1
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Caggiati A, Labropoulos N, Boyle EM, Drgastin R, Gasparis A, Doganci S, Meissner M. The anterior saphenous vein. Part 2. Anatomic considerations in normal and refluxing patients. Endorsed by the American Vein and Lymphatic Society, the American Venous Forum, and the International Union of Phlebology. J Vasc Surg Venous Lymphat Disord 2024; 12:101855. [PMID: 38551527 DOI: 10.1016/j.jvsv.2024.101855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/19/2024]
Abstract
BACKGROUND The term Anterior Accessory of the Great Saphenous Vein suggests this is a branch tributary vein despite this vessel's anatomic features of a truncal vein. A multisocietal group suggested to designate this the anterior saphenous vein (ASV). This study was aimed to evaluate its ultrasound anatomy in normal and varicose limbs. METHODS The clinical anatomy of the ASV was evaluated by narrative review of the literature. Additionally, the course of the ASV was evaluated in 62 limbs with no evidence of venous disease and 62 limbs with varicosities. RESULTS The ASV length, patterns of origin and termination are reported in both normal and patients with varicose veins. Discussion of the patterns is supported by the narrative review of the literature. CONCLUSIONS The ASV must be considered a truncal vein and its treatment modalities should be the same that for the great and small saphenous veins rather than a tributary vein.
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Affiliation(s)
| | | | - Edward M Boyle
- Inovia Vein Specialty Centers, St Charles Health System, Bend, OR, USA.
| | - Rachel Drgastin
- Inovia Vein Specialty Centers, St Charles Health System, Bend, OR, USA
| | | | - Suat Doganci
- Department of Cardiovascular Surgery, Health Sciences University, Gulhane School of Medicine, Ankara, Turkey
| | - Mark Meissner
- Division of Vascular Surgery, Department of Surgery, University of Washington Medical Center, Seattle, WA, USA
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2
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Łazarz DP, Carmen Yika AD, Pękala JR, Walocha JA, Pękala PA. Clinical anatomy of the human Achilles subtendons twist - meta-analysis. Ann Anat 2024:152271. [PMID: 38677622 DOI: 10.1016/j.aanat.2024.152271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Revised: 04/10/2024] [Accepted: 04/23/2024] [Indexed: 04/29/2024]
Abstract
PURPOSE This study aimed to provide a comprehensive and current overview of the anatomy of the Achilles tendon (AT) twisted structure, as there is a discrepancy in the literature regarding its rotating morphology. METHODS An extensive literature search was conducted across multiple databases to identify all studies that reported relevant data on the AT torsion, with no date or language restrictions applied. Data was extracted and assessed for this meta-analysis following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The quality of the included articles was examined using the anatomical quality assessment (AQUA) tool. RESULTS Seven articles (n=690 limbs) were pooled into this meta-analysis. The prevalence of Achilles tendon torsion types was as follows: type II was the most common (46.7%, 95% CI: 31.6-60.9%), followed by type I (44.7%, 95% CI: 29.8-59.0%), and least commonly, type III (8.6%, 95% CI: 1.8-18.8%). Additionally, morphometric analysis, utilizing the method described by van Gils et al., revealed a mean Achilles tendon torsion of 46.5° (95% CI: 25.1-67.9°). CONCLUSIONS This meta-analysis underscores the prominent and variable twist within the Achilles tendon among individuals, emphasizing the inherent diversity in AT morphology. Furthermore, the study highlights the importance of considering torsion angle as a potential factor influencing AT pathologies and biomechanical function.
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Affiliation(s)
- Dominik P Łazarz
- International Evidence-Based Anatomy Working Group, Cracow, Poland; Department of Anatomy, Jagiellonian University Medical College, Cracow, Poland
| | - Alicia Del Carmen Yika
- International Evidence-Based Anatomy Working Group, Cracow, Poland; Department of Anatomy, Jagiellonian University Medical College, Cracow, Poland
| | - Jakub R Pękala
- International Evidence-Based Anatomy Working Group, Cracow, Poland; Department of Anatomy, Jagiellonian University Medical College, Cracow, Poland
| | - Jerzy A Walocha
- International Evidence-Based Anatomy Working Group, Cracow, Poland; Department of Anatomy, Jagiellonian University Medical College, Cracow, Poland
| | - Przemysław A Pękala
- International Evidence-Based Anatomy Working Group, Cracow, Poland; Department of Anatomy, Jagiellonian University Medical College, Cracow, Poland.
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3
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Valenzuela-Fuenzalida JJ, Inostroza-Wegner A, Osorio-Muñoz F, Milos-Brandenberg D, Santana-Machuca A, Nova Baeza P, Donoso MO, Bruna-Mejias A, Iwanaga J, Sanchis-Gimeno J, Gutierrez-Espinoza H. The Association between Anatomical Variants of Musculoskeletal Structures and Nerve Compressions of the Lower Limb: A Systematic Review and Meta-Analysis. Diagnostics (Basel) 2024; 14:695. [PMID: 38611609 PMCID: PMC11011940 DOI: 10.3390/diagnostics14070695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Revised: 03/14/2024] [Accepted: 03/21/2024] [Indexed: 04/14/2024] Open
Abstract
Objective: The aim of this study was to describe the main anatomical variants and morphofunctional alterations in the lower limb that compress surrounding nervous structures in the gluteal region, thigh region, and leg and foot region. Methods: We searched the Medline, Scopus, Web of Science, Google Scholar, CINAHL, and LILACS databases from their inception up to October 2023. An assurance tool for anatomical studies (AQUA) was used to evaluate methodological quality, and the Joanna Briggs Institute assessment tool for case reports was also used. Forest plots were generated to assess the prevalence of variants of the gluteal region, thigh, and leg. Results: According to the forest plot of the gluteal region, the prevalence was 0.18 (0.14-0.23), with a heterogeneity of 93.52%. For the thigh region, the forest plot presented a prevalence of 0.10 (0.03-0.17) and a heterogeneity of 91.18%. The forest plot of the leg region was based on seven studies, which presented a prevalence of 0.01 (0.01-0.01) and a heterogeneity of 96.18%. Conclusions: This review and meta-analysis showed that, in studies that analyzed nerve compressions, the prevalence was low in the thigh and leg regions, while in the gluteal region, it was slightly higher. This is mainly due to the PM region and its different variants. We believe that it is important to analyze all the variant regions defined in this study and that surgeons treating the lower limb should be attentive to these possible scenarios so that they can anticipate possible surgical situations and thus avoid surgical complications.
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Affiliation(s)
- Juan José Valenzuela-Fuenzalida
- Department of Morphology and Function, Faculty of Health Sciences, Universidad De Las Américas, Santiago 7500000, Chile; (J.J.V.-F.); (A.S.-M.)
- Departament de Morfología, Facultad de Medicina, Universidad Andrés Bello, Santiago 8320000, Chile; (A.I.-W.); (F.O.-M.); (P.N.B.); (M.O.D.); (A.B.-M.)
| | - Alfredo Inostroza-Wegner
- Departament de Morfología, Facultad de Medicina, Universidad Andrés Bello, Santiago 8320000, Chile; (A.I.-W.); (F.O.-M.); (P.N.B.); (M.O.D.); (A.B.-M.)
| | - Francisca Osorio-Muñoz
- Departament de Morfología, Facultad de Medicina, Universidad Andrés Bello, Santiago 8320000, Chile; (A.I.-W.); (F.O.-M.); (P.N.B.); (M.O.D.); (A.B.-M.)
| | - Daniel Milos-Brandenberg
- Escuela de Medicina, Facultad Ciencias de la Salud, Universidad del Alba, Santiago 8320000, Chile;
| | - Andres Santana-Machuca
- Department of Morphology and Function, Faculty of Health Sciences, Universidad De Las Américas, Santiago 7500000, Chile; (J.J.V.-F.); (A.S.-M.)
| | - Pablo Nova Baeza
- Departament de Morfología, Facultad de Medicina, Universidad Andrés Bello, Santiago 8320000, Chile; (A.I.-W.); (F.O.-M.); (P.N.B.); (M.O.D.); (A.B.-M.)
| | - Mathias Orellana Donoso
- Departament de Morfología, Facultad de Medicina, Universidad Andrés Bello, Santiago 8320000, Chile; (A.I.-W.); (F.O.-M.); (P.N.B.); (M.O.D.); (A.B.-M.)
- Escuela de Medicina, Universidad Finis Terrae, Santiago 7501015, Chile
| | - Alejandro Bruna-Mejias
- Departament de Morfología, Facultad de Medicina, Universidad Andrés Bello, Santiago 8320000, Chile; (A.I.-W.); (F.O.-M.); (P.N.B.); (M.O.D.); (A.B.-M.)
| | - Joe Iwanaga
- Department of Oral and Maxillofacial Anatomy, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8510, Japan;
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, LA 70112, USA
- Department of Neurology, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, LA 70112, USA
- Department of Structural & Cellular Biology, Tulane University School of Medicine, New Orleans, LA 70112, USA
| | - Juan Sanchis-Gimeno
- GIAVAL Research Group, Department of Anatomy and Human Embryology, Faculty of Medicine, University of Valencia, 46001 Valencia, Spain;
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Caggiati A, Labropoulos N, Boyle EM, Drgastin R, Gasparis A, Doganci S, Meissner M. The Anterior Saphenous Vein. Part 2. Anatomic considerations in normal and refluxing patients. Endorsed by the American Vein and Lymphatic Society, the American Venous Forum and the International Union of Phlebology. Phlebology 2024:2683555231223055. [PMID: 38526958 DOI: 10.1177/02683555231223055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/27/2024]
Abstract
BACKGROUND The term Anterior Accessory of the Great Saphenous Vein suggest this is a branch tributary vein despite this vessel's anatomic features of a truncal vein. A multisocietal group suggested to designate this the Anterior Saphenous Vein (ASV). This study was aimed to evaluate its ultrasound anatomy in normal and varicose limbs. METHODS The clinical anatomy of the ASV was evaluated by narrative review of the literature. Additionally, the course of the ASV was evaluated in 62 limbs with no evidence of venous disease and 62 limbs with varicosities. RESULTS The ASV length, patterns of origin and termination are reported in both normal and patients with varicose veins. Discussion of the patterns is supported by the narrative review of the literature. CONCLUSIONS The ASV must be considered a truncal vein and its treatment modalities should be the same that for the great and small saphenous veins rather than a tributary vein.
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Affiliation(s)
| | | | - Edward M Boyle
- Inovia Vein Specialty Centers, St Charles Health System, Bend, OR, USA
| | - Rachel Drgastin
- Inovia Vein Specialty Centers, St Charles Health System, Bend, OR, USA
| | | | - Suat Doganci
- Department of Cardiovascular Surgery, Health Sciences University, Gulhane School of Medicine, Ankara, Turkey
| | - Mark Meissner
- Division of Vascular Surgery, Department of Surgery, University of Washington Medical Center, Seattle, WA, USA
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5
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Chmielewski PP. Exploring the uncharted: Missing anatomical names in the Terminologia Anatomica. Clin Anat 2024; 37:193-200. [PMID: 37596983 DOI: 10.1002/ca.24109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 07/07/2023] [Accepted: 08/03/2023] [Indexed: 08/21/2023]
Abstract
Effective communication and precise navigation within the intricacies of the human body rely on robust anatomical terminology. Since its creation by the Federative Committee on Anatomical Terminology (FCAT), the Terminologia Anatomica (TA 1998) has consistently served as the benchmark in the field. However, the constant advancement of anatomical knowledge requires regular revisions, updates, and enhancements of anatomical nomenclature to accommodate the latest scientific discoveries. The recent adoption of the second edition of Terminologia Anatomica (TA 2019) by the International Federation of Associations of Anatomists (IFAA) has drawn attention to certain notable omissions. Despite over a century of dedicated work establishing standard anatomical terminology, specific widely recognized gross anatomical structures are still absent from the official listing in the Terminologia Anatomica. There is, however, a consensus that the inclusion of names for trivial or variably present structures should be avoided. Accordingly, this article focuses on a thoughtfully selected group of anatomical structures, which are so important that they are routinely discussed during anatomy courses, despite their exclusion from the official lists of anatomical terms. These basic structures hold fundamental importance for both anatomy education and clinical practice. Consequently, their appropriate nomenclature warrants consideration for inclusion in future editions of TA.
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Affiliation(s)
- Piotr Paweł Chmielewski
- Division of Anatomy, Department of Human Morphology and Embryology, Faculty of Medicine, Wroclaw Medical University, Wrocław, Poland
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Valenzuela-Fuenzalida JJ, Navarro KLK, Urbina P, Trujillo-Riveros M, Nova-Baeza P, Orellana-Donoso M, Rodriguez-Luengo M, Beccerra Farfan A, Sanchis-Gimeno JA. Prevalence of the Bifid Mandibular Condyle and Its Relationship with Pathologies of the Temporomandibular Joint: A Systematic Review and Meta-Analysis. Diagnostics (Basel) 2023; 13:3282. [PMID: 37892103 PMCID: PMC10606711 DOI: 10.3390/diagnostics13203282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Revised: 10/16/2023] [Accepted: 10/19/2023] [Indexed: 10/29/2023] Open
Abstract
OBJECTIVE The aim of this study was to describe the prevalence of anatomical variants in the bifid mandibular condyle (BMC) and report its association with temporomandibular joint (TMJ) pathology. METHODS We searched the Medline, Scopus, Web of Science, Google Scholar, CINAHL, and LILACS databases from their inception up to September 2023. Two authors independently performed the search, study selection, and data extraction, and they also assessed the methodological quality with an assurance tool for anatomical studies (AQUA). Finally, the pooled prevalence was estimated using a random effects model. RESULTS A total of 50 studies met the eligibility criteria. Twenty studies, with a total of 88,625 subjects, were included in the meta-analysis. The overall prevalence of the bifid mandibular condyle (BMC) variant was 1% (95% CI = 1% to 2%). CONCLUSIONS The correlation between the BMC and TMJ pathologies has a relatively low prevalence in studies that present a considerable number of subjects. From a clinical point of view, a direct association cannot be made between the presence of the BMC and TMJ pathologies or symptoms.
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Affiliation(s)
- Juan José Valenzuela-Fuenzalida
- Department of Morphology and Function, Faculty of Health and Social Sciences, Universidad de Las Américas, Santiago 8370040, Chile;
- Departamento de Morfología, Facultad de Medicina, Universidad Andrés Bello, Santiago 8370146, Chile; (P.U.); (M.T.-R.); (P.N.-B.); (M.O.-D.); (M.R.-L.)
| | - Kora-lle Keller Navarro
- Department of Morphology and Function, Faculty of Health and Social Sciences, Universidad de Las Américas, Santiago 8370040, Chile;
| | - Pia Urbina
- Departamento de Morfología, Facultad de Medicina, Universidad Andrés Bello, Santiago 8370146, Chile; (P.U.); (M.T.-R.); (P.N.-B.); (M.O.-D.); (M.R.-L.)
| | - Martin Trujillo-Riveros
- Departamento de Morfología, Facultad de Medicina, Universidad Andrés Bello, Santiago 8370146, Chile; (P.U.); (M.T.-R.); (P.N.-B.); (M.O.-D.); (M.R.-L.)
| | - Pablo Nova-Baeza
- Departamento de Morfología, Facultad de Medicina, Universidad Andrés Bello, Santiago 8370146, Chile; (P.U.); (M.T.-R.); (P.N.-B.); (M.O.-D.); (M.R.-L.)
| | - Mathias Orellana-Donoso
- Departamento de Morfología, Facultad de Medicina, Universidad Andrés Bello, Santiago 8370146, Chile; (P.U.); (M.T.-R.); (P.N.-B.); (M.O.-D.); (M.R.-L.)
- Escuela de Medicina, Universidad Finis Terrae, Santiago 7501015, Chile
| | - Macarena Rodriguez-Luengo
- Departamento de Morfología, Facultad de Medicina, Universidad Andrés Bello, Santiago 8370146, Chile; (P.U.); (M.T.-R.); (P.N.-B.); (M.O.-D.); (M.R.-L.)
| | - Alvaro Beccerra Farfan
- Departamento de Ciencias Química y Biológicas, Facultad de Ciencias de la Salud, Universidad Bernardo O’Higgins, Santiago 8370993, Chile;
| | - Juan A. Sanchis-Gimeno
- Department of Human Anatomy and Physiology, Faculty of Health Sciences, University of Johannesburg, Johannesburg 2092, South Africa;
- GIAVAL Research Group, Department of Anatomy and Human Embryology, Faculty of Medicine, University of Valencia, 46001 Valencia, Spain
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7
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Valenzuela-Fuenzalida JJ, Baez-Flores B, Sepúlveda RÁ, Medina CM, Pérez R, López E, Sanchis J, Orellana Donoso M, Silva JL, Rodriguez MC, Iwanaga J. Anatomical variations and abnormalities of the maxillary region and clinical implications: A systematic review and metaanalysis. Medicine (Baltimore) 2023; 102:e34510. [PMID: 37747000 PMCID: PMC10519516 DOI: 10.1097/md.0000000000034510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 07/03/2023] [Accepted: 07/05/2023] [Indexed: 09/26/2023] Open
Abstract
OBJECTIVE The objective of this review is to investigate and analyze the anatomical variations present in the maxillary sinus (MS), through the examination of the prevalence of these variations, as well as the corresponding prevalence of clinically significant pathologies and complications associated with them. METHODS The search process was carried out in the following databases; MEDLINE, SCIELO, WOS, CINHAL, SCOPUS, and GOOGLE SCHOLAR, using as search terms; "Maxillary bone," "Maxillary sinus," "Paranasal sinus," "Anatomical variations," "Sinusitis" and "Clinical anatomy." RESULTS A total of 26 articles and 12969 samples were included, from which 12,594 subjects had their sex recorded giving a total of 5802 males and 6792 females. The variants reported by the included were Haller cells, Concha Bullosa, Number of septa, Hypoplastic sinus, Agger Nasi, Thickening of the MS mucosa, Deviation of the nasal septum, Accessory ostium, and Onodi cells. Among the mentioned, the ones that presented the greatest number of studies (between 8 and 10 studies included) were: the Haller Cells, the Concha Bullosa, and the Number of septa, where prevalence was 0.30, 0.36, 0.39 respectively. These variations can lead to sinusitis, cause some types of tumors, or affect neighboring structures that could be compromised by this variation. CONCLUSION As a result, it is certainly complex to distinguish the presence of anatomical variations from pathological abnormalities. Therefore, knowledge of the different variations and their clinical relationships could be a useful asset for clinicians dedicated to this region.
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Affiliation(s)
- Juan José Valenzuela-Fuenzalida
- Departamento de Morfología, Facultad de Medicina, Universidad Andres Bello, Santiago, Chile
- Departamento de Ciencias Química y Biológicas Facultad de Ciencias de la Salud, Universidad Bernardo O’Higgins, Santiago, Chile
| | - Belén Baez-Flores
- Departamento de Morfología, Facultad de Medicina, Universidad Andres Bello, Santiago, Chile
| | | | - Claudia Moya Medina
- Department of Morphology and Function, Faculty of Health and Social Sciences, Universidad de las Américas, Santiago, Chile
| | - Rubén Pérez
- Department of Morphology and Function, Faculty of Health and Social Sciences, Universidad de las Américas, Santiago, Chile
| | - Esteban López
- Department of Morphology and Function, Faculty of Health and Social Sciences, Universidad de las Américas, Santiago, Chile
| | - Juan Sanchis
- Giaval Research Group, Faculty of Medicine, University of Valencia, Valencia, Spain
| | - Mathias Orellana Donoso
- Departamento de Morfología, Facultad de Medicina, Universidad Andres Bello, Santiago, Chile
- Escuela de Medicina, Universidad Finis Terrae, Santiago, Chile
| | - Javiera Leyton Silva
- Departamento de Morfología, Facultad de Medicina, Universidad Andres Bello, Santiago, Chile
| | | | - Joe Iwanaga
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, LA
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Keim SA, Harmon DJ, Martindale JR, Lopez EN, Sanky C, Brooks WS, Cotter MM, Davies DL, Doroudi M, Fahl JC, Farias A, Granite G, Harrell KM, Kar R, Kramer KL, Jackson J, Jones S, Lackey-Cornelison W, Laitman JT, Latacha K, Lewis SR, Lovejoy Mork A, Marzban H, McNary TG, McWhorter DL, Merchant A, Mussell JC, Quinn MM, Reidenberg JS, Royer D, Sakaguchi A, Sawyer FK, Topping DB, Wainman B, Wineski LE, Zumwalt AC, Hankin MH. Essential anatomy for core clerkships: A clinical perspective. Anat Sci Educ 2023; 16:943-957. [PMID: 36929575 DOI: 10.1002/ase.2272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Revised: 03/12/2023] [Accepted: 03/13/2023] [Indexed: 06/18/2023]
Abstract
Clerkships are defining experiences for medical students in which students integrate basic science knowledge with clinical information as they gain experience in diagnosing and treating patients in a variety of clinical settings. Among the basic sciences, there is broad agreement that anatomy is foundational for medical practice. Unfortunately, there are longstanding concerns that student knowledge of anatomy is below the expectations of clerkship directors and clinical faculty. Most allopathic medical schools require eight "core" clerkships: internal medicine (IM), pediatrics (PD), general surgery (GS), obstetrics and gynecology (OB), psychiatry (PS), family medicine (FM), neurology (NU), and emergency medicine (EM). A targeted needs assessment was conducted to determine the anatomy considered important for each core clerkship based on the perspective of clinicians teaching in those clerkships. A total of 525 clinical faculty were surveyed at 24 United States allopathic medical schools. Participants rated 97 anatomical structure groups across all body regions on a 1-4 Likert-type scale (1 = not important, 4 = essential). Non-parametric ANOVAs determined if differences existed between clerkships. Combining all responses, 91% of anatomical structure groups were classified as essential or more important. Clinicians in FM, EM, and GS rated anatomical structures in most body regions significantly higher than at least one other clerkship (p = 0.006). This study provides an evidence-base of anatomy content that should be considered important for each core clerkship and may assist in the development and/or revision of preclinical curricula to support the clinical training of medical students.
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Affiliation(s)
- Sarah A Keim
- Department of Surgery, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Derek J Harmon
- Department of Biomedical Education and Anatomy, The Ohio State University College of Medicine, Columbus, Ohio, USA
| | - James R Martindale
- Office of Medical Education, University of Virginia School of Medicine, Charlottesville, Virginia, USA
| | - Elisabeth N Lopez
- Department of Molecular Pathobiology, New York University College of Dentistry, New York, New York, USA
| | - Charles Sanky
- Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Department of Medical Education, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - William S Brooks
- Department of Cell, Developmental, and Integrative Biology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Meghan M Cotter
- Department of Academic Affairs, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - David L Davies
- Department of Neurobiology and Developmental Sciences, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Majid Doroudi
- Department of Cellular and Physiological Sciences, University of British Columbia, Vancouver, British Columbia, Canada
| | - Jeffrey C Fahl
- Department of Anatomy, Albany Medical College, Albany, New York, USA
| | - Anna Farias
- Schulich School of Medicine and Dentistry, Windsor, Ontario, Canada
| | - Guinevere Granite
- Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
| | - Kelly M Harrell
- Department of Anatomy and Neurobiology, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA
| | - Rekha Kar
- Department of Cell Systems and Anatomy, University of Texas Health San Antonio, San Antonio, Texas, USA
| | - Kenneth L Kramer
- Department of Medical Education, Creighton University, Omaha, Nebraska, USA
| | - Jon Jackson
- Anatomy & Cell Biology, Burrell College of Osteopathic Medicine, Las Cruces, New Mexico, USA
| | - Shiloh Jones
- Anatomical Sciences Education Center, Oregon Health & Science University, Portland, Oregon, USA
| | - Wendy Lackey-Cornelison
- Department of Medical Education, University of Toledo College of Medicine and Life Sciences, Toledo, Ohio, USA
| | - Jeffrey T Laitman
- Medical Education (Anatomy), Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Kimberly Latacha
- Department of Genetics, Cell Biology, and Anatomy, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Steven R Lewis
- New York Institute of Technology College of Osteopathic Medicine, Jonesboro, Arkansas, USA
| | - Amy Lovejoy Mork
- Department of Pathology and Anatomy, Morehouse School of Medicine, Atlanta, Georgia, USA
| | - Hassan Marzban
- Department of Human Anatomy and Cell Science, University of Manitoba, Winnipeg, Canada
| | - Thomas G McNary
- Division of Anatomy and Molecular Medicine, Alabama College of Osteopathic Medicine, Dothan, Alabama, USA
| | | | - Aftab Merchant
- Department of Health Sciences Education, University of Illinois College of Medicine, Rockford, Illinois, USA
| | - Jason C Mussell
- Department of Cell Biology and Anatomy, LSUHSC-NO, New Orleans, Louisiana, USA
| | - Melissa M Quinn
- Department of Biomedical Education and Anatomy, The Ohio State University College of Medicine, Columbus, Ohio, USA
| | - Joy S Reidenberg
- Department of Medical Education, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Danielle Royer
- Department of Cell and Developmental Biology, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Alan Sakaguchi
- Department of Cell Systems and Anatomy, University of Texas Health San Antonio, San Antonio, Texas, USA
| | - F Kip Sawyer
- Department of Anesthesiology, Huntington Hospital, Pasadena, California, USA
| | - Daniel B Topping
- Department of Anatomy and Cell Biology, University of Florida College of Medicine, Gainesville, Florida, USA
| | - Bruce Wainman
- Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Lawrence E Wineski
- Department of Pathology and Anatomy, Morehouse School of Medicine, Atlanta, Georgia, USA
| | - Ann C Zumwalt
- Department of Anatomy and Neurobiology, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts, USA
| | - Mark H Hankin
- Anatomical Sciences Education Center, Oregon Health & Science University, Portland, Oregon, USA
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Orellana-Donoso M, Milos-Brandenberg D, Benavente-Urtubia A, Guerra-Loyola J, Bruna-Mejias A, Nova-Baeza P, Becerra-Farfán Á, Sepulveda-Loyola W, Luque-Bernal RM, Valenzuela-Fuenzalida JJ. Incidence and Clinical Implications of Anatomical Variations in the Pancreas and Its Ductal System: A Systematic Review and Meta-Analysis. Life (Basel) 2023; 13:1710. [PMID: 37629567 PMCID: PMC10455790 DOI: 10.3390/life13081710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 07/27/2023] [Accepted: 08/03/2023] [Indexed: 08/27/2023] Open
Abstract
OBJECTIVE This systematic review analyzes the anatomical variants in the pancreas and its ductal system to report on their association with pancreatic pathologies. METHODS We conducted a search of the MEDLINE, Scopus, Web of Science, Google Scholar, CINAHL, and LILACS databases from their inception to July 2023. The methodological quality was assessed with the Anatomical Quality Assessment (AQUA) tool. Finally, the pooled prevalence was estimated using a random effects model. RESULTS 55 studies were found that met the eligibility criteria. The overall prevalence of pancreas divisum (PD) was 18% (95% CI = 15-21%). The prevalence of PD associated with pancreatitis was 30% (95% CI = 1-61%). CONCLUSIONS An anatomical variant of the pancreas such as PD may be the cause of bile duct obstruction, resulting in various clinical complications, such as pancreatitis. Hence, knowing this variant is extremely important for surgeons, especially for those who treat the gastroduodenal region.
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Affiliation(s)
- Mathias Orellana-Donoso
- Escuela de Medicina, Universidad Finis Terrae, Santiago 7500000, Chile;
- Departamento de Morfología, Facultad de Medicina, Universidad Andrés Bello, Santiago 8370146, Chile; (A.B.-U.); (J.G.-L.); (A.B.-M.); (P.N.-B.)
| | - Daniel Milos-Brandenberg
- Escuela de Medicina, Facultad Ciencias de la Salud, Universidad del Alba, Santiago 8320000, Chile;
| | - Andoni Benavente-Urtubia
- Departamento de Morfología, Facultad de Medicina, Universidad Andrés Bello, Santiago 8370146, Chile; (A.B.-U.); (J.G.-L.); (A.B.-M.); (P.N.-B.)
| | - Javier Guerra-Loyola
- Departamento de Morfología, Facultad de Medicina, Universidad Andrés Bello, Santiago 8370146, Chile; (A.B.-U.); (J.G.-L.); (A.B.-M.); (P.N.-B.)
| | - Alejandro Bruna-Mejias
- Departamento de Morfología, Facultad de Medicina, Universidad Andrés Bello, Santiago 8370146, Chile; (A.B.-U.); (J.G.-L.); (A.B.-M.); (P.N.-B.)
| | - Pablo Nova-Baeza
- Departamento de Morfología, Facultad de Medicina, Universidad Andrés Bello, Santiago 8370146, Chile; (A.B.-U.); (J.G.-L.); (A.B.-M.); (P.N.-B.)
| | - Álvaro Becerra-Farfán
- Departamento de Ciencias Química y Biológicas, Facultad de Ciencias de la Salud, Universidad Bernardo O’Higgins, Santiago 8370993, Chile;
| | - Walter Sepulveda-Loyola
- Faculty of Health and Social Sciences, Universidad de las Américas, Santiago 8370040, Chile;
| | - Ricardo Miguel Luque-Bernal
- Unidad de Anatomía, Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogotá 111221, Colombia;
| | - Juan José Valenzuela-Fuenzalida
- Departamento de Morfología, Facultad de Medicina, Universidad Andrés Bello, Santiago 8370146, Chile; (A.B.-U.); (J.G.-L.); (A.B.-M.); (P.N.-B.)
- Department of Morphology and Function, Faculty of Health and Social Sciences, Universidad de Las Américas, Santiago 8370040, Chile
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Natsuyama Y, Zhang M, Yang T, Shimada K, Ren K, Kamikawa Y, Chen J, Yi SQ. Morphological study of the arterial supply to the menisci in pigs with special reference to creating meniscus injury model. Folia Morphol (Warsz) 2023:VM/OJS/J/94921. [PMID: 37285086 DOI: 10.5603/fm.a2023.0041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 05/27/2023] [Accepted: 05/29/2023] [Indexed: 06/08/2023]
Abstract
BACKGROUND Some reports have used pigs to establish models of meniscus injury. However, accurate information on the origin, course, and access of the arteries supplying the menisci remains unclear. This information is important to avoid damaging vital arteries when creating the meniscus injury model. MATERIALS AND METHODS In this study, fetal and adult pigs were employed to investigate the arterial supply of the menisci in pigs using gross anatomical and histological methods. RESULTS Macro-anatomically, the anterior horn, body, and posterior horn of the medial meniscus were found to be supplied by the medial superior genicular artery, medial inferior genicular artery, and posterior middle genicular artery. The anterior and posterior horns of the lateral meniscus were supplied by the cranial tibial recurrent artery and the middle genicular artery, respectively. Anastomosis was observed in some cases, but appeared to be infrequent and too thin to expect the anastomotic branches to provide adequate blood flow. The histological examination showed that the arteries entered the meniscus along the tie-fiber. The access process of the artery was the same irrespective of whether it was in fetal or mature pigs, the medial or lateral meniscus, or the anterior horn or body or posterior horn. The medial inferior genicular artery ran along the medial meniscus in the circumferential direction. Therefore, the clinical longitudinal incision should take into account the characteristics of the vessel course in order to protect the blood vessels from damage. CONCLUSIONS Based on the results of this study, the protocol for creating a pig meniscus injury model should be reconsidered.
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Affiliation(s)
- Yutaro Natsuyama
- Department of Frontier Health Sciences, Graduate School of Human Health Sciences, Tokyo Metropolitan University, Tokyo, Japan
- Department of Anatomy, Tokyo Medical University, Tokyo, Japan
| | - Mingshou Zhang
- Department of Frontier Health Sciences, Graduate School of Human Health Sciences, Tokyo Metropolitan University, Tokyo, Japan
| | - Ting Yang
- Department of Frontier Health Sciences, Graduate School of Human Health Sciences, Tokyo Metropolitan University, Tokyo, Japan
| | - Kazuyuki Shimada
- Department of Frontier Health Sciences, Graduate School of Human Health Sciences, Tokyo Metropolitan University, Tokyo, Japan
| | - Ke Ren
- Faculty of Physical Education, Qu Jing Normal University, Yun Nan, China
| | - Yasuko Kamikawa
- Department of Maxillofacial Diagnostic and Surgical Science Field of Oral and Maxillofacial Rehabilitation, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Juefei Chen
- Department of Frontier Health Sciences, Graduate School of Human Health Sciences, Tokyo Metropolitan University, Tokyo, Japan
| | - Shuang-Qin Yi
- Department of Frontier Health Sciences, Graduate School of Human Health Sciences, Tokyo Metropolitan University, Tokyo, Japan.
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11
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Koppes DM, Vesseur MAM, Schepens-Franke AN, Kruitwagen RFPM, Notten KJB, Scheele F. Anatomy in the daily practice of the gynecologist, essential or just window dressing? Anat Sci Educ 2023; 16:497-503. [PMID: 36448881 DOI: 10.1002/ase.2236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Revised: 09/17/2022] [Accepted: 11/26/2022] [Indexed: 05/11/2023]
Abstract
Traditionally, anatomy was one of the basic pillars of medical training. However, due to the expansion of medical science and medical knowledge in general, anatomy teaching has steadily declined and the way anatomy is taught has changed. These changes go hand in hand with growing literature about a perceived and proven lack of anatomical knowledge. While anatomy is important for all doctors, these developments seem to be more worrying for surgical residents. At the same time, little is known about how clinicians use anatomy in daily practice. The primary aim of this study was to increase understanding of the role of anatomy in the daily practice of gynecologists. An explorative qualitative study was performed to answer the question "What is the tangible utility of solid anatomical knowledge in the daily practice of the gynecologist"? Semi-structured interviews with gynecologists and obstetrics and gynecology (ObGyn) residents from Belgium and the Netherlands were held and the responses were analyzed using a phenomenographic inductive coding approach. Anatomical knowledge was important and used for technical skills and non-technical achievements in the daily practice of gynecologists, and three themes were distinguished. Specifically, anatomical knowledge was important and used (1) for daily activities, (2) for the feeling of self-efficacy, and (3) to gain a respected name as a doctor. These findings are discussed in light of (perceived) insufficient anatomical knowledge, and recommendations are made for the postgraduate education of ObGyn doctors.
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Affiliation(s)
- Dorothea M Koppes
- Department of Obstetrics and Gynecology, Faculty of Health, Medicine and Life Sciences, Maastricht University Medical Centre, Maastricht, the Netherlands
- School for Oncology and Developmental Biology (GROW), Faculty of Health, Medicine and Life Sciences, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Maud A M Vesseur
- Faculty of Medicine, University Maastricht, Maastricht, the Netherlands
| | | | - Rutgerus F P M Kruitwagen
- Department of Obstetrics and Gynecology, Faculty of Health, Medicine and Life Sciences, Maastricht University Medical Centre, Maastricht, the Netherlands
- School for Oncology and Developmental Biology (GROW), Faculty of Health, Medicine and Life Sciences, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Kim J B Notten
- Department of Obstetrics and Gynecology, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - Fedde Scheele
- Amsterdam Academic Medical Center, Research in Education, Location VUmc, Amsterdam, the Netherlands
- Athena Institute for Trans-Disciplinary Research, The Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
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12
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Valenzuela-Fuenzalida JJ, Baeza-Garrido V, Navia-Ramírez MF, Cariseo-Ávila C, Bruna-Mejías A, Becerra-Farfan Á, Lopez E, Orellana Donoso M, Loyola-Sepulveda W. Systematic Review and Meta-Analysis: Recurrent Laryngeal Nerve Variants and Their Implication in Surgery and Neck Pathologies, Using the Anatomical Quality Assurance (AQUA) Checklist. Life (Basel) 2023; 13:life13051077. [PMID: 37240722 DOI: 10.3390/life13051077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 04/12/2023] [Accepted: 04/17/2023] [Indexed: 05/28/2023] Open
Abstract
INTRODUCTION The recurrent laryngeal nerve (RLN) is the structure responsible for sensory and motor innervation of the larynx, and it has been shown that its lesion due to a lack of surgical rigor led to alterations such as respiratory obstruction due to vocal cords paralysis and permanent phonation impairment. The objectives of this review were to know the variants of the RLN and its clinical relevance in the neck region. METHODS This review considered specific scientific articles that were written in Spanish or English and published between 1960 and 2022. A systematic search was carried out in the electronic databases MEDLINE, WOS, CINAHL, SCOPUS, SCIELO, and Latin American and Caribbean Center for Information on Health Sciences to compile the available literature on the subject to be treated and was enrolled in PROSPERO. The included articles were studies that had a sample of RLN dissections or imaging, intervention group to look for RLN variants, or the comparison of the non-recurrent laryngeal nerve (NRLN) variants, and finally, its clinical correlations. Review articles and letters to the editor were excluded. All included articles were evaluated through quality assessment and risk of bias analysis using the methodological quality assurance tool for anatomical studies (AQUA). The extracted data in the meta-analysis were interpreted to calculate the prevalence of the RLN variants and their comparison and the relationship between the RLN and NRLN. The heterogeneity degree between included studies was assessed. RESULTS The included studies that showed variants of the RLN included in this review were 41, a total of 29,218. For the statistical analysis of the prevalence of the RLN variant, a forest plot was performed with 15 studies that met the condition of having a prevalence of less than 100%. As a result, the prevalence was shown to be 12% (95% CI, SD 0.11 to 0.14). Limitations that were present in this review were the publication bias of the included studies, the probability of not having carried out the most sensitive and specific search, and finally, the authors' personal inclinations in selecting the articles. DISCUSSION This meta-analysis can be considered based on an update of the prevalence of RLN variants, in addition to considering that the results show some clinical correlations such as intra-surgical complications and with some pathologies and aspects function of the vocal cords, which could be a guideline in management prior to surgery or of interest for the diagnostic.
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Affiliation(s)
- Juan José Valenzuela-Fuenzalida
- Department of Morphology and Function, Faculty of Health Sciences, Universidad de las Américas, Santiago 8370040, Chile
- Departamento de Morfología, Facultad de Medicina, Universidad Andrés Bello, Santiago 8370186, Chile
| | - Vicente Baeza-Garrido
- Departamento de Morfología, Facultad de Medicina, Universidad Andrés Bello, Santiago 8370186, Chile
| | | | - Carolina Cariseo-Ávila
- Departamento de Morfología, Facultad de Medicina, Universidad Andrés Bello, Santiago 8370186, Chile
| | - Alejandro Bruna-Mejías
- Departamento de Ciencias y Geografía, Facultad de Ciencias Naturales y Exactas, Universidad de Playa Ancha, Valparaíso 2360072, Chile
| | - Álvaro Becerra-Farfan
- Departamento de Ciencias Química y Biológicas, Facultad de Ciencias de la Salud, Universidad Bernardo O'Higgins, Santiago 8370874, Chile
| | - Esteban Lopez
- Department of Morphology and Function, Faculty of Health Sciences, Universidad de las Américas, Santiago 8370040, Chile
| | | | - Walter Loyola-Sepulveda
- Kinesiology School, Faculty of Health Sciences, Universidad de las Américas, Santiago 8370040, Chile
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13
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Hu H, Piao JZ, Lee JH, Bae H, Choi YJ, Hong SO, Gil YC, Hu KS, Kim HJ. Face painting as an anatomical learning tool based on individual ultrasonographic examination. Clin Anat 2023; 36:426-432. [PMID: 36342361 DOI: 10.1002/ca.23974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 10/30/2022] [Accepted: 10/31/2022] [Indexed: 11/09/2022]
Abstract
Considering the shift to online education during the COVID-19 pandemic, new and easily accessible educational videos and content on clinical anatomy are necessary. This study utilized numerous references and data on the anatomy of Asian facial muscles and blood vessels to accurately depict human anatomy through face painting. It aimed to provide clinicians accurate educational video content on anatomy to help prevent possible complications during noninvasive facial and surgical procedures. A 26-year-old Korean-Chinese male volunteer was used as a face painting model. The location of the blood vessels of the face was confirmed through ultrasonography images using a real-time two-dimensional B-mode. The model's face was painted by an artist majoring in anatomy. To reveal most anatomical structures on both sides of the face, the left side showed the structures observed when the skin and superficial fat layer are removed, and the right side revealed the deeper layer structures that can be seen when some muscles are cut. Fifteen superficial and deep muscles important in esthetic procedures were meticulously painted on the face. The face painting took a total of 6 h, and the video was edited to 5 min. This study merged the advantages of 2D and 3D by painting directly on the skin surface of a living model. Thus, it can provide more dynamic surface anatomy data. These contents inform clinicians about 3D anatomic location, which can help avoid complications when performing clinical procedures on the face.
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Affiliation(s)
- Hyewon Hu
- Division in Anatomy and Developmental Biology, Department of Oral Biology, Human Identification Research Institute, BK21 FOUR Project, Yonsei University College of Dentistry, Seoul, South Korea
| | - Jiong-Zhen Piao
- Division in Anatomy and Developmental Biology, Department of Oral Biology, Human Identification Research Institute, BK21 FOUR Project, Yonsei University College of Dentistry, Seoul, South Korea
| | - Ji-Hyun Lee
- Division in Anatomy and Developmental Biology, Department of Oral Biology, Human Identification Research Institute, BK21 FOUR Project, Yonsei University College of Dentistry, Seoul, South Korea
| | - Hyungkyu Bae
- Division in Anatomy and Developmental Biology, Department of Oral Biology, Human Identification Research Institute, BK21 FOUR Project, Yonsei University College of Dentistry, Seoul, South Korea
| | - You-Jin Choi
- Division in Anatomy and Developmental Biology, Department of Oral Biology, Human Identification Research Institute, BK21 FOUR Project, Yonsei University College of Dentistry, Seoul, South Korea
| | - Sung Ok Hong
- Department of Oral and Maxillofacial Surgery, Kyung Hee University College of Dentistry, Kyung Hee University Hospital at Gangdong, Seoul, South Korea
| | - Young-Chun Gil
- Department of Anatomy, Chungbuk National University College of Medicine, Cheongju, South Korea
| | - Kyung-Seok Hu
- Division in Anatomy and Developmental Biology, Department of Oral Biology, Human Identification Research Institute, BK21 FOUR Project, Yonsei University College of Dentistry, Seoul, South Korea
| | - Hee-Jin Kim
- Division in Anatomy and Developmental Biology, Department of Oral Biology, Human Identification Research Institute, BK21 FOUR Project, Yonsei University College of Dentistry, Seoul, South Korea.,Department of Electrical and Electronic Engineering, Yonsei University, Seoul, South Korea
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14
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Tkach AV, Kutia SA, Tkach VV. [Anatomical and clinical characteristics of the chorda tympani]. Zh Nevrol Psikhiatr Im S S Korsakova 2023; 123:113-117. [PMID: 37966449 DOI: 10.17116/jnevro2023123101113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2023]
Abstract
The article presents information about the applied and clinical anatomy of the chorda tympani. Brief information is given about the history of its discovery, embryonic and postnatal development, features of anatomy, topography and morphology. The clinical aspects of the lesion and methods of studying the function of the chorda tympani are described.
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Affiliation(s)
- A V Tkach
- Vernadsky Crimean Federal University, Simferopol, Russia
| | - S A Kutia
- Vernadsky Crimean Federal University, Simferopol, Russia
| | - V V Tkach
- Vernadsky Crimean Federal University, Simferopol, Russia
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Porzionato A, Macchi V, Stecco C, Boscolo-Berto R, Loukas M, Tubbs RS, De Caro R. Clinical Anatomy and Medical Malpractice-A Narrative Review with Methodological Implications. Healthcare (Basel) 2022; 10:1915. [PMID: 36292362 PMCID: PMC9601975 DOI: 10.3390/healthcare10101915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Revised: 09/25/2022] [Accepted: 09/27/2022] [Indexed: 11/04/2022] Open
Abstract
Anatomical issues are intrinsically included in medico-legal methodology, however, higher awareness would be needed about the relevance of anatomy in addressing medico-legal questions in clinical/surgical contexts. Forensic Clinical Anatomy has been defined as "the practical application of Clinical Anatomy to the ascertainment and evaluation of medico-legal problems". The so-called individual anatomy (normal anatomy, anatomical variations, or anatomical modifications due to development, aging, para-physiological conditions, diseases, or surgery) may acquire specific relevance in medico-legal ascertainment and evaluation of cases of supposed medical malpractice. Here, we reviewed the literature on the relationships between anatomy, clinics/surgery, and legal medicine. Some methodological considerations were also proposed concerning the following issues: (1) relevant aspects of individual anatomy may arise from the application of methods of ascertainment, and they may be furtherly ascertained through specific anatomical methodology; (2) data about individual anatomy may help in the objective application of the criteria of evaluation (physio-pathological pathway, identification-evaluation of errors, causal value, damage estimation) and in final judgment about medical responsibility/liability. Awareness of the relevance of individual anatomy (risk of iatrogenic lesions, need for preoperative diagnostic procedures) should be one of the principles guiding the clinician; medico-legal analyses can also take advantage of its contribution in terms of ascertainment/evaluation.
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Affiliation(s)
- Andrea Porzionato
- Section of Anatomy, Department of Neuroscience, University of Padova, Via Gabelli, 65, 35127 Padova, Italy
| | - Veronica Macchi
- Section of Anatomy, Department of Neuroscience, University of Padova, Via Gabelli, 65, 35127 Padova, Italy
| | - Carla Stecco
- Section of Anatomy, Department of Neuroscience, University of Padova, Via Gabelli, 65, 35127 Padova, Italy
| | - Rafael Boscolo-Berto
- Section of Anatomy, Department of Neuroscience, University of Padova, Via Gabelli, 65, 35127 Padova, Italy
| | - Marios Loukas
- Department of Anatomical Sciences, True Blue Campus, St. George’s University, St. George 1473, Grenada
| | - Ronald Shane Tubbs
- Department of Anatomical Sciences, True Blue Campus, St. George’s University, St. George 1473, Grenada
- Department of Neurosurgery, Tulane University, New Orleans, LA 70112, USA
| | - Raffaele De Caro
- Section of Anatomy, Department of Neuroscience, University of Padova, Via Gabelli, 65, 35127 Padova, Italy
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Vasil'ev Y, Enina Y, Dydykin S, Aleshkina O, Suetenkov D, Kulikova N, Chemidronov S, Velichko E, Antonov O, Diachkova E, Kolsanov A. X-ray and anatomical features of the lower jaw alveolar cortical layer in children. Ann Anat 2022; 245:152005. [PMID: 36183932 DOI: 10.1016/j.aanat.2022.152005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 09/09/2022] [Accepted: 09/11/2022] [Indexed: 11/29/2022]
Abstract
INTRODUCTION the world studies showed the interest in measurement of the buccal or anterior cortical plate thickness. Data indicate a significant superiority of the spongy substance over the compact one in the distal part of the jaw, which makes it possible to think about a higher effectiveness of transcortical injections. The empirical "rule of 10" provides for the choice of a method of anesthesia in children for primary teeth but demonstrates difficulties with high-quality anesthesia accompanied for permanent teeth. Therefore, the importance of clinical examination and anatomical investigation of the jaw cortical plate in children for competent planning of transcortical interventions has been determined. AIM To study the features of the clinical and X-ray anatomy of the cortical layer in distal alveolar part of the mandible in children. MATERIAL AND METHODS The assessment of the X-ray anatomical characteristics of the mandible was carried out according to 150 anonymized cone-beam computed tomograms of patients aged 6-12 years, performed for the treatment of major diseases. Qualitative assessment and examination of the cortical plate of the distal alveolar part of the mandible were carried out on the skeletonized certified preparations of aged 6-12 in the amount of 50. RESULTS The age characteristics of the cortical plate in the area of the chewing group of teeth in the mandible were determined according to macro anatomical studies, which confirms with the X-ray results. Therefore, the obtained images serve as actual confirmation of X-ray studies, which are ranked by age. The thickness of the cortical plate in the second primary molar of the mandible in subgroups 6, 7 and 8 years has a proportional increase from the cervical region to the apical projection. The average thickness of the cortical plate is 1.57mm at 6 years, 1.52mm at 7 years, 1.6mm at 8 years and 1.84 at 9 years. The cortical plate thickness in the first primary molar of the mandible in subgroups 6 and 7 years has a proportional decrease from the cervical region to the apical projection as well as an inverse proportion to age. The average thickness of the cortical plate is 1.33mm. In the first molar of the mandible at the age limit of 6-12 years the attention is drawn to the linear increase in tissue volume from the cervical region to the apical projection up to 8 years. At 6-8 years the average thickness of the cortical plate in this age group is 1.74±0.2mm, at 9 years - 2.03mm, at 10 - average value in the cervical region it is 1.53 ± 0.23mm, in the root middle it is 2.19± 0.13mm and in the apical projection it is 1.98± 0.16mm, at 11 - 2.22mm and at 12 - 2.35mm. For the second primary molar the average thickness of the buccal cortical plate of the second primary molar is 1.4mm in cervical part, 1.68mm in the root middle and 1.81mm in the apical projection. Finally, thickness of the buccal cortical plate in the cervical region of the first permanent molar is 2mm in groups. CONCLUSION The study makes it possible to determinate with noninvasive way the age limit for the least pronounced zone of the buccal cortical plate.
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Affiliation(s)
| | | | | | - Olga Aleshkina
- Saratov State Medical University named after V. I. Razumovsky, Saratov, Russia
| | - Dmitriy Suetenkov
- Saratov State Medical University named after V. I. Razumovsky, Saratov, Russia
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Ivarson J, Hermansson A, Meister B, Zeberg H, Bolander Laksov K, Ekström W. Transfer of anatomy during surgical clerkships: an exploratory study of a student-staff partnership. Int J Med Educ 2022; 13:221-229. [PMID: 36049218 PMCID: PMC9905002 DOI: 10.5116/ijme.62eb.850a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 08/04/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVES This qualitative study aims to explore how fourth-year medical students on the surgery course perceived a clinical anatomy workshop organised by near-peer student teachers in partnership with faculty. METHODS Forty-seven medical students participated in a workshop on clinical anatomy in the dissection laboratory. A voluntary response sampling method was used. The students' perceptions of the workshop were explored through a thematic content analysis of transcribed, semi-structured group interviews and written comments. RESULTS A majority of the students had not revisited the dissection laboratory since their second year, and all students described the workshop as a unique opportunity to vertically integrate anatomical knowledge. Four main themes were identified as most valuable for the students' learning experience, namely that the workshop 1) was taught by knowledgeable and friendly near-peer tutors (NPTs), 2) consisted of highly relevant anatomical content, 3) offered a hands-on experience of cadavers in the dissection laboratory, and 4) was taught in a focused session in the middle of the surgery course. CONCLUSIONS This study shows how hands-on workshops in clinical anatomy, developed in student-staff partnerships and taught by NPTs, can enable senior medical students to recall and vertically integrate anatomical knowledge during surgical clerkships. The results have implications for curriculum design, giving voice to senior students' wishes for spaced repetition and vertical integration of pre-clinical anatomy knowledge during their clinical training. Moreover, this study may inspire other students and faculty to develop similar near-peer teaching activities through student-staff partnerships.
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Affiliation(s)
- Josefin Ivarson
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - André Hermansson
- Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Björn Meister
- Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Hugo Zeberg
- Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Klara Bolander Laksov
- Centre for Psychiatry Research, Department of Clinical Neuroscience, CAP Research Centre, Karolinska Institutet, Sweden
| | - Wilhelmina Ekström
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
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18
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Park JH, Choi YJ, Lee M, Kim D, Kwon HW, Park KR, Park SB, Cho J. Anatomical Characteristics of Extensor Hallucis Longus Tendon Variations and Its Clinical Implications: A Korean Cadaveric Study. Int J Environ Res Public Health 2022; 19:9833. [PMID: 36011469 PMCID: PMC9408564 DOI: 10.3390/ijerph19169833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 08/07/2022] [Accepted: 08/08/2022] [Indexed: 06/15/2023]
Abstract
The purpose of this study is to ascertain the morphological characteristics of the extensor hallucis longus (EHL) tendon variation using larger-scale dissection of Korean cadavers and to classify the types of variation along with incidence. A total of 158 feet from adult formalin-fixed cadavers (50 males, 29 females) were dissected. The morphological characteristics and measurements of the EHL tendon variants were evaluated. Three types of the EHL tendon variation were classified, wherein the most common type was Type 2 (106 feet, 67.1%), Type 3 (3 feet, 1.9%) was the rarest type, and Type 1 without accessory tendon was found in 49 feet (31.0%). Type 2K (11 feet, 7%) and Type 3K (1 foot, 0.6%) were described as new subtypes. The present study suggests morphological characteristics of the EHL tendon variation in Korean populations and high morphological variability of the EHL tendon along with the possibility of differences according to race or ethnicity and gender. Furthermore, a newly updated classification complemented by new subtypes of variation will help foot and ankle surgeons in diagnosis and surgical planning with hallux problems.
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Affiliation(s)
- Jeong-Hyun Park
- Department of Anatomy & Cell Biology, School of Medicine, Kangwon National University, Chuncheon 24341, Korea
| | - Yu-Jin Choi
- Department of Anatomy & Cell Biology, School of Medicine, Kangwon National University, Chuncheon 24341, Korea
| | - Mijeong Lee
- Department of Anatomy & Cell Biology, School of Medicine, Kangwon National University, Chuncheon 24341, Korea
| | - Digud Kim
- Department of Anatomy & Cell Biology, School of Medicine, Kangwon National University, Chuncheon 24341, Korea
| | - Hyung-Wook Kwon
- Department of Anatomy & Cell Biology, School of Medicine, Kangwon National University, Chuncheon 24341, Korea
| | - Kwang-Rak Park
- Department of Anatomy, School of Medicine, Keimyung University, Daegu 42601, Korea
| | - Sa-Beom Park
- Center of Biohealth Convergence and Open Sharing System, Hongik University, Seoul 04066, Korea
| | - Jaeho Cho
- Department of Orthopaedic Surgery, Chuncheon Sacred Heart Hospital, Hallym University, Chuncheon 24253, Korea
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19
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Park JH, Cho J, Kim D, Kwon HW, Lee M, Choi YJ, Yoon KH, Park KR. Anatomical Classification for Plantaris Tendon Insertion and Its Clinical Implications: A Cadaveric Study. Int J Environ Res Public Health 2022; 19:5795. [PMID: 35627332 PMCID: PMC9140714 DOI: 10.3390/ijerph19105795] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 04/20/2022] [Accepted: 05/09/2022] [Indexed: 02/06/2023]
Abstract
The purposes of this study were to ascertain the morphological characteristics of a plantaris tendon (PT) insertion using a larger-scale dissection of Korean cadavers and to classify the types of PT insertion related to the calcaneal tendon (CT). A total of 108 feet from adult formalin-fixed cadavers (34 males, 20 females) were dissected. The morphological characteristics and measurements of the PT insertion were evaluated. Five types of PT insertion were classified, wherein the most common type was Type 1 (39 feet, 63.1%). Type 2 and Type 3 were similar, with 16 feet (14.8%) and 15 feet (13.9%), respectively. Type 4 (6 feet, 5.6%) was the rarest type, and Type 5 had 25 feet (23.1%). The case of an absent PT was noted in 7 feet (6.5%). In the proximal portion, the tendon had a thick and narrow shape, became thin and wide in the middle portion, and then changed to thick and narrow again just before the insertion into the calcaneal tuberosity. This study confirmed the five types according to the location of the PT and the area of its insertion-related CT. The morphology of the PT insertion may be anatomically likely to influence the occurrence of tendinopathy in the CT.
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Affiliation(s)
- Jeong-Hyun Park
- Department of Anatomy & Cell Biology, School of Medicine, Kangwon National University, Chuncheon 24341, Korea; (J.-H.P.); (D.K.); (H.-W.K.); (M.L.); (Y.-J.C.)
| | - Jaeho Cho
- Department of Orthopaedic Surgery, Chuncheon Sacred Heart Hospital, Hallym University, Chuncheon 24253, Korea;
| | - Digud Kim
- Department of Anatomy & Cell Biology, School of Medicine, Kangwon National University, Chuncheon 24341, Korea; (J.-H.P.); (D.K.); (H.-W.K.); (M.L.); (Y.-J.C.)
| | - Hyung-Wook Kwon
- Department of Anatomy & Cell Biology, School of Medicine, Kangwon National University, Chuncheon 24341, Korea; (J.-H.P.); (D.K.); (H.-W.K.); (M.L.); (Y.-J.C.)
| | - Mijeong Lee
- Department of Anatomy & Cell Biology, School of Medicine, Kangwon National University, Chuncheon 24341, Korea; (J.-H.P.); (D.K.); (H.-W.K.); (M.L.); (Y.-J.C.)
| | - Yu-Jin Choi
- Department of Anatomy & Cell Biology, School of Medicine, Kangwon National University, Chuncheon 24341, Korea; (J.-H.P.); (D.K.); (H.-W.K.); (M.L.); (Y.-J.C.)
| | - Kwan Hyun Yoon
- Division in Biomedical Art, Incheon Catholic University Graduate School, Incheon 21987, Korea;
| | - Kwang-Rak Park
- Department of Anatomy, School of Medicine, Keimyung University, Daegu 42601, Korea
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20
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Olivares-Perez ME, Graglia S, Harmon DJ, Klein BA. Virtual anatomy and point-of-care ultrasonography integration pilot for medical students. Anat Sci Educ 2022; 15:464-475. [PMID: 34748279 DOI: 10.1002/ase.2151] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 10/12/2021] [Accepted: 11/03/2021] [Indexed: 06/13/2023]
Abstract
Despite its significant clinical use, there is no standardized point-of-care ultrasonography (POCUS) curriculum in undergraduate medical education. As Covid-19 abruptly mandated the use of virtual education, instructors were challenged to incorporate and improve POCUS education within these new constraints. It was hypothesized that integrating POCUS into anatomy via brief video lessons and a subsequent interactive virtual lesson would lead to an objective understanding of POCUS concepts, improved understanding of the corresponding anatomy, and subjective improvement of student confidence with POCUS. A cross-sectional descriptive study assessed first-year medical students' perspectives and performance before and after the interventions (n = 161). The intervention was split into two parts: (1) three optional 10-minute POCUS videos that reinforced anatomy concepts taught in the laboratory sessions, and (2) a subsequent two-hour interactive virtual session reviewing POCUS and anatomy concepts. Students completed a knowledge and confidence assessment tool before and after the interactive session. Survey responses (n = 51) indicated that 94% of students felt the optional videos improved their understanding of POCUS and were educationally valuable. One half of medical students (50%) indicated that the demonstrations improved their anatomy understanding. Initial self-reported confidence was low after the optional video lessons, despite an average score of 58% on the knowledge assessment (n = 130). However, confidence increased significantly along with an increase in score performance to 80% after the interactive session (n = 39, P < 0.01). Results suggest that the virtual integration pilot enhanced student learning of both anatomy and POCUS.
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Affiliation(s)
- Marcus E Olivares-Perez
- Department of Emergency Medicine, University of California, San Francisco-Fresno, Fresno, California, USA
| | - Sally Graglia
- Department of Emergency Medicine, University of California, San Francisco, San Francisco, California, USA
- Department of Emergency Medicine, Zuckerberg San Francisco General Hospital, San Francisco, California, USA
| | - Derek J Harmon
- Department of Anatomy, University of California, San Francisco, School of Medicine, San Francisco, California, USA
| | - Barbie A Klein
- Department of Anatomy, University of California, San Francisco, School of Medicine, San Francisco, California, USA
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21
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Park KR, Park WJ, Lee SW, Kim H, Lee H, Lee JH. A Simple Method to Locate the Master Knot of Henry Using the Correlation between the Flexor Tendon Length Parameter and the Foot Length. Int J Environ Res Public Health 2022; 19:2281. [PMID: 35206468 DOI: 10.3390/ijerph19042281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 02/12/2022] [Accepted: 02/15/2022] [Indexed: 12/10/2022]
Abstract
The precise location of the Master Knot of Henry (MKH) has important clinical significance, but its anatomical definition has not been agreed upon. The purpose of this study is to present a linear regression equation for predicting length variables based on foot length, by evaluating the correlation of length variables related to flexor hallucis longus (FHL) and flexor digitorum longus (FDL), with respect to the location of the MKH. A total of 95 limbs were dissected from 48 adult cadavers, and were fixed in formalin. Measurements were made for the length parameter, with reference to the landmark. The relevance between length variables was analyzed through simple correlation analysis and linear regression analysis. The foot length was 213.69 ± 17.53 mm, MKH-great toe distal phalanx was 140.16 ± 14.69 mm, MKH-FHL insertion was 124.55 ± 13.46 mm, MKH-little toe distal phalanx was 121.79 ± 13.41 mm, MKH-FDL little toe insertion was 109.07 ± 14.16 mm, and the FHL-FDL angle was 33.15 ± 5.39. The correlation coefficient between all the length variables for foot length showed a high positive correlation. We derived a regression equation that can predict the length of each variable. This regression formula is considered to be highly useful because it can estimate the positional relationship of the MKH relatively simply.
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22
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Wahl L, Iwanaga J, Chabot AB, Dumont AS, Tubbs RS. Hypoplasia of the Tentorium Cerebelli: Case Report and Review of the Literature. Kurume Med J 2022; 67:49-52. [PMID: 35095020 DOI: 10.2739/kurumemedj.ms671009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The second largest intracranial specialization of the dura mater, the tentorium cerebelli, is a transverse fold that partially separates the cerebellum and cerebral hemispheres. During routine dissection of the posterior cranial fossa, a left-sided hypoplastic region of the tentorium cerebelli was observed. This fenestration was seen at the posterior portion of the tentorium as a posteromedial strip of tissue rising vertically to interface with the falx cerebri. Although isolated cases of tentorial hypoplasia have been reported in, for example, cases of Chiari II malformation, we believe isolated fenestration of this membrane is very rare, especially in the absence of the Chiari II malformation. The current case adds to the sparse literature on isolated tentorial defects and might be of interest to neurosurgeons or clinicians who review intracranial imaging.
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Affiliation(s)
- Lauren Wahl
- Department of Cell and Developmental Biology, University of Colorado
| | - Joe Iwanaga
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine.,Division of Gross and Clinical Anatomy, Department of Anatomy, Kurume University School of Medicine
| | - A Bert Chabot
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine
| | - Aaron S Dumont
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine
| | - R Shane Tubbs
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine.,Department of Structural & Cellular Biology, Tulane University School of Medicine.,Department of Anatomical Sciences, St. George's University.,Department of Neurosurgery and Ochsner Neuroscience Institute, Ochsner Health System
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23
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Fukuoka H, Fukuoka N, Kibe T, Tubbs RS, Iwanaga J. Oral Herpes Zoster Infection Following COVID-19 Vaccination: A Report of Five Cases. Cureus 2021; 13:e19433. [PMID: 34909338 PMCID: PMC8663753 DOI: 10.7759/cureus.19433] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/10/2021] [Indexed: 02/01/2023] Open
Abstract
Recently, two cases of oral herpes zoster (HZ) following COVID-19 vaccines were reported. It was suggested that COVID-19 vaccine-related oral HZ cases might be missed or misdiagnosed as stomatitis or isolated oral herpes. In this report, five cases of oral HZ following COVID-19 vaccinations are presented. Four cases were observed on the hard palate (V2), and one case was found on the mandible (V3). Four patients did not receive any treatment for their oral HZ, but one patient also had skin reactions on her right orbit and ear and was thus treated with an antiviral drug. As these cases were seen during such a short period of time and in one practice, the relationship with the COVID-19 vaccination appears to be related.
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Affiliation(s)
| | | | - Toshiro Kibe
- Department of Oral and Maxillofacial Surgery, Field of Oral and Maxillofacial Surgery, Developmental Therapeutics Course, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, JPN
| | - R Shane Tubbs
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, USA
- Department of Neurosurgery and Ochsner Neuroscience Institute, Ochsner Health System, New Orleans, USA
- Department of Anatomical Sciences, St. George's University, St. George's, GRD
| | - Joe Iwanaga
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, USA
- Department of Neurology, Tulane University School of Medicine, New Orleans, USA
- Department of Anatomy, Dental and Oral Medical Center, Kurume University School of Medicine, Kurume, JPN
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24
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Fyllos A, Raoulis V, Mitrousias V, Banios K, Chytas D, Zibis A. Surgical Implications of the Arterial Anatomy around the Knee: A Cadaveric Pictorial Essay. Diagnostics (Basel) 2021; 11:diagnostics11112004. [PMID: 34829351 PMCID: PMC8621235 DOI: 10.3390/diagnostics11112004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Revised: 10/24/2021] [Accepted: 10/25/2021] [Indexed: 11/17/2022] Open
Abstract
We completed an anatomic cadaver study in order to examine the arterial supply around the knee and to create useful images regarding the arterial surgical anatomy around the knee. A total of four unmatched fresh-frozen cadaveric knees were utilized. There was no medical history of osteoporosis, bony or soft-tissue injury or surgery in any of the knees. The femoral arteries were cannulated with a large catheter at the proximal aspect of the cadavers, and liquid latex in different colours was injected. Τhe specimens were then placed into a bath of 8.0% sodium hypochlorite to complete debridement of the soft tissues to various degrees. The specimens were checked every 15 to 30 min until adequate debridement occurred, and photographs were taken during each stage of this process. Sodium hypochlorite, among others, chemically debrides the vessel walls leaving the casts of the vessel lumens filled with solid coloured latex in order to illustrate the vascular supply pattern to the structures of interest. Knowing the probability of where these arteries should be located adds to the knowledge that surgeons have at their disposal when performing procedures involving arthroscopy, arthroplasty and osteotomies, which can help decrease unnecessary damage to the arteries.
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Affiliation(s)
- Apostolos Fyllos
- Laboratory of Anatomy, Department of Medicine, School of Health Sciences, University of Thessaly, 3 University Str, Biopolis, 41110 Larissa, Greece; (A.F.); (V.R.); (V.M.); (K.B.)
| | - Vasileios Raoulis
- Laboratory of Anatomy, Department of Medicine, School of Health Sciences, University of Thessaly, 3 University Str, Biopolis, 41110 Larissa, Greece; (A.F.); (V.R.); (V.M.); (K.B.)
- Department of Orthopedic Surgery, University Hospital of Larissa, 3 University Str, Biopolis, 41110 Larissa, Greece
| | - Vasileios Mitrousias
- Laboratory of Anatomy, Department of Medicine, School of Health Sciences, University of Thessaly, 3 University Str, Biopolis, 41110 Larissa, Greece; (A.F.); (V.R.); (V.M.); (K.B.)
- Department of Orthopedic Surgery, University Hospital of Larissa, 3 University Str, Biopolis, 41110 Larissa, Greece
| | - Konstantinos Banios
- Laboratory of Anatomy, Department of Medicine, School of Health Sciences, University of Thessaly, 3 University Str, Biopolis, 41110 Larissa, Greece; (A.F.); (V.R.); (V.M.); (K.B.)
- Department of Orthopedic Surgery, General Hospital of Karditsa, Peripheral Road Karditsa-Kastania, 43100 Karditsa, Greece
| | - Dimitrios Chytas
- Department of Physiotherapy, University of Peloponnese, 20 Plateon Str, 23100 Sparta, Greece;
| | - Aristeidis Zibis
- Laboratory of Anatomy, Department of Medicine, School of Health Sciences, University of Thessaly, 3 University Str, Biopolis, 41110 Larissa, Greece; (A.F.); (V.R.); (V.M.); (K.B.)
- Correspondence:
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25
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Iwanaga J, Fukuoka H, Fukuoka N, Yutori H, Ibaragi S, Tubbs RS. A narrative review and clinical anatomy of herpes zoster infection following COVID-19 vaccination. Clin Anat 2021; 35:45-51. [PMID: 34554601 PMCID: PMC8652627 DOI: 10.1002/ca.23790] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 09/21/2021] [Indexed: 01/08/2023]
Abstract
INTRODUCTION In this review, cases of herpes zoster (HZ) infection following receipt of COVID-19 vaccines will be analyzed. We also present two cases of oral HZ following the COVID-19 vaccine and discuss this clinical anatomy. MATERIALS AND METHODS A database search using PubMed was conducted in August 2021 and 20 articles were found to be eligible for review. Patient data and vaccine information were analyzed. In addition, two cases of oral HZ infection following the receipt of COVID-19 vaccines are presented. RESULTS A total of 399 cases were identified. The affected dermatomes mimicked the regular distribution of HZ. For the dermatomes of the face, the various reports used different ways to describe the areas involved; CNV, CNV1, CNV2, CNV3, lower jaw, forehead, and under the eyebrow (CNV, 2 cases; CNV1, 4 cases; CNV2, 3 cases; and CNV3, 3 cases). Some patients who had a history of varicella zoster virus vaccination had HZ following the COVID-19 vaccination. Two patients with oral HZ following vaccination were found to have involvement of the greater palatine nerve. CONCLUSIONS Vaccine-related HZ cases have been reported worldwide. Although many studies with a larger number of cases are ongoing, detailed information can be obtained from case reviews as reported herein.
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Affiliation(s)
- Joe Iwanaga
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, Louisiana, USA.,Department of Neurology, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, Louisiana, USA.,Dental and Oral Medical Center, Kurume University School of Medicine, Kurume, Fukuoka, Japan.,Division of Gross and Clinical Anatomy, Department of Anatomy, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | | | | | - Hirokazu Yutori
- Department of Oral and Maxillofacial Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Soichiro Ibaragi
- Department of Oral and Maxillofacial Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - R Shane Tubbs
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, Louisiana, USA.,Department of Neurology, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, Louisiana, USA.,Department of Anatomical Sciences, St. George's University, St. George's, Grenada.,Department of Structural & Cellular Biology, Tulane University School of Medicine, New Orleans, Louisiana, USA.,Department of Surgery, Tulane University School of Medicine, New Orleans, Louisiana, USA.,Department of Neurosurgery and Ochsner Neuroscience Institute, Ochsner Health System, New Orleans, Louisiana, USA.,University of Queensland, Brisbane, Australia
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26
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Park JH, Kim D, Kwon HW, Lee M, Choi YJ, Park KR, Youn KH, Cho J. A New Anatomical Classification for Tibialis Posterior Tendon Insertion and Its Clinical Implications: A Cadaveric Study. Diagnostics (Basel) 2021; 11:diagnostics11091619. [PMID: 34573961 PMCID: PMC8466387 DOI: 10.3390/diagnostics11091619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 08/27/2021] [Accepted: 09/01/2021] [Indexed: 11/18/2022] Open
Abstract
The variations in the tibialis posterior tendon (TPT) could not be defined by previous classification; thus, this study used a larger-scale cadaver with the aim to classify the types of TPT insertion based on the combination of the number and location of TPT insertions. A total of 118 feet from adult formalin-fixed cadavers were dissected (68 males, 50 females). The morphological characteristics and measurements of TPT insertion were evaluated. Four types of TPT insertions were classified, wherein the most common type was type 4 (quadruple insertions, 78 feet, 66.1%), which was divided into four new subtypes that were not defined in the previous classification. The second most common type was type 3 (triple insertions, 25 feet, 21.2%) with three subtypes, including the new subtype. Type 2 was found in 13 feet (11%), and the rarest type was type 1 (2 feet, 1.7%), wherein the main tendon was only attached to the navicular bone and the medial cuneiform bone. We suggest high morphological variability of the TPT in relation to the insertion location, along with the possibility of significant differences according to race and gender. Moreover, this classification will help clinicians understand adult flatfoot deformity-related posterior tibial tendon dysfunction (PTTD).
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Affiliation(s)
- Jeong-Hyun Park
- Department of Anatomy & Cell Biology, School of Medicine, Kangwon National University, Chuncheon 24341, Korea; (J.-H.P.); (D.K.); (H.-W.K.); (M.L.); (Y.-J.C.)
| | - Digud Kim
- Department of Anatomy & Cell Biology, School of Medicine, Kangwon National University, Chuncheon 24341, Korea; (J.-H.P.); (D.K.); (H.-W.K.); (M.L.); (Y.-J.C.)
| | - Hyung-Wook Kwon
- Department of Anatomy & Cell Biology, School of Medicine, Kangwon National University, Chuncheon 24341, Korea; (J.-H.P.); (D.K.); (H.-W.K.); (M.L.); (Y.-J.C.)
| | - Mijeong Lee
- Department of Anatomy & Cell Biology, School of Medicine, Kangwon National University, Chuncheon 24341, Korea; (J.-H.P.); (D.K.); (H.-W.K.); (M.L.); (Y.-J.C.)
| | - Yu-Jin Choi
- Department of Anatomy & Cell Biology, School of Medicine, Kangwon National University, Chuncheon 24341, Korea; (J.-H.P.); (D.K.); (H.-W.K.); (M.L.); (Y.-J.C.)
| | - Kwang-Rak Park
- Department of Anatomy, School of Medicine, Keimyung University, Daegu 42601, Korea;
| | - Kwan Hyun Youn
- Division in Biomedical Art, Incheon Catholic University Graduate School, Incheon 21987, Korea;
| | - Jaeho Cho
- Department of Orthopaedic Surgery, Chuncheon Sacred Heart Hospital, Hallym University, Chuncheon 24253, Korea
- Correspondence:
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27
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Shen D, Ono K, Do Q, Ohyama H, Nakamura K, Obata K, Ibaragi S, Watanabe K, Tubbs RS, Iwanaga J. Clinical anatomy of the inferior labial gland: a narrative review. Gland Surg 2021; 10:2284-2292. [PMID: 34422599 DOI: 10.21037/gs-21-143] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Accepted: 06/03/2021] [Indexed: 12/20/2022]
Abstract
Objective In this article we review the literature on the inferior labial gland from a clinical and anatomical perspective. Background Regardless of its importance in clinical practice, there are no medical literature that comprehensively reviewed the inferior labial gland. Methods A database search using PubMed and Google Scholar was conducted. The following keywords were used in the search: "lower labial salivary gland", "lower labial gland", "inferior labial salivary gland", AND "inferior labial gland". Conclusions The human labial glands are types of minor salivary gland that continuously secrete small amounts of mucous and serous substances to maintain oral health. The inferior labial glands are innervated by the inferior labial branch of the mental nerve, and the inferior labial branch of the facial artery is the main arterial supply to the lower lip. Although they only have an auxiliary role in saliva production compared to the major salivary glands, minor salivary glands provide a certain amount of lubrication in the oral cavity by the continuous outflow of saliva. The inferior labial gland not only promotes moisturization in the oral cavity but also secretes substances with antibacterial effects, which is important for the function of the oral cavity. A recent study showed that the rate of salivary secretion from the inferior labial glands does not change with age, and in some cases the inferior labial glands are used for diagnosing intractable diseases such as Sjogren's syndrome and cystic fibrosis. In addition, since the inferior labial glands themselves can be the site of cyst and/or neoplasia development, we should be careful to distinguish them from other diseases. Elucidation of the anatomy, physiology, and pathology of the inferior labial glands, is important for understanding human health and diseases.
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Affiliation(s)
- Daniel Shen
- Harvard School of Dental Medicine, Harvard University, Boston, MA, USA
| | - Kisho Ono
- Department of Oral and Maxillofacial Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Okayama, Japan
| | - Quang Do
- Harvard School of Dental Medicine, Harvard University, Boston, MA, USA
| | - Hiroe Ohyama
- Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, MA, USA
| | - Ken Nakamura
- Dental and Oral Medical Center, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Kyoichi Obata
- Department of Oral and Maxillofacial Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Okayama, Japan
| | - Soichiro Ibaragi
- Department of Oral and Maxillofacial Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Okayama, Japan
| | - Koichi Watanabe
- Division of Gross and Clinical Anatomy, Department of Anatomy, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - R Shane Tubbs
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, LA, USA.,Department of Neurology, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, LA, USA.,Department of Anatomical Sciences, St. George's University, St. George's, Grenada.,Department of Structural & Cellular Biology, Tulane University School of Medicine, New Orleans, LA, USA.,Department of Neurosurgery and Ochsner Neuroscience Institute, Ochsner Health System, New Orleans, LA, USA.,Department of Surgery, Tulane University School of Medicine, New Orleans, LA, USA
| | - Joe Iwanaga
- Dental and Oral Medical Center, Kurume University School of Medicine, Kurume, Fukuoka, Japan.,Division of Gross and Clinical Anatomy, Department of Anatomy, Kurume University School of Medicine, Kurume, Fukuoka, Japan.,Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, LA, USA.,Department of Neurology, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, LA, USA
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Soulii L, Amirouche F, Solitro G, Boroda N, Echenique DB, Mejia A, Gonzalez MH. Evaluation of A2 and A4 Hand Pulley Repair Using Tendon Graft Rings. J Hand Surg Am 2021; 46:626.e1-626.e6. [PMID: 33579590 DOI: 10.1016/j.jhsa.2020.11.025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Revised: 09/23/2020] [Accepted: 11/27/2020] [Indexed: 02/02/2023]
Abstract
PURPOSE To compare the mechanical characteristics of A2 and combined A2-A4 pulley repair in the intact and damaged flexor pulley system. METHODS After control testing, we recorded tendon excursion and flexion of 11 cadaveric fingers after several interventions: (1) complete excision of A2 and A4, (2) repair of the A2 with one ring of tendon graft, (3) repair of the A2 with 2 rings of tendon graft, and (4) repair of the A2 with 2 rings combined with repair the A4 with one ring. RESULTS At the proximal interphalangeal (PIP) joint, the maximum rotational angle decreased by an average of 30% after complete excision of the A2 and A4 pulleys. This angle was still decreased compared with the control by an average of 25% after one-ring repair at A2, 23% after 2-ring repair at A2, and 17% after 2-ring repair at A2 combined with one-ring repair at A4. At the metacarpophalangeal joint, the average maximum rotational angle decreased by an average of 17% after complete excision of the A2 and A4 pulleys. This angle was still decreased compared with the control by an average of 11% after one-ring repair at A2, 7% after 2-ring repair at A2, and 4% after 2-ring repair at A2 combined with one-ring repair at A4. Kinematic behavior at the PIP joint with an intact pulley system was most closely approximated by the 3-loop repair. The least similar behavior was with a 2-ring construct at A2. CONCLUSIONS All repairs increased average flexion at the PIP and metacarpophalangeal joints compared with the unrepaired samples. The 3-ring configuration exhibited a higher recovery of PIP flexion compared with the other repairs. CLINICAL RELEVANCE Although each repair restored flexion, clinical studies are necessary to evaluate the clinical relevance of the mechanical results of this study.
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Affiliation(s)
- Lioubov Soulii
- Department of Orthopedic Surgery, College of Medicine, University of Illinois at Chicago, Chicago IL
| | - Farid Amirouche
- Department of Orthopedic Surgery, College of Medicine, University of Illinois at Chicago, Chicago IL.
| | - Giovanni Solitro
- Department of Orthopedic Surgery, College of Medicine, University of Illinois at Chicago, Chicago IL
| | - Nickolas Boroda
- Department of Orthopedic Surgery, College of Medicine, University of Illinois at Chicago, Chicago IL
| | - Diego Barragan Echenique
- Department of Orthopedic Surgery, College of Medicine, University of Illinois at Chicago, Chicago IL
| | - Alfonso Mejia
- Department of Orthopedic Surgery, College of Medicine, University of Illinois at Chicago, Chicago IL
| | - Mark H Gonzalez
- Department of Orthopedic Surgery, College of Medicine, University of Illinois at Chicago, Chicago IL
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Chabot AB, Iwanaga J, Dumont AS, Tubbs RS. A Rare Anatomical Variation of the Lesser Occipital Nerve. Cureus 2021; 13:e15901. [PMID: 34336417 PMCID: PMC8312764 DOI: 10.7759/cureus.15901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/24/2021] [Indexed: 11/08/2022] Open
Abstract
The lesser occipital nerve (LON) is a cutaneous branch of the cervical plexus that arises from the second and sometimes the third spinal nerve and innervates the scalp. During routine dissection of the neck, the LON was observed to arise directly from the spinal accessory nerve. The aberrant nerve measured 1.9 mm in diameter and 10.2 cm in length. Although anatomical variations of the LON such as duplication and triplication have been observed, we believe the origination of this nerve directly and exclusively from the spinal accessory nerve is exceedingly rare. The current case adds to the sparse literature on the variations of the LON and might be of interest to clinicians treating neurological conditions or surgeons operating in the area.
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Affiliation(s)
- A Bert Chabot
- Department of Neurosurgery, Tulane University School of Medicine, New Orleans, USA
| | - Joe Iwanaga
- Department of Neurosurgery, Tulane University School of Medicine, New Orleans, USA
| | - Aaron S Dumont
- Department of Neurosurgery, Tulane University School of Medicine, New Orleans, USA
| | - R Shane Tubbs
- Anatomical Sciences, St. George's University, St. George's, GRD.,Department of Neurosurgery and Structural & Cellular Biology, Tulane University School of Medicine, New Orleans, USA.,Neurosurgery and Ochsner Neuroscience Institute, Ochsner Health System, New Orleans, USA
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Iwanaga J, Terada S, Kim HJ, Tabira Y, Arakawa T, Watanabe K, Dumont AS, Tubbs RS. Easy three-dimensional scanning technology for anatomy education using a free cellphone app. Clin Anat 2021; 34:910-918. [PMID: 33984162 DOI: 10.1002/ca.23753] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 04/29/2021] [Indexed: 02/06/2023]
Abstract
The COVID-19 pandemic has brought difficult times to anatomy educators and medical/dental students. Under normal circumstances, gross anatomy classes give students opportunities to touch and observe human bones and cadaveric tissues, thus enhancing their understanding; such morphology is difficult to learn from textbooks alone. As many studies have shown, three-dimensional (3D) technologies used in online lectures can serve as alternatives to real specimens for providing knowledge of anatomy. However, such technologies are often expensive. The goal of this study was to create 3D anatomy models for online lectures using a free cellphone app. Free application software (Qlone) was used to create 3D anatomical models. The extracranium and intracranium of adult skull, fetal skull, mandible, temporal bone, second cervical vertebra, and ilium were all scanned and exported to the computer in 3D format. A total of 53 anatomical structures were evaluated by nine observers. Although the 53 structures used in this study did not include all the structures that students need to learn, visibility was good/acceptable for most of the 53. The free and simple 3D scanning app used in this study could enable anatomy educators to provide better content to students during online lectures.
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Affiliation(s)
- Joe Iwanaga
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, Louisiana, USA.,Department of Neurology, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, Louisiana, USA.,Dental and Oral Medical Center, Kurume University School of Medicine, Kurume, Fukuoka, Japan.,Division of Gross and Clinical Anatomy, Department of Anatomy, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Satoshi Terada
- Japan Community Health Care Organization (JCHO) Mishima General Hospital, Mishima City, Shizuoka, Japan.,OCD Co., Ltd., Tokyo, Japan
| | - Hee-Jin Kim
- Division in Anatomy and Developmental Biology, Department of Oral Biology, Human Identification Research Institute, BK21 FOUR Project, Yonsei University College of Dentistry, Seoul, South Korea
| | - Yoko Tabira
- Division of Gross and Clinical Anatomy, Department of Anatomy, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Takamitsu Arakawa
- Department of Rehabilitation of Sciences, Kobe University Graduate School of Health Sciences, Kobe, Hyogo, Japan
| | - Koichi Watanabe
- Division of Gross and Clinical Anatomy, Department of Anatomy, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Aaron S Dumont
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, Louisiana, USA
| | - R Shane Tubbs
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, Louisiana, USA.,Department of Neurology, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, Louisiana, USA.,Department of Structural & Cellular Biology, Tulane University School of Medicine, New Orleans, Louisiana, USA.,Department of Neurosurgery and Ochsner Neuroscience Institute, Ochsner Health System, New Orleans, Louisiana, USA.,Department of Anatomical Sciences, St. George's University, St. George's, Grenada.,Department of Surgery, Tulane University School of Medicine, New Orleans, Louisiana, USA
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31
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Bauman B, Kernahan P, Weinhaus A, Walker MJ, Irwin E, Sundin A, Yerxa D, Vakayil V, Harmon JV. An Interprofessional Senior Medical Student Preparation Course: Improvement in Knowledge and Self-Confidence Before Entering Surgical Training. Adv Med Educ Pract 2021; 12:441-451. [PMID: 33994822 PMCID: PMC8112855 DOI: 10.2147/amep.s287430] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 02/23/2021] [Indexed: 06/12/2023]
Abstract
PURPOSE Senior medical students are variably prepared to begin surgical training; and a national curriculum was established through the American College of Surgeons to better prepare senior medical students for surgical training. The purpose of our course is to prepare senior medical students to more effectively enter surgical training programs. We recently enhanced our independently developed surgical training preparation course by increasing exposure to surgical anatomy, medical physiology, surgical skills, and point-of-care ultrasound. We evaluated the impact of our interprofessional training course to increase confidence and readiness among senior medical students entering surgical training. METHODS The course focused on pre- and post-operative patient care, surgical anatomy, human physiology, and bedside ultrasound. Didactic lectures in anatomy, human physiology, and bedside ultrasound were provided prior to all hands-on simulated patient care sessions and mock surgical procedures. To evaluate our interprofessional curriculum, we administered pre- and post-course surveys, pre- and post-course knowledge tests, and a final surgical anatomy laboratory practical examination to 22 senior medical students who were enrolled in the course. All students created a final surgical anatomy presentation. RESULTS The students demonstrated a 100% pass rate in surgical anatomy. The knowledge test, which included assessment of knowledge on perioperative surgical decision making, human physiology, and bedside ultrasound, demonstrated an average improvement of 10%. Statistically significant improvements in median confidence values were identified in 10 of 32 surveyed categories, including surgical skills (p < 0.05); 84% of student goals for the course were achieved. The medical students' surveys confirmed increased confidence related to the use of point-of-care ultrasound, teamwork experience, and basic surgical skills through small group interactive seminars and surgical simulation exercises. CONCLUSION Our preparation for surgical training course resulted in high student satisfaction and demonstrated an increased sense of confidence to begin surgical training. The 10% improvement in medical student knowledge, as evaluated by a written examination, and the significant improvement in confidence level self-assessment scores confirms this surgery preparation course for senior medical students successfully achieved the desired goals of the course.
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Affiliation(s)
- Brent Bauman
- Department of Surgery, University of Minnesota, Minneapolis, MN, USA
| | - Peter Kernahan
- Department of Surgery, University of Minnesota, Minneapolis, MN, USA
- Program in Human Anatomy, University of Minnesota, Minneapolis, MN, USA
| | - Anthony Weinhaus
- Program in Human Anatomy, University of Minnesota, Minneapolis, MN, USA
| | - Michael J Walker
- Program in Human Anatomy, University of Minnesota, Minneapolis, MN, USA
| | - Eric Irwin
- Department of Surgery, University of Minnesota, Minneapolis, MN, USA
| | - Andrew Sundin
- Department of Surgery, University of Minnesota, Minneapolis, MN, USA
| | - Derek Yerxa
- College of Biological Sciences, University of Minnesota, Minneapolis, MN, USA
| | - Victor Vakayil
- Department of Surgery, University of Minnesota, Minneapolis, MN, USA
| | - James V Harmon
- Department of Surgery, University of Minnesota, Minneapolis, MN, USA
- Program in Human Anatomy, University of Minnesota, Minneapolis, MN, USA
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Pękala PA, Mann MR, Pękala JR, Tomaszewski KA, LaPrade RF. Evidence-Based Clinical Anatomy of the Popliteofibular Ligament and Its Importance in Orthopaedic Surgery: Cadaveric Versus Magnetic Resonance Imaging Meta-analysis and Radiological Study. Am J Sports Med 2021; 49:1659-1668. [PMID: 33017542 DOI: 10.1177/0363546520950415] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND The popliteofibular ligament (PFL) is a static stabilizer of the posterolateral corner of the knee, preventing varus angulation, tibial rotation, and posterior translation. The PFL is anatomically variable, and there is no current review that outlines its prevalence rate and morphological variations. PURPOSE To investigate the anatomic prevalence and morphological qualities of the PFL in various global patient populations via a meta-analysis of relevant literature involving both cadaveric dissections and patient-based research using magnetic resonance imaging (MRI) scans. STUDY DESIGN Meta-analysis. METHODS We pooled literature data detailing PFL prevalence rates and performed a retrospective MRI study of 100 knees to determine the overall PFL prevalence. Data searches and analyses were performed according to Anatomical Quality Assurance and PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. RESULTS There were 30 cadaveric studies and 11 MRI studies (including our radiological investigation), representing a total of 1595 lower limbs. The meta-analysis of cadaveric studies showed a higher prevalence of the PFL than the meta-analysis of MRI studies, with 98.4% (95% CI, 97.5%-99.2%) and 89.0% (95% CI, 73.9%-98.6%), respectively. Our MRI investigation reported a PFL prevalence of 92.0%. CONCLUSION The PFL was found to be a constant or rarely absent anatomic structure of the human knee according to the analysis of cadaveric dissection studies, and it was identified notably less on MRI, albeit not significantly. Increasing PFL anatomic knowledge, including awareness of its prevalence and morphological diversity, will improve injury diagnoses, treatment methods, and prognoses.
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Affiliation(s)
- Przemysław A Pękala
- International Evidence-Based Anatomy Working Group, Department of Anatomy, Jagiellonian University Medical College, Kraków, Poland.,Faculty of Medicine and Health Sciences, Andrzej Frycz Modrzewski Kraków University, Kraków, Poland
| | - Mitchell R Mann
- International Evidence-Based Anatomy Working Group, Department of Anatomy, Jagiellonian University Medical College, Kraków, Poland
| | - Jakub R Pękala
- International Evidence-Based Anatomy Working Group, Department of Anatomy, Jagiellonian University Medical College, Kraków, Poland
| | - Krzysztof A Tomaszewski
- International Evidence-Based Anatomy Working Group, Department of Anatomy, Jagiellonian University Medical College, Kraków, Poland.,Faculty of Medicine and Health Sciences, Andrzej Frycz Modrzewski Kraków University, Kraków, Poland
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Farley E, Hindmarch J, Eizenberg N, Midwinter M. Surgical applied anatomy: alive and kicking. ANZ J Surg 2021; 91:832-836. [PMID: 33734548 DOI: 10.1111/ans.16680] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Revised: 01/30/2021] [Accepted: 02/02/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Contention exists amongst anatomists, clinicians and surgeons about how much anatomical knowledge medical students need, although what is taught should be aligned with current surgical practice. The aim of this study was to explore the scope of recent advances in applied anatomy as highlighted in the ANZ Journal of Surgery in each of the surgical specialties. METHODS The 2018 volume of the ANZ Journal of Surgery was narrowed to 254 articles by applying the search term 'anatomy'. The main topic was extracted from each paper. The content of the paper was assessed for 'novel description' or 'novel application' of anatomical knowledge and classified accordingly. RESULTS Most papers with an anatomical focus were from general surgery, which focused on surgical techniques, outcomes and management. Vascular surgery had the highest percentage of papers with a novel description and application of anatomy. Although cardiothoracic and paediatric surgery had no papers with a novel description of anatomy, novel applications of anatomy were a focus in each speciality. CONCLUSION The trend towards novel applications of anatomical knowledge in all surgical specialties should encourage medical schools to shape their anatomy curricula in tandem with such advances as they evolve. The high proportion of novel applications and descriptions of anatomy in general surgery indicates continued growth as a benchmark of anatomical understanding. Vascular surgery's proportion of novel application and description of anatomy may change the way students will learn vascular anatomy to incorporate endovascular, radiologically based approaches.
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Affiliation(s)
- Edward Farley
- Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Jake Hindmarch
- Melbourne Clinical School, The University of Notre Dame, Melbourne, Victoria, Australia
| | - Norman Eizenberg
- Melbourne Clinical School, The University of Notre Dame, Melbourne, Victoria, Australia
| | - Mark Midwinter
- Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
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Pękala PA, Rosa MA, Łazarz DP, Pękala JR, Baginski A, Gobbi A, Mann MR, Tomaszewski KA, LaPrade RF. Clinical Anatomy of the Anterior Meniscofemoral Ligament of Humphrey: An Original MRI Study, Meta-analysis, and Systematic Review. Orthop J Sports Med 2021; 9:2325967120973192. [PMID: 33748296 PMCID: PMC7903842 DOI: 10.1177/2325967120973192] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Accepted: 10/09/2020] [Indexed: 01/14/2023] Open
Abstract
Background: The anterior meniscofemoral ligament (aMFL) of Humphrey is an anatomically variable fibrous band of connective tissue that attaches between the lateral aspect of the medial femoral condyle and posterior horn of the lateral meniscus, running posterior to the anterior cruciate ligament and anterior to the posterior cruciate ligament (PCL). The presence of an intact aMFL may contribute to stabilization of the lateral compartment of the knee joint. Purpose: The original magnetic resonance imaging (MRI) arm of this study aimed to assess the aMFL incidence among Polish patients. The goal of the systematic review and meta-analysis was to review the literature discussing the clinical anatomy of the aMFL and provide data on its prevalence. It was hypothesized that significant heterogeneity exists within the published literature. Study Design: Cross-sectional study and systematic review; Level of evidence, 3. Methods: A retrospective investigation was performed on the MRI scans of 100 knees (52 right, 48 left) of Polish patients. Scans were randomly selected from a database of MRI examinations performed in 2019. For the meta-analysis, major online databases were queried for data on the aMFL, and 2 authors independently assessed and extracted data from all included studies. A quality assessment of the included articles was performed using the Anatomical Quality Assessment tool. Results: In the MRI arm of this study, the aMFL was found in 62 of the 100 lower limbs. The meta-analysis included 41 studies with a total of 4220 limbs. The aMFL was present in 55.5% (95% CI, 45.5%-65.3%) of cases. Arthroscopic studies yielded the highest prevalence (82.3% [95% CI, 36.6%-100.0%]); of MRI studies, the highest prevalence was at 3.0-T strength (51.0% [95% CI, 13.3%-88.2%]). Conclusion: Significant variability in the prevalence of the aMFL was found in the literature. More emphasis should be placed on the clinical relevance of injuries to the aMFL because of its significant role in the function of the knee. It is important to be aware that, because of the anatomy of the aMFL, the ligament can also function to support a torn PCL.
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Affiliation(s)
- Przemysław A Pękala
- Department of Anatomy, Jagiellonian University Medical College, Kraków, Poland.,Faculty of Medicine and Health Sciences, Andrzej Frycz Modrzewski Kraków University, Kraków, Poland
| | - Mateusz A Rosa
- Department of Anatomy, Jagiellonian University Medical College, Kraków, Poland
| | - Dominik P Łazarz
- Department of Anatomy, Jagiellonian University Medical College, Kraków, Poland
| | - Jakub R Pękala
- Department of Anatomy, Jagiellonian University Medical College, Kraków, Poland
| | - Adam Baginski
- Department of Anatomy, Jagiellonian University Medical College, Kraków, Poland
| | - Alberto Gobbi
- Orthopaedic Arthroscopic Surgery International Bioresearch Foundation, Milan, Italy
| | - Mitchell R Mann
- Department of Anatomy, Jagiellonian University Medical College, Kraków, Poland
| | - Krzysztof A Tomaszewski
- Department of Anatomy, Jagiellonian University Medical College, Kraków, Poland.,Faculty of Medicine and Health Sciences, Andrzej Frycz Modrzewski Kraków University, Kraków, Poland
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Pękala PA, Łazarz DP, Rosa MA, Pękala JR, Baginski A, Gobbi A, Wojciechowski W, Tomaszewski KA, LaPrade RF. Clinical Anatomy of the Posterior Meniscofemoral Ligament of Wrisberg: An Original MRI Study, Meta-analysis, and Systematic Review. Orthop J Sports Med 2021; 9:2325967120973195. [PMID: 33748297 PMCID: PMC7903841 DOI: 10.1177/2325967120973195] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 10/09/2020] [Indexed: 01/14/2023] Open
Abstract
Background The posterior meniscofemoral ligament (pMFL) of Wrisberg attaches to the posterior horn of the lateral meniscus and the lateral intercondylar aspect of the medial femoral condyle and passes posteriorly to the posterior cruciate ligament (PCL). The pMFL plays a role in recovery after PCL injuries and offers stability to the lateral meniscus, promoting normal knee function. Purpose/Hypothesis The aim of the magnetic resonance imaging (MRI) arm of this study was to evaluate the prevalence of the pMFL in Polish patients. The purpose of the systematic review and meta-analysis was to evaluate the clinical relevance of the pMFL in knee surgery. It was hypothesized that extensive variability exists in reports on the prevalence, function, and clinical significance of the pMFL. Study Design Cross-sectional study and systematic review; Level of evidence, 3. Methods A retrospective MRI investigation was conducted on 100 randomly selected lower limbs of Polish patients (56 male, 44 female) performed in 2019 to determine the prevalence of the pMFL. Additionally, an extensive literature search of major online databases was performed to evaluate all reported data on the pMFL. Assessments of article eligibility and data extraction were completed independently by 2 reviewers, and all disagreements were resolved via a consensus. A quality assessment of the included articles was performed using the Anatomical Quality Assessment tool. Results In the MRI arm of this study, the pMFL was observed in 73 of the 100 limbs. In the meta-analysis, 47 studies were included, totaling 4940 lower limbs. The pooled prevalence of the pMFL was found to be 70.4% (95% CI, 63.4%-76.9%); the mean length was 27.7 mm (95% CI, 24.8-30.5 mm) and the mean widths were 4.5, 6.1, and 4.1 mm for the meniscal and femoral attachments and midportion, respectively. The mean pMFL thickness was 2.3 mm (95% CI, 1.8-2.7 mm). Conclusion Despite the variability in the literature, the pMFL was found to be a prevalent and large anatomic structure in the knee joint. The shared features of this ligament with the PCL necessitate the consideration of its value in planning and performing arthroscopic procedures of the knee.
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Affiliation(s)
- Przemysław A Pękala
- Department of Anatomy, Jagiellonian University Medical College, Kraków, Poland.,Faculty of Medicine and Health Sciences, Andrzej Frycz Modrzewski Kraków University, Kraków, Poland
| | - Dominik P Łazarz
- Department of Anatomy, Jagiellonian University Medical College, Kraków, Poland
| | - Mateusz A Rosa
- Department of Anatomy, Jagiellonian University Medical College, Kraków, Poland
| | - Jakub R Pękala
- Department of Anatomy, Jagiellonian University Medical College, Kraków, Poland
| | - Adam Baginski
- Department of Anatomy, Jagiellonian University Medical College, Kraków, Poland
| | - Alberto Gobbi
- Orthopaedic Arthroscopic Surgery International Bioresearch Foundation, Milan, Italy
| | - Wadim Wojciechowski
- Department of Radiology, Comarch Healthcare, Kraków, Poland.,Department of Radiology, Jagiellonian University Medical College, Kraków, Poland
| | - Krzysztof A Tomaszewski
- Department of Anatomy, Jagiellonian University Medical College, Kraków, Poland.,Faculty of Medicine and Health Sciences, Andrzej Frycz Modrzewski Kraków University, Kraków, Poland
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Iwanaga J, Kamura Y, Nishimura Y, Terada S, Kishimoto N, Tanaka T, Tubbs RS. A new option for education during surgical procedures and related clinical anatomy in a virtual reality workspace. Clin Anat 2021; 34:496-503. [PMID: 33502787 DOI: 10.1002/ca.23724] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Accepted: 01/19/2021] [Indexed: 12/16/2022]
Abstract
The COVID-19 pandemic and mandatory social distancing has brought challenges to anatomy educators who generally need in-person classes. The purpose of this study is to share the experience of a distant online lecture on a surgical procedure and related anatomy in a three-dimensional (3D) virtual reality (VR) workspace and to compare it with reported teaching methods, that is, an in-person class and a Zoom online class. The lecture was delivered by three authors of this article in a VR workspace that enables people to meet through VR. The lectures were about combinations of dental surgical procedures and related clinical anatomy. Physically, the attendees could have been located anywhere in the world, so lecturers joined from the United States and the attendees were all from Japan. VR environment and its flexibility enabled attendees to join the lecture actively, helping them to gain understanding of the surgical procedure and anatomy more efficiently. The use of VR technology with a live communication tool demonstrated in this study has several advantages over previous education methods, although there are still technical issues or disadvantages that need to be addressed. Development of the technology and app/software is required so that more data can be processed at higher speed. Use of VR technology with a live communication tool could be an alternative teaching method. Its overall advantages are a closer look at the slides/monitor and concurrent observation of the multiple assets in various directions by multiple attendees. These advantages cannot be achieved by any other teaching method without VR assets with the workspace provided by Spatial. Even during the mandatory social distancing due to the COVID-19 pandemic, this could enable us to foster 3D understanding of surgery and related anatomy. Further study is now needed to evaluate the effectiveness of this newly proposed teaching method by comparing it with traditional in-person and online classes with a live communication tool.
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Affiliation(s)
- Joe Iwanaga
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, Louisiana, USA
- Department of Neurology, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, Louisiana, USA
- Dental and Oral Medical Center, Kurume University School of Medicine, Fukuoka, Japan
- Division of Gross and Clinical Anatomy, Department of Anatomy, Kurume University School of Medicine, Fukuoka, Japan
| | | | - Yuu Nishimura
- Nishimura Dental Clinic, Yokoshibahikari-machi, Chiba, Japan
- Japan Community Health Care Organization (JCHO) Mishima General Hospital, Mishima City, Shizuoka, Japan
| | - Satoshi Terada
- Japan Community Health Care Organization (JCHO) Mishima General Hospital, Mishima City, Shizuoka, Japan
- OCD Co., Ltd, Tokyo, Japan
| | - Naotaka Kishimoto
- Division of Dental Anesthesiology, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Tsuyoshi Tanaka
- Department of Periodontology, University of Florida College of Dentistry, Gainesville, Florida, USA
| | - R Shane Tubbs
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, Louisiana, USA
- Department of Neurology, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, Louisiana, USA
- Department of Structural & Cellular Biology, Tulane University School of Medicine, New Orleans, Louisiana, USA
- Department of Neurosurgery and Ochsner Neuroscience Institute, Ochsner Health System, New Orleans, Louisiana, USA
- Department of Anatomical Sciences, St. George's University, St. George's, Grenada
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Dupont G, Bordes SJ, Lachkar S, Wahl L, Iwanaga J, Loukas M, Tubbs RS. The effects of obesity on the human body part III: Cardiovascular, digestive, excretory, endocrine, and reproductive. Clin Anat 2020; 34:307-311. [PMID: 33170983 DOI: 10.1002/ca.23700] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 10/15/2020] [Accepted: 11/02/2020] [Indexed: 11/06/2022]
Abstract
This third installment of The Effects of Obesity on the Human Body discusses the endocrine, digestive, reproductive, cardiovascular, and excretory systems. Obesity is known to upset hormonal balance, leading to widespread metabolic disorders involving organs such as the liver and pancreas. Furthermore, the hypersecretion of leptin from adipose tissue triggers various responses from the cardiovascular and gastrointestinal systems, with implications for energy and nutrient balance and uptake.
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Affiliation(s)
- Graham Dupont
- Tulane University School of Medicine, New Orleans, Louisiana, USA
| | - Stephen J Bordes
- Department of Anatomical Sciences, St. George's University School of Medicine, St. George's, Grenada
| | | | - Lauren Wahl
- Department of Cell and Developmental Biology, University of Colorado, Boulder, Colorado, USA
| | - Joe Iwanaga
- Division of Gross and Clinical Anatomy, Department of Anatomy, Kurume University School of Medicine, Kurume, Fukuoka, Japan.,Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, Louisiana, USA
| | - Marios Loukas
- Department of Anatomical Sciences, St. George's University School of Medicine, St. George's, Grenada.,Department of Anatomy, University of Warmia and Mazury, Olsztyn, Poland
| | - R Shane Tubbs
- Department of Anatomical Sciences, St. George's University School of Medicine, St. George's, Grenada.,Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, Louisiana, USA.,Department of Neurology, Tulane University School of Medicine, New Orleans, Louisiana, USA.,Department of Structural and Cellular Biology, Tulane University School of Medicine, New Orleans, Louisiana, USA
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Czako L, Simko K, Thurzo A, Galis B, Varga I. The Syndrome of Elongated Styloid Process, the Eagle's Syndrome-From Anatomical, Evolutionary and Embryological Backgrounds to 3D Printing and Personalized Surgery Planning. Report of Five Cases. Medicina (Kaunas) 2020; 56:E458. [PMID: 32916813 PMCID: PMC7558969 DOI: 10.3390/medicina56090458] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 09/04/2020] [Accepted: 09/07/2020] [Indexed: 11/28/2022]
Abstract
Background and Objectives: The symptoms of Eagle's syndrome are associated with the elongated styloid process of the temporal bone or calcification of the stylohyoid ligament. The first mention of pain syndrome associated with the elongated styloid process dates back to 1937, when it was described by Watt Weems Eagle. Over the last decade, experts in the field have shown a lively interest in the issue of the relationship between the elongated styloid process and various symptoms. This article presents the correlation between the clinical signs of Eagle's syndrome and alterations in surrounding anatomical structures. It includes a brief review of the evolutionary, embryological and clinical anatomical background of the elongated styloid process. Materials and Methods: Between 2018 and 2019, five patients were admitted to our workplace with 1-3-year history of bilateral or unilateral throat pain, otalgia and pharyngeal foreign body sensation. As a therapeutic novelty in the surgical approach to this condition, we used individual 3D printed models to measure and identify the exact location of the resection of the styloid process without damaging the surrounding anatomical structures, such as the facial, accessory, hypoglossal, and vagal nerves; the internal jugular vein; and the internal carotid artery. Results: Compared to traditional surgical methods without 3D models, 3D models helped to better identify cutting edges and major landmarks used in surgical treatment of Eagle's syndrome. Printed models provided assistance with the exact location of the styloid process resection position without damaging the surrounding anatomical structures such as the facial, accessory, hypoglossal, and vagal nerves; the internal jugular vein; and the internal carotid artery. Conclusion: In our clinical report, we used 3D printed models for navigation and planning during surgical procedures involving resections of the elongated styloid process. Additionally, we can formulate a new hypothesis: the elongated styloid process is a form of atavism of the bony hyoid apparatus in our evolutionary ancestors that is evolutionarily encoded or arises from disrupted degeneration of the middle portion of embryonal Reichert´s cartilage of the second pharyngeal arch. Under normal conditions, this portion does not ossify but degenerates and transforms into a connective tissue band, the future stylohyoid ligament.
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Affiliation(s)
- Ladislav Czako
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Comenius University in Bratislava and University Hospital, 81372 Bratislava, Slovakia; (K.S.); (B.G.)
| | - Kristian Simko
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Comenius University in Bratislava and University Hospital, 81372 Bratislava, Slovakia; (K.S.); (B.G.)
| | - Andrej Thurzo
- Department of Simulation and Virtual Medical Education, Faculty of Medicine, Comenius University in Bratislava, 81372 Bratislava, Slovakia;
| | - Branislav Galis
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Comenius University in Bratislava and University Hospital, 81372 Bratislava, Slovakia; (K.S.); (B.G.)
| | - Ivan Varga
- Institute of Histology and Embryology, Faculty of Medicine, Comenius University in Bratislava, 81372 Bratislava, Slovakia;
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Ackermann J, Wedel T, Holthaus B, Bojahr B, Hackethal A, Brucker S, Biebl M, Westermann M, Günther V, Krüger M, Maass N, Mettler L, Peters G, Alkatout I. Didactic Benefits of Surgery on Body Donors during Live Surgery Events in Minimally Invasive Surgery. J Clin Med 2020; 9:jcm9092912. [PMID: 32917056 PMCID: PMC7563950 DOI: 10.3390/jcm9092912] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Revised: 09/04/2020] [Accepted: 09/07/2020] [Indexed: 12/11/2022] Open
Abstract
Background: Live surgery events serve as a valuable tool for surgical education, but also raise ethical concerns about patient safety and professional performance. In the present study, we evaluate the technical feasibility and didactic benefits of live surgery on body donors compared to real patients. Methods: A live surgery session performed on a body donor’s cadaver embalmed in ethanol–glycerol–lysoformin was integrated into the live surgery program presented at a major gynecological convention of minimally invasive surgery. Surgical procedures carried out in real patients were paralleled in the body donor, including the dissection and illustration of surgically relevant anatomical landmarks. A standardized questionnaire was filled by the participants (n = 208) to evaluate the appropriateness, effectiveness, and benefits of this novel concept. Results: The live surgery event was appreciated as a useful educational tool. With regard to the use of body donors, authenticity was rated high (85.5%), and the overall value of body donors for surgical education and training was rated very high (95.0%). The didactic benefit of simultaneous operations performed on body donors and real patients was considered particularly useful (95.5%), whereas complete replacement of real patients by body donors was not favored (14.5%). Conclusions: The study demonstrated both the technical feasibility and didactic benefits of performing minimally invasive surgery in body donors as part of live surgery events. This novel concept has the potential to enhance anatomical knowledge, providing insights into complex surgical procedures, and may serve to overcome yet unresolved ethical concerns related to live surgery events.
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Affiliation(s)
- Johannes Ackermann
- Department of Obstetrics and Gynecology, Kiel School of Gynaecological Endoscopy, University Hospitals Schleswig-Holstein, Campus Kiel, Arnold-Heller Str. 3, House C, 24105 Kiel, Germany; (J.A.); (M.W.); (V.G.); (M.K.); (N.M.); (L.M.); (G.P.)
| | - Thilo Wedel
- Institute of Anatomy, Christian-Albrechts University Kiel, Otto-Hahn-Platz 8, 24118 Kiel, Germany;
| | - Bernd Holthaus
- Clinic of Obstetrics and Gynecology, St. Elisabeth Hospital, 49401 Damme, Germany;
| | - Bernd Bojahr
- Clinic of Minimally Invasive Surgery, Kurstraße 11, 14129 Berlin-Zehlendorf, Germany;
| | | | - Sara Brucker
- Department für Frauengesundheit, University Hospital Tübingen, Calwer Straße 7, 72076 Tübingen, Germany;
| | - Matthias Biebl
- Department of Surgery, Campus Virchow Klinikum, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, Germany;
| | - Martina Westermann
- Department of Obstetrics and Gynecology, Kiel School of Gynaecological Endoscopy, University Hospitals Schleswig-Holstein, Campus Kiel, Arnold-Heller Str. 3, House C, 24105 Kiel, Germany; (J.A.); (M.W.); (V.G.); (M.K.); (N.M.); (L.M.); (G.P.)
| | - Veronika Günther
- Department of Obstetrics and Gynecology, Kiel School of Gynaecological Endoscopy, University Hospitals Schleswig-Holstein, Campus Kiel, Arnold-Heller Str. 3, House C, 24105 Kiel, Germany; (J.A.); (M.W.); (V.G.); (M.K.); (N.M.); (L.M.); (G.P.)
| | - Magret Krüger
- Department of Obstetrics and Gynecology, Kiel School of Gynaecological Endoscopy, University Hospitals Schleswig-Holstein, Campus Kiel, Arnold-Heller Str. 3, House C, 24105 Kiel, Germany; (J.A.); (M.W.); (V.G.); (M.K.); (N.M.); (L.M.); (G.P.)
| | - Nicolai Maass
- Department of Obstetrics and Gynecology, Kiel School of Gynaecological Endoscopy, University Hospitals Schleswig-Holstein, Campus Kiel, Arnold-Heller Str. 3, House C, 24105 Kiel, Germany; (J.A.); (M.W.); (V.G.); (M.K.); (N.M.); (L.M.); (G.P.)
| | - Liselotte Mettler
- Department of Obstetrics and Gynecology, Kiel School of Gynaecological Endoscopy, University Hospitals Schleswig-Holstein, Campus Kiel, Arnold-Heller Str. 3, House C, 24105 Kiel, Germany; (J.A.); (M.W.); (V.G.); (M.K.); (N.M.); (L.M.); (G.P.)
| | - Göntje Peters
- Department of Obstetrics and Gynecology, Kiel School of Gynaecological Endoscopy, University Hospitals Schleswig-Holstein, Campus Kiel, Arnold-Heller Str. 3, House C, 24105 Kiel, Germany; (J.A.); (M.W.); (V.G.); (M.K.); (N.M.); (L.M.); (G.P.)
| | - Ibrahim Alkatout
- Department of Obstetrics and Gynecology, Kiel School of Gynaecological Endoscopy, University Hospitals Schleswig-Holstein, Campus Kiel, Arnold-Heller Str. 3, House C, 24105 Kiel, Germany; (J.A.); (M.W.); (V.G.); (M.K.); (N.M.); (L.M.); (G.P.)
- Correspondence: ; Tel.: +49-431-500-21450
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Varotto E, Militello PM, Platania E, Sferrazza P, Galassi FM. Paleopathological study of a podal osteochondroma from the prehistoric Hypogeum of Calaforno (Sicily). Clin Anat 2020; 34:19-23. [PMID: 32281156 DOI: 10.1002/ca.23603] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 03/04/2020] [Accepted: 04/06/2020] [Indexed: 11/10/2022]
Abstract
In this article, we report a case of isolated podal osteochondroma from the prehistoric Hypogeum of Calaforno (Giarratana, Ragusa, Sicily). Although the phalanx exhibiting the benign tumoral mass comes from a context featuring several commingled remains, the very good state of preservation of this bone allowed us to perform a comprehensive study of the neoplasm by applying a multidisciplinary approach encompassing archeology, morphology, stereomicroscopy, and radiology. The results from this very ancient specimen have been assessed in the light of the available paleopathological literature and clinical implications currently encountered in modern patients.
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Affiliation(s)
- Elena Varotto
- Department of Humanities (DISUM), University of Catania, Catania CT, Italy.,FAPAB Research Center, Avola SR, Italy.,Archaeology, College of Humanities, Arts and Social Sciences, Flinders University, Adelaide, South Australia, Australia
| | | | - Erica Platania
- Department of Humanities (DISUM), University of Catania, Catania CT, Italy
| | - Paolo Sferrazza
- Department of Humanities (DISUM), University of Catania, Catania CT, Italy.,Department of Prehistory, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Francesco Maria Galassi
- FAPAB Research Center, Avola SR, Italy.,Archaeology, College of Humanities, Arts and Social Sciences, Flinders University, Adelaide, South Australia, Australia.,Santa Lucia Clinic-Polydiagnostic Medical Center, Siracusa SR, Italy
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Aurore V, Röthlisberger R, Boemke N, Hlushchuk R, Bangerter H, Bergmann M, Imboden S, Mueller MD, Eppler E, Djonov V. Anatomy of the female pelvic nerves: a macroscopic study of the hypogastric plexus and their relations and variations. J Anat 2020; 237:487-494. [PMID: 32427364 DOI: 10.1111/joa.13206] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 03/27/2020] [Accepted: 03/30/2020] [Indexed: 01/16/2023] Open
Abstract
The autonomic nerves of the lesser pelvis are particularly prone to iatrogenic lesions due to their exposed position during manifold surgical interventions. Nevertheless, the cause of rectal and urinary incontinence or sexual dysfunctions, for example after rectal cancer resection or hysterectomy, remains largely understudied, particularly with regard to the female pelvic autonomic plexuses. This study focused on the macroscopic description of the superior hypogastric plexus, hypogastric nerves, inferior hypogastric plexus, the parasympathetic pelvic splanchnic nerves and the sympathetic fibres. Their arrangement is described in relation to commonly used surgical landmarks such as the sacral promontory, ureters, uterosacral ligaments, uterine and rectal blood vessels. Thirty-one embalmed female pelvises from 20 formalin-fixed and 11 Thiel-fixed cadavers were prepared. In all cases explored, the superior hypogastric plexus was situated anterior to the bifurcation of the abdominal aorta. In 60% of specimens, it reached the sacral promontory, whereas in 40% of specimens, it continued across the pelvic brim until S1. In about 25% of the subjects, we detected an accessory hypogastric nerve, which has not been systematically described so far. It originated medially from the inferior margin of the superior hypogastric plexus and continued medially into the presacral space. The existence of an accessory hypogastric nerve was confirmed during laparoscopy and by histological examination. The inferior hypogastric plexuses formed fan-shaped plexiform structures at the end of both hypogastric nerves, exactly at the junction of the ureter and the posterior wall of the uterine artery at the uterosacral ligament. In addition to the pelvic splanchnic nerves from S2-S4, which joined the inferior hypogastric plexus, 18% of the specimens in the present study revealed an additional pelvic splanchnic nerve originating from the S1 sacral root. In general, form, breadth and alignment of the autonomic nerves displayed large individual variations, which could also have a clinical impact on the postoperative function of the pelvic organs. The study serves as a basis for future investigations on the autonomic innervation of the female pelvic organs.
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Affiliation(s)
- Valerie Aurore
- Institute of Anatomy, University of Bern, Bern, Switzerland
| | - Raphael Röthlisberger
- Institute of Anatomy, University of Bern, Bern, Switzerland.,Department of Urology, Inselspital Bern, University Hospital, Bern, Switzerland
| | - Nane Boemke
- Institute of Anatomy, University of Bern, Bern, Switzerland
| | | | | | | | - Sara Imboden
- Department of Obstetrics and Gynaecology, Inselspital Bern, University Hospital, Bern, Switzerland
| | - Michael D Mueller
- Department of Obstetrics and Gynaecology, Inselspital Bern, University Hospital, Bern, Switzerland
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Martínez-Marcos A, Sañudo JR. Cranial Nerves: Phylogeny and Ontogeny. Anat Rec (Hoboken) 2020; 302:378-380. [PMID: 30724480 DOI: 10.1002/ar.24072] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2018] [Revised: 01/22/2019] [Accepted: 02/03/2019] [Indexed: 11/07/2022]
Abstract
This Special Issue, entitled "Cranial Nerves: phylogeny, ontogeny, morphology and clinical significance," has been divided into two consecutive volumes. We present here the first volume, devoted to phylogeny and ontogeny. Articles in this volume examine these two topics from a microscopic point of view. This volume includes an historical review that serves as an introduction. It also includes a review of the organization of cranial nerves from a neuromeric perspective which, together with two articles in amphioxi and lampreys, give emphasis to a comparative approach. Finally, several articles examine cranial nerves zero (nervus terminalis), I (olfactory), II (optic), III, IV and VI (oculomotor), VIII (cochlear and vestibular), and XI (accessory or spinal). Together, they provide a general overview of the neuroanatomical organization of cranial nerves, while offering insights into an evo-devo paradigm. Anat Rec, 302:378-380, 2019. © 2019 Wiley Periodicals, Inc.
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Affiliation(s)
- Alino Martínez-Marcos
- Laboratorio de Neuroplasticidad y Neurodegeneración, Facultad de Medicina de Ciudad Real, Centro Regional de Investigaciones Biomédicas, Universidad de Castilla-La Mancha, Ciudad Real, Spain
| | - José Ramón Sañudo
- Departamento de Anatomía y Embriología, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain
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Abstract
This Special Issue entitled "Cranial Nerves: phylogeny, ontogeny, morphology and clinical significance" has been divided into two consecutive volumes. This second volume is devoted to morphology and clinical relevance. Articles in this volume examine these topics from a macroscopic point of view and with a surgical interest. This volume includes articles on oculomotor nerves III, IV, and VI and their course in the orbit; intracranial and extracranial views of the V and VII pairs; and branching patterns of IX, X, XI, and XII pairs with medical significance. Together, these articles provide a general overview of cranial nerves' gross anatomical organization, as well as improving on the knowledge necessary for clinical approaches. Anat Rec, 302:555-557, 2019. © 2019 Wiley Periodicals, Inc.
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Affiliation(s)
- Alino Martínez-Marcos
- Laboratorio de Neuroplasticidad y Neurodegeneración, Facultad de Medicina de Ciudad Real, Centro Regional de Investigaciones Biomédicas, Universidad de Castilla-La Mancha, 13071, Ciudad Real, Spain
| | - José Ramón Sañudo
- Departamento de Anatomía y Embriología, Facultad de Medicina, Universidad Complutense de Madrid, 28040, Madrid, Spain
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Boscolo-Berto R, Siracusano S, Porzionato A, Polguj M, Porcaro AB, Stecco C, Macchi V, De Caro R. The underestimated posterior lymphatic drainage of the prostate: An historical overview and preliminary anatomical study on cadaver. Prostate 2020; 80:153-161. [PMID: 31746484 DOI: 10.1002/pros.23927] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Accepted: 11/05/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND The evidence of pelvic lymph node metastases after radical prostatectomy (RP) with pelvic lymph node dissection (PLND) is one of the strongest prognostic factors for poor oncologic outcome. The extent of PLND, although representing a crucial step in RP, is still controversial. Currently, there is a critical drawback in clinical practice due to the lack of congruence between the known lymphatic drainage and cancer dissemination despite defined management by a surgical approach. We hypothesized the existence of alternative pathways for the lymphatic drainage of the prostate currently not considered in clinical daily practice. METHODS We carried out a literature review of the anatomic description of nodal drainage of prostate reported by online databases (MEDLINE/PubMed, EBSCO, Web of Science, Ovid, and Scopus) and the original texts since the 18th century, with an additional anatomical dissection on a human cadaver to confirm theoretical data. RESULTS The anatomical dissection study converged with the historical anatomical treatises in describing three groups of lymphatics devoted to carrying out prostatic nodal drainage. Apart from the ascending ducts from the cranial gland leading to the external iliac nodes; the lateral ducts leading to the hypogastric nodes; small lymphatic vessels from the posterior surface of the prostate, directed to the pararectal lymphatic plexus, in the direction of the lateral sacral lymph nodes and those at the sacral promontory (ie, pararectal and presacral lymph nodes) were observed. CONCLUSIONS Our preliminary findings demonstrate that lymphatic drainage of the prostate extends beyond standard nodal templates actually considered in surgical daily practice, despite the knowledge reported by historical anatomical treatises. Further anatomical and experimental evidence are needed to investigate anatomical variability in humans, as well as to add more topographical details.
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Affiliation(s)
- Rafael Boscolo-Berto
- Department of Neurosciences, Institute of Human Anatomy, University of Padova, Padova, Italy
| | - Salvatore Siracusano
- Department of Surgery, Dentistry, Paediatrics and Gynaecology, Urologic Clinic University Hospital, Ospedale Policlinico, Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Italy
| | - Andrea Porzionato
- Department of Neurosciences, Institute of Human Anatomy, University of Padova, Padova, Italy
| | - Michał Polguj
- Department of Angiology, Interfaculty Chair of Anatomy and Histology, Medical University of Lodz, Lodz, Poland
| | - Antonio Benito Porcaro
- Department of Surgery, Dentistry, Paediatrics and Gynaecology, Urologic Clinic University Hospital, Ospedale Policlinico, Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Italy
| | - Carla Stecco
- Department of Neurosciences, Institute of Human Anatomy, University of Padova, Padova, Italy
| | - Veronica Macchi
- Department of Neurosciences, Institute of Human Anatomy, University of Padova, Padova, Italy
| | - Raffaele De Caro
- Department of Neurosciences, Institute of Human Anatomy, University of Padova, Padova, Italy
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Bork F, Stratmann L, Enssle S, Eck U, Navab N, Waschke J, Kugelmann D. The Benefits of an Augmented Reality Magic Mirror System for Integrated Radiology Teaching in Gross Anatomy. Anat Sci Educ 2019; 12:585-598. [PMID: 30697948 PMCID: PMC6899842 DOI: 10.1002/ase.1864] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Revised: 11/08/2018] [Accepted: 11/22/2018] [Indexed: 05/09/2023]
Abstract
Early exposure to radiological cross-section images during introductory anatomy and dissection courses increases students' understanding of both anatomy and radiology. Novel technologies such as augmented reality (AR) offer unique advantages for an interactive and hands-on integration with the student at the center of the learning experience. In this article, the benefits of a previously proposed AR Magic Mirror system are compared to the Anatomage, a virtual dissection table as a system for combined anatomy and radiology teaching during a two-semester gross anatomy course with 749 first-year medical students, as well as a follow-up elective course with 72 students. During the former, students worked with both systems in dedicated tutorial sessions which accompanied the anatomy lectures and provided survey-based feedback. In the elective course, participants were assigned to three groups and underwent a self-directed learning session using either Anatomage, Magic Mirror, or traditional radiology atlases. A pre- and posttest design with multiple choice questions revealed significant improvements in test scores between the two tests for both the Magic Mirror and the group using radiology atlases, while no significant differences in test scores were recorded for the Anatomage group. Furthermore, especially students with low mental rotation test (MRT) scores benefited from the Magic Mirror and Anatomage and achieved significantly higher posttest scores compared to students with a low MRT score in the theory group. Overall, the results provide supporting evidence that the Magic Mirror system achieves comparable results in terms of learning outcome to established anatomy learning tools such as Anatomage and radiology atlases.
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Affiliation(s)
- Felix Bork
- Chair for Computer Aided Medical Procedures and Augmented Reality, Faculty of InformaticsTechnical University of MunichMunichGermany
| | - Leonard Stratmann
- Chair for Vegetative Anatomy, Faculty of MedicineLudwig‐Maximilians UniversityMunichGermany
| | - Stefan Enssle
- Chair for Vegetative Anatomy, Faculty of MedicineLudwig‐Maximilians UniversityMunichGermany
| | - Ulrich Eck
- Chair for Computer Aided Medical Procedures and Augmented Reality, Faculty of InformaticsTechnical University of MunichMunichGermany
| | - Nassir Navab
- Chair for Computer Aided Medical Procedures and Augmented Reality, Faculty of InformaticsTechnical University of MunichMunichGermany
| | - Jens Waschke
- Chair for Vegetative Anatomy, Faculty of MedicineLudwig‐Maximilians UniversityMunichGermany
| | - Daniela Kugelmann
- Chair for Vegetative Anatomy, Faculty of MedicineLudwig‐Maximilians UniversityMunichGermany
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Chmielewski PP, Domagała ZA. Terminologia Anatomica and its practical usage: pitfalls and how to avoid them. Folia Morphol (Warsz) 2019; 79:198-204. [PMID: 31411339 DOI: 10.5603/fm.a2019.0086] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2019] [Accepted: 07/10/2019] [Indexed: 11/25/2022]
Abstract
In 2016, the Federative International Programme for Anatomical Terminology tentatively approved the updated and extended version of anatomical terminology that replaced the previous version of Terminologia Anatomica (1998). This modern version has already appeared in new editions of leading anatomical atlases and textbooks, including Netter's Atlas of Human Anatomy, even though it was originally available only as a draft and the final version is different. We believe that updated and extended versions of anatomical terminology are important and they can be a powerful tool in communication between anatomists and other specialists around the world. In general, the new version uses more precise and adequate anatomical terms and many segments, including the part dealing with the nervous system, which is also known as the Terminologia Neuroanatomica, have been considerably improved. Nevertheless, some segments have not been extended or modernised, while other parts have been modified considerably, thereby posing a challenge to those who prefer the traditional version of Latin terminology because a number of official names for bones, muscles, organs and blood vessels have been changed. Whilst most of these changes seem to be inspired by a long anatomical tradition and thus cannot come as a surprise to anyone in the field, other modifications are characterised by terminological innovativeness. Selected new and unexpected changes that might cause confusion among those who prefer traditional anatomical terms and definitions are discussed here.
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Affiliation(s)
- P P Chmielewski
- Division of Anatomy, Department of Human Morphology and Embryology, Faculty of Medicine, Wroclaw Medical University, 6a Chałubińskiego Street, 50-368 Wrocław, Poland.
| | - Z A Domagała
- Division of Anatomy, Department of Human Morphology and Embryology, Faculty of Medicine, Wroclaw Medical University, 6a Chałubińskiego Street, 50-368 Wrocław, Poland
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Chmielewski PP. New Terminologia Anatomica highlights the importance of clinical anatomy. Folia Morphol (Warsz) 2019; 79:15-20. [PMID: 31025701 DOI: 10.5603/fm.a2019.0048] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 04/10/2019] [Accepted: 04/10/2019] [Indexed: 11/25/2022]
Abstract
Although not all authors agree that Terminologia Anatomica merits special attention, any type of scientific terminology should be clear, exact, logical, coherent and worldwide accepted. A precise definition of every anatomical term is also crucial. New changes have recently been approved by the Federative International Programme for Anatomical Terminology as the previous version of terminology required minor revisions. This situation offers an opportunity to take a closer look at these new and interesting modifications. It turns out that selected traditional terms have been excluded from the list of official anatomical names. Furthermore, many changes have been introduced to modernise the Terminologia Anatomica. Nevertheless, the new version of anatomical terminology has both strengths and limitations, which warrants further refinement.
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Affiliation(s)
- P P Chmielewski
- Division of Anatomy, Department of Human Morphology and Embryology, Faculty of Medicine, Wroclaw Medical University, 6a Chałubińskiego Street, 50-368 Wrocław, Poland.
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Chmielewski PP, Strzelec B. Should Terminologia Anatomica be revised and extended? A critical literature review. Folia Morphol (Warsz) 2019; 79:1-14. [PMID: 31025702 DOI: 10.5603/fm.a2019.0047] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Revised: 12/29/2018] [Accepted: 12/31/2018] [Indexed: 11/25/2022]
Abstract
The first edition of the Terminologia Anatomica was published in 1998 by the Federative Committee for Anatomical Terminology, whereas the second edition was issued in 2011 by the Federative International Programme for Anatomical Terminologies. Since then many attempts have been made to revise and extend the official terminology as several inconsistencies have been noted. Moreover, numerous crucial terms were either omitted or deliberately excluded from the official terminology, like sulcus popliteus and diaphragma urogenitale, respectively. Furthermore, several synonyms are to be discarded. Notwithstanding the criticism, the use of the current version of terminology is strongly recommended. Although the Terminologia Anatomica is open to future expansion and revision, every change should be made after a thorough discussion of the historical context and scientific legitimacy of a given term. The anatomical nomenclature must be as simple as possible but also precise and coherent. It is generally accepted that hasty innovation ought not to be endorsed. Therefore, there is a need to take a closer look at these new proposals as they have been presented in numerous dispersed papers. This article provides an overview of these issues and concentrates on selected revisions and extensions that are didactically and clinically useful, thereby summarising the salient aspects of these new and compelling proposals.
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Affiliation(s)
- P P Chmielewski
- Division of Anatomy, Department of Human Morphology and Embryology, Faculty of Medicine, Wroclaw Medical University, 6a Chałubińskiego Street, 50-368 Wrocław, Poland. .,Department and Clinic of Vascular, General and Transplantation Surgery, Jan Mikulicz-Radecki Medical University Hospital, Wroclaw Medical University, Wroclaw, Poland.
| | - B Strzelec
- Department and Clinic of Vascular, General and Transplantation Surgery, Jan Mikulicz-Radecki Medical University Hospital, Wroclaw Medical University, Wroclaw, Poland.,Department and Clinic of Gastrointestinal and General Surgery, Wroclaw Medical University, Wroclaw, Poland
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D'Antoni AV, Mtui EP, Loukas M, Tubbs RS, Zipp GP, Dunlosky J. An evidence-based approach to learning clinical anatomy: A guide for medical students, educators, and administrators. Clin Anat 2019; 32:156-163. [PMID: 30307063 PMCID: PMC7379743 DOI: 10.1002/ca.23298] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Accepted: 10/06/2018] [Indexed: 11/29/2022]
Abstract
The amount of information that medical students learn is voluminous and those who do not use evidence-based learning strategies may struggle. Research from cognitive and educational psychology provides a blueprint on how best to learn science subjects, including clinical anatomy. Students should aim for high-cognitive learning levels as defined in the SOLO taxonomy. Using a real-world example from a modern clinical anatomy textbook, we describe how to learn information using strategies that have been experimentally validated as effective. Students should avoid highlighting and rereading text because they do not result in robust learning as defined in the SOLO taxonomy. We recommend that students use (1) practice testing, (2) distributed practice, and (3) successive relearning. Practice testing refers to nonsummative assessments that contain questions used to facilitate retrieval (e.g., flashcards and practice questions). Practice questions can be fill-in, short-answer, and multiple-choice types, and students should receive explanatory feedback. Distributed practice, the technique of distributing learning of the same content within a single study session or across sessions, has been found to facilitate long-term retention. Finally, successive relearning combines both practice testing and distributed practice. For this strategy, students use practice questions to continue learning until they can answer all of the practice questions correctly. Students who continuously use practice testing, distributed practice, and successive relearning will become more efficient and effective learners. Our hope is that the real-world clinical anatomy example presented in this article makes it easier for students to implement these evidence-based strategies and ultimately improve their learning. Clin. Anat., 2018. © 2018 The Authors. Clinical Anatomy published by Wiley Periodicals, Inc. on behalf of American Association of Clinical Anatomists.
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Affiliation(s)
- Anthony V. D'Antoni
- Division of Anatomy, Department of RadiologyWeill Cornell MedicineNew YorkNew York
| | - Estomih P. Mtui
- Division of Anatomy, Department of RadiologyWeill Cornell MedicineNew YorkNew York
| | - Marios Loukas
- Department of Anatomical SciencesSt. George's University School of MedicineGrenadaWest Indies
| | | | - Genevieve Pinto Zipp
- Department of Interprofessional Health Sciences and Health AdministrationSchool of Health and Medical Sciences, Seton Hall UniversitySouth OrangeNew Jersey
| | - John Dunlosky
- Department of Psychological SciencesKent State UniversityKentOhio
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Sundaram V, Dharani P, Gnanadevi R, Kavya R. Studies on clinical anatomy of the maxillofacial and mandibular regions of the Madras Red sheep (Ovis aries) in India. Folia Morphol (Warsz) 2018; 78:389-393. [PMID: 30371934 DOI: 10.5603/fm.a2018.0098] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Revised: 09/28/2018] [Accepted: 10/03/2018] [Indexed: 11/25/2022]
Abstract
BACKGROUND The present study aimed to study the clinical anatomy of the maxillofacial and mandibular regions of the Madras Red sheep through the morphometric analysis of some clinically important parameters pertaining to the regional anaesthesia. MATERIALS AND METHODS The study was conducted in 20 male and 20 female adult Madras Red sheep around 20-25 kg body weight. Eleven parameters re- lated to the clinical regional anaesthesia of the maxillofacial and the mandibular regions were recorded. RESULTS The distance between the facial tuberosity to the infraorbital canal was 2.25 ± 0.14 cm in males and 2.14 ± 0.15 cm in females. The distance from the infraorbital canal to the root of the alveolar tooth was 1.73 ± 0.28 cm in males and 1.73 ± 0.13 cm in females. The length and height of the mandibles were 15.37 ± 0.56 cm, 9.00 ± 0.24 cm and in males 14.53 ± 0.24 cm, 9.68 ± 0.16 cm in females, respectively. The maximum height of the mandible to the coro- noid process, width or height of the mandibular foramen and the distance from the condyloid process to the base of the mandible were recorded as 9.0 ± 24, 0.82 ± 0.05, 6.68 ± 0.19 cm in males and 9.68 ± 0.16, 0.83 ± 0.04, 6.25 ± ± 0.28 cm in females, respectively. CONCLUSIONS The present study revealed that most of the parameters showed statistically significant difference between the sexes i.e. the males had higher values. However, from the practical point of view, these differences were meagre. The results were discussed with regard to their clinical applications in various regional anaesthesia performed in maxillofacial and mandibular regions of the Madras Red sheep.
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Affiliation(s)
- V Sundaram
- Department of Basic Veterinary Sciences, School of Veterinary Medicine, Faculty of Medical Sciences, The University of the West Indies, Trinidad and Tobago.
| | - P Dharani
- College of Veterinary Science, SriVenkateswara Veterinary University, Proddatur, Andra Pradesh, India
| | - R Gnanadevi
- Department of Veterinary Anatomy, Madras Veterinary College, Tamilnadu Veterinary and Animal Sciences University, Chennai, India
| | - R Kavya
- Department of Veterinary Anatomy, Madras Veterinary College, Tamilnadu Veterinary and Animal Sciences University, Chennai, India
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