nucleus, ganglion, fasciculus and funiculus.

5.To master the composition of the reflex arch. To know the conception of the reflex.

6.To know the structures of the nerve fiber and nerve.

7.To know the type and function of the neuroglia.

Basic content:

一.Division of the nervous system (10 min)

 

The central part : brain and spinal cord

The peripheral part: cranial , spinal and visceral (autonomic nervous system) nerves

 

. Composition of the nervous system

Nerve cells (neurons) and neuroglia

1.Neurons (40 min)
   Independent structural and functional units of the nervous sytem

1) Structure : consists of cell body and processes (an axon and one or more dendrite)

2) Myelinated and nonmyelinated nerve fibres

Myelinated nerve fibres: The nerve fibres (mainly axon) enveloped by myelin sheath which is formed by Schwann cell in the PNS and oligodendrocyte in the CNS)

Unmyelinated nerve fibres: The nerve fibres not enveloped by myelin sheath.

3) Synapses : One neuron contacts with another neuron to form synapse. Synapse consists of presynaptic membrane , postsynaptic membrane and synaptic cleft. The axodendritic synapse is most common , and the axosomatic is quite common.

4) Classify:

   According to the number of the processes

  a. pseudounipolar neuron

  b. bipolar neuron

  c. multipolar neuron

According to function of the neuron:

  a.sensory neuron

  b.motor neuron

  c.interneuron

  Others, Golgi I and II, et al.

2. Neuroglia ( glial cells) (20 min)
  Large neuroglia ( oligodendrocyte , Schwann cell ,ependymal cell and astrocyte) and

small neuroglia ( microglia)

 

三、The reflex and reflex arch


 1 Conception of the reflex (10 min)

 2 Composition of the reflex arch (20 min)

   sensory receptors, afferent neurons, interneurons , efferent neurons and effectors 

 

四、Terminology

 

1. Gray matter and white matter , cortex and medulla (15 min)

1)Gray matter: Groups of nerve cell bodies and their dendrites in the CNS are termed gray matter.

2)White matter: Bundles of nerve fibres in the CNS are termed white matter.

2. Nucleus and ganglion (10 min)

1)Nucleus: Nerve cells with the same shape and function in the CNS are grouped together to form nucleus.

2)Ganglion: Nerve cells with the same shape and function in the PNS are grouped together to form ganglion.

3. Fasciculus , funiculus and nerves (15 min)

1)Fasciculus: A group of nerve fibres with common origins, destinations and functions in the CNS is termed fasciculus.

2)Funiculus: A group of nerve fibres with different origins, destinations and functions in the CNS is termed funiculus.

3)Nerves: Nerve fibres grouped together in the PNS are termed nerves.

 

 

五.Summmary (10 min)

 

Emphasis:

Division of the nervous system,the basic structure and classification the neuron, the neuroanatomical terms

 

Difficulty:

Neuroanatomical terms

 

教学手段与方法:

1Multimedia assistant teaching

2Network station:http://202.116.15.22:100/

3Specimen,illustrations and anatomical models

 

思考题、讨论题或作业:

1.Explain the cortex and medulla

2. Explain the Fasciculus and funiculus

 

参考资料(包括辅助教材、参考书、文献等):

1Susan Standring .Gray’s anatomy (Thirty-ninth edition). Churchill Livingstone.London,UK.2004

2Keith L. Moore, Anne M. R. Agur.Essential clinical anatomy(Second edition). Lippincott Williams & Wilkins. Baltimore:USA. 2002

3Richard S. Snell. Clinical anatomy for medical students. (Sixth edition). Lippincott Williams & Wilkins. Baltimore:USA. 2000

4Stephen G. Waxman. Correlative neuroanatomy.(Twenty-fourth edition). McGraw-HILL.New York. USA.2000

 

 

 

 

 

      Systematic Anatomy      课程教案

授课题目(教学章节或主题):

Spinal nerves

授课类型 

     Lecture

授课时间

20065 22

13周 星期一 第79

教学内容(包括基本内容、重点、难点三部分):

Objective

1.To master the composition, branches, components and distribution of the spinal nerves.

2.To know the location and formation of the cervical plexus, points of emergence of the superficial branches of the cervical plexus.

3.To master the formation, course and distribution of the phrenic nerve.

4.To master the location and formation of the brachial plexus. To master the courses and distribution of the long thoracic nerve. and dorsal thoracic nerve, to know the clinical signs of injury to these two nerves. To master the origins, courses, main branches and distrbition of the median nerve, ulnar nerve, radial nerve, musculocutaneous nerve and axillary nerve, to know the clinical signs of injury to these nerves.

5.To master the course, distribution of the anterior branches of the thoracic nerves.

6.To know the formation and location of the lumbar plexus. To master the formation, course, location, main branches of the femoral nerve and obturator nerve. To know the location and distribution of the iliohypogastric nerve, ilioinguinal nerve and lateral cutaneous nerve.

7.To know the formation and location of the sacral plexus. To master the formation, course, branches and surface projection of the sciatic nerve. To master the course, branches and distribution of the tibial nerve and the common peroneal nerve. To know the clinical signs of injury to these two nerves. To know the course, branches and distribution of the perineal nerve. To know the distribution of the superior gluteal nerve, inferior gluteal nerve and posterior femoral cutaneous nerve.

Basic content:

. Introduction (20 min)

   

There are 31 pairs of spinal nerves, which are divided into 8 pairs of cervical (C1-8), 12 pairs of thoracic(T1-12), 5 pairs of lumbar(L1-5), 5 pairs of sacral(S1-5), and 1 pair of coccygeal nerves(Co 1).

1. Spinal nerve roots

Each nerve consists of  an anterior(ventral) root and a posterior(dorsal) root. The anterior root contains motor fibers. The posterior root contains sensory fibers originating in the pseudounipolar neurons in the spinal ganglion.

2.Types of nerve fibers in the spinal nerve

1)Somatic afferent (sensory) fibers: distributed in the skin,sketetal muscles, joints and tendons;

2)Visceral afferent fibers: distributed in the visceral organs, cardiovascular system and glands;

3)Somatic  efferent (motor) fibers:innervate the skeletal muscles;

4)Visceral efferent fibers: innervate the smooth muscles, cardiovascular system and glands.

3. Branches of typical spinal nerves

1) The dorsal branch: is distributed to the muscles and skin of the posterior part of the body.

2) The communicating branch

3) The meningeal branch

4) The anterior branch : is distributed to the limbs, the lateral and ventral trunk. The anterior branches form the cervical, brachial, lumbar and sacral plexuses with exception of the thoracic nerves(they remain segamental).

 

. The cervical plexus (30 min)

1. The formation: C1-4

2.Location:deeply in the sternocleiodmastoid muscle.

3. Branches: superficial and deep branches

1) The superficial (cutaneous) branches:

   emerge near the middle of the posterior border of the sternocleiodmastoid muscle.

The lesser occipital nerve

The greater auricular nerve

The transverse nerve of neck

The supraclavicular nerve

2) The deep branches

  innervate the deep muscles of the neck, the infrahyoid muscles the levator scapulae and diaphragm.

The phrenic nerve

A. Course

B. Distribution: supply the diaphragm, the sensory fibers supply the pericardium, the mediastinal pleurae and diaphragmatic peritoneum. The right phrenic nerve is also distributed to the liver, the gallbladder and the biliary sytem.

 

. The brachial plexus (50 min)
1. The formation: C5-8 and T1.

2. Branches

1) The branches above the clavicle

The long thoracic N.:innervates the serratus anterior. The lesion of the N causes the “wing” of the scapula.

The dorsal scapular N.: innervates the levator scapulae and rhomboideus

The suprascapular N.: innervates the supraspinatus and the infraspinatus.

2) The branches below the clavicle

The thoracodorsal N:supplies the latissimus dorsi.

The lateral and medial pectoral nerves(anterior thoracic N): supplies the pectoralis major and pectoralis minor.

The musculocutaneous N:supplies the coracobrachialis, biceps, and brachialis muscle.It ends as the lateral antebrachial cutaneous N.

The median N

A.Course

B.Branches: the forearm muscular branches, the handa recurrent branch,three common palmar digital nerves and proper palmar digital nerves .

C.Distribution:

   Motor branches: in the forearm the pronators and flexor muscles except the brachioradialis, the flexor carpi ulnaris and the medial half of the flexor digitorum profundus; in the handthe first and second lumbricales and the thenar muscles except the adductor pollicis.

   Sensory branches: the skin of the palmar surface of the radial half of the hand and thumb and the lateral 2 12 fingers , and the dorsal surface of the middle ,distal ends of the same fingers .

D.Clinical features of the N. lesion: easily injured at the wrist and causes “ape hand”

The ulnar N

A. Course

B. Branches: the forearm muscular branches, the handa superficial and a deep branches, a dorsal branch

C. Distribution:

  Motor branches: in the forearmthe flexor carpi ulnaris and the medial half of the flexor digitorum profundus; in the handthe adductor pollicis, the third and fourth lumbricales, interossei.

  Sensory branches:hand the skin of the ulnar half of the hand, and the ulnar one and half fingers.

D.Clinical features of the N. lesion: “clawhand”

The radial N

A. Course

B. Branches: at the elbow jointthe superficial and deep branches

C. Distribution:

   Motor branches: in the forearmall extensors; the armall extensors and the brachioradialis

   Sensory branches: handthe dorsal surface of the radial half of the hand, and the proximal digits of the lateral two and half fingers.

D. Clinical features of the N. lesion: “Wristdrop”

The axillary N

A. Course

B. Distribution : supply the deltoid and teres major

C. Clinical features of the N. lesion: “quadrate” shoulder.

 

.The anterior branches of thoracic nerves (10 min)
1. Number: 12 pairs. Among them, 11 pairs are the intercostals nerves, 1 pair are the subcostal nerves.

2. Course

3. Segmental distribution:

T2the sternal angle

T4the nipple

T6the xiphoid process

T8the costal arch

T10the umbilicus

T12the anterior superior iliac spine

 

. The lumbar plexus (15 min)
1. Formation: part of T12(inconstant),L1-3 and part of L4

2. Location: situated in the psoas major

3 Main branches

1) The iliohypogastric N

2) The ilioinguinal N

3) The lateral femoral cutaneous

4) The femoral N

Course:descends beneath the inguinal ligment to enter the femoral trigone on the lateral side of the femoral atery

Main branches: saphenous N (cutaneous N)

Distribution:suppies the quadriceps femoris, sartorius and pectineus. The sensory branches supply the anterior and medial surfaces of the thigh and the saphneous nerve to the medial side of the leg and foot.

Clinical features of the N. lesion: impossible to flex the thigh . The extension of the leg and the knee jerk are lost.

5) The obturator N: distributed to the muscles and skin of the medial side of the thigh.

6) The genitofemoral N: distributed to the cresmater and skin over the scrotum( or the greater lip of pudendum).

 

. The sacral plexus (25 min)

1. Formation: L4-5(the lumbosacral trunk), the anterior branches of the sacral and coccygeal nerves.

2. Location:situated in front of the piriformis on the posterior wall of the pelvis.

3. Main branches:

1) The superior gluteal N:supplies the gluteus medius and minimus and the tensor fasciae latae.

2) The inferior gluteal N:supplies the gluteus maximus.

3) The posterior femoral cutaneous N

4) The pudendal N:

 The anal N(inferior rectal N);

 The perineal N;

 The dorsal N of penis or clitoris

5) The sciatic N

Course: leaves the pelvis through the greater sciatic foramen below the piriformis, and descends between the greater trochanter of the femur and the ischial tuberosity along the posterior surface of the thigh to the popliteal fossa, where it terminates by dividing into the tibial and common peroneal nerves.

Distribution:supplies the muscles and skin of the posterior side of the thigh.

Branches:

A.The tibial N

a.Course: descends between the superficial and deep layers of the posterior muscles of the leg and enters to the sole of the foot.

b.Branches: back of the legthe medial sural cutaneous N.;  sole of the footthe medial and lateral plantar nerves

c.Distribution: the posterior muscles of the leg and the muscles of the sole of the foot.

  d.Clinical features of the N. lesion: “hook-like” foot.

B. The common peroneal N

a.Course:passes around the neck of the fibula to enter deep to the peroneus longus and is divided into the superficial and deep peroneal nerves.

b.Branches: in the back of the legthe lateral sural cutaneous N.; in the anterior and lateral sides of the legthe superficial and deep peroneal nerves.

c.Distribution: the superficial peroneal nerve supplies the lateral muscles of the leg; the deep peroneal nerve supplies the anterior muscles of the leg and the muscles of the dorsal foot.

  d.Clinical features of the N. lesion: “foot-drop” or “taplies equinovarus”.

 

 

Emphasis:

1. Composition and components of the spinal nerves.

2. Main branches and distrbition of the median nerve, ulnar nerve, radial nerve, musculocutaneous nerve and axillary nerve, and the clinical signs of injury to these nerves.

3. Main branches and distribution of the femoral nerve

4. Course, branches and distribution of the sciatic nerve.

5. Distribution of the tibial nerve and the common peroneal nerve, and the clinical signs of injury to these nerves..

 

Difficulty:

Course of the spinal nerves

 

教学手段与方法:

1Multimedia assistant teaching

2Network station:http://202.116.15.22:100/

3Specimen,illustrations and anatomical models

 

思考题、讨论题或作业:

1. Which nerve may be injuried after fracture of the surgical neck of the humerus, and analyze the clinical features of the nerve lesion.

2. Which nerve may be injuried after fracture of the medial epicondyle of the humerus, and analyze the clinical features of the nerve lesion.

3. Which nerve may be injuried after fracture of the fibular neck, and analyze the clinical features of the nerve lesion.

参考资料(包括辅助教材、参考书、文献等):

1Susan Standring .Gray’s anatomy (Thirty-ninth edition). Churchill Livingstone.London,UK.2004

2Keith L. Moore, Anne M. R. Agur.Essential clinical anatomy(Second edition). Lippincott Williams & Wilkins. Baltimore:USA. 2002

3Richard S. Snell. Clinical anatomy for medical students. (Sixth edition). Lippincott Williams & Wilkins. Baltimore:USA. 2000

4Stephen G. Waxman. Correlative neuroanatomy.(Twenty-fourth edition). McGraw-HILL.New York. USA.2000

 

 

 

 

 

      Systematic Anatomy      课程教案

授课题目(教学章节或主题):

Cranial nerves

授课类型 

     Lecture

授课时间

20065 29

14周 星期一 第79

教学内容(包括基本内容、重点、难点三部分):

Objective

1. To master the names, order, component, location to attached to the brain and cranial exit in the base of the skull.

2. To master the function and distribution of the olfactory nerve.

3. To master the function and course of the optic nerve.

4. To master the component, course, and distribution of the oculomotor nerve. To master the parasympathetic component of the oculomotor nerve and its function. To know location and component of the ciliary ganglion. To know the clinical signs of injury to the oculomotor nerve.

5. To master the course and distribution of the trochlear nerve.

6.To master the component and distribution of the trigeminal nerve. To master the location and component of the trigeminal ganglion. To master the branches and distribution of the ophthalmic nerve, maxillary nerve and mandibular nerve.

7.To master the course and distribution of the abducent nerve.

8.To master the component, course, main branches(chorda tympani and branches outside the facial canal) and distribution of the facial nerve. To know the clinical signs of injury to the facial nerve. To know the location and communication of the pterygopalatine ganglion and submamdibualr ganglion.

9.To master the course and function of the vestibulocochlear nerve.

10.To master the component, main branches(lingual branch and carotid branch) and distribution of the glossopharnygeal nerve. To know the location and communication of the otic ganglion.

11.To master the component, course and distribution of the vagus nerve. To master the course and distribution of the superior laryngeal nerve. To master the course and distribution of the left and right recurrent pharyngeal nerves. To know the branches and distribution of the anterior and posterior vagal trunks.

12.To master the course and distribution of the accessory nerve. To know the clinical signs of injury to the nerve.

13.To master the course and distribution of the hypoglossal nerve. To know the clinical signs of the injury to the nerve.

Basic content:

. Introduction

1. The names and orders of the cranial nerves (10 min)

   I olfactory N;       II optic N;     III oculomotor N;    IV trochlear N;

   V trigeminal N;      VI abducent N;  VII facial N;       VIII vestibulocochlear;

IX glossopharyngeal N; X vagus N;      XI accessory N;     XII hypoglossal N

2. Functional components of the cranial nerves (10 min)

1) Somatic efferent(motor) fibers

2) Special visceral efferent fibers

3) General visceral efferent fibers

4) General somatic afferent(sensory) fibers

5) Special somatic afferent(sensory) fibers

6) General visceral afferent fibers

7) Special visceral afferent fibers

 

.12 pairs of the cranial nerves

1. Olfactory nerve (5 min)

      The olfactory nerves(olfactory filaments) are the central processes of the olfactory cells in the olfactory mucosa of the nase and perforate the cribriform plate , end in the olfactory bulb.

2.Optic nerve (5 min)

      Arise from the ganglion cells in the retina and converge on the optic disc, pass through the optic canal into the cranial fossa .after forming the optic chiasm, it changes its name to optic tract.

3. Oculomotor nerve (20 min)

     Arise from the oculomotor nucleus and the accessory oculomotor nucleus(Edinger-Westphal nucleus). It enters the orbit through the superior orbital fissure and supplies the levator palpebrae superioris, superior , medial, and inferior rectus muscles, and the inferior oblique muscle, the ciliary and the constrictor pupillae muscles.

The ciliary ganglion is a parasympathetic ganglion. The preganglionic fibers of the oculomotor nerve are relayed in the ganglion. The cells in the ganglion give rise to fibers which supplies the ciliary and the constrictor pupillae muscles.

4. Trochlear nerve (5 min)

    Originates from the trochlear nucleus . It enters the orbit through the superior orbital fissure and supplies the superior oblique muscle.

5. Abducent nerve (5 min)
  
Originates from the abducent nucleus . It enters the orbit through the superior orbital fissure and supplies the lateral rectus muscle.

6. Trigeminal nerve (20 min)
1) Roots of the trigeminal nerve: contains a large sensory root, which originates in the trigeminal ganglion , and a smaller motor root, which originates in the motor nucleus of V.

2) Three divisions: the ophthalmic, maxillary and mandibular nerves.

(1) The ophthalmic N: distribution in the face above the fissure of the eye.

The lacrimal N

The frontal N

The nasocilliary N

(2) The maxillary N: distribution in the face between the fissures of the eye and the mouth

The infraorbital N

The zygomatic N

The pterygopalatine N

The superior alveolar nerves

(3) The mandibular N: sensory distribution in the face below the fissure of the mouth, the motor fibers to supply the masticatory muscles, mylohyoid, tensor tympani muscle

The auriculotemporal N

The buccal N

The lingual N

The inferior alveolar N

The nerve of masticatory muscles

7. The facial nerve (20 min)

1) Components: (l) the somatic efferent fibers take origin from the facial nucleus and supply the muscles of expression, (2) the visceral efferent fibers arise from the superior salivatory nucleus and control the secretion of the lacrimal gland, the submandibular and sublingual salivary glands and the mucous membrane of the nose and palate, and (3) the visceral afferent fibers arise from the cells of the geniculate ganglion. The periphery processes of the ganglionic cells are distributed to the taste buds on the anterior 2/3 of the tongue.

2) Course: passes through the internal acoustic meatus, and enters the facial canal. The nerve leaves the facial canal through the stylomastoid foramen, then runs forward into the parotid gland. Finally, it is distributed to muscles of expression .

3) The branches within the facial canal

(1) The greater petrosal nerve: distributed to the lacrimal gland and the glands of the nose and palate.

(2) The chorda tympani: distributed to the mucous membrane covering the anterior 2/3 of the tongue, the submandibular and sublingual glands.

(3) The stapedial nerve

4) The branches outside the facial canal: supply the muscles of expression.

(1) The temporal branches

(2) The zygomatic branches

(3) The buccal branches

(4) The marginal mandibular branch

(5) The cervical branch

5) The parasyrnpathetic ganglia

(l) The pterygopalatine ganglion: The fibers of the greater petrosal.nerve enter and are relayed in the ganglion. The cells in the ganglion send the postganglionic fibers to distribute to the lacrimal gland and the mucous membrane of the nasal cavity and palate and control their se, cretion .

(2) The submandibular ganglion: The fibers of the chorda tympani enter and are relayed in the ganglion. The cells in the ganglion send the postganglionic fibers to distribute to the submandibular and sublingual glands and control their secretions.

6) The clinical features of the facial nerve lesion

(1) Lesion in the facial canal : wrinkles on the forehead are smoothed out, the eye can not shut voluntarily, the nasolabial fold becomes smooth on the affected side; when a smile is attempted ,the angle of mouth draw to the unaffected side; there is a loss of taste in the anterior 2/3 of the tongue;reduced salivation;the sounds are very loud in the affected ear due to the paralysis of the stapedius .

(2) Lesion outside the facial canal : there is paralysis of the muscles of expression only.

8. The vestibulocochlear (acoustic) nerve (5 min)

    It consists of choclear nerve and vestibular nerve.

1) The cochlear nerve(for hearing):Peripheral processes are distributed to the spiral organ (organ of Corti). And central processes form the cochlear nerve and end in the ventral and dorsal cochlear nuclei.

2) The vestibular nerve(for equilibrium): Peripheral processes are distributed to the ampullae of the semicircular canals and the maculas of the utricle and saccule, and the central processes form the vestibular nerve and end in the vestibular nuclei.

9. The glossopharyngeal nerve (10 min)

1) Components:

the somatic efferent fibers arise from the ambiguous nucleus and supply the stylopharyngeus;

the visceral efferent fibers arise from inferior salivatory nucleus and control the secretion of the parotid gland;

the visceral afferent fibers arise from the inferior ganglion to supply the mucous membrane of the pharynx, the tonsil, the middle ear, the posterior 1/3 of the tongue, and the carotid glomus and the carotid sinus;

the somatic afferent fibers arise from the superior ganglion and supply the skin of the posterior surface of the auricle.

2) Course: The nerve leaves the skull through the jugular foramen, and passes forwards between the internal jugular vein and internal carotid artery to reach the root of the tongue.

3) The main branches

(l) The tympanic nerve : distributed to the parotid gland.

(2) The carotid sinus branch (often double):  descends along the internal carotid artery to the wall of carotid sinus and the carotid glomus.

(3) The lingual branches : distributed to the posterior 1/3 of the tongue. They contains both fibers of special sense (taste) and of general sensations.

(4) The pharyngeal branches: distributed to the pharynx and the stylopharyngeus.

4) The otic ganglion: its preganglionic fibers come from the lesser petrosal nerve. The postganglionic fibers pass through a communicating branch to the auriculotemporal nerve which supplies the parotid gland.

10. The vagus nerve (20 min)
1) Components :

The visceral efferent fibers

The visceral afferent fibers

The somatic afferent fibers

The somatic efferent fibers

2) Course: It leaves the skull through the jugular foramen and descends within the carotid sheath. The vagus nerve enters the thorax and forms the pulmonary plexus and the esophageal plexus. Left vagus descends in front of the esophagus to form the anterior vagal trunk, right vagus descends behind the esophagus to form the posterior vagal trunk. The vagal trunks enter the abdominal cavity through the esophageal hiatus of the diaphragm and divide into their terminal branches. The anterior vagal trunk divides into the anterior gastric branches and the hepatic branches; the posterior vagal trunk divides into the posterior gastric branches and the celiac branches.

3) The branches of the vagus nerve

(1) The branches in the neck

The superior laryngeal nerve : distributed to the mucous membrane of the larynx above the level of the fissure of glottis and the cricothyroid .

The cervical cardiac branches: form the cardiac plexuses and distributed to the heart and the wall of the aorta.

The pharyngeal branch

(2) The branches in the thorax

The recurrent laryngeal nerve: enters the larynx and then is named the inferior laryngeal nerve. The nerve supplies all the muscles of larynx except for the cricothyroid, and is distributed to the mucous membrane of the larynx below the level of glottis.

The broncheal branches,and the esophageal branches

(3) The branches in the abdomen

The anterior gastric branches and posterior gastric branches : are distributed to the stomach. The branch reaching to the pyloric canal and pylorus is named the “crowls foot".

The hepatic branches: join the hepatic plexus and supply the liver and gallbladder to regulate the bile secretion.

The celiac branches: join the celiac plexus and supply most viscera of the abdomen and alimentary tract anterior to transverse colon.

4) Clinical feature of the vagus lesion

Unilateral injury of the recurrent laryngeal nerve produce the paralysis of vocal fold on the same side, resulting in a weak hoarse voice. Bilateral injury of the recurrent laryngeal nerves produce aphonia and even apnea.

11. The accessory nerve (5 min)

1) Root :consists of the cranial and spinal roots. The smaller cranial root arises from the ambiguous nucleus. The cranial root arises from the accessory nucleus in the anterior horn of the upper 5-6 cervical segments.

2) Course: leave the skull through the jugular foramen.

3) Distribution: The cranial root is distributed to the sternocleidomastoid and the trapezius.The spinal root joins the vagus and supplies the muscles of the larynx and pharynx.

12. The hypoglossal nerve (10 min)

1) Origin: arises from the hypoglossal nucleus.

2) Course: leaves the skull through the hypoglossal canal.

3) Distribution: supplies all the extrinsic and intrinsic muscles of the tongue (with the exception of the palatoglossus).

4) Clinical feature of the hypoglossal nerve lesion

    Injury to the hypoglossal nerve results in paralysis and atrophy of the affected side of the tongue. The tongue deviates to the paralyzed side during protrusion.

 

Emphasis:

1. Component and distribution of the oculomotor nerve.

2. Division and distribution of the trigeminal nerve.

3. Main branches and distribution of the facial nerve, and the clinical signs of injury to the facial nerve.

4. Main branches and distribution of the glossopharyngeal nerve.

5. Main branches and distribution of the vagus nerve.

 

Difficulty:

1. Course of the cranial nerves.

2. Components of parasympathetic ganglia.

 

教学手段与方法:

1Multimedia assistant teaching

2Network station:http://202.116.15.22:100/

3Specimen,illustrations and anatomical models

 

思考题、讨论题或作业:

1. Describe which nerves innervate the tongue.

 Describe which nerves supply the tongue.

2. Describe which nerves innervate the eyeball. Describe which nerves supply the eyeball.

3. Narrate the main distribution of the facial nerve, and the clinical signs of injury to the facial nerve.

 

参考资料(包括辅助教材、参考书、文献等):

1Susan Standring .Gray’s anatomy (Thirty-ninth edition). Churchill Livingstone.London,UK.2004

2Keith L. Moore, Anne M. R. Agur.Essential clinical anatomy(Second edition). Lippincott Williams & Wilkins. Baltimore:USA. 2002

3Richard S. Snell. Clinical anatomy for medical students. (Sixth edition). Lippincott Williams & Wilkins. Baltimore:USA. 2000

4Stephen G. Waxman. Correlative neuroanatomy.(Twenty-fourth edition). McGraw-HILL.New York. USA.2000

 

      Systematic Anatomy      课程教案

授课题目(教学章节或主题):

Telencephalon

授课类型 

     Lecture

授课时间

20066 5

15周 星期一 第79

教学内容(包括基本内容、重点、难点三部分):

Objective

1.To master the main fissures or sulci and gyri of the cerebrum. To master the division of the cerebral hemisphere.

2.To master the location and composition of the basal nuclei. To know the function of the basal neuclei.

3.To know the kinds of the fibers composited of the cerebral medullary substance. To know the location and fiber connection of the corpus callosum. To master the location, division of the internal capsule. To master the locations and functions of the main fibers in the internal capsule.

4.To master the location, division and communication of the lateral ventricle.

5.To master the functional localization of the somesthetic area, motor area, visual area, acoustic area and language areas in the cerebral cortex. To know the functional localization of the gnostic area and taste area.

6.To know the conception of the limbic system.

Basic content:

. External structure
1 Three constant fissures(sulci) and five lobes (10 min)

1) Three constant fissures: the lateral cerebral fissure( of Sylvius), the central sulcus( of Rolando) and the parietooccipital fissure

2) Five lobes: the frontal lobe, the parietal lobe, the occipital lobe, the temporal lobe and the insula.

2 The main gyri and sulci on the dorsolateral surface of the hemisphere (15 min)

The frontal lobe

    the precentral sulcus and the precentral gyrus, the superior and middle suci and the superior, middle and inferior frontal gyri.

The parietal lobe

     the postocentral sulcus and the postocentral gyrus, the intraparietal sulcus and the superior and inferior parietal lobues, the supramarginal gyrus and the angular gyrus.

The temporal lobe

     the superior and inferior sulci and the superior, middle and inferior gyri, two transverse temporal gyri.

3. The main gyri and sulci on the medial surface of the hemisphere (10 min)

    the paracentral lobule, corpus callosum, cingulate gyrus , parietooccipital fissure, calcarine fissure, cuneus, lingual gyrus, hippocampal fissure and dentate gyrus , and hippocampus.

4. The main gyri and sulci on the inferior surface of the hemisphere (5 min)

  The frontal lobe: the olfactory bulb, the olfactory tract and the olfactory trigone

  The temporal lobe: parahippocampal gyrus, uncus

 

. Internal structure

    is composed of the cerebral cortex, the cerebral medullary substance, the basal ganglia and two lateral ventricles.

1. Lateral ventricles (10 min)

Location: one in each cerebral hemisphere

Division: the anterior horn, posterior horn, inferior horn and central part(body)

Communication: communicate with the third ventricle through the two interventricular foramens( of Monro)

2. The basal ganglia (basal nuclei) (10 in)

    include the lentiform nucleus, the caudate nucleus, the claustrum and the amygdaloid body.

3. The cerebral cortex (40 min)

      According to phylogenesis, the cerebral cortex can be divided into archicortex(hippocampus, dentate gyrus), paleocortex(rhinencephalon), neocortex. The former two contain three layers, and the neocortex contains six layers. The pyramidal cells are the most important cells in the cortex.

Classification of principal areas          

      According to Brodmann’s classification system (based on cytoarchitecture), the cerebral cortex can be divided into 52 areas.

Functional localizations of the cerebral cortex

A. the somesthetic area(primary sensory area)

I. Location: the postcentral gyrus and the posterior part of the paracentral lobule (parietal lobe-area 3,1, and 2)

II. Features :

 a the primary sensory area are dicussated

 b the somatotopic representation is inverted.

 c the size of the cortical area for the body parts is determined by its need for sensitivity

B. the primary motor area
I. Location: the precentral gyrus and the anterior part of the paracentral lobule (frontal lobe-area 4. Area 6 is the premotor area)

II. Features :

a the primary motor area are dicussated

b the somatotopic representation is inverted.

c the size of the cortical area for the body parts is determined by the its need for importance and dexterity of the movement

C. Visual area

  Surrounds the calcarine sulcus of the occipital lobe (occipital lobe-area 17) . The visual cortex is also termed the striate area. Each visual area receives data from the temporal half of the ipsilateral retina and the nasal half of the contralateral retina.

D. The acoustic area ( auditory area)

      In the transverse temporal gyri( temporal lobe-areas 41 and 42). Each auditory area receives the auditory radiation from the cochlea of the both ears.

E. The taste area (gustatory area) : close to the facial sensory and extends onto the opercular surface of the lateral cerebral fissure(parietal lobe-area 43)

F.The gnostic area

     corresponds to areas 5,7,39,40 and receives inputs from multiple sensory modalities and integrates them. 

H. The language areas ( dominant hemisphere)

I. The motor speech area (Broca’s area) : in the opercular and triangular portion of the inferior frontal gyrus ( frontal lobe-area 44 and 45)

II. The auditory speech area ( Wernicke’s area) : in the posterior portion of the superior temporal gyrus( temporal lobe-area 22)

III. The writing word area : in the posterior portion of the middle frontal gyrus (frontal lobe-area 8).

IV. The visual speech area : in the angular gyrus( parietal lobe-area 39)

4. The medullary substance (30 min)

The association fibers: connect the gyri in one hemisphere

The commissural fibers: connect the gyri in one hemisphere to in the other hemisphere.Such as the corpus callosum and fornix

The projection fibers: connect the cortex with the subcortical structures.

A The internal capsule : is a broad band of myelinated fibers that between the lentiform nucleus and the medial caudate nucleus, thalamus.

B Division of the internal capsule: The anterior limb, the posterior limb and genu.

     The anterior limb: between the lentiform nucleus and the medial caudate nucleus. It contains the anterior thalamic radiation and frontopontine tract. 

The posterior limb : between the lentiform nucleus and the thalamus. It contains the corticospinal tract, thalamocortical tract, optic radiation, acoustic radiation, parieto-occopito-temporo-pontine tract, corticorubral tract

   The genu: in the junction of the anterior and posterior limbs. It contains the corticonuclear tract.

C The lesion of the internal capsule

     Anesthesia and hemiplegia on the opposite side of the body, and blindness in the opposite visual field

5. The limbic system (10 min)

Composition: the limbic lobe(parahippocampal, cingulated, and subcallosal gyri), the amygdala, and hippocampal formation and associated structure.

Function:contributes to the preservation of the individual and the continuation of the species.

 

三.Summmary (10 min)

 

 

 

Emphasis:

1. Main fissures or sulci and gyri of the cerebrum

2. Location and composition of the basal nuclei

3. Location, division and fibers of internal capsule

4. Functional localization of the somesthetic area, motor area, visual area, acoustic area and language areas in the cerebral cortex

 

Difficulty:

1.     Conception of internal capsule

2.     Conception of the limbic system

教学手段与方法:

1Multimedia assistant teaching

2Network station:http://202.116.15.22:100/

3Specimen,illustrations and anatomical models

思考题、讨论题或作业:

1.Discuss the clinical signs of lesion to the internal capsule by the anatomical knowledge.

2.Describe the location and features of the somesthetic area(primary sensory area).

3.Describe the composition of the limbic system.

参考资料(包括辅助教材、参考书、文献等):

1Susan Standring .Gray’s anatomy (Thirty-ninth edition). Churchill Livingstone.London,UK.2004

2Keith L. Moore, Anne M. R. Agur.Essential clinical anatomy(Second edition). Lippincott Williams & Wilkins. Baltimore:USA. 2002

3Richard S. Snell. Clinical anatomy for medical students. (Sixth edition). Lippincott Williams & Wilkins. Baltimore:USA. 2000

4Stephen G. Waxman. Correlative neuroanatomy.(Twenty-fourth edition). McGraw-HILL.New York. USA.2000

 

      Systematic Anatomy      课程教案

授课题目(教学章节或主题):

Sensory Pathways,

Motor Pathways

授课类型 

     Lecture

授课时间

20066 12

16周 星期一 第79

教学内容(包括基本内容、重点、难点三部分):

Objective

Part one The sensory pathways

1. To master orign and projection area of the conscious deep sensory pathway of the trunk and limbs. To master the locations of the three orders of neurons and position of decussation of the medial lemniscus of the pathway. To know the unconscious deep sensory pathway

2. To master origin and projection area of the superficial sensory pathway of trunk and limbs. To master the locations of the three orders of neurons and position of decussation of the 2nd neurons of the pathway. To master origin and projection area of the superficial sensory pathway of head and face. To master the locations of the three orders of neurons and position of decussation of the trigeminal lemniscus of the pathway.

3. To master the composition, decussation and projection area of the visual pathway. To master the route of the pupillary reflexes.

4. To know the acoustic pathway and equilibratory pathway.

 

Part two The motor pathways

1. To master the compostion of the pyramidal system. To master the conceptin of the upper and lower motor neurons. To know the clinical signs of the injury to the upper and lower motor neurons.

2. To master the orign, location through the internal capsule and specificity of the controlled cranial nerve neuclei of the corticoneuclear tract. To master the anatomical basis between the supranuclear paralysis and infranuclear paralysis. To master the origin, ending, location in the internal capsule and brain stem of the corticospinal tract. To master the conception of the pyramidal decussation.

3. To master the composition and function of the extrapyramidal system. To know the composition of the corticoponto-cerebellar-cortex circuit.

4. To know the chemical pathways of the nervous system.

Basic content:

Part one The sensory pathways

. Introduction (5 min)

Divided into 4 groups: superficial, deep, visceral and special. Most sensory pathways contain three orders of neurons:  the first order neurons in the spinal ganglia; the second neurons in the spinal cord or brain stem; the third neurons in the ventral posterior nucleus of the thalamus .

1.    The deep sensory (or the proprioceptive) pathways (20 min)

(1) The conscious deep sensory pathways

The deep sensory pathway of trunk and limbs 

    Receptors of the muscle, tendon, periosteum and joint, and skinthe spinal ganglia(the first neurons)gracile fasciculus and cuneate fasciculus the gracile and cuneate nuclei(the second neurons)    medial lemniscus the ventral posterolateral(VPL) nucleus of the thalamus( the third neurons) superior and middle parts of the postcentral gyrus and the postetior part of the paracentral lobule.

The deep sensory pathways of head and face: is not known.

(2) The unconscious deep sensory pathway

      The receptors of the muscles, tendon, periosteum and jointthe spinal ganglia (the first order neurous) the central processes of the first order neurous the thoracic nucleus and posterior grey horn(the second neurons)the anterior or posterior spinocerebellar tractthe cerebellum

2. The superficial sensory pathways (25 min)

   Convey the sensation of pain, temperature and rude tactile from the skin and mucosa to the centers.

(1) The superficial sensory pathway of trunk and limbs

The pain and thermal pathway

The cutaneous exteroceptor of the trunk and limbs the spinal ganglia (the first neurons) the dorsolateral fasciculus( upward within one or two segments ) Laminae I, IV and V of the posterior horn( the second neurons)    lateral spinothalamic tract the ventral posterolateral(VPL) nucleus of the thalamus( the third neurons)the upper and middle parts of the postcentral gyrus, and the posterior part of the paracentral lobule.

The rude tactile and pressure sensasion pathway

    The rute is almost same as the pain and thermal pathway except that fibers of the first order neurons enter into the spinal cord through lateral part and the axons of the second neurons form the bilateral anterior spinothalamic tracts.

(2) The superficial sensory pathway of head and face

     The superficial receptor in the skin and mucosa of the head and facethe trigeminal ganglion(the first neurons) the central processesthe spinal and pontine nuclei of the trigeminal nerve (pain and temperature sensationspinal nucleus, touch sensationpontine nucleus, the second neurons)   the trigeminal lemniscus→ the ventral posteromedial(VPM) nucleus of the thalamus(the third neurons) the inferior part of the postcentral gyrus.

3. The visual pathways (30 min)

(l) The visual pathway

     The receptors (rods and cones) the bipolar cells (the first order neurons) the ganglion cells (the second neurons) optic nerve the optic chiasma(fibers from the nasal halves of the retinae cross) the optic tract Within the chiasma a partial decussationthe lateral geniculate nucleusthe optic radiation(geniculocalcarine tract)the calcarine sulcus of the occipital lobe

(2) Pupillary light reflexes

Pathway

Direct and indirect(or consensual) papillary light reflexes

Clinical features of visual pathway lesion

4.The acoustic(auditory) pathway (10 min)

   Receptors(spiral organ of Corti) the bipolar cells in the spiral ganglion(the first order neurons) the cochlear nervethe cochlear nuclei(the second neurons)         the lateral lemniscus (also receive the fibers from the ipsilateral superior olivary nucleus and the cochlear nuclei) the medial geniculate body(the third neurons)the acoustic radiationthe transverse temporal gyri .

5.The equilibratory pathway (10 min)

     Receptors (the cristae ampullae, maculae of the utricle and saccule)bipolar neurons in the vestibular ganglion (the first order neurons) the vestibular nerve the vestibular nucleus ( the second neurons) →①the medial longitudinal fasciculus;the vestibulospinal tract;entering the

   Cerebellum via the inferior cerebellar peduncle;connecting with the reticular formation of brain stem, vagus and glossopharyngeal nuclei;connecting with the temporal, parietal and frontal cortex of the hemisphere.

Part two  The Motor (descending) Pathways

   concerned with motor function, and include pyramidal system and extrapyramidal system.

1. The pyramidal system (40 min)

     It is concerned with the voluntary movement of the skeletal muscles.

     It is composed of two orders of neurons: the upper and lower motor neurons.

      The upper motor neurons: giant pyramidal cells (Betz cells) and other pyramidal cells in the precentral gyrus and paracentral lobule,including their axons (the corticonuclear tract and the corticospinal tract).

The lower motor neurons: cranial motor cells of the brain stem, motor cells of the anterior horn of the spinal cord including their axons(cranial nerves and spinal nerves).

(l) The corticonuclear(corticobulbar) tract

   Pyramidal neurons in the inferior part of the precentral gyrus the corticonuclear tractthrough the genu of internal capsulethe bilateral motor nuclei of the cranial nerves(oculomotor, trochlear,abducent, trigeminal motor, ambiguous, accessory nuclei and superior part of the facial nucleus, and to the contralateral hypoglossal nucleus and the inferior part of the facial nucleus) .

(2) The corticospinal tract

   Pyramidal cells of the superior and middle parts of the precentral gyrus and the paracentral lobulethe corticospinal tract through the posterior limb of internal capsule the intermediate 3/5 of the cerebral crus the basilar part of the pons the ventral part of the medulla oblongata lateral corticospinal tract  ipsilateral and contralateral anterior horns of spinal cord anterior corticospinal tract (above the mid-thoracic segments) the anterior horn .

(3) Clinical features of the upper and lower motor neurons lesion

2. The extrapyramidal system (10 min)

     It is the nervous pathways which influence and control the movement of body except the pyramidal system. The system includes the corpus striatum, cerebellum, together with the subthalamic nucleus, substantia nigra, red nucleus, and brain stem reticular formation.

     The ma, in functions: regulate the muscles tone, coordinate the muscular activities, maintain the normal body posture and produce habitual and rhythmic movements.

(l) The cortico-pallidal system

(2) The corticoponto-cerebellar system

 

Emphasis:

1. The superficial sensory pathway.

2. The visual pathway

3. The corticonuclear(corticobulbar) tract

4. The corticospinal tract

Difficulty:

 Analyze the clinical features of nervous pathway lesion.

 

教学手段与方法:

1Multimedia assistant teaching

2Network station:http://202.116.15.22:100/

3Specimen,illustrations and anatomical models

 

思考题、讨论题或作业:

1. Discuss the clinical features of visual pathway lesion.

2. Discuss the clinical features of the corticonuclear(corticobulbar) tract lesion on one side.

 

参考资料(包括辅助教材、参考书、文献等):

1Susan Standring .Gray’s anatomy (Thirty-ninth edition). Churchill Livingstone.London,UK.2004

2Keith L. Moore, Anne M. R. Agur.Essential clinical anatomy(Second edition). Lippincott Williams & Wilkins. Baltimore:USA. 2002

3Richard S. Snell. Clinical anatomy for medical students. (Sixth edition). Lippincott Williams & Wilkins. Baltimore:USA. 2000

4Stephen G. Waxman. Correlative neuroanatomy.(Twenty-fourth edition). McGraw-HILL.New York. USA.2000

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