Search

Background: The sciatic nerve bifurcates into the tibial and common fibular nerves in six different regions: the pelvic region, gluteal region, proximal, middle, or distal third of the posterior thigh, or in the popliteal fossa. Inadequate knowledge of sciatic nerve anatomy could lead to failed nerve blocks, and damage during intramuscular injections. Limited studies have been done on African population groups and lack a quantifiable method to classify the levels of sciatic nerve bifurcation., Aim: Thus, this descriptive cadaver study aimed to assess the bifurcation level of the sciatic nerve in a South African population group using a quantifiable method., Methods: Three hundred and thirty-eight formalin-fixed limbs from three universities were dissected between March and August 2018. Type A was classified if the sciatic nerve bifurcated within the pelvic region. A sciatic nerve bifurcation level index (SNBLI) was developed for this study to quantitatively classify the region of sciatic nerve bifurcation into types B to F., Results: Type F bifurcation was most common (79.6%), and types B and C were not observed. In 15 (0.04%) specimens, two separate nerves entered the gluteal region and converged to form the sciatic nerve distal to the piriformis, which could bifurcate either in the distal third of the posterior thigh or popliteal fossa., Conclusion: This is the first study to provide information on the sciatic nerve bifurcation in a large South African cadaver cohort. Moreover, we created a quantifiable method that can be used to classify the sciatic nerve bifurcation level. This will be beneficial in ensuring accurate comparison between different population groups in future., (Copyright © 2021 Elsevier Masson SAS. All rights reserved.)

The literature states that transitional vertebrae at any junction are characterized by features retained from two adjacent regions in the vertebral column. Currently, there is no published literature available that describes the prevalence or morphology of thoracolumbar transitional vertebrae (TLTV). The aim of this study was to identify the qualitative characteristics of transitional vertebrae at the thoracolumbar junction and establish a technique to differentiate the various subtypes that may be found. A selection of vertebral columns from skeletal remains (n = 35) were evaluated in this study. Vertebrae were taken based on features that are atypical for vertebrae in each relative region. The transitional vertebrae were qualitatively identified based on overlapping thoracic and lumbar features of vertebrae at the thoracolumbar junction. The following general overlapping characteristics were observed: aplasia or hypoplasia of the transverse process, irregular orientation on the superior articular process and atypical mammillary bodies. The results show that the most frequent location of the transitional vertebrae was in the thoracic region (f = 23). The second most frequent location was in the lumbar region (f = 10). In two specimens of the selection (f = 2), an additional 13th thoracic vertebra was present which functioned as a transitional vertebra. This study concluded that one can accurately identify the characteristics of transitional vertebrae at the thoracolumbar junction. In addition, the various subtypes can be differentiated according to the region in the vertebral column the vertebra is located in and the relative number of vertebral segments in the adjacent regions of the vertebral column. This provides a qualitative tool for researchers to differentiate the transitional vertebrae from distinctly different typical thoracic or lumbar vertebrae at the thoracolumbar junction., (© 2018 Anatomical Society.)

Interpersonal violence (IPV) and heavy alcohol consumption are major problems in the Western Cape Province of South Africa. Cranio-maxillofacial fractures, particularly nasal and zygomatic bone fractures, as well as isolated radial fractures (Colles fractures) and ulnar shaft fractures (parry fractures), are indicative of IPV, while alcoholic liver disease (ALD) is the consequence of chronic alcohol abuse. We therefore aim to investigate whether a significant association exists between the prevalence of cranio-maxillofacial fractures and parry fractures and ALD in a Western Cape population. Embalmed cadavers (n = 124) used for medical students' anatomy training at the Division of Anatomy and Histology, Faculty of Medicine and Health Sciences, Stellenbosch University were studied. The cadavers were dissected according to departmental protocol. The liver of each cadaver was investigated for macroscopic pathology lesions. Tissue samples were removed, processed to wax, and sectioned and stained with hematoxylin and eosin (H&E). All soft tissue was removed from the skulls, radii, and ulnae, which were then investigated for healed skeletal trauma. The results showed 37/124 (29.8%) cadavers had healed cranio-maxillofacial fractures and 24/124 (19.4%) cadavers had morphologic features of ALD. A total of 12/124 (9.7%) cadavers showed signs of both ALD and healed cranio-maxillofacial trauma. More males were affected than females, and left-sided facial fractures were statistically more common compared to the right side. This study illustrated a significant trend between alcohol abuse and cranio-maxillofacial fractures in individuals from communities with a low socio-economic status (SES) where IPV is a major problem., (Copyright © 2016 Elsevier Inc. All rights reserved.)

The internal vertebral venous plexus (IVVP) plays a putative role in thermoregulation of the spinal cord. Cold cutaneous venous blood may cool, while warm venous blood from muscles and brown fat areas may warm the spinal cord. The regulating mechanisms for both cooling and warming are still unknown. Warm venous blood mainly enters the IVVP via the intervertebral veins. In the thoracic area these veins are connected to the posterior intercostal veins. In this study, anatomical structures were investigated that might support the mechanisms by which warmed venous blood from the intercostal muscles and the recently described paravertebral patches of brown adipose tissue are able to drain into the vertebral venous plexus. Therefore, tissue samples from human cadavers (n = 21) containing the posterior intercostal vein and its connections to the IVVP and the azygos veins were removed and processed for histology. Serial sections revealed that the proximal parts of the posterior intercostal veins contained abundant smooth muscle fibers at their opening into the azygos vein. Furthermore, the walls of the proximal parts of the posterior intercostal veins contain plicae that allow the vessel to dilate, thereby allowing it to serve as a pressure chamber. It is suggested that a cold induced closure of the intercostal/azygos opening can result in retrograde blood flow from the proximal posterior intercostal vein towards the IVVP. This blood flow would be composed of warm blood from the paravertebral brown adipose tissue and blood containing metabolic heat from the muscles draining into the intercostal veins., (Copyright © 2013 Wiley Periodicals, Inc.)

It has been noted by staff at the Faculty of Health Sciences, Stellenbosch University that medical students neglect the study of surface anatomy during dissection. This study reports on the novel use of Lodox(®) Statscan(®) images in anatomical education, particularly the teaching of surface anatomy. Full body digital X-ray images (Lodox Statscan) of each cadaver (n = 40) were provided to second year medical students. During dissection students were asked to visualize landmarks, organs, and structures on the digital X-ray and their cadaver, as well as palpate these landmarks and structures on themselves, their colleagues, and the cadaver. To stimulate student engagement with surface anatomy, dissection groups were required to draw both the normal and actual position of organs on a laminated image provided. The accuracy of the drawings was subsequently assessed and students were further assessed by means of practical identification tests. In addition, students were asked to complete an anonymous questionnaire. A response rate of 79% was obtained for the student questionnaire. From the questionnaire it was gathered that students found the digital X-ray images beneficial for viewing most systems' organs, except for the pelvic organs. Although it appears that students still struggle with the study of surface anatomy, most students believed that the digital X-rays were beneficial to their studies and supported their continued use in the future., (Copyright © 2012 American Association of Anatomists.)

Identification of the facial nerve trunk is essential during surgery of the parotid gland. Numerous landmarks have been researched and used. The relation between the facial nerve to two constant bony landmarks, the tip of the mastoid process and the central point of the transverse process of the atlas was investigated. Forty cadavers were dissected. A preauricular incision exposed the nerve trunk. Bony landmarks were identified and marked. The distance from the nerve trunk to the mastoid process and the atlas was measured. The mean distance between the mastoid process and nerve for the left was 9.18 +/- 2.05 mm and for the right, 9.35 +/- 1.67 mm. The mean distance between the atlas and the nerve for the left was 14.31 +/- 3.59 mm and for the right, 13.76 +/- 4.65 mm. Confidence intervals were determined. The importance of the aforementioned data revolves around minimizing the chance of injury to the facial nerve during surgery. The applicability of these landmarks needs to be studied in the clinical setting.

Current trends in medical education focus on outcomes-based learning as a means to facilitate student learning. The aim of this study was to evaluate a clinically applied module in head and neck anatomy for third-year dental students. The module linked clinical examination, regional dental blocks simulated on cadaver specimens, radiographic images and clinical case scenarios. A Likert-type questionnaire, completed by all students (n = 49), was used to evaluate student perceptions of this module objectively. The results indicate that an average number of students found that clinical examination received sufficient time (mean: 2.98) during the module, while a substantial number of students agreed that the integration of dental procedures stimulated them to study specific regional anatomy (mean: 3.82) and increased their interest in their future careers as dentists (mean: 4.04). The radiographs improved their understanding of anatomy (mean: 3.41) while the clinical case studies were a positive learning experience (mean: 3.10). The majority of students (mean: 4.12) felt that they were continuously made aware that they were studying appropriate matter for their future work as dentists. It seems evident that the integration of clinically relevant content facilitates and encourages the understanding of anatomy.

This is a brief review of the origin and normal variations of the genial tubercles, and specifically, a mandibular spine as an anatomical variation or abnormality. The case presented is that of abnormal genial tubercles observed during dissection of the floor of the mouth. A review and description on the morphology of the genial tubercles are given.

Despite developing prior to the appearance of secondary sexual characteristics of the skeleton, the permanent dentition exhibits sexual dimorphism. Therefore, teeth can serve as a means to estimate sex assigned at birth even in young individuals. This project takes a large global sample of maximum dimensions of the crown as well as measurements of the crown at the cervix to explore sexual dimorphism. Dimorphism is noted in teeth throughout the dental arcade, particularly in the canines. We provide sectioning points as well as the probability of correct classification (ranging from 50.9% to 81.3%) for each measurement to aid the practitioner in sex estimation from the dentition. This research provides a method to estimate sex without arbitrary population specifications. We argue for a global approach that incorporates more population variation to remove the need to estimate "ancestry," (which in actuality is translated to a social race category) and therefore does not force sexual dimorphism-related variation into these mutable and ambiguous categories. Further, this paper demonstrates the utility of the dentition as an additional indicator to aid with the estimation of sex assigned at birth in forensic anthropology. The goal of this research is to better understand the expression of sexual dimorphism across the skeleton in a global context., (© 2024 American Academy of Forensic Sciences.)

Surface anatomy is an important skill for students in preparation for patient care, and peer examination is often used to teach musculoskeletal and surface anatomy. An alternative pedagogical approach is to use bodies represented in artworks. Represented bodies display fictive anatomy, providing students with the opportunity to apply their musculoskeletal knowledge and to think critically when evaluating the anatomical fidelity of a represented body. An elective course at the University of Michigan enabled undergraduate students to analyze the musculoskeletal and surface anatomy depicted in Renaissance artworks. Students traveled to Italy in 2018 (n = 14) and 2022 (n = 15) to analyze the fictive anatomy portrayed in artistic sculptures and musculoskeletal structures depicted in wax anatomy models and sculpted skeletons. In assignments, students were asked to identify musculoskeletal structures as portrayed in the context of represented anatomy created by Italian Renaissance artists and to assess the fidelity of the depicted anatomy. The students also applied their knowledge of musculoskeletal anatomy to describe body position and evaluate muscle function in their assessments of the accuracy or inaccuracy of the fictive anatomy. The students reported that evaluating the anatomical fidelity of represented bodies in artworks supported their learning of musculoskeletal and surface anatomy, and that their critical thinking skills improved in the course. Evaluation of the anatomical fidelity of represented bodies in artworks is an effective pedagogical approach that can be implemented in art museums as an adjunctive learning experience to deepen students' musculoskeletal and surface anatomy knowledge and further develop their critical thinking skills. [ABSTRACT FROM AUTHOR]

Documented skeletal collections are valuable resources for anthropological studies aimed at reconstruction of the biological profile and examination of osteological trauma and pathology. The Free State Collection for Anthropological Research is a new, contemporary skeletal collection, based in central South Africa that has become available for such studies. This paper aims to provide an overview of the collection to encourage its future use in national and international research. The collection currently contains 64 female and 122 male skeletons of individuals that have died in the Free State province since the year 2000. Black individuals constitute 94.6% of the collection. Age-at-death ranges between 19 and 86 years, with an overall mean of 40 years. Year-of-birth ranges from 1927 to 1991. Tuberculosis (22.6%) and influenza/pneumonia (20.4%) are the most common cause of death for these individuals. Although the current demographic profile of the collection is skewed, new individuals are continuously being added. The collection offers several opportunities for anthropological research. The relatively young age-at-death and contemporary nature of the collection make it a useful tool for validation of existing methods for estimations of components of the biological profile. It can also be used in conjunction with other collections for the development of new methods for age and sex estimation and studies of trauma and disease manifestation of the skeleton. [ABSTRACT FROM AUTHOR]

Objectives: Introducing SPINEPS, a deep learning method for semantic and instance segmentation of 14 spinal structures (ten vertebra substructures, intervertebral discs, spinal cord, spinal canal, and sacrum) in whole-body sagittal T2-weighted turbo spin echo images., Material and Methods: This local ethics committee-approved study utilized a public dataset (train/test 179/39 subjects, 137 female), a German National Cohort (NAKO) subset (train/test 1412/65 subjects, mean age 53, 694 female), and an in-house dataset (test 10 subjects, mean age 70, 5 female). SPINEPS is a semantic segmentation model, followed by a sliding window approach utilizing a second model to create instance masks from the semantic ones. Segmentation evaluation metrics included the Dice score and average symmetrical surface distance (ASSD). Statistical significance was assessed using the Wilcoxon signed-rank test., Results: On the public dataset, SPINEPS outperformed a nnUNet baseline on every structure and metric (e.g., an average over vertebra instances: dice 0.933 vs 0.911, p < 0.001, ASSD 0.21 vs 0.435, p < 0.001). SPINEPS trained on automated annotations of the NAKO achieves an average global Dice score of 0.918 on the combined NAKO and in-house test split. Adding the training data from the public dataset outperforms this (average instance-wise Dice score over the vertebra substructures 0.803 vs 0.778, average global Dice score 0.931 vs 0.918)., Conclusion: SPINEPS offers segmentation of 14 spinal structures in T2w sagittal images. It provides a semantic mask and an instance mask separating the vertebrae and intervertebral discs. This is the first publicly available algorithm to enable this segmentation., Key Points: Question No publicly available automatic approach can yield semantic and instance segmentation masks for the whole spine (including posterior elements) in T2-weighted sagittal TSE images. Findings Segmenting semantically first and then instance-wise outperforms a baseline trained directly on instance segmentation. The developed model produces high-resolution MRI segmentations for the whole spine. Clinical relevance This study introduces an automatic approach to whole spine segmentation, including posterior elements, in arbitrary fields of view T2w sagittal MR images, enabling easy biomarker extraction, automatic localization of pathologies and degenerative diseases, and quantifying analyses as downstream research., (© 2024. The Author(s).)

Anatomical variations of the sciatic nerve were supposed as potential causes for incomplete blocks at the level of the popliteal fossa. Therefore, we aimed to conduct an anatomical and ultrasound survey of the mid-femoral sciatic nerve and its division. A regional block of the sciatic nerve is a procedure for analgesia and anaesthesia of the lower extremity. Various approaches to the sciatic nerve are used in clinical practice. However, the sciatic nerve demonstrates several variations regarding its topography and division. The anatomical study included twenty lower limbs of ten adult cadavers. The ultrasound study involved ten upper legs of five healthy volunteers The sciatic nerve was found distally to the piriformis muscle in all our cadaveric specimens. It was divided into two major branches (common peroneal nerve and tibial nerve) at a mean distance of 68.1 ± 19.3 mm above the popliteal crease. The observed distances ranged widely from 35 to 113 mm. The mid-femoral sciatic nerve and its division were entirely revealed using ultrasound in all volunteers. The sciatic nerve presents significant anatomical variations, which may cause an incomplete block. Understanding ultrasound anatomy and ultrasound appearance of the sciatic nerve is essential for performing ultrasound-guided sciatic blocks. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this study was to evaluate the long-term clinical, functional, and radiological outcomes of operative and nonoperative treated patients with thoracolumbar fracture. Materials and Methods: Between January 2016 and December 2021, data of patients hospitalized in our clinic due to thoracolumbar (T11-L2) fracture were collected and analyzed. Results: Two hundred eighteen patients met the inclusion criteria. One hundred thirty eight patients (63.3%) were operated and 80 patients (36.7%) were treated with nonsurgical methods. The duration of follow-up ranged from 13 to 82 months. There was a significant difference between the first admission oswestry disability index (ODI) and visual analog scale (VAS) and the final visit ODI and VAS when both operative and nonoperative treatment patients were evaluated separately and when evaluated together. The scores at the last control visit were significantly lower than the initial scores (p<0.001). When the fracture level was compared with the ODI and VAS, a significant difference was observed in the ODI score at the first admission (p=0.03). The ODI score at first admission was highest in patients with T11 fractures and lowest in patients with L2 fractures. There was a significant correlation between the "Anterior Vertebral Body Compression Percentage %" and four-vessel cerebral angiography (p<0.001). Conclusion: Patients with high vertebral depression and low functionality were operated, and regardless of the treatment protocol, pain decreased and functionality increased in all patients. The height of the vertebral corpus affects the angle of kyphosis, and surgical management is needed for the kyphotic deformity. Patients with high thoracolumbar fractures were more painful. [ABSTRACT FROM AUTHOR]

Curricular development and modification involve first identifying a problem and then performing a needs assessment, which can guide the design of curricular components. Pedagogical changes, coupled with reductions in curricular time for gross anatomy, pose challenges and impose restrictions within medical school curricula. In order to make anatomy education effective and efficient, it is important to determine the anatomy considered essential for medical education through a targeted needs assessment. In this study, 50 adult primary care resident physicians in family medicine (FM) and internal medicine (IM) were surveyed to assess the importance of 907 anatomical structures, or groups of structures, across all anatomical regions from a curated list based on the boldface terms in four primary anatomy texts. There were no statistically significant differences in the ratings of structures between the two groups for any anatomical region. In total, 17.0% of structures, or groups of structures, were classified as essential, 58.0% as more important, 24.4% as less important, and 0.7% as not important. FM residents rated tissues classified as skeleton, nerves, fasciae, anatomical spaces, blood vessels, lymphatics, and surface anatomy (p < 0.0001) significantly higher than IM residents, but there were no differences in the rating of muscles or organs (p > 0.0056). It was notable that 100.0% of cranial nerves were classified as essential, and 94.5% of surface anatomy structures were classified as essential or more important. It is proposed that results of this study can serve to inform curricular development and revision. [ABSTRACT FROM AUTHOR]

Since investigation of the timing of the skeletal traits among the acetabula of different populations is lacking, this study aims to evaluate the relevance of geographical origin in the acetabulum aging process and in the usability of the SanMillán-Rissech aging method. The acetabula of 826 European North Americans derived from the Bass Collection (USA) have been analyzed and compared with 611 Portuguese acetabula from the Luis Lopes Collection (Portugal) applying the most updated acetabular age estimation technique (2017). After evaluating and comparing the acetabular aging rates between both populations by Mann–Whitney U tests, the inaccuracy values (bias and absolute error) were analyzed and compared using population-specific reference samples and using references differing in geographical origin by Wilcoxon tests. In general terms, the North Americans age faster than the Portuguese, especially the females, reaching the consecutive acetabular stages at younger ages. Regarding the SanMillán-Rissech method accuracy, using population-specific reference samples produces, as a general rule, better outcomes. In addition, an exhaustive meta-analysis of inaccuracy values has demonstrated that this method provides better estimation values than pubic symphysis and auricular surfaces regardless of the geographic coherence of the reference sample. These inter-population skeletal differences are derived from different factors than age, highlighting the impact of both biological and social background on age estimation. A thorough analysis of the skeletal age-based timing becomes essential to understanding, deciphering and being able to minimize bias and potential inaccuracy or even counteract them when applying the age estimation methods to different populations. [ABSTRACT FROM AUTHOR]

Nadbath facial nerve block is the most common procedure to anesthetize the facial nerve at stylomastoid foramen in intraocular surgeries, but it is associated with complications. Also, this foramen exhibits ethnic and racial variations with regard to its location. There is scanty literature describing the topographical location of this foramen. So, the study is carried out. The purpose of the study is to describe the topography of stylomastoid foramen from the surrounding landmarks so that Nadbath facial nerve block can be performed with minimum complications. The study was conducted using 80 adult dry skulls of unknown age and sex, and the distance of this foramen was measured from the tip, upper end, and lower end of the anterior border of the mastoid process and jugular foramen. The statistical analysis consisting of mean, SD, median, range mode, and t test was calculated. Mean distances of stylomastoid foramen from the upper end, the lower end of anterior border and tip of mastoid process and jugular foramen on right side were 1.5±0.16, 1.02±0.09, 0.84±0.09, and 0.49±0.06 cm and those on left side were 1.5±0.16, 1.02±0.09, 0.84±0.09, and 0.5±0.06 cm, respectively. The mode of these distances was 1.5, 1, 0.8, and 0.5, both on the right and left sides. The topographic information about stylomastoid foramen given in this study is useful to anesthetists to carry out Nadbath facial nerve block successfully with minimum complications., Competing Interests: The authors report no conflicts of interest., (Copyright © 2024 by Mutaz B. Habal, MD.)

Study Design: Retrospective comparative study. Objectives: To compare radiological and functional outcomes of patients with fixation constructs utilizing pedicle screw stabilization at the fracture level (FL group) versus patients with non-fracture level (NFL group) fixation in single level fractures of the thoracolumbar junction (T11-L1). Methods: 53 patients of whom fracture level screw was used in 34 (FL group) were compared to 19 patients in NFL group. Radiological parameters analyzed were sagittal index, bi-segmental kyphosis (Cobb) angle and degree of vertebral height restoration. Prospectively collected patient reported functional outcomes and post-operative complications were also studied. Stepwise regression analysis adjusted by age, gender and functional scores was performed to account for the small numbers and unequal sizes of the groups. Results: Back pain score was significantly lower in the FL group (P < 0.025). Core Outcome Measures Index scores and leg pain scores, though low in the FL group, were not statistically significant. The regression analysis showed that the inclusion of the fracture-level screw was independently associated with a greater change in sagittal index and vertebral height restoration post-operatively. Sagittal index was maintained through to final follow up as well. The bi-segmental Cobb's angle correction was not associated with fracture-level screw construct. There was no significant difference between the groups for revision surgery, deep infection, implant failure or length of hospital stay. Conclusion: The inclusion of the fracture-level pedicle screws in the fixation construct significantly improves the immediate and final measured radiological parameters, with improved functional scores in single level unstable vertebral fractures of the thoracolumbar junction. [ABSTRACT FROM AUTHOR]

Online anatomical resources are rising in popularity since the COVID-19 pandemic, but the pedagogical principles and effectiveness of their use remain unclear. This article aims to demonstrate evidence-informed ways in which fellow educators can create engaging online learning resources in clinical neuroanatomy and compare the effectiveness of text-based and online learning resources. Data were analyzed from the Soton Brain Hub (SBH) YouTube page. Separately, a cross-sectional study comparing the learning gain of using text-based and video resources was done. The knowledge gain and retention were compared between groups using a pre-teaching and post-teaching multiple choice questions. YouTube analytics showed the average time a viewer spends on a video was found to be highly correlated to the length of the video, r = 0.77, p < 0.001 (0.69-0.82). The cross-sectional study indicated a significant difference in mean normalized learning gain of video resources 61.9% (n = 53, CI 56.0-67.7%) versus text resources 49.6% (n = 23, CI 39.1-60.1%) (p = 0.030). However, there was no difference in retained learning gain between video resources 39.1% (n = 29, CI 29.2-49.0%) versus text-based 40.0% (n = 13, CI 23.9-56.1%) (p = 0.919). Students engage most with short videos less than 5 min which reduces the intrinsic load of learning. Online resources are as effective as text-based resources in providing learning gain and retention. In the future, the continued rise in popularity of online learning resources may result in further reduction in traditional face-to-face teaching., (© 2023 American Association for Anatomy.)

Copyright of Medical Records is the property of Medical Records and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Purpose: With the increasing significance of diagnostic imaging in clinical practice, long-term anatomical education and training is required to ensure that students can reliably distinguish anatomical structures and interpret images. To improve students' motivation and prospects for learning imaging anatomy, we developed an integrated anatomical practice program combining cadaveric dissection with cadaver CT data processing and analysis during undergraduate students' dissection courses. Methods: Workstations imported with post-mortem CT data of dissected cadavers and various forms of clinical CT/MRI data were set in the dissection room. Medical students had free access to the imaging data during cadaver dissection, and they were challenged to process and analyze the data for submission of voluntary imaging reports on their topics of interest. Finally, we surveyed the integrated anatomical education of 481 medical students. Results: The positive response rate to the integrated anatomical practice was 74.9%, and 79.4% of the students answered that this form of practice offered a suitable introduction to anatomical imaging. The usefulness of this approach in understanding the 2- to 3D arrangement of the human body and enhancing interest in anatomy was also confirmed. The submission rate of voluntary imaging reports also increased annually and is currently 97.4%. Conclusion: Our integrated anatomical practice only allowed students to actively browse CT images and facilitated imaging processing and analysis of their region of interest. This practice may improve students' long-term ability to analyze images and deepen their understanding. A competitive imaging contest may help improve students' motivation when they begin learning imaging anatomy. [ABSTRACT FROM AUTHOR]

Objective: To investigate the prevalence of 11 thoracic vertebrae (TVs), four lumbar vertebrae (LVs) and six LVs among asymptomatic Chinese volunteers, and the influence of spine variations on the global spinal sagittal parameters. Methods: A total of 389 asymptomatic Chinese volunteers were recruited. Each subject underwent a full‐spine X‐ray examination with measurement of global spinal sagittal parameters. The radiographs were examined by a spine surgeon and a radiologist to determine the variation in the number of vertebrae. These parameters were used to compare individuals with five LVs to those with 11 TVs, four LVs, and six LVs. Results: The study population included 12 individuals (3.1%) with seven cervical vertebrae (C) + 11 thoracic vertebrae (T) + five lumbar vertebrae (L), 8 (2.1%) with 7C + 11T + 6L, 8 (2.1%) with 7C + 12T + 4L, and 15 (3.9%) with 7C + 12T + 6L. Compared to the 7C + 12T + 5L individuals, those with 7C + 11T + 5L had significantly lower C6–T5 Cobb values (P < 0.05); 7C + 12T + 4L individuals had significantly greater thoracic inlet angles (P < 0.05) and significantly lower pelvic tilt (P < 0.05); individuals with 7C + 12T + 6L had significantly greater sacral slope, pelvic tilt, pelvic incidence, and L1–5 Cobb values (all P < 0.05), but significantly lower thoracic inlet angle (P < 0.05). There were no significant differences in any of the parameters examined between the 7C + 11T + 6L group and the 7C + 12T + 5L group. Conclusions: Asymptomatic adults with 7C + 12T + 6L, 7C + 12T + 4L, and 7C + 11T + 5L presented with different spinal sagittal alignment compared to those with 7C + 12T + 5L. Compared to variation in the number of LVs, the variation in the number of TVs had less effect on global spinal sagittal parameters. Spinal surgeons and researchers should be aware of the effects of variation in numbers of TVs and LVs on global spinal parameters and sagittal balance. [ABSTRACT FROM AUTHOR]

To become skilled physicians, medical students must master surface anatomy. However, the study of surface anatomy is less emphasized in medical and allied health science curricula, and the time devoted to direct engagement with the human body is limited. This scoping review was designed to answer one research question: "What are the elements and strategies that are effective in teaching surface anatomy?" The review was performed using a five‐stage scoping review framework, including research question identification, relevant study identification, study selection, data charting, and result collating and reporting. Three databases were searched using two search terms combined with a Boolean operator: "teaching" and "surface anatomy." The initial pool of 3,294 sources was assessed for duplication, and study eligibility was evaluated using inclusion and exclusion criteria. Data were abstracted from 26 original articles by one researcher and verified by two other researchers. A thematic analysis was performed, and several elements of effective teaching strategies for surface anatomy were identified, namely contextualized teaching, embracing experiential learning, and learning facilitation. This review revealed that a multimodal approach was most commonly used in surface anatomy instruction. Hence, future research should explore the effectiveness of multimodal teaching strategies that adopt the three aforementioned primary elements of effective teaching in an authentic learning environment. It is pertinent to clarify the effectiveness of these teaching strategies by evaluating their impact on student learning, organizational changes, and benefits to other stakeholders. [ABSTRACT FROM AUTHOR]

In contrast to medical education, information on the use of arts as a learning approach is scarce in veterinary anatomy. The aim of this prospective, questionnaire‐based study was to survey students' use of drawing in various aspects of veterinary anatomy learning (self‐study, examinations, preparation for, and reflection on cadaver dissection). The quantitative data showed that first‐year students with artistic preferences used drawing significantly more often in most aspects of anatomy learning than students with no such preferences, apart from the reported use of drawing in examinations and for reflection after cadaver dissection. The lack of significant correlations of the reported use of drawing in examinations with any other study variable provided support for the author's observation that student‐generated drawings are not as commonly used in examinations as previously. In contrast to the study hypothesis, previous university studies did not correlate significantly with any aspect of the use of drawing in anatomy learning. None of the reported uses of drawing addressed the benefits of drawing in learning the comparative anatomy of animal species, a characteristic distinguishing veterinary anatomy from human anatomy. Qualitative student feedback indicated that encouragement and teacher‐produced images would increase the use of drawing as a learning approach even if the implementation of drawing into the curriculum is not feasible. Conclusions from this study were implemented through self‐directed learning in anatomy courses that replaced the canceled cadaveric dissections during the COVID‐19 outbreak and also through the ongoing drawing workshops to further advance the use of drawing in veterinary anatomy learning. [ABSTRACT FROM AUTHOR]

Objective: We aim to describe the parotid fascia as a landmark that can help identify the immediately underlying facial nerve trunk. Methods: Dissection of the parotid fascia and identification of the facial nerve trunk were carried out on 8 fresh cadaveric parotid glands. The attachments and arrangement of the parotid gland and its fascia were evaluated and histologically assessed, with special attention to the fascia overlying the facial nerve trunk. Results: The parotid fascia envelops the posterior aspect of the parotid gland in an open-book fashion. Posteriorly, it connects to the anterior and medial aspect of the mastoid tip. Posterosuperiorly, it attaches to the inferior aspect of the tragal pointer. Directly medial to the fascia lies the facial nerve trunk. Conclusion: The parotid fascia, particularly the parotid–mastoid segment overlying the facial nerve trunk, can be utilized as an additional landmark of depth to help identify the facial nerve trunk during a parotidectomy in conjunction with other commonly used standard anatomic landmarks. The parotid fascia sling spans from the mastoid and tragal pointer to the parotid gland and can be easily palpated intraoperatively. Once the fascia is removed, the facial nerve trunk is identified. [ABSTRACT FROM AUTHOR]

Background: Botulinum toxin type A (BoNT-A) injection administered at an inappropriate site or depth can produce an unwanted change in facial animation because the depressor anguli oris (DAO) and depressor labii inferioris (DLI) muscles are partially overlapped. Therefore, simple BoNT-A injection guidelines, based on 3-dimensional (3D) facial anatomic references and landmarks, would be very useful.Objectives: The aim of this study was to establish novel BoNT-A injection guidelines that include the soft tissue thickness at the lower perioral region. Data were acquired with a 3D scanning system combined with dissections in order to obtain accurate injection sites and depths for the DAO and DLI.Methods: 3D scans of the facial skin, superficial fat, and facial muscle surface were performed in 45 embalmed cadavers. The thicknesses of the skin and subcutaneous layer were calculated automatically from superimposed images at each of 5 reference points (P) in the perioral region.Results: In every case (100%), P3 and P5 were located in the DLI and DAO areas, respectively (45/45). Therefore, we defined P3 as the "DLI point" and P5 as the "DAO point." The soft tissue thicknesses at the DLI and DAO points were 6.4 [1.7] mm and 6.7 [1.8] mm, respectively.Conclusions: The P3 and P5 described in this study are effective guidelines that only target the DLI and DAO. Clinicians, specifically, can easily use facial landmarks, such as the cheilion and pupil, to assign the DLI and DAO points without any measurement or palpation of the modiolus. [ABSTRACT FROM AUTHOR]

The mental spines are bony prominences found in the lingual surface of anterior mandible, and usually they are arranged in two groups, superior pair and inferior pair. Mostly they are asymptomatic, but sometimes they may interfere with the prosthodontic treatment or with some surgeries. The lingual foramen can be found in different locations around the mental spines, and they are very important vital organ because they transmit nerves and arteries, which may cause a serious problem during some types of surgeries in this region such as implant placement. Here, we report a case of 55-year-old, Kurdish woman with elongated superior mental spine with bilaterally lingual foramina located distally to lower central incisors, that have been seen during a routine CBCT scan. The length of the spine was 6.4 mm, the height was 5.5 mm and the width was 1.9 mm. So, any dentist wants to perform any type of surgery in sublingual and submental regions should be careful of such anatomical variations. [ABSTRACT FROM AUTHOR]

The benefits of a comparatively inexpensive radiographic system such as the Lodox® scanner in forensic facilities where CT-imaging and radiologist support is not financially viable will be explored. Prodigious caseloads in many under-resourced mortuaries preclude the use of advanced radiological modalities. The aim of this research is to examine the utilization of the Lodox® scanner in one of the busiest mortuaries in South Africa in relation to the nature of the cases scanned and, furthermore, to provide case studies where this imaging modality proved vital in the examination of the deceased and in the approach to the autopsy. The research is a retrospective epidemiological review on the use of the Lodox® scanner at the Salt River Medico-legal Laboratory, Cape Town, South Africa, from 1 January 2017 to 31 December 2017. A total of 3885 cases was admitted to the mortuary; the majority was scanned. A large proportion of cases were male. Ages ranged from foetuses to the elderly. The manner of death in more than a third of the cases was homicide which mainly involved firearm fatalities. This was followed by natural deaths. Pertinent case studies are presented to demonstrate that the use of the Lodox® scanner as an adjunct (or even obviating autopsy) proves to save time and labour and is financially beneficial. In conclusion, the Lodox® scanner is an indispensable tool in mortuaries with heavy caseloads because its use improves quality assurance, saves time, and is cost effective in the examination of both natural and unnatural deaths. [ABSTRACT FROM AUTHOR]

Purpose: Localization of the facial nerve trunk (FNT) [i.e., the portion of the facial nerve between the stylomastoid foramen (SMF) and pes anserinus] may be required during various surgical interventions such as parotidectomy and hypoglossal-facial anastomosis. Several landmarks have been proposed for efficient identification of the FNT. We sought to assess the anatomical features of the digastric branch of the facial nerve (DBFN) and its potential as a landmark to identify FNT. Methods: Fifteen sides of eight cadaveric heads were dissected to find the DBFN. Anatomic features of DBFN including its point of origin relative to SMF, length, and important relationships, as well as the distance between the insertion point on the digastric muscle and mastoid tip were recorded. Results: DBFN was found in all specimens originating from the FNT outside the SMF with an average length (± standard deviation) of 15.4 ± 3.4 mm. In all specimens, the DBFN inserted on the superomedial aspect of the posterior belly of the digastric muscle (PBD). In 8/15 specimens, DBFN was accompanied by the stylomastoid artery on its anteromedial side. Average distance (± standard deviation) between the mastoid tip and the nerve insertion point on PBD was 13.6 ± 2.0 mm (range 10–17). Conclusions: The DBFN is a reliable landmark for identifying the FNT. It could be consistently identified within 15–20 mm of the mastoid tip on the superomedial aspect of the PBD. The DBFN may be used as a supplementary landmark for efficient localization of the FNT. Level of evidence: Not applicable (anatomic study). [ABSTRACT FROM AUTHOR]

While dissection remains the method of choice for teaching human anatomy, ethical requirements for obtaining cadavers has made the process of acquiring human bodies more strenuous for institutions. In Africa and at the School of Anatomical Sciences in South Africa, dependence on unclaimed bodies has been prevalent. The aim of the present study was to determine whether more rigorous application of ethical consent has altered the provenance of the cadavers in the School of Anatomical Sciences, University of the Witwatersrand. The numbers of bequeathed/donated/unclaimed cadavers received over the period 2013–2017, as well as their sex and population affinity were analyzed. The majority (96.8%) of the cadavers dissected over the period were from bequests/donations. Marginally more females than males were available. In addition, the population affinity of the cadavers had changed from a majority of South African African (unclaimed) bodies to a majority of South African White (bequest/donated) bodies. The study shows that even with ethical constraints it is possible to transition from the use of mainly unclaimed bodies to the acquisition of bequeathed/donor bodies. However, there may be challenges in relation to anatomical collections in the School as few of the bequest/donated cadavers remain in the School to be added to the collections. These changes also affect the demographics of the Schools' collections. [ABSTRACT FROM AUTHOR]

With the acceptance of the Daubert criteria as the standards for best practice in forensic anthropological research, more emphasis is being placed on the validation of published methods. Methods, both traditional and novel, need to be validated, adjusted, and refined for optimal performance within forensic anthropological analyses. Recently, a custom postcranial database of modern South Africans was created for use in Fordisc 3.1. Classification accuracies of up to 85% for ancestry estimation and 98% for sex estimation were achieved using a multivariate approach. To measure the external validity and report more realistic performance statistics, an independent sample was tested. The postcrania from 180 black, white, and colored South Africans were measured and classified using the custom postcranial database. A decrease in accuracy was observed for both ancestry estimation (79%) and sex estimation (95%) of the validation sample. When incorporating both sex and ancestry simultaneously, the method achieved 70% accuracy, and 79% accuracy when sex-specific ancestry analyses were run. Classification matrices revealed that postcrania were more likely to misclassify as a result of ancestry rather than sex. While both sex and ancestry influence the size of an individual, sex differences are more marked in the postcranial skeleton and are therefore easier to identify. The external validity of the postcranial database was verified and therefore shown to be a useful tool for forensic casework in South Africa. While the classification rates were slightly lower than the original method, this is expected when a method is generalized. [ABSTRACT FROM AUTHOR]

Anatomical relationships are challenging concepts for first‐year medical students. The use of progressive drawing, where an image is created from a blank template, has long been utilized for outlining anatomical relationships and continuity from one region to another, and has shown positive outcomes for student learning. More recently, computerized progressive drawing has been introduced; however, challenges, including issues with visual clarity, have been described. In this study, 17 computerized screencasts of drawings covering neurovasculature of the limbs, abdomen, pelvis, head, and neck were created and provided to first‐year medical students at Morehouse School of Medicine. An animated method for drawing was utilized to increase visual clarity. Surveys were provided to 181 first‐year medical students to collect feedback about these screencasts. Sixty percent (n = 108) of students completed at least one survey. Respondents rated all 17 screencasts with a minimum of 4.7/5 for helpfulness in learning the material for course examinations. A majority of students (77.8%) reported viewing the screencasts more than once on at least one survey, and students reported varying methods for utilizing the screencasts. A majority of students provided positive feedback relating to technical quality. Some significant differences in course performance were seen based on screencast usage. The positive responses from students indicate that this is a useful method in medical education. Anat Sci Educ 11: 445–460. © 2018 American Association of Anatomists. [ABSTRACT FROM AUTHOR]

The village and street dogs represent a unique model of canine populations. In the absence of selective breeding and veterinary care, they are subject mostly to natural selection. Their analyses contribute to understanding general mechanisms governing the genetic diversity, evolution and adaptation. In this study, we analyzed the genetic diversity and population structure of African village dogs living in villages in three different geographical areas in Northern Kenya. Data obtained for neutral microsatellite molecular markers were compared with those computed for potentially non-neutral markers of candidate immunity-related genes. The neutral genetic diversity was similar to other comparable village dog populations studied so far. The overall genetic diversity in microsatellites was higher than the diversity of European pure breeds, but it was similar to the range of diversity observed in a group composed of many European breeds, indicating that the African population has maintained a large proportion of the genetic diversity of the canine species as a whole. Microsatellite marker diversity indicated that the entire population is subdivided into three genetically distinct, although closely related subpopulations. This genetical partitioning corresponded to their geographical separation and the observed gene flow well correlated with the communication patterns among the three localities. In contrast to neutral microsatellites, the genetic diversity in immunity-related candidate SNP markers was similar across all three subpopulations and to the European group. It seems that the genetic structure of this particular population of Kenyan village dogs is mostly determined by geographical and anthropogenic factors influencing the gene flow between various subpopulations rather than by biological factors, such as genetic contribution of original migrating populations and/or the pathogen-mediated selection. On the other hand, the study of oldest surviving dogs suggested a biological mechanism, i.e. a possible advantage of the overal heterozygosity marked by the the microsatellite loci analyzed. [ABSTRACT FROM AUTHOR]

The study of human anatomy has long been inseparable from illustration, as the portrayal of the dissected body alongside a descriptive text supports the understanding of this complex topic. With the advent of new technologies, applications for revealing the details of the human body have increased to include Computed Tomography and Magnetic Resonance Imaging scanning, digital photography and videography, and three-dimensional (3D) printing. In addition, the distribution of the captured image has become widespread in both online teaching and in hard copy textbooks. While these digital images and applications are invaluable for online teaching, particularly during pandemics, anatomists must consider whether the use of the images and data derived from human bodies (either donor or unclaimed) is ethical, as it is not always clear whether permission has been obtained for their creation.Questions regarding the ethical sourcing and use of images will become more urgent as the utilization of electronic data becomes routine. Particularly concerning is the distribution of images and videos in the public domain on social media, where the context and link with education may be severed. Other considerations include respect for the privacy of the deceased, ownership of images, and commercialization. An initial question that should be posed is "Who is responsible for the oversight of digital and 3D printed models of bodies?" The ethical use of such images needs to be considered by the global anatomy community in order to ensure that anatomists do not retreat into the ethical mire of their forefathers., (© 2022. The Author(s), under exclusive license to Springer Nature Switzerland AG.)

In contrast to medical education, information on the use of arts as a learning approach is scarce in veterinary anatomy. The aim of this prospective, questionnaire-based study was to survey students' use of drawing in various aspects of veterinary anatomy learning (self-study, examinations, preparation for, and reflection on cadaver dissection). The quantitative data showed that first-year students with artistic preferences used drawing significantly more often in most aspects of anatomy learning than students with no such preferences, apart from the reported use of drawing in examinations and for reflection after cadaver dissection. The lack of significant correlations of the reported use of drawing in examinations with any other study variable provided support for the author's observation that student-generated drawings are not as commonly used in examinations as previously. In contrast to the study hypothesis, previous university studies did not correlate significantly with any aspect of the use of drawing in anatomy learning. None of the reported uses of drawing addressed the benefits of drawing in learning the comparative anatomy of animal species, a characteristic distinguishing veterinary anatomy from human anatomy. Qualitative student feedback indicated that encouragement and teacher-produced images would increase the use of drawing as a learning approach even if the implementation of drawing into the curriculum is not feasible. Conclusions from this study were implemented through self-directed learning in anatomy courses that replaced the canceled cadaveric dissections during the COVID-19 outbreak and also through the ongoing drawing workshops to further advance the use of drawing in veterinary anatomy learning., (© 2020 American Association for Anatomy.)

Research on the benefits of visual learning has relied primarily on lecture-based pedagogy, but the potential benefits of combining active learning strategies with visual and verbal materials on learning anatomy has not yet been explored. In this study, the differential effects of text-based and image-based active learning exercises on examination performance were investigated in a functional anatomy course. Each class session was punctuated with an average of 12 text-based and image-based active learning exercises. Participation data from 231 students were compared with their examination performance on 262 questions associated with the in-class exercises. Students also rated the helpfulness and difficulty of the in-class exercises on a survey. Participation in the active learning exercises was positively correlated with examination performance ( r = 0.63, P < 0.001). When controlling for other key demographics (gender, underrepresented minority status) and prior grade point average, participation in the image-based exercises was significantly correlated with performance on examination questions associated with image-based exercises ( P < 0.001) and text-based exercises ( P < 0.01), while participation in text-based exercises was not. Additionally, students reported that the active learning exercises were helpful for seeing images of key ideas (94%) and clarifying key course concepts (80%), and that the image-based exercises were significantly less demanding, less hard and required less effort than text-based exercises ( P < 0.05). The findings confirm the positive effect of using images and active learning strategies on student learning, and suggest that integrating them may be especially beneficial for learning anatomy. Anat Sci Educ 10: 444-455. © 2017 American Association of Anatomists. [ABSTRACT FROM AUTHOR]

Background: Anatomy educators are increasing their utilisation of radiology in anatomy education in line with growing requirements for undergraduate radiology competency and clinical need. Aims: We aimed to evaluate student perceptions of radiology and to outline the technical and academic considerations underlying the integration of radiology into musculoskeletal practical anatomy sessions. Materials and methods: The formal integration of radiology into anatomy practical sessions took place over a 5-week period during the lower limb musculoskeletal component of the anatomy course taught to first-year medical students. During practical sessions, students were required to rotate between aligned audio-visual radiology presentations, osteology/anatomical models, and prosection/dissection learning stations. After completing the course, students were invited to complete a survey to establish their opinions on radiology as a mode of learning and their satisfaction with radiological integration in anatomical practical sessions. Results: Most students were not familiar with radiology prior to attending our university. All our students agreed or strongly agreed that learning to read radiographs in anatomy is important and most agreed that radiology is a valid assessment tool. Sixty percent stated that radiology facilitated their understanding of anatomy. The majority believed that radiology was best suited to clinically relevant anatomy and X-rays were their preferred learning tool. Conclusions: The practical approach to integrating radiology into undergraduate musculoskeletal anatomy described here did not place strain on existing academic resources. Most students agreed that radiology should be increased in anatomy education and that learning to understand radiographs in anatomy was important for clinical practice. [ABSTRACT FROM AUTHOR]

An accurate knowledge of anatomy, especially natural variation within individuals, is of vital clinical importance. Cadaver dissection during anatomical training may be a valuable introduction to pathology for undergraduate students, which can contribute greatly to a successful medical career. The purpose of this study was to determine the extent and type of pathology lesions in a cadaver population ( n = 127) used for medical dissection. This was done to gauge whether sufficient pathology lesions representative of all the organ systems were present in the cadaver population to warrant the use of cadavers as an additional pathology learning resource. This study demonstrated a wide variety of pathology lesions in different organ systems. The respiratory system was most affected with pulmonary tuberculosis (TB) lesions being the most common finding (seen in 76% of cadavers) followed by bronchopneumonia and emphysema. Other common pathology findings included atherosclerosis, colonic diverticula, and chronic pyelonephritis. Skeletal fractures and degenerative joint disease were also noted. This study shows that cadaveric dissection offers a chance to alert and expose students to a wide variety of gross pathology and histopathology. It has been suggested that most medical students will practice in primary health care and as such more attention should be given to the pathology of commonly encountered diseases. This is particularly true for developing countries, where diseases such as TB are commonly encountered. The integration of pathology into the dissection hall may therefore be beneficial to student learning while simultaneously optimizing the use of cadaver material. Anat Sci Educ 9: 575-582. © 2016 American Association of Anatomists. [ABSTRACT FROM AUTHOR]

The aim of the study was to report on a case of isolated spontaneous fracture of the genial tubercles, an uncommon pathological condition, the onset of which may be associated with non-specific but potentially life-threatening signs and symptoms, such as haematoma or swelling of the oral floor. We conducted a literature review to identify similar cases, focusing on their diagnosis, management and causes. To date, only 15 cases of spontaneous genial tubercle fracture have been described in 14 reports in the English medical literature. Patients were mainly female, with a mean age of 70 years. Only 5/15 cases (33%) were managed surgically, the others (66%) conservatively. A full functional recovery of the tongue movements, swallowing and talking is achievable with conservative therapy in most cases, but surgery is indicated for patients with persistent dysfunction or clinical discomfort. The case described here was treated conservatively, consistently with the literature, with active observation, corticosteroids and prophylactic i.v. antibiotic therapy leading to a complete recovery within a few weeks. Though extremely uncommon, genial tubercle fracture should be included in the differential diagnosis of haematoma and swelling of the oral floor. It is potentially life-threatening, requiring active monitoring and careful airway management. Conservative procedures and a long-term follow-up are needed to control possible functional restrictions and symptoms, and surgical treatment should be considered in refractory cases. [ABSTRACT FROM AUTHOR]