8 surprisingly powerful ways to answer anatomy exam questions

How to learn anatomy

1. In order to learn anatomy, you must focus on building a three-dimensional picture of anatomy in your mind. Do not see structures as isolated, but rather in relation to one another. Visualize the body as a map. Once you learn to read it, you will always be able to identify the structures. Kenhub is such an excellent resource as it combines the visual with the written and also tests your knowledge with quizzes. Acland’s video Atlas is also an excellent option if you want to develop the three-dimensional image of anatomy in your head.

This will also stand you in good stead for a career in surgery, as surgeons must know the three-dimensional anatomy of a procedure in order to operate safely. Videos, photographs and diagrams are far more beneficial than text written on a page. This text should supplement your knowledge, and provide you with basic facts, e.g., the spinal roots of a nerve, or the insertion of a tendon.

Building up this three dimensional image is essential, as you will be able to deduce which structures are which, by applying it to the task at hand. Always start with the bones. The bones form the foundation for the muscles and visceral tissue, and a good understanding of bony landmarks, muscle insertion points and tendinous attachments will build up this three dimensional image. For example, the lesser trochanter on the posteromedial aspect of the superior femoral shaft is the insertion of the iliopsoas muscle. Two muscles form Iliopsoas: iliacus and psoas major. The former is innervated by the femoral nerve and the later by the lumbar plexus direct branches. The nerve roots of the femoral nerve are L2-L4 posterior divisions. This is how you build anatomical knowledge, by linking it to other knowledge.

2. Learn the muscles by compartments (anterior compartment of the thigh , flexor compartment of the arm, etc). If you know which muscles lie in which compartment, then you can work the answer out. For example, if you are in your anatomy exam, and you see the pin has been placed on the lateral compartment of the leg, you will know it is either fibularis longus or brevis. If you see the pin in the anterior compartment of the thigh, you know it is one of the quadriceps muscles (vastus medialis, intermedius, lateralis or rectus femoris). This will make your job a lot easier, especially in multiple-choice exams.

3. Acronyms can also be helpful for learning anatomical structures. For example, the lumbar plexus branches can be learnt by the acronym: 'I twice Get Lunch On Fridays' (Iliohypogastric, Ilioinguinal, Genitofemoral, Lateral femoral cutaneous, obturator, femoral).

Other things are much easier to learn by simple identification; e.g. the carpals (scaphoid and lunate articulate with the radius, triquetrum on the ulnar side, and the pea shaped pisiform sits on top of it). The trapezium with the thumb, the trapezoid adjacent to it, the capitate (like a capital city in the middle of the country), articulates with the middle metacarpal. The hamate with its hook then articulates with the remaining two lateral metacarpals. The cranial nerves are also much easier to learn by simple identification on a model or diagram.

Prosections based exams

4. The kinds of questions they can ask you in this type of exam are limited. The structures they pin must be visible to you, and hence are unlikely to be lymphatic vessels, very small arteries or nerves, or deep small structures of the abdominal, thoracic and cranial cavities. They are most likely to test you on nerves, muscles and arteries of the limbs. The cranial cavity (bony elements), as well as cranial nerves and foramina are also easily tested. Cardiac anatomy is also readily tested, as the coronary arteries, valves, and cardiac chambers are clearly identifiable in a decent prosection.

5. Focus your learning on the topics you have covered in your syllabus, and also address the structures that are visible in prosections in your revision. Theoretical anatomy will give you limited benefit in this type of exam. If you have access to your dissecting room out of timetabled sessions, it is highly advisable to access it and practice identifying the structures. Remember that the more times you see the anatomy the more likely you are to remember it.

Dissection (in course assessment)

6. Your skill in dissection may form a proportion of your end of year mark. The key things for dissection are:

• Do not cut randomly; study the anatomy if you do not know it. If you go in without planning, you will most likely damage structures beneath the surface.
• Be aware of landmarks where nerves and vessels run.
• You should know the anatomy well enough to identify variation. This is a significant part of your assessment. It shows you are paying attention, and you may write it up as a case report if it has clinical relevance.
• Use scalpels only on the skin. Blunt dissection should be used otherwise. It can be used to separate muscle from muscle, and nerve from artery.

Be methodical in the approach to your dissection. For example, when dissecting the arm:

When you cut the skin, be brave and ensure you cut through the entire skin, through to the subcutaneous fascia. The skin and fat should be reflected together, and the fascia should be neatly incised. The muscles should then be identified and separated. Be careful not to cut a muscle artery or nerve. The scalpel should be used on the skin only. You should almost always use blunt dissection (splay open scissors to separate structures, use blunt probes to divide structures stuck together with fascia).

Blunt dissection will also build up the kind of skills you will need to be a surgeon. Anatomical knowledge will alert you of certain areas to be wary of. For example, the ulnar nerve runs behind the medial epicondyle, so be wary when dissecting here not to damage the nerve. The radial artery enters the hand by passing between the two heads of the first dorsal interosseus, and forms the deep palmar arch. When removing the skin from the dorsal aspect of the hand, it is therefore advisable to be careful to not damage the radial artery.

Written exams

7. These exams will rely on your knowledge of anatomy that is not in front of you. You could theoretically be asked anything about the human body. Nerve roots, muscle actions and insertions, innervations, functional areas of the body, etc. This style of exam is the most difficult. You could be tested on anything that is part of your syllabus. The best way to deal with this is to learn the content they have provided you and read around the topic, e.g., if you are learning the muscle, learn the actions and innervations as you go along. This will save you time in the long run.

8. If you decide to make notes on your lecture/tutorials, keep them concise and draw plenty of diagrams. Watch videos and use your notes to give you textbook knowledge, e.g., the functions of all the 12 cranial nerves, the blood supply to the hand, etc. These are things that you will find it difficult to see, and therefore must learn. Many written questions may be multiple choice, which will make it easier to get the correct answer. They may also focus on function, e.g., what are the two actions of the biceps brachii? The answer is supination and elbow flexion.