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Download KUHS MBBS 1st Year Human Anatomy Syllabus

Download KUHS (Kerala University of Health Sciences) MBBS (Bachelor of Medicine, Bachelor of Surgery) 1st Year Human Anatomy Syllabus

This post was last modified on 06 August 2021


Present in clause 2.10 of the curriculum.
2.9 Teaching learning methods
As shown in clause 2.4 course outline.
2.10 Content of each subject in each year

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HUMAN ANATOMY
(I) GOAL

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The broad goal of teaching of undergraduate students in Anatomy aims at providing
comprehensive knowledge of the gross and microscopic structure and development of human body
to provide a basis for understanding the clinical correlation of organs or structures involved and
the anatomical basis for the disease presentations
(II) OBJECTIVES

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At the end of the course the students shall be
able to:
(A) Knowledge
Comprehend the normal disposition, clinically relevant interrelationships, functional and

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cross sectional anatomy of the various structures in the body.
Identify the microscopic structure and correlate elementary ultra-structure of various organs
and tissues and correlate the structure with the functions as a prerequisite for
understanding the altered state in various disease processes.
Comprehend the basic structure and connections of the central nervous system and

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analyse the integrative and regulative functions of the organs and systems. He/She shall be
able to explain the developmental basis of the major variations and abnormalities.
Demonstrate knowledge of the basic principles and sequential development of the
Organs and systems; recognize the critical stages of development and the effects of
common teratogen, genetic mutations and environmental hazards. He

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/She shall able to explain the developmental basis of the major variations and
abnormalities.
(B)Skills
At the end of the course the student shall be able to:
Identify and locate all the structures of the body and mark the topography of the living

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anatomy
Identify the organs and tissues under the microscope
Understand the principles of Karyotyping and identify the gross congenital anomalies.
Understand principles of newer imaging techniques and interpretation of Computerized
Tomography (CT) Scan sonogram etc.

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Understand clinical basis of some common clinical procedures i.e. intramuscular and
intravenous injection, lumbar puncture and kidney biopsy etc.
8



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(C)Integration
From the integrated teaching of other basic sciences, students
shall be able to comprehend the regulation and integration of the functions
of the organs and systems in the body and thus interpret the anatomical basis
of disease process.

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(III) DETAILED SYLLABUS-DETAILS OF THE COURSE
Duration of the Course
Semesters
2
Total number of hours

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650
Lectures
95
Seminars
37

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Practicals
518
Innovation session (projects, structured discussion, integrated teaching,
formative evaluation and revision) Part of practicals:
DETAILS OF LECTURES

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1. General Anatomy




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: 15hr
Epithelium: Classification, simple and compound epithelium, glandular
and sensory epithelium
:
2hr

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Connective tissue: Cells, matrix
: 2hr
Cartilage: Classification, structure, cells and matrix
: 1hr
Bone: Types, types of epiphysis, microscopy. Ossification in brief, blood supply : 2hr

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Joints: Classification and structure of synovial joint
: 1hr
Vascular tissue: Elastic artery, medium sized artery, large vein
:
1hr

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Lymphatic tissue: General features, lymph node- structure and function,
spleen, structure and circulation, Tonsil, Thymus
:
2hr
Muscular tissue: Structure of Skeletal, Smooth and cardiac Muscles

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:
1hr
Skin: Structure of thin and thick skin
:
1hr

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Nervous tissue: Neurons, Neuroglia, peripheral nerve structure optic nerve
structure, Schwann cells, myelination, myelinated nerve fibre, Ganglia
:
2hr
2General Embryology

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: 11hr
Oogenesis, Ovarian Cycle
:
1hr
Menstrual cycle

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:
1hr
Male reproductive system- Spermatogenesis
:
1hr

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Fertilization, Implantation, assisted reproductive techniques
:
1hr
Bilaminar embryo
:

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1hr
9


Trilaminar embryo
:

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1hr
Intraembryonic mesoderm and folding of embryo
:
2hr
Formation and circulation of placenta

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:
1hr
Foetal membranes
:
1hr

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Twinning and teratology (Structure of Umbilical cord and placenta
to be taught along with General Embryology)
:
1hr
2 Gross Anatomy

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(X-rays and surface marking of each region to be taken after the
dissection of the corresponding region is completed)
Upper Limb
:
4hr

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Brachial plexus
:
1hr
Mammary gland
:

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1hr
Shoulder joint:
Palmar space
:
1hr

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Seminars (Give more importance to applied Anatomy)
:
8hr
Axilla and Axillary artery
:

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1hr
Venous and lymphatic drainage of upper limb
:
1hr
Radio-Ulnar joints, Pronation & supination

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:
1hr
Brachial artery, Anastomoses around elbow joint
:
1hr

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Radial nerve, Ulnar nerve, Median nerve
:
2hr
Retinacula
:

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1hr
Elbow joint, wrist joint, Ist carpometacarpal Joint
:
1hr
Lower Limb

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:
4hr
Hip joint
:
1hr

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Arches of foot
:
1hr
Knee joint
:

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1hr
Development of Limbs, Dermatomes of Upper and Lower Limbs : 1hr
Seminars (Give more importance to applied
Anatomy)
:

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6hr
Venous and lymphatic drainage of lower
limb
:
1hr

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10


Femoral triangle, Adductor canal
:
1hr

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Obturator nerve, Sciatic Nerve
:
1hr
Femoral artery and nerve
:

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1hr
Ankle joint, Popliteal fossa
:
1hr
Sub talar joint, inversion and eversion

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:
1hr
Thorax
:
9 hr

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Thoracic wall (including movements)
:
1hr
Pleura
:

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1hr
Lungs including development of lung
:
1hr
Pericardium

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:
1hr
Blood supply of heart
:
1hr

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Arterial arches
:
1hr
Foetal circulation
:

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1hr
Development of heart
:
2hr
Seminars (Give more importance to applied Anatomy)

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: 5hr
Mediastinum-Boundaries and contents
:
1hr
Thoracic duct, Esophagus, Thoracic Aorta

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:
1hr
Veins of Thorax :
1hr
Chambers of heart-All chambers

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:
1hr
Splanchnic nerves, sympathetic trunk
:
1 hr

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Genetics
:
4hr
Classification of chromosomes, karyotyping, sex chromosomes,
Barr body

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:
1hr
Normal male, normal female, Chromosomal aberrations-in brief
:
1hr

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Turner's syndrome, Klinefelter's syndrome and Down's syndromes
(Charts tobe shown) Genetic Counseling, Pedigree Chart, Genetic
Engineering and inheritance
: 2hr
11

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Head& Neck
: 17hr
Scalp
: 1hr

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Parotid Gland
: 1hr
Development of face
: 1hr
Pituitary gland

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: 1hr
Dural venous sinuses
: 1hr
: 1hr
Cervical fascia

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: 1hr
Development of branchial arches
: 1hr
Extra Ocular muscles
: 1hr

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T. M. Joint
: 1hr
Thyroid gland
: 1hr
Cervical Sympathetic

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: : : 1hr
Pharynx
: 1hr
Larynx
: 1hr

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Eyeball, Layers-development in brief
: 1hr
Tongue
: 1hr
Facial Nerve

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: 1hr
Middle Ear
Seminars (Give more importance to applied Anatomy)
: 12hr
Suboccipital triangle

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: 1hr
Eyelid and lacrimal apparatus
: 1hr
Nasal cavity, PNS
: 1hr

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Soft palate, Palatine tonsil
: 1hr
Muscles of facial expression
: 1hr
Vessels and nerves of the face

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: 1hr
Posterior triangle of neck
: 1hr
Anterior triangles of neck
: 1hr

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Mandibular nerve, occulomotor nerve
: 1hr
Submandibular and sublingual gland
: 1hr
Lymph nodes of head and neck

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: 1hr
Hyoglossus muscle
: 1hr

Brain and Spinal Cord

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:15Hrs
Spinal cord- external features and blood supply
: 1hr
Blood supply of brain- Superficialand deep,
: 1hr

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Meninges & cisterns
: 1 hr
Medulla oblongata
: 1hr
Pons

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: 1hr
12


Cerebellum
: 1hr

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4th Ventricle
: 1hr
3rd Ventricle, Lateral ventricles
: 1hr
Midbrian

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: 1hr
Sulci, gyri and functional areas of cortex
: 1hr
: 1hr
White matter & Internal capsule

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: 1hr
Visual pathway
: 1hr
Basal ganglia
: 1hr

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Thalamus
Development of CNS IN BRIEF including functional Column : 1hr
Abdomen, Pelvis, and Perineum
: 16hrs
Anterior abdominal wall and Rectus sheath

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: 1hr
Inguinal canal, Spermatic cord and descent of testis
: 1hr
Peritoneum in brief
: 1hr

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Development of GIT, derivatives and anomalies
:1hr
Stomach including development
: 1hr
Portal vein

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: 1hr
Liver
: 1hr
Kidney -gross features, development and anomalies
: 1hr

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Diaphram - gross features, development
: 1hr
Uterus- gross features, development and anomalies
: 1hr
Prostate and male urethra

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: 1hr
Rectum and Anal canal
: 1hr
Urinary bladder
: 1hr

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Perineal Pouches
: 1hr
Ischiorectal fossa
: 1hr
Pelvic floor

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: 1hr
Seminars (Give more importance to applied Anatomy Lymphatic drainage
and blood supply of all organs should be given importance
: 6hr
Duodenum and development

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: 1hr
Pancreas, spleen
: 1hr
Extra hepatic biliary apparatus
:1hr

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Coeliac trunk, Supra renal gland
:1hr
Ureter, Pudendal nerve
:1hr
Caecum, Vermiform appendix

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: 1hr

Diagrams
I Cross Section Diagrams

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A upper limb

13


No. Name
Fig.

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Pg.No Book
1.
Section through middle of arm
Cunningham's manual of practical Anatomy
68

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68
15th Edn Vol. 1
2.
Oblique section through the hand
Cunningham's manual of practical Anatomy

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88
90
15th Edn Vol. 1
B. Lower limb
1.

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Transverse section through
Gray's Anatomy 40 th Edn
80.2 1351
middle of right thigh
2.

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Transverse section through
Cunningham's manual of practical Anatomy
182
196
middle of leg

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15th Edn Vol. 1
3.
Transverse section through knee
Cunningham's manual of practical Anatomy
joint

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202
218
15th Edn vol.1
C. Neck
Transverse section through the

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Cunningham's manual of practical Anatomy
neck at the level of cricoid(C6
62
76
15th Edn Vol-3

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level) cartilage
D. Thorax
1
Horizontal section through the
Cunningham's manual of practical Anatomy

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thorax at the level of T-4
70
58
15th Edn Vol-2
Vertebra

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E. Abdomen
Horizontal section through
1
the abdomen at the level
139 124

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Cunningham's manual of practical Anatomy
of epiploic foramen-T12
15th Edn Vol-2
vertebra
Horizontal section through the

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2
abdomen at the level pylorus -
128
116 Cunningham's manual of practical Anatomy
L1vertebra

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15th Edn Vol-2
Horizontal section through the
Cunningham's manual of practical Anatomy
3
abdomen at the level of -L4

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129
116 15th Edn Vol-2
F. Brain
Transverse section of spinal
6.8

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80
IB singh Text Book of Neuro Anatomy 9th Edn.
1
cord showing ascending &
descending tracts.

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Transverse section of medulla
IB singh Text Book of Neuro Anatomy 9th Edn.
2
at the level of Pyramidal
8.2

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96
decussation
3
Transverse section of
8.3

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97
IB singh Text Book of Neuro Anatomy 9th Edn.
medulla at the level of
sensory decussation
4

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Transverse section of medulla at
8.4
98
IB singh Text Book of Neuro Anatomy 9th Edn.
the level of olive

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14


5
Transverse section at the level
8.9

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102 IB singh Text Book of Neuro Anatomy
of lower part of pons (at the
9th Edn.
level of facial colliculus
6

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Transverse section at the level
8.11
104 IB singh Text Book of Neuro Anatomy 9th Edn.
of upper part of pons
7

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Transverse section at the level
8.16
106 IB singh Text Book of Neuro Anatomy 9th Edn.
of lower part of mid brain (at
the level of inferior colliculus)

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8
Transverse section at the level
8.19 108
IB singh Text Book of Neuro Anatomy 9th Edn.
of upper part of mid brain (at

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the level of superior colliculus)
9
Horizontal section at the level of
282
286 Cunningham's manual of practical Anatomy

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inter ventricular foramen
15th Edn Vol-3
II SAGITTAL SECTION
1
Sagittal section through shoulder

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64
65
Cunningham's manual of practical Anatomy
15th Edn Vol-1
2

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Median section of brain
238
255 Cunningham's manual of practical Anatomy
15th Edn Vol-3
3

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Median section through
235
216 Cunningham's manual of practical Anatomy
malepelvis
15th Edn Vol-2

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4
Median section through female
236
216 Cunningham's manual of practical Anatomy
pelvis

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15th Edn Vol-2
111 GROSS ANATOMY
A
Upper limb
1

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Typical spinal Nerve
2
6
Cunningham's manual of practical Anatomy
15th Edn Vol-1

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2
Brachial plexus
24
33
Cunningham's manual of practical Anatomy

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15th Edn Vol-1
3
Anastomosis around elbow joint
80
82

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Cunningham's manual of practical Anatomy
15th Edn Vol-1
Superficial palmar arch 4 Deep
4
90

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92
Cunningham's manual of practical Anatomy
palmar arch
15th Edn Vol-1
B

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Lower limb
1
Femoral triangle
131
140 Cunningham's manual of practical Anatomy

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15th Edn Vol-1
2
Longitudinal arches of foot -
213
226 Cunningham's manual of practical Anatomy

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Medial -
15th Edn Vol-1
15


Gray's Anatomy 41st

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3
Structures surrounding the hip
81.5 1377
Edn.
joint

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C
Thorax
1
Typical intercostal space
16

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12
Cunningham's manual of practical Anatomy
15th Edn Vol-2
Relations of heart & great
53

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44
Cunningham's manual of practical Anatomy
2
vessels to the anterior wall of
15th Edn Vol-2

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thorax Surfacemarking- Borders
, Surfaces, valves of heart)
3
51
41

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Cunningham's manual of practical Anatomy 15th
Sternocostal surface of the heart
Edn Vol-2
4
40

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32
Cunningham's manual of practical Anatomy 15th
Mediastinal surface of lung -Left
Edn Vol-2
lung

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5
41
33
Cunningham's manual of practical Anatomy 15th
Mediastinal surface of lung - Right

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Edn Vol-2
lung
d. Abdomen
1
Visceral surface of liver

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176
156 Cunningham's manual of practical Anatomy
15th Edn Vol-2
2
Structures seen posterior to

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149
132 Cunningham's manual of practical Anatomy
the stomach
15th Edn Vol-2
3

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Anterior surface of right and left
191
169 Cunningham's manual of practical Anatomy 15th
kidneys showing relations
Edn Vol-2

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4
Posterior surface of right
190
168 Cunningham's manual of practical Anatomy 15th
and left kidneys showing

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Edn Vol-2
e. Herel
adati
a o
n n

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d s
neck
1
Diagrammatic section of eyeball
164

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184
Cunningham's manual of practical Anatomy
15th Edn Vol-3
2
Dissection of

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111
131
Cunningham's manual of practical Anatomy
submandibular region
15th Edn Vol-3

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showing hyoglossus muscle
and its relations
3
Distribution of cutaneous nerves
75

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98
Cunningham's manual of practical Anatomy
to Head & Neck
15th Edn Vol-3
f. Brain

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1
Circle of willis
196
218
Cunningham's manual of practical Anatomy

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15th Edn Vol-3
2
Blood supply of cerebrum
a
197

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198 Cunningham's manual of practical Anatomy
Inferior Surface
15th Edn Vol-3
16


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b
Superolateral surface
201
221 Cunningham's manual of practical Anatomy
15th Edn Vol-3

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c
Medial surface
232
250 Cunningham's manual of practical Anatomy
15th Edn Vol-3

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6
Floor of IV ventricle- posterior view
243 Cunningham's manual of practical Anatomy
227
15th Edn Vol-3

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7
Sulci, gyri of cerebral hemisphere
a
Superolateral surface
182 IB singh Text Book of Neuro Anatomy 9th Edn.

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13.6A
b
Medial surface
184 IB singh Text Book of Neuro Anatomy 9th Edn.
13.8A

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c
Inferior Surface
186 IB singh Text Book of Neuro Anatomy 9th Edn.
13.10 A
The question on the diagrams in the question paper carrying 4 marks

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(2marks each in both Paper 1 & paper 2 should be STRICTLY limited from the above list only)
DETAILS OF PRACTICALS- Dissection including Osteology and Histology)
Upper Limb


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: 60hrs

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Introduction, Pectoral region and axilla, cutaneous
nerves and vessels
The brachial plexus, Axillary artery
The dissection of back
The free upper limb Lymph vesels and lymph nodes of upper limb

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cutaneous nerves of upper limb and deep fascia of upper limb
The shoulder- movements of the limb at the shoulder, the shoulder
joint
The arm- Cubital fossa, anterior compartment, Posterior
compartment of arm

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The forearm and hand, Palmar aponeurosis, superficial palmar arch,
Flexor retinaculum, Flexor tendons
The arteries and nerves of the flexor compartment of the forearm
Muscles of the front of the forearm and hand, deep palmar arch,
Fascial compartments of the palm

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The extensor compartment of the forearm and the hand, Extensor
tendons of the fingers Joints of the upper limb
Elbow joint, wrist joint, radio ulnar joints, intercarpal , carpo
metacarpal & Intermetacarpal joints
Lower limb

--- Content provided by​ FirstRanker.com ---

: 60 hrs
Front of thigh, femoral triangle, adductor canal
Medial side of thigh
17


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Gluteal region
Popliteal fossa
Back of thigh
Hip joint
Front of leg and dorsum of foot, superficial dissection

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Anterior compartment of leg
Lateral and medial compartments of leg, back of leg
Sole of the foot I and II layers, III and IV layers, V and VI layers
Knee joint, Ankle joint, Tibio-fibular and other joints, revision
Thorax

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: 30hrs
Introduction: Walls of thorax,
Cavity of thorax, pleura
Mediastinum, Root of lungs Autonomic nervous system
The lungs, Anterior mediastinum

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Middle mediastinum, surface anatomy of the heart, blood supply
Chambers of heart, right atrium, right ventricle, left ventricle
Aorta, superior mediastinum arch of aorta,left atrium
Conducting system of heart, Thoracic part of aorta Vagus, Oesophagus,
Thoracic duct, Posterior intercostal vessels,

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Joints of thorax, Revision
Head & Neck
: 130 hrs
Cervical vertebrae, Skull, The scalp
The temple and the face, Nerves and vessels of scalp and superficial

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temporal region, The superficial dissection of face
The side of the neck, Posterior triangle, Sub occipital triangle
The anterior triangle of neck, The median region of the front of neck,
subdivisions of anterior triangle,
The cranial cavity: Structures seen after removal of cerebrum,

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Anterior cranial fossa, middle cranial fossa, posterior cranial fossa
Deep dissection of the face: Nerves of the face, Structures in the cheek
and lips The eyelids, The lacrimal apparatus
The orbits, The structures in the orbits ,extraocular muscles, nerves,
ophthalmic artery

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The parotid region, The parotid gland, facial nerve, vessels
The temporal and infratemporal region Temporal fascia, Temporalis muscle
The Superficial contents of the infratemporal fossa Temporomandibular joint,
The deeper contents of the infratemporal fossa,
the submandibular gland, mylohohyiod muscle, hyoglossus

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The mouth and pharynx , Pharyngeal wall, subdivisions of pharynx, soft palate
The cavity of the nose, nasal septum, lateral wall
The larynx,
The tongue
The organs of hearing and equilibrium

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The eye ball
The contents of the vertebral canal,
The joints of the neck.

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Brain
: 42 hrs
Introduction: The membranes of the brain- meninges
The blood vessels of the brain
The medulla, pons,

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The cerebellum, The fourth ventricle The midbrain,
The cerebrum ? sulci, gyri & functional areas
The White matter of cerebrum III ventricle, the lateral ventricle and the choroid fissure
The thalami and the optic tracts
The deep dissection of the hemisphere, deep muclei of the telencephalon,

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The nuclei and connections of the thalamus, Cerebral topography
Abdomen
: 124 hrs
Introduction: Anterior abdominal wall muscles, inguinal canal Nerves and vessels of anterior
abdominal wall

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Male external genital organs
Dissection of the loin
Abdominal Cavity Shape, Boundaries, Divisions of peritoneal cavity Ligaments of liver, Spleen
Oesophagus, Vagal trunk , Stomach
Mesentery, Superior mesenteric artery, Inferior mesenteric artery, Arterial anastomosis

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in GI tract, Structure of small intestine, Large intestine
Duodenum, Portal vein, Ducts of liver Pancreas, Liver, Gall bladder, Cystic duct
Abdominal structures in contact with diaphragm Autonomic nervous system
Supra renal glands, The kidneys, Abdominal part of ureter
The diaphragm, The posteriorabdominal wall muscles,The inferior vena cava,

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Lymph nodes of posteior abdominal wall, The nerves of posterior abdominal wall,
The pelvic viscera, ovaries, uterine tubes,Pelvic part of ureters
Urinary bladder, Internal surface of urinary bladder, Ductus deferens, Prostate, Male urethra,
Uterus, Rectum, Anal canal
Vessels of lesser pelvis, nerves of lesser pelvis, Obturator nerve, Autonomic nerves

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The muscles of lesser pelvis, pelvic diaphragm
Joints of pelvis
Perineum
:12 hrs
Ischiorectal fossa,

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Perineal pouches Perineal body, Pudendal canal
Histology
: 60 hrs
Epithelium
Connective tissue

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Cartilage- Hyaline, elastic, fibro cartilage
Bone- Compact bone- C.S & L.S
Muscles- Skeletal, Smooth, cardiac

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Nervous tissue- neuron, nerve fibre, sciatic and optic nerves, sympathetic, spinal ganglia
Blood vessel- Large and medium sized artery, large and medium sized vein
Lymphoid tissue- lymph node, spleen, thymus, palatine tonsil
Skin- thin, thick
Mammary gland-active &inactive

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Placenta & umbilical cord
Respiratory system- trachea & lung
Nervous system- spinal cord, cerebrum cerebellum
Cornea, retina
Endocrine system- thyroid, parathyroid, supra renal, pituitary

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Excretory system- kidney, ureter, urinary bladder
Reproductive system
a) Male - Testis epididymis, vas deferens, prostate
b) Female ? ovary, uterus- proliferative and secretory, cervix, fallopian tube
Digestive system

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Salivary glands - mucous, serous & mixed,
Pancreas, liver, gall bladder,
Tongue ? filiform, fungiform & circumvallate,
Oesophagus stomach-fundus, pylorus,
Duodenum, jejunum, ileum,

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Large intestine, vermiform appendix
Genetics
Demonstration of karyotyping charts- Normal male, Normal female,
Down syndrome, Turner's Syndrome, Klinefelter's Syndrome,
Chromosome spread

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Prescribed text books
1. Cunningham's Manual of Practical Anatomy-3 Volumes
2. Essentials of Human Anatomy-A.K.Datta, 3 Volumes
3. Inderbir Singh's Text Book of Anatomy - 3 volumes
4. Human Embryology - I.B Singh

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5. IB Singh's Text Book of Human Neuro Anatomy
6. Human Neuro Anatomy-Vishram Singh
7. Text Book of Human Histology-Inder Bir Singh
8. Surface and Radiological Anatomy-A. Halim & A.C.Das
9. Text Book of Osteology by I.B.Singh

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10. Text Book of General Anatomy-G.P.Pal
11. Clinically Anatomy-A Problem solving approach by Neeta V Kulkarni -2 Volumes
12. Gross Anatomy Text Books (3 Vol) ? Dr. Vishram Singh
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Reference text Books

1. Gray's Anatomy
2. Cunningham's text book of Anatomy
3. Grant's Atlas of Anatomy

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4. Langman's Medical Embryology- T. W. Sadler
5. Clinical Neuro Anatomy- Richard S Snell
6. Essentials of Human Embryolgy- A. K. Datta
7. Essentials of Human Genetics- Bhatnagar, Kothari and Lopa Mehta
8. Histology Atlas- De Fiore

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9. Text Book of Histology -Hamilton Bailey
10. Clinically Oriented Anatomy- Keith L Moore
11. Gray's Anatomy for students- Richard L Drake
12. The Developing Human- Moore and Persaud
13. Clinical Anatomy by Regions Richard S Snell

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14. Human genetics -S.D.Gangane
15. Text Book of Human Histology-Gunasekharan
Evaluation
University Examination

Theory

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Paper I
- 50 marks ,


Paper II
? 50 marks

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Viva Voce ? 20 marks ? 4 stations, Embryology, Osteology, Radiology,
Surface marking

Theory
-Topic Division

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Paper I - General Embryology, General Anatomy, Genetics, Upper Limb, Lower
Limb, Thorax
Paper II - Head and Neck, Brain, Abdomen, Pelvis, Perineum
University Practicals
Total 40 marks

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Histology - 15 marks
a) 14 spotters of ? mark each to include one Karyotype also
b) Discussion 2 slides, one systemic and one general = 4 marks each
Gross Anatomy - 25 marks
a) 10 spotters X 1 mark = 10 marks

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b) Discussion
i)
Above diaphragm ? 8 marks
ii) Below diaphragm ? 7 marks
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