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Introduction: Evolving trends in medical education and modern curricular changes have reduced the amount of time and resources allocated for anatomy education. As the amount of dedicated anatomy education time decreases, more self-directed learning is required. Cadaveric dissection and didactic teaching have been supplemented with multimedia, clinical anatomy, and imaging for over 20 years, with mixed results. Specifically, the use of video-based anatomy teaching increases medical learning, if done methodically., Methods: A 20-minute video was produced highlighting surgical anatomy using the following operative cases: perineal anatomy (artificial urinary sphincter case), inguinal and testicular anatomy (scrotal orchidopexy for acute testicular torsion), prostate anatomy (robotic radical prostatectomy), and bladder anatomy (endoscopy). The annotated video was shown to first-year medical students. Pre- and post-video multiple choice question quizzes were given to the students. Once submitted, the students completed a survey., Results: Overall, 191 first-year medical students participated in our study. Average scores were similar between each quiz (50±16% vs. 49±17%) and there was no statistically significant change. Seventy-seven percent of participants felt the video improved their knowledge of urologic anatomy and 83% agreed the video should be shown to future classes. Sixty percent of participants felt the video solidified their anatomy knowledge, 78% felt the video was stimulating and entertaining, and 43% of the students felt the video increased their interest in pursuing urology as a career choice., Conclusions: Anatomy teaching can be supplemented using surgical videos, especially in a time when in-person anatomy teaching is limited. Further study is required to determine whether this teaching modality improves long-term anatomy knowledge retention.

Background: Understanding the relationships between structures is critical for surgical trainees. However, the heterogeneity of the literature on visual-spatial ability (VSA) in surgery makes it challenging for educators to make informed decisions on incorporating VSA into their programs. We conducted a scoping review of the literature on VSA in surgery to provide a map of the literature and identify where gaps still exist for future research., Methods: We searched databases until December 2019 using keywords related to VSA and surgery. The resulting articles were independently screened by two researchers for inclusion in our review., Results: We included 117 articles in the final review. Fifty-nine articles reported significant correlations between VSA tests and surgical performance, and this association is supported by neuroimaging studies. However, it remains unclear whether VSA should be incorporated into trainee selection and whether there is a benefit of three-dimensional (3D) over two-dimensional (2D) training., Conclusions: It appears that VSA correlates with surgical performance in the simulated environment, particularly for novice learners. Based on our findings, we make suggestions for how surgical educators may use VSA to support novice learners. Further research should determine whether VSA remains correlated to surgical performance when trainees move into the operative environment., (© 2020 Kalun, Dunn, Wagner, Pulakunta, Sonnadara; licensee Synergies Partners.)

Thanatophoric dysplasia is the lethal skeletal dysplasia characterized by marked underdevelopment of the skeleton and short-limb dwarfism. The child will be having a short neck, narrow thoracic cage and protuberant abdomen. Other anatomical features include a relatively enlarged head with frontal bossing, prominent eyes, hypertelorism and the depressed nasal bridge. The diagnosis is usually made with the ultrasonography in the second trimester. In this study we report a case of this rare entity with emphasis on its anatomical features, abnormalities and clinical profile with relevant review of literature.

Background: Anatomical studies regarding the inferior oblique muscle are scarce and the exact location of the entry of oculomotor nerve to the muscle has not been reported. In the present study, the objectives were to examine the exact location of the entry of oculomotor nerve to the inferior oblique muscle and to study the topographical anatomy of the muscle., Methods: The study included 56 intact orbits from 28 embalmed south Indian adult cadavers. The entire course of the nerve to the inferior oblique was exposed from both anterior and posterior aspects in all specimens. The exact location of the entry of nerve supplying the inferior oblique muscle was identified and the distances of the muscle from inferior and medial orbital margins were measured., Results: The oculomotor nerve entered the inferior oblique muscle through the orbital surface in 42 (75%) cases, through the ocular surface in 10 (17.9%) cases and through the posterior border in 4 (7.1%) cases. The distance of the muscle from the inferior orbital margin was 1 mm in majority (78.5%) of the cases. The distance of the muscle from the medial orbital margin was 11 mm in majority (42.8%) of the cases., Conclusion: The present study reports that the oculomotor nerve most often enters the inferior oblique muscle through its orbital surface. Detailed knowledge of the topographical anatomy of inferior oblique muscle and its site of nerve entry are essential for surgeons when performing ophthalmological surgery and regional anesthesia.

Background: The median artery is a transitory vessel that represents the arterial axis of the forearm during early embryonic life. It normally regresses in the second embryonic month. Its persistence in the human adult has been recorded in 2 different patterns: as a large, long vessel (palmar type) which reaches the hand; or as a small and short vessel (antebrachial type) which ends before reaching the wrist joint. The palmar type is of major clinical significance., Objective: This study was undertaken to investigate the incidence and course of the palmar type of the median artery in South Indian cadavers., Material and Methods: 25 upper limbs of South Indian cadavers were taken to study the median artery., Results: The occurrence of median artery was 8%; of which 4% was on the right side and the other 4% was on the left side. On both sides, the artery originated from the ulnar artery. On the right side, the artery was involved in the formation of superficial palmar arch, whereas the artery on the left side did not join the arch; it terminated as 1st and 2nd common palmar digital arteries., Conclusion: Persistent median artery is closely related to the anterior interosseous nerve, it is possible that the artery may compress the anterior interosseous nerve and cause the anterior interosseous nerve syndrome (Fig. 2, Ref. 17).

Purpose: The superficial branch of radial nerve (SBRN) is one of the cutaneous nevus biopsied for diagnosis of peripheral neuropathy. The purpose of this study is to find out the cross sectional microanatomy of the (SBRN) at antecubital fossa for changes in the fascicular, non-fascicular components with respect to age and also to find cross sectional area of SBRN in healthy volunteers., Materials and Methods: Sixty SBRN were harvested bilaterally from 30 fresh human bodies (25 males and five females) with ages of 37 to 88 years. Samples were divided into three age groups (G1, 37-55 years; G2, 55-70 years; G3, ≥ 71 years) and studied at different magnifications after histological processing for morphometric analysis - total cross-sectional (Asc), fascicular (Af), and non-fascicular area (Anonf). Fifteen volunteers SBRN cross sectional area was measured by ultrasonography (US)., Results: The SBRN was found to have 2-6 fascicles. The differences in the adipose tissue (FAT) areas, between G1 and G2 (p=0.233) and between G2 and G3 (p=0.458) were not statistically significant. However, a significant difference was seen between G3 and G1 (p=0.021). The differences in the non-adipose tissue (FAT) areas, between G1 and G2 (p=0.110), between G2 and G3 (p=0.950) and between G3 and G1 (p=0.210) were not statistically significant. The amount of adipose tissue (FAT) in the epifascicular and interfascicular region increased in elderly individuals (age ≥ 71 years). Ultrasonographic cross-sectional area ranged from 2 to 3 mm²., Conclusions: Our study revealed comparatively more adipose tissue in human SBRN with advanced age (≥ 71 years). Findings may help to explain poor prognosis with advancing age following repair. SBRN ultrasonographical Asc was comparable to histological Asc in ages between 37-55 years.

Introduction: The posterior thoracic wall, an area drained by the azygos venous system, is a common site for surgical intervention. Since the venous part of the cardiovascular system is subject to most common variation, abnormalities in the azygos venous system are often reported., Case Presentation: During routine dissection classes for undergraduate medical students, we encountered a variation in the azygos venous system in a 65 years old south Indian male cadaver. We observed that there was no accessory azygos vein, and left 4th, 5th, 6th and 7th posterior intercostal veins terminated directly into azygos vein., Conclusion: Identifying these types of variations is important during imaging this region and surgical operations of mediastinum.

Introduction: The knowledge of the branching pattern of external branch of the superior laryngeal nerve and its relationship with the superior thyroid artery is the key point for identifying the external branch of the superior laryngeal nerve during surgeries of the neck., Case Presentation: During routine dissection of the left head and neck region of a 50 years old female cadaver, we observed a variation of the external branch of the superior laryngeal nerve around the superior thyroid artery. The external branch of the superior laryngeal nerve has presented one medial and three lateral branches. The medial branch was running on the surface of the inferior constrictor and pierced it; where as the lateral three branches are located laterally to the superior thyroid artery. The medial two lateral branches were piercing the substance of the thyroid gland, where as the lateral most branch was communicating with the left sympathetic chain., Conclusion: It is very important that surgeons carefully dissect the region of the superior pole of the thyroid gland to expose the abnormal branching pattern of external branch of the superior laryngeal nerve prior to ligation of individual thyroid vessels.

During routine anatomy dissection classes for undergraduate medical students, an unilateral case of superficial ulnar artery (SUA) in a 75-year-old male human cadaver arosing from the third part of the right axillary artery at the junction of the two median nerve roots was observed. In the hand, the SUA coursed over the flexor retinaculum and anastomosed with the superficial palmar branch of the radial artery to form the superficial palmar arch. After the origin of the SUA, the axillary artery continued as the brachial artery, which was divided into radial and common interosseous arteries at the neck of the radius. The normal ulnar artery was absent. In the same cadaver, a thin walled dilatation was seen on its palmar aspect at the base of the 1st metacarpal bone (Fig. 2, Ref. 11). Full Text (Free, PDF) www.bmj.sk.

Objective: The study was designed to identify any association between the sacral hiatus of the dry sacral bones with that of patients with low back pain (LBP). The knowledge of the sacral hiatus is important in caudal epidural block (CEB)., Methods: Three hundred forty three (183 male and 160 female) complete and undamaged adult South Indian dry sacral bones and fifty two (30 male and 22 female) radiographs were included in the present study. The above radiographs were of patients with history of LBP. The osteological observation and the radiographic study were compared to find any associations of LBP with the location of the apex of the sacral hiatus., Results: In dry male sacrum, in 39.3% cases the sacral hiatus was inverted U shape and in 50.6% cases the female sacrum was inverted V shape. Deficient dorsal wall of the sacrum was observed in 2.7% and 12.5% in male and female sacra, respectively. The apex of the sacral hiatus was observed the most at S4 level (81.4% in male and 61.2% in female). Deficient dorsal wall was found in 40% of male and 27.2% female patients presented with LBP. The apex of the sacral hiatus in the LBP patients observed at the S4 level was 46.6% in male and 54.5% in female respectively., Conclusion: The patients with LBP had a higher percentage of deficient dorsal walls in comparison to the osteological findings (Fig. 12, Tab. 7, Ref. 12). Full Text (Free, PDF) www.bmj.sk.

It is well known that variations in the branching pattern of the mandibular nerve frequently account for the failure to obtain adequate local anesthesia in routine oral and dental procedures, and also for the unexpected injury to branches of the nerves during surgery. During our routine dissection, we found the presence of a communicating branch between the mylohyoid and lingual nerves in a middle aged male cadaver. We also discussed its clinical and surgical implications in this report.

The kidneys and the renal vessels are subject to a wide variety of variations. We report a rare variation of the right kidney and right renal vessels in a 60-year-old male cadaver. The right kidney was pyramidal in shape and the hilum was directed anteriorly. The right renal vessels were twisted against each other, and the inferior vena cava had a kink to the right side. Knowledge of this variation may be useful for the nephrologists, radiologists and surgeons.

Although variations in the attachments of the lumbrical muscles have been commonly reported, these have been seen mainly in the Caucasian population. The present study has been undertaken in South Indian population. The upper extremities of 24 South Indian (20 male and four female) cadavers were examined. Three instances of variant origins of the lumbrical muscles (two instances of the second and one of the first lumbrical) were seen. The muscles were unusually long extending to the level of the proximal border of the flexor retinaculum and in two of the cases it was taking origin from the flexor digitorum profundus tendon and its accessory belly. In one case it was taking origin from the flexor digitorum profundus and superficialis tendons. An anomalous origin of the lumbrical from muscles in the forearm has the potential to cause compression of the median nerve in the carpal tunnel.