General Medicine

Dissections last 12 days, start at 2:30pm and end 5:30pm each day and they finish with the credit interview on the last day. Introductory lectures are a compulsory part of dissections and they take place in great lecture hall on 14:30. Subject of the course is preparation of all anatomical structures of the whole body with the objective to identify its structure and topographical relationships.

Students are divided into groups continuously alternating in preparation of particular regions according to assistant’s instructions.

Recommended textbooks:

• Grant's Dissector, Williams and Wilkins 1999
• Any Atlas of Anatomy from our list
  

Anatomical dissection Credit :
The conditions are: full active attendance in dissections and passing of the final interview, where the structures have to be identified.

(H – head, N – neck, Th – thorax, A/P – abdomen/pelvis, B – back)

day 1

dorsal side
training of dissection technique
Back and neck:orientation in all regions, palpable structures, dissection of skin and subcutaneous fat . med. and lat. branches of cutaneous nerves (intercostal nn.) trapezius m.,.latissimus dorsi m.
Upper Limb: orientation, palpable structures skin incisions and removal of the skin dorsally in whole entire lenght of the determined regions. Skin incisions will be carried out by an assistant.: cutaneous nerves and veins. In the deltoid and scapular regions remove the fascia and dissect following muscles: m. deltoideus, m. supra- et infraspinatus, m. teres minor et major. In posterior brachial and antebrachial regions try to find the n. cutaneus brachii lat., sup., et inf., n. cutaneus antebrachii post., eventually the tributaries of the v. cephalica and v. basilica, r. dorsalis n. ulnaris, r. superf. n. radialis. In the posterior carpal region prepare the rete venosum dorsale manus, nn. digitales dors. comm. et proprii
Lower Limb: orientation, palpable structures skin incisions and removal of the skin dorsally in whole entire length of the determined regions. Try to find nn. clunium (sup., med., inf.) in the glutaeal region. Demonstrate sites of i.m. injection. :
If you are finished , continue the programme of day 9.

day 2

ventral side
training of dissection technique
orientation in all regions, palpable structures, projection of organs onto thoacic (points of auscultation) and abdominal wall (points according to Lanz, McBurney, Murphy) dissection of skin and subcutaneous fat
H: dissection of frontal, parietal et temporal region: spf temporal vessels., supraorbital n. and vessels,.auriculotemporal n
N: ant. et lat. cervical region.: platysma, nervous puncture (punctum nervosum), ext jugular v..
Th: major et minor pectoral m., topography of intercostal space, . int thoracic a..
A/P: spf. epigastric vessels., muscles of abdominal wall, canalis inguinalis, sheath of rectus abdominis. Hernias.
Limbs (UL+LL): Remove the skin – properly. Exercise in the dissection of subcutaneous vessels and nerves
Upper limb: Dissect subcutaneous structures ventrally: v. cephalica, v.basilica and hiatus basilicus, n. cutaneus antebrachii med. et lat., v.obliqua cubiti, palmar aponeurosis, m. palmaris brevis. Carefully enter an axilla
Lower limb : Dissect subcutaneous structures ventrally: v. saphena magna + hiatus saphenus, vasa pudenda externa, vasa epigastrica superficialia, vasa circumflexa ilium superficialia, lymph nodes and cutaneous nerves: rr.cutanei ant. from femoral nerve et rr. cutanei med. from obturator nerve. In the regio dorsalis pedis: Dissect: rete venosum , n.cutaneus dorsalis med., intermed. and lat.

day 3

ventral side
mimic muscles, cutaneous branches of cervical plexus, canalis inguinalis
H: mimic muscles, facial vessels and their branches, n. VII., parotid duct. ,m. orbicularis oculi et. palpebral ligg,. lacrimal gl, canaliculi et saccus lacrimalis, infraorbital n..
N: cutaneous nerves of cervical plexus : minor (lesser) occipital n.,.greater auricular n., transverse cervical n.., supraclavicular nn., ext jugular v., remove m. platysma
Th: prepare opening of thoracic cavity – (make „windows“ in intercostal spaces)
A/P: dissection of canalis inguinalis. clean the aponeurosis m.obliquus abd. ext. and prepare canalis inguinalis.
1. layer:anulus inguinalis spf., n.genitofemoralis, n.ilioinguinalis, lig.inguinale reflexum, funiculus spermaticus
2. layer:m.obliquus abd.internus, tendo conjunctivus, m.cremaster
3. layer:m.transversus abdominis, lig.interfoveolare, trigonum Hesselbachi
Draw a scheme of inguinal canal and repeat hernias!
Upper limb (right): Dissection of the axilla together with students working on the thorax – remove fascia axillaris et fascia brachii and prepare: vasa axillaria, fasciculus med. lat. and dorsalis of the pars infraclavicularis plexus brachialis, n.axillaris, n.radialis, n.medianus, n.ulnaris, n.cutaneus brachii et antebrachii med., a.brachialis, a.profunda brachii, a.circumflexa humeri ant. et post. On the forearm, wrist and hand dissect: n.cut. antebrachii med. et lat., ramus palmaris n. mediani and ulnaris, reflect palmar aponeurosis (distally) and find arcus palmaris superficialis.
Lower limb (left): Finish the dissection of lamina superficialis fasciae latae femoris and hiatus saphenus. Open the fascial covering of m. sartorius, remove fascia lata (sharply demarcate the border of lig.inguinale et tractus iliotibialis), finish the dissection of v.saphena magna, prepare n. saphenus, a.genus descendens and start the dissection of fossa iliopectinea – demonstrate its topography (femoral hernias)

day 4

ventral side
retromandibular fossa, submandibular and submental triangle, opening of thoracic cavity, opening of abdominal cavity
H: continue spf layer dissection. remove spf.part of parotid gland, preserve facial n. plexus., dissect masseter m., temporalis m., retromandibular v. and ext carotid a..
N: submandibular and submental triangle: submandibular gland and duct,. lingual n facial vessels, hypoglossal n., hyoglossus m., mylohyoideus m and n., submental vessels
Th: opening of thoracic cavity demonstartion of situs viscerum thoracis, phrenic n., dissection of sternum: int., thoracic vessels, m. transversus thoracis, demonstration of pleural spaces, corpus thymicum , brachiocephalic vv., sup.v. cava
A/P:. opening of abdominal cavity demonstartion of situs viscerum abdominis
rectus abdominis sheath (vagina) – cut in the midline, sever rectus abdominis m., look for inferior epigastric a., pyramidalis m., arcuate line (linea semicircularis)
Limbs (UL+LL): finish programme of the day 3

day 5

ventral side
entering of infratemporal fossa, resection of zygomatic arch, resection of coronoid process, dissection of carotid triangle, infrahyoid muscles, omental bursa, spermatic cord
H: infratemporal fossa adipous body of cheek, lat. et med pterygoid mm.., maxillary a., buccal n, lingual n. inf.alveolar n., remove venous pterygoid plexus
N: carotid triangle - int. et ext carotid a.,int. Jugular v.., superior thyroid a., sup. laryngeal a. et n., lingual a., arch of n. XII. deep ansa cervicalis., n. X., truncus. sympathicus et ggl. cervicale superius, infrahyoid muscles
Th: arch of aorta , arterious lig.
A/P: : small intestine, dissection of omental bursa, hepatoduodenal lig., coeliac trunk
Dissection of external genitalia ♂- scrotum, spermatic cord,
Upper limb: continue dissection of axilla – subscapular a., anterior et posterior circumflex humeral arteries, quadrangular and triangular spaces (humerotricipital et omotricipital), dissect biceps brachii m., coracobrachial m., brachial m., note relationship between medial septum and ulnar n. Remove forearm fascia (preserve lacertus fibrosus , flexor retinaculum). Dissection of radial group of muscles, radial vessels, radial n.,(spf. and deep branches – its relationship to supinator m.). Dissection of superficial palmar arch and common palmar digital arteries and nerves. Dissection of proper digital arteries (only 2 digits).
Lower limb: dissect femoral triangle and its floor iliopectineal fossa:
Femoral vessels and nerve., profunda femoris vessels, spaces below inguinal lig – lacuna vasorum and musculorum. Remove fascia of anterior crural region, clean superior extensor retinaculum, dissect pes anserinus (common attachement of sartorius, gracilis and semitendinosus), dissect extensor muscles , anterior tibial vessels). Dissect peroneal mm., spf. and deep branches of peroneal (fibular) nerve. Remove fascias of dorsum pedis and lateral retromalleolar region (region behind lateral ankle), clean inferior extensor retinaculum, superior et inferior fibular (peroneal) retinaculum, clean extensor hallucis brevis and extensor digitorum brevis.

day 6

ventral side
lateral cervical triangle, scalenic fissure, mediastinum
H: continue work from previous day . dissect on one side to the depth
N: lateral cervical triangle, scalenic fissure, brachial plexus (pars supraclavicularis) elevation of sternocleidomastoid m., sympathetic nerves + nn. cardiaci,n.X.,thyrocervical trunk, phrenic n.
Th: removal of right lung., dissection of mediastinum from right side
A/P: posterior aspect of anterior abdominal wall,: remove peritoneum and dissect inf.
epigastric vessels, chorda urachi, chorda a.umbilicalis, deferent duct/round lig of uterus
vasa spermatica, vasa colica, removal of small intestine
Limbs (UL+LL): finish programme of the day 5

day 7

ventral side
opening of mandibular canal,
H: finish work from previous day,opening of mandibular canal, eventually exarticulation of temporomandibular joint (one side)
N: finish work from previous day
Th : posterior mediastinum, azygos v,
A/P: removal of large intestine
Upper limb: Cut lacertus fibrosus and dissect cubital fossa – brachial a., median n. (its relationship to pronator teres), collateral and reccurent arteries forming anastomoses around elbow. Clean ventral side of wrist and hand (palm of hand), note relationship of ulnar a. and n. to flexor retinaculum. Cut retinaculum, clean the space of carpal tunnel with its contents. Dissect lumbrical mm., chiasma tendinum (intersection of superficialis and profundus tendons), deep palmar arch, deep branch of ulnar n. Clean fibrous digital sheaths of tendons. Clean and study muscles of thenar and hypothenar.
Lower limb: Finish dissection of profunda femoris vessels, lat. et med. femoral circumflex arteries, perforating arteries, adductor muscles, obturator nerve. Dissection of retromalleolar spaces (behind ankles). Cut and open abductor hallucis, clean plantar muscles.

day 8

ventral side
opening of skull, removal of brain, opening of pericardium and removal of heart , removal of internal abdominal organs , retroperitoneum
H: opening of skull demonstartion of meninges, venous sinuses, cranial nerves
Dissection of sinus cavernosus, cavum trigeminale
Th: opening of pericardium and removal of heart., dissection of coronary arteries.
A/P: removal of internal abdominal organs (as a complex), dissection of retroperitoneum kidneys and suprarenal glands, ureters, splanchnic nerves,, coeliac plexus, thoracic duct
Limbs (UL+LL): complete dissection of anterior aspect of limbs ( finish programme of the day 7)

day 9

dorsal side
orbit, suboccipital triangle, opening of spinal canal, spinal cord
H: dissection of venous sinuses, finish infratemporal and retromandibular fossa,
N :. greater occipital n. and occipital a.., suboccipital triangle, n. occipitalis minor, event. tertius,.vertebral a.
B : trapezius m.,latissimus dorsi , accessory n., thoracodorsal n.,.rhomboid m
meninges of spinal cord, cauda equina,
Upper limb: Dissection of quadrangular and triangular spaces (humerotricipital et omotricipital), follow circumflex scapular artery and its rich anastomotic network with suprascapular a., sever spinal part of deltoid m., dissect axillary n., posterior circumflex humeral artery. Clean heads of triceps, cut lateral head of triceps and follow radial n. and profunda brachii artery. Look for medial collateral artery. Remove fascia of dorsal side of forearm, clean spf. layer of extensors (including anconaeus), clean deep layer of extensors, deep branch of radial n., post interosseal artery. Remove fascias of dorsum of wrist and hand, dissect tendons of extensors (look for extensor indicis) and attachements of extensors of wrist. Dissection of dorsal arterial arch. Dissection of radial a. within the anatomical snuff box (radial foveola), dorsal metacarpal and dorsal digital arteries. Look for dorsal interosseal muscles.
Lower limb: Then lence the glutaeus maximus muscle (orthogonal to its fibres) and reflect it (cut its origin from sacrotuberous ligament). Dissect foramen supra- et infrapiriforme and search for mm.gemelli, tendon of the m. obturatorius int., m. quadratus femoris, n. ischiadicus, n. cutaneus femoris post., vasa et n. glutaeus sup. et inf., vasa pudenda int. (remove veins). In the regio femoris posterior dissect the tributaries of the v. saphena magna, n. cut. femoris post. Distally (main trunk is situated underneath the fascia), remove the fascia lata, prepare the n. cut. femoris post., n. ischiadicus (n. tibialis et peronaeus comm.), hiatus adductorius, vasa poplitea and extensors of the thigh. In the regio cruris posterior prepare the n. suralis, v. saphena parva, remove the fascia (sharply demarcate retinaculum mm. flexorum), lance the tendo calcaneus, unfix the m. triceps surae et m. plantaris longus. In the planta pedis dissect plantar aponeurosis, lance it and reflect it together with the m. flexor dig. brevis and prepare structures in the central compartment of the sole: vasa plantaria, n. plantaris med. et lat. Prepare the m. flexor digitorum brevis, chiasma t
Finish dissection of deep layer of gluteal region, gluteus medius., sever and open gluteus minimus, look for a tendon of obturator externus. Finish dissection of extensors of thigh, , adductor hiatus (opening of adductor canal), popliteal fossa and popliteal vessels, genicular arteries (sup. and inf.), tibial n., common proneal nerve. Clean flexor muscles, posterior tibial vessels and peroneal (fibular) vessels.
Finish dissection of planta pedis (sole of foot) with flexor tendons (intersection between flexor digitorum longus and brevis – chiasma tendineum), common plantar digital nn. and aa., connection between flexor digitorum and quadratus plantae.

day 10

ventral side ( first finish disection on dorsal side if it is necessary)
orbit, scalenovertebral trigonum, topography and blood vessels of pelvis
H: chorda tympani, styloid septum,, n. IX., lig. stylohyoid lig.
Dissection of orbit – both sides:I. layer: frontal a. et n., levator palpebrae superioris,. lacrimal a. et n supratrochlear n., n. IV., lacrimal gland
II. layer / only one side/ : cut levator palpebrae superioris and m. rectus sup. and expose n. III., n.IV., n.VI., nasociliary n., n. ethmoidalis ant. et post., infratrochlear n., nn. ciliares longi et breves, ciliary ggl.
N: scalenovertebral trigonum, vertebral a., ggl. cervicale inf. (stellatum), reccurent laryng.n.
Th:it is possible to remove left lung and dissect mediastinum from the left side: hemiazygos v.,acessory hemiazygos,.thoracic duct, thoracic aorta, vagus. Finish dissection of heart
A/P: topography and blood vessels of pelvis,

day 11

ventral side
finish the course, prepare for examination

day 12

CREDIT examination

Dentistry

Dissections last 10 days, start at 2:30pm and end 5:30pm each day and they finish with the credit interview on the last day. Introductory lectures are a compulsory part of dissections and they take place in great lecture hall on 14:30. Subject of the course is preparation of all anatomical structures of limbs and muscles of the trunk with the objective to identify its structure and topographical relationships.

Students are divided into groups continuously alternating in preparation of particular regions according to assistant’s instructions. Students must identify structures of all regions dissected on the previous day. Starting the third day are the students graded.

Recommended textbooks:

• Grant's Dissector, Williams and Wilkins 1999
• Any Atlas of Anatomy from our list
  

Anatomical dissection Credit :
The conditions are: full active attendance in dissections and passing of the final interview (credit examination), where the structures of dissected bodies have to be identified.

(H – head, N – neck, Th – thorax, A/P – abdomen/pelvis, B – back)

day 1

dorsal side
training of dissection technique
orientation in all regions, palpable structures, dissection of skin and subcutaneous fat .
med. and lat. branches of cutaneous nerves (intercostal nn.) trapezius m.,.latissimus dorsi m.

day 2

ventral side
training of dissection technique
orientation in all regions, palpable structures, projection of organs onto thoacic (points of auscultation) and abdominal wall (points according to Lanz, McBurney, Murphy) dissection of skin and subcutaneous fat
H: dissection of frontal, parietal et temporal region: spf temporal vessels., supraorbital n. and vessels,.auriculotemporal n, mimic muscles, facial vessels and their branches, n. VII., parotid duct. ,m. orbicularis oculi et. palpebral ligg,. lacrimal gl, canaliculi et saccus lacrimalis, infraorbital n..
N: ant. et lat. cervical region.: platysma, nervous puncture (punctum nervosum), ext jugular v.. cutaneous nerves of cervical plexus : minor (lesser) occipital n.,.greater auricular n., transverse cervical n.., supraclavicular nn., ext jugular v., remove m. platysma
Th: major et minor pectoral m., topography of intercostal space, . int thoracic a..
A/P: spf. epigastric vessels., muscles of abdominal wall, canalis inguinalis, sheath of rectus abdominis. Hernias.

day 3

ventral side
mimic muscles, retromandibular fossa, submandibular and submental triangle, opening of thoracic cavity, canalis inguinalis
H: continue spf layer dissection: mimic muscles, remove spf.part of parotid gland, preserve facial n. plexus., dissect masseter m., temporalis m., retromandibular v. and ext carotid a..
N: submandibular and submental triangle: submandibular gland and duct,. lingual n facial vessels, hypoglossal n., hyoglossus m., mylohyoideus m and n., submental vessels
Th: opening of thoracic cavity (make „windows“ in intercostal spaces) demonstartion of situs viscerum thoracis, phrenic n., dissection of sternum: int., thoracic vessels, m. transversus thoracis, demonstration of pleural spaces, corpus thymicum , brachiocephalic vv., sup.v. cava
A/P:. dissection of canalis inguinalis
1. layer:anulus inguinalis spf., n.genitofemoralis, n.ilioinguinalis, lig.inguinale reflexum, funiculus spermaticus
2. layer:m.obliquus abd.internus, tendo conjunctivus, m.cremaster
3. layer:m.transversus abdominis, lig.interfoveolare, trigonum Hesselbachi

day 4

ventral side
entering of infratemporal fossa, resection of zygomatic arch, resection of coronoid process, dissection of carotid triangle, infrahyoid muscles, opening of abdominal cavity, omental bursa, spermatic cord
H: infratemporal fossa adipous body of cheek, lat. et med pterygoid mm.., maxillary a., buccal n, lingual n. inf.alveolar n., remove venous pterygoid plexus
N: carotid triangle - int. et ext carotid a.,int. Jugular v.., superior thyroid a., sup. laryngeal a. et n., lingual a., arch of n. XII. deep ansa cervicalis., n. X., truncus. sympathicus et ggl. cervicale superius, infrahyoid muscles
Th: arch of aorta , arterious lig.
A/P: : opening of abdominal cavity demonstartion of situs viscerum abdominis
small intestine, dissection of omental bursa, hepatoduodenal lig., coeliac trunk
Dissection of external genitalia ♂- scrotum, spermatic cord,

day 5

ventral side
lateral cervical triangle, scalenic fissure, mediastinum
H: continue work from previous day . dissect on one side to the depth, opening of mandibular canal, eventually exarticulation of temporomandibular joint (one side)
N: lateral cervical triangle, scalenic fissure, brachial plexus (pars supraclavicularis) elevation of sternocleidomastoid m., sympathetic nerves + nn. cardiaci,n.X.,thyrocervical trunk, phrenic n.
Th: removal of right lung., dissection of mediastinum from right side, posterior mediastinum structures
A/P: posterior aspect of anterior abdominal wall,: remove peritoneum and dissect inf.
epigastric vessels, chorda urachi, chorda a.umbilicalis, deferent duct/round lig of uterus
vasa spermatica, vasa colica, removal of small intestine

day 6

ventral side
opening of skull, removal of brain, opening of pericardium and removal of heart , removal of internal abdominal organs , retroperitoneum
H: opening of skull demonstartion of meninges, venous sinuses, cranial nerves
Dissection of sinus cavernosus, cavum trigeminale
Th: opening of pericardium and removal of heart., dissection of coronary arteries.
A/P: removal of internal abdominal organs (as a complex), dissection of retroperitoneum kidneys and suprarenal glands, ureters, splanchnic nerves,, coeliac plexus, thoracic duct

day 7

dorsal side
orbit, suboccipital triangle, opening of spinal canal, spinal cord
H: dissection of venous sinuses, finish infratemporal and retromandibular fossa,
N :. greater occipital n. and occipital a.., suboccipital triangle, n. occipitalis minor, event. tertius,.vertebral a.
B : trapezius m.,latissimus dorsi , accessory n., thoracodorsal n.,.rhomboid m
meninges of spinal cord, cauda equina,

day 8

ventral side
orbit, scalenovertebral trigonum, topography and blood vessels of pelvis
H: chorda tympani, styloid septum,, n. IX., lig. stylohyoid lig.
Dissection of orbit – both sides:I. layer: frontal a. et n., levator palpebrae superioris,. lacrimal a. et n supratrochlear n., n. IV., lacrimal gland
II. layer / only one side/ : cut levator palpebrae superioris and m. rectus sup. and expose n. III., n.IV., n.VI., nasociliary n., n. ethmoidalis ant. et post., infratrochlear n., nn. ciliares longi et breves, ciliary ggl.
N: scalenovertebral trigonum, vertebral a., ggl. cervicale inf. (stellatum), reccurent laryng.n.
Th:it is possible to remove left lung and dissect mediastinum from the left side: hemiazygos v.,acessory hemiazygos,.thoracic duct, thoracic aorta, vagus. Finish dissection of heart
A/P: topography and blood vessels of pelvis,

day 9

ventral side
finish the course, prepare for examination

day 10

CREDIT examination