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Anatomy and Physiology 2011/12

For 2011-12 the Physiology and Anatomy Sessions have been combined to consist of a full day's training. These sessions will be for CT1 trainees only and will be a compulsory part of their curriculum. Trainees will be expected to take a full days study leave for sessions where Physiology is combined to Anatomy and trainees will be expected read up on and attend both sessions. Each session is limited to 18 attendees so please ensure you register onto your desired sessions.

Anatomy and Physiology Teaching

Participants: compulsory for all CT1s (including LATs).

Availability: Each module for anatomy and physiology is run twice to allow choice for attendance. Please only book one option for each module. Each module only has places for a maximum of 18 trainees.

Registration: via individual Event registration.

Objective: Anatomy and Physiology teaching to support learning for ISCP curriculum and for MRCS examinations. Emphasis is given to continuing professional education rather than ‘coaching’ for the MRCS examinations.

Dates: See below. 5 anatomy modules and 4 physiology modules are delivered on Tuesdays and it is advised that CT1s ensure that they combine anatomy and physiology teaching sessions. On the Tuesdays where anatomy and physiology modules are provided, it is recommended that the whole day be taken as study leave to allow for self-study and travel in the mornings.

Organisation: Anatomy and physiology teaching are linked by dates. CT1s are advised to take study leave for the whole day (except for the anatomy module 3 which is not linked to physiology teaching).

Curriculum: see attached documents for anatomy and physiology modules.

Preparation: Trainees are expected to read up and study on the module topics before attendance in order to gain maximal educational benefit from the teaching.

Dates

Tuesday 18th October/Tuesday 1st November

  • Anatomy module 1 (Thorax and Spine)
  • Physiology module 1 (Applied Physiology and Shock)

Tuesday 22nd November/Tuesday 29th November

  • Anatomy module 2 (Abdomen and Pelvis)
  • Physiology module 2(Applied Physiology of Hypoxia and Hypercapnia)

Tuesday 6th December/Tuesday 13th December

  • Anatomy module 3 (Upper Limb)

Tuesday 14th February/Tuesday 21st February

  • Anatomy module 4 (Lower Limb)
  • Physiology module 3 (Regulation of blood volume and osmolarity)

Tuesday 13th March/Tuesday 20th March

  • Anatomy module 5 (Head, Neck and Neuroanatomy)
  • Physiology module 4 (Pain. Acid base balance)

Venue

Physiology

Applied and Integrated Medical Sciences Centre for Excellence in Teaching and Learning, University of Bristol
School of Medical Sciences
University Walk
Bristol
BS8 1TD

Anatomy

Centre for Clinical and Comparative Anatomy
University of Bristol
Southwell Street
Bristol
BS2 8EJ

General Information

Refreshments: Core trainees are advised to bring their own refreshments or to make their own arrangements for food and refreshments during the 30-minute gap between physiology and anatomy modules on Tuesdays at 5pm. There are numerous cafes and sandwich shops in the vicinity that are easily accessible during the short walk from the physiology venue to the anatomy venues.

Travel: No car-parking arrangements are available at the University of Bristol and surrounding areas are for ‘residents-only’. There are NCP car parks available 10-15 minutes away by foot. Good bus and train links are available to Bristol and the University (University Transport Details). Trainees are advised to plan their travel and if coming by car are advised to offer a lift to colleagues.

Attendance outcomes: A record of attendance will be kept by the Deanery. Attendance details are provided to your Programme Directors and will be assessed at the yearly ARCPs. Certificates will be provided for each module to trainees, who attend, for their portfolio.

Trainee feedback: Trainees will be asked to provide anonymised feedback on each module. This is important for the School of Surgery to ensure that the standards of delivery and content of the teaching is maximized for Severn School of Surgery core trainees in the future.

Non-attendance: Failure to attend a module requires a trainee to complete an explanation form and is returnable to Chad Elliott at the School of Surgery.

Physiology Information

The teaching will be divided into four modules each run twice. Places will be limited to 18 core trainees per session via the on-line registration system. The sessions are designed to improve understanding of physiological and pathophysiological concepts as detailed below. They will consist of seminars, case study discussions, hands-on physiology practical sessions and interactive Human Patient Simulator (HPS) demonstrations. The balance of activities in each of the four sessions will vary according to the topic being considered. Core trainees are expected to have read-up on the relevant topics prior to the sessions – these sessions are intended to be demonstrations and re-enforcement of existing knowledge. These sessions are compulsory for year 1 core trainees. Each 1st year must attend 1 of the physiology sessions.

Overview of the sessions: Core Training Physiology Objectives

Anatomy Information

The Severn School of Surgery programme for anatomy teaching will be held in the Department of Anatomy at the School of Veterinary Sciences, University of Bristol, Southwell Street, Bristol. The sessions will be held in the evenings from 5:30pm to 8:30pm to allow as many core trainees to attend without impacting on clinical work/training. Teaching will be provided by senior clinical anatomy demonstrators under the direction of Dr Alice Roberts. Core trainees are expected to have read-up on the relevant anatomical topics prior to the sessions – these sessions are intended to be demonstrations and re-enforcement of existing knowledge. Places will be limited to 18 core trainees per session via the on-line registration system. All core trainees must bring hospital ID cards as proof of identification to be allowed access to the Veterinary School. Please note refreshments/food will not be served, but drinks are available for purchase from dispensing machines at the Veterinary School.

Directions

We are very keen to receive feedback for these sessions as it is the only way they can be improved. Therefore we would be very grateful is all trainees who attend sessions could take the time to complete the following feedback form and email it to Chad Elliott.

Severn School of Surgery – Core Anatomy Teaching Curriculum

Anatomy: Thorax and spine

Vertebral column

  • Vertebrae, including: characteristics of vertebrae from different regions of the vertebral column; movements; development and stabilisation of curvatures
  • Contents of the vertebral canal: meninges, spinal cord, spinal nerve roots, spinal nerves; relationships to vertebrae and intervertebral joints; anatomical basis of spinal pathologies, eg: back pain, intervertebral disc prolapse, injuries to spinal cord and nerves, and whiplash injuries; anatomical basis of lumbar puncture, regional and epidural anaesthesia
  • Surface anatomy and muscle groups of the back
  • Dermatomes and peripheral nerve distribution; myotomes; basic neurological examination of the limbs and trunk

Thorax

  • Thoracic walls, including: anatomy of intercostal spaces; diaphragm; functional anatomy of ventilation; anatomical basis of pneumothorax, and placement of chest drain for simple and tension pneumothorax
  • Pleural cavities and lungs, including: extent and surface markings; lymphatic drainage of lungs and its role in lung cancer metastases; anatomical basis of lung and pleural disease
  • Mediastinum, including: main divisions and contents; anatomy of the heart and great vessels, including surface projections; anatomical basis of common congenital cardiac abnormalities, heart murmurs and their effects; function and arrangement of the coronary arteries; position and function of heart valves; anatomical basis of coronary artery and valve disease and surgery, and referred pain from phrenic and intercostal nerves; placement of chest drain for cardiac tamponade
  • Thoracic inlet and outlet, including major structures passing between the neck and thorax; possible complications of when inserting central venous lines
  • Thoracic outlet, including major structures passing between the thorax and abdomen

Anatomy: Abdomen and pelvis

Abdomen

  • Anterior and posterior abdominal walls, inguinal region, peritoneal cavity
  • The anatomy of abdominal contents (including relationships, blood supply, lymphatic drainage, innervation): oesophagus, stomach, small and large intestines, appendix, liver, gallbladder, pancreas, spleen, kidneys, ureters and adrenal glands; the anatomical basis of arterial occlusion and strangulation of the intestines, intestinal surgery, portal hypertension, metastatic spread of cancer and referred pain (especially from the gallbladder and appendix), spread of infection into the subhepatic and subphrenic spaces
  • Surface anatomy, in particular relation to examination of the abdomen and of the inguinal region for hernias
  • Radiology, in particular: diagnostic images of the alimentary, pancreato-biliary and urinary tracts

Pelvis and perineum

  • Pelvic bones, joints, ligaments; muscles of the pelvic side wall and pelvic floor
  • Pelvic peritoneum and fascia; anatomical basis of ectopic pregnancy, prolapse and suprapubic catheterisation
  • The anatomy of pelvic contents (including relationships, blood supply, lymphatic drainage, innervation): ureters, bladder, urethra, rectum, anal canal; internal and external genitalia (in the female: ovaries, uterine tubes, uterus, vagina; in the male: vas deferens, seminal vesicles, prostate)
  • Perineum and external genitalia (vulva in the female; scrotum, testis, penis in the male); ischioanal fossa
  • Anatomical basis of metastatic spread of cancer in the pelvis; rectal and vaginal examinations; urinary catheterisation in males and females; cervical smear

Anatomy: Breast and upper limb

Axilla and breast

  • Boundaries and contents of axilla: brachial plexus, axillary artery, lymph nodes (particularly in relation to lymphatic drainage of breast and metastatic spread of breast cancer and melanoma)

Upper limb

  • Bones, including surface anatomy and radiological appearance; sites of common fractures (clavicle, humerus, distal radius, scaphoid) and complications
  • Factors influencing stability of the shoulder, elbow, wrist and interphalangeal joints; common injuries and their consequences (eg: shoulder, elbow, finger dislocations)
  • Nerves and vessels, including course and distribution, key relations, major pulse points, eg: subclavian, brachial, radial pulses; common sites of peripheral nerve injury and their functional effects (brachial plexus, axillary, radial, ulnar, median nerve lesions)
  • Anatomical basis of common conditions, including: rotator cuff injuries, carpal tunnel syndrome.

Anatomy: Lower limb

  • Bones, including surface anatomy and radiological appearance; sites of common fractures (neck and shaft of femur; tibia and fibula) and complications
  • Factors influencing stability of the hip, knee and ankle joints; common ligamentous injuries and tests for ligamentous integrity
  • Nerves and vessels, including course and distribution, key relations, major pulse points, eg: femoral, popliteal, posterior tibial and dorsal pedal pulses; veins in relation to sites of venepuncture, venous cut-downs and varicose veins; anatomical basis of varicosities, DVT and embolism; common sites of peripheral nerve injury and their functional effects (eg: sciatic and common peroneal lesions); deep fascia of the lower limb and compartment syndromes
  • Basis of neurological examination of the lower limb, including dermatomes, myotomes and functional muscle groups
  • Lymphatic drainage to inguinal lymph nodes (limb, trunk skin and perineum)

Anatomy: Head, Neck and Neuroanatomy

Head and Neck

  • Major palpable and imaging features of the skull and cervical spine
  • Course and distribution of the cranial nerves (including anatomical basis of facial nerve palsy and neurological examination)
  • The anatomy of major structures (including relationships, neurovascular supply, lymphatic drainage): ear and pharyngotympanic tube; anatomical basis of conductive and sensorineural deafness, otalgia, and referred pain to the ear; orbit, eye, eyelids and conjunctivae; nasal cavity and sinuses (including anatomical basis of epistaxis and sinusitis); oral cavity and tongue; palate and pharynx, including tonsils (including anatomical basis of quinsy, dysphagia); salivary glands (including blockage and swellings); larynx and trachea (including anatomical baiss of upper airway obstruction, infantile stridor, vocal nerve paralysis and hoarseness; airway management, endotracheal and nasogastric tube insertion; tracheostomy and laryngotomy), thyroid and parathyroid glands; contents of carotid sheath
  • Fascia and fascial spaces of the neck in relation to spread of infection; cervical swellings

Neuroanatomy

  • Blood supply and venous drainage of the brain and spinal cord; anatomical basis of stroke
  • Meninges; major dural venous sinuses
  • CSF production, circulation and drainage (including subarachnoid space and ventricular system)
  • The anatomy of major structures within the CNS (including position, organisation, connections, vascular supply, venous drainage and key relations): cerebral cortex, internal capsule, cerebellum, basal ganglia, thalamus, hypothalamus, brainstem, spinal cord
  • Main motor and sensory pathways of the brain and spinal cord; spinal reflexes
  • Recognition of the signs and symptoms of common neurological disorders and intracranial haemorrhages