Clinical Anatomy最新文献

{"title":"Variations in Human Trigeminal and Facial Nerve Branches and Foramina Identified by Dissection and Microcomputed Tomography.","authors":"Hannah L Grimes, Valentina Pizzuti, Maria A Wright, Kane P J Colston, Thomas Santarius, Susan Jones","doi":"10.1002/ca.24288","DOIUrl":"https://doi.org/10.1002/ca.24288","url":null,"abstract":"<p><p>The aim of this study was to identify branches of the trigeminal and facial nerves (FNs) relevant to surgical incisions and injections and the scalp block techniques in the frontotemporal region, and to determine their relationships with superficial vascular structures and bony landmarks. Half-heads from consenting embalmed donors (6 male, 2 female, mean age at death 78.4 years) were used in this study. Detailed dissection was carried out to identify the position of the auriculotemporal nerve (ATN) relative to the superior temporal artery (STA) and the FN in six subjects (5 male, 1 female). The results provide a minimum safe distance of 5 mm between the STA and the frontotemporal branches of the FN at the level of the low edge of the zygoma and 8 mm between the low edge of the zygoma and the FN trunk, providing a pre-auricular triangle of safety for incisions and injections. Variability between subjects was up to 60%. Microcomputed tomography (microCT) scans were taken from all eight subjects and the three-dimensional reconstructions were used to identify the supraorbital notch (SON), the zygomaticotemporal foramen (ZTF), and the zygomaticofacial foramen (ZFF). The volume and relative locations of these foramina were calculated for 5-8 subjects. The closest distance between ZTF and the frontozygomatic suture (FZS) ranged from 9 to 21 mm (26% variation); 3 subjects had a single ZTF while 5 subjects had two ZTF. The angle at the center of the orbit between ZFF and the FZS ranged from 156° to 166° (2.5% variation). These findings demonstrate that both traditional cadaveric dissection methods and contemporary microCT methods can be used to investigate the relative locations of nerves or their foramina in the human head. The findings provide anatomical considerations for fronto-temporal incisions and local anesthesia.</p>","PeriodicalId":50687,"journal":{"name":"Clinical Anatomy","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144044119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What Do We Know About Ligaments?","authors":"Joe Iwanaga,&nbsp;Keishiro Kikuchi,&nbsp;Mi-Sun Hur,&nbsp;Hotaka Kawai,&nbsp;Yoko Tabira,&nbsp;Miguel A. Reina,&nbsp;Robert F. LaPrade,&nbsp;Koichi Watanabe","doi":"10.1002/ca.24289","DOIUrl":"10.1002/ca.24289","url":null,"abstract":"<div>\u0000 \u0000 <p>Ligaments have been extensively studied in anatomy and are traditionally defined as structures that connect bones and contribute to joint stability. However, a universally accepted definition of “ligament” remains elusive. Many structures classified as ligaments do not connect bones, such as the ligamentum arteriosum, raising questions about the criteria used for their designation. Moreover, distinguishing ligaments from tendons presents a significant challenge because of their shared histological characteristics and the lack of a clear, standardized definition of “ligament”. Historically, ligaments have been named primarily on the basis of their gross anatomical appearance rather than well-defined structural or functional criteria. Ambiguities in nomenclature such as the interchangeable use of “patellar ligament” and “patellar tendon” further complicate classification. Additionally, dissection bias can lead to the artificial identification of ligaments because traditional dissection techniques can isolate tissue layers in a manner that creates the illusion of distinct ligament structures. Given these limitations, gross anatomical dissection alone is insufficient to confirm the presence of a ligament, necessitating histological validation based on a fundamental definition. Establishing a precise classification system that differentiates traditional bone-to-bone ligaments from other connective structures is imperative. Close collaboration between anatomists and surgeons is essential for refining anatomical definitions because inaccurate classifications can have direct implications for clinical practice, particularly in ligament reconstruction. A research-driven, standardized definition of ligaments can enhance anatomical education and improve surgical precision.</p>\u0000 </div>","PeriodicalId":50687,"journal":{"name":"Clinical Anatomy","volume":"38 5","pages":"610-612"},"PeriodicalIF":2.3,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144006497","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Discovery of the Pericytes: A Historical Note","authors":"Domenico Ribatti","doi":"10.1002/ca.24291","DOIUrl":"10.1002/ca.24291","url":null,"abstract":"<div>\u0000 \u0000 <p>Pericytes are adventitial cells located within the basement membranes of capillaries and post-capillary venules. Because they have multiple cytoplasmic processes and distinctive cytoskeletal elements, and envelope endothelial cells, pericytes are considered cells that stabilize the vessel wall, controlling endothelial cell proliferation and thereby the growth of new capillaries. Several molecules are involved in controlling and modulating the interactions between pericytes and endothelial cells, such as platelet-derived growth factor beta (PDGFβ), transforming growth factor beta (TGFβ), and angiopoietins (Angs).</p>\u0000 </div>","PeriodicalId":50687,"journal":{"name":"Clinical Anatomy","volume":"38 5","pages":"606-609"},"PeriodicalIF":2.3,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144006561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Renal Arterial Anatomy: Implications for Normothermic Machine Perfusion in Renal Transplantation.","authors":"Lily Mae Miller, Peter Douglas, Julie Glen, Emma Aitken","doi":"10.1002/ca.24286","DOIUrl":"https://doi.org/10.1002/ca.24286","url":null,"abstract":"<p><p>Normothermic machine perfusion (NMP) is a novel technology that has shown potential in viability assessment and reconditioning of donor organs. Normothermic machine perfusion is technically more challenging in kidneys with multiple renal arteries (RAs). This study aimed to characterize the anatomical variation in RAs with a view to the development of optimal equipment for RA cannulation in NMP. Magnetic resonance angiograms obtained from all potential living donors at our centre between 2018 and 2022 were evaluated with PACS 3D with vessel analysis. Three independent reviewers measured RA characteristics (number, cross-sectional area, diameter, distance, angulation). A total of 618 kidneys were included for analysis. Kidneys were categorized into five groups based on the anatomical configuration of arteries. 75.4% had a single RA (group one). One quarter of kidneys were found to have multiple RAs, with inferior accessory arteries the commonest variation. Of the 139 kidneys with multiple RAs (24.6%): 5.3% had two equal sized RAs (group two), 5.5% had a superior accessory artery (group three), 11.7% an inferior accessory artery (group four), and 2.1% had three RAs (group five). Left RAs were of larger diameter, but right RAs were longer (p < 0.001). The number of arteries supplying the right kidney significantly predicted the number of arteries supplying the left kidney (β = 0.15). 23.7% of kidneys with two RAs and 30.8% with three RAs had distances between vessels > 28 mm (length of the existing clamp used for perfusion). 19.1% of main RAs had originated from the aorta at angles ≥ 135°. These findings highlight the insufficiencies with existing NMP equipment for cannulation of the RA. A larger clamp may facilitate perfusion of more kidneys with multiple vessels, whilst soft, flexible cannulae are likely to be needed to accommodate the wide range in angulation of RA origin demonstrated.</p>","PeriodicalId":50687,"journal":{"name":"Clinical Anatomy","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144025473","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Positional Relationship Between the Orbicularis Oculi and Zygomaticus Complex Muscles by Ultrasonography: New Anatomical Insights for Crow's Feet Injection.","authors":"Jiong-Zhen Piao, Ji-Hyun Lee, Kyung-Seok Hu, Hee-Jin Kim","doi":"10.1002/ca.24290","DOIUrl":"https://doi.org/10.1002/ca.24290","url":null,"abstract":"<p><p>The orbicularis oculi muscle (OOc) is strongly associated with facial aging as its contraction causes the formation of crow's feet. Botulinum neurotoxin (BoNT) injection is a representative treatment targeting muscle. The aim of this study was to demonstrate the anatomical relationship between the OOc and the zygomaticus complex muscles, and to visualize the distribution of the facial nerve that innervates the OOc, thereby providing reference data for BoNT injections targeting that muscle. The positional relationships and overlapping ranges between the OOc, zygomaticus minor (Zmi), and zygomaticus major (ZMj), and their distances from the skin, were measured on four different perpendicular planes using ultrasonography. Specimens of the OOc were stained with modified Sihler's stain. The mean distances between the lateral canthus horizontal plane (LCHP) and the zygomaticus complex muscles superior margin were 20.0, 17.9, 22.8, and 20.8 mm in perpendicular planes LC (lateral canthus), OR (orbital rim), M (midpoint of the frontal process of zygomatic bone), and J (Jugale point), respectively. The mean distances between the OOc and the skin were 4.9, 4.8, 5.5, and 4.7 mm in those perpendicular planes. The mean distances between the zygomaticus complex muscles and the OOc were 3.0, 3.1, 4.5, and 4.1 mm. The authors propose new insights for crow's feet injection based on anatomical information obtained from ultrasonography and Sihler's staining, which should contribute to minimizing complications and improving the efficacy of BoNT administration.</p>","PeriodicalId":50687,"journal":{"name":"Clinical Anatomy","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144030611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of Different Teaching Modalities in Human Gross Anatomy Education","authors":"Aisling Mooney,&nbsp;Nathan E. Thompson,&nbsp;Simone Hoffmann","doi":"10.1002/ca.24287","DOIUrl":"10.1002/ca.24287","url":null,"abstract":"<div>\u0000 \u0000 <p>With increasing cost and time constraints, anatomy education has shifted away from classic dissection in favor of more effective teaching modalities. Here we investigated different teaching modalities on test performance and student satisfaction in the human gross anatomy laboratory at the New York Institute of Technology College of Osteopathic Medicine (NYITCOM). The anatomy laboratory for first-year osteopathic students at NYITCOM was divided into stations including radiology, case-based learning, prosection, and dissection. Content covered at those stations was tested via anatomy laboratory examinations, comprised of computer-based identification and multiple-choice questions. Our data encompassed 459 first-year medical students taking anatomy in 2022 at both NYITCOM campus sites (Arkansas and New York). We coded 355 exam questions by teaching modality used in the anatomy laboratory. Questions covered in multiple modalities were classified as ‘mixed’. Performance among modalities was analyzed using a three-way ANOVA. Prosection-based questions (mean = 75.6) performed significantly worse than dissection (mean = 83.4, <i>p</i> &lt; 0.01) and mixed-modality (mean = 80.7, <i>p</i> &lt; 0.01). There was no significant difference in performance on material taught through dissection, radiology, case-based activity and mixed modalities. In addition, we investigated the effect of an instructor at the case-based activity station using repeated measures ANOVA. Our results indicate that case-based activity stations performed better without an instructor present (mean = 77.4 v. 72.7; <i>p</i> &lt; 0.05). This study showed that teaching via prosection results in poorer performance than other teaching modalities and that dissection or hybrid models appear more effective in knowledge retention. Contrary to actual performance, students rated prosection as the most effective teaching modality. These results come at a critical time when COVID-19 has accelerated the shift away from dissection in favor of virtual methods.</p>\u0000 </div>","PeriodicalId":50687,"journal":{"name":"Clinical Anatomy","volume":"38 5","pages":"594-605"},"PeriodicalIF":2.3,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144027398","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Utility of Anatomy Assessment in Preclinical Undergraduate Medical Curricula: A Scoping Review","authors":"Choy Ker Woon,&nbsp;Kah Hui Wong,&nbsp;Aspalilah Alias,&nbsp;Razif Abas,&nbsp;Siti Nurma Hanim Hadie","doi":"10.1002/ca.24283","DOIUrl":"10.1002/ca.24283","url":null,"abstract":"<div>\u0000 \u0000 <p>Anatomy assessments are crucial for developing critical thinking and analytical skills in preclinical undergraduate medical curricula. However, because there is little published empirical evidence, the value of anatomy assessment remains largely unexplored. The aim of this scoping review, conducted in accordance with the Joanna Briggs Institute (JBI) scoping review guidelines, was to explore the utility elements adopted in anatomy assessment within preclinical undergraduate medical curricula. A rigorous three-step search approach across five electronic databases (Scopus, WoS, PubMED, Wiley Online, and EBSCOHost) generated an initial pool of 721 records, which were assessed for duplication and eligibility, leading to the inclusion of 43 records from which data were extracted. The extracted data covered various utility elements of anatomy assessment including validity, reliability, practicality, feasibility, cost-effectiveness, and educational impact, along with various assessment contexts such as assessed competencies, assessment function, and assessment tools. The findings indicate a strong emphasis on assessing cognitive competencies in anatomy education; psychomotor and affective competencies received less attention. Identified gaps include limited exploration of validity evidence, assessment methods, cost-effectiveness, and educational impact of assessment. Moreover, the study highlights challenges in implementing formative assessments alongside summative assessments, constraints in assessing psychomotor skills, and the subjective nature of assessing affective competencies. By addressing these gaps and leveraging innovative assessment tools and practices, educators can enhance the quality of anatomy education and prepare students better for their future careers in medicine.</p>\u0000 </div>","PeriodicalId":50687,"journal":{"name":"Clinical Anatomy","volume":"38 5","pages":"576-593"},"PeriodicalIF":2.3,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Musculoskeletal Anatomy Education: A Survey of North American Medical Programs","authors":"Taylor Orchard,&nbsp;Jason Peeler","doi":"10.1002/ca.24282","DOIUrl":"10.1002/ca.24282","url":null,"abstract":"<p>Postgraduate data reveal that most physicians lack adequate anatomical knowledge and clinical confidence when practicing musculoskeletal (MSK) medicine. Curricular data from nationally accredited medical programs clearly indicate that the total time dedicated to gross anatomy instruction has decreased over recent decades. However, little information is available regarding the MSK anatomy learning environment across accredited medical programs in North America. The purpose of this study was to document the current state of preclinical MSK anatomy education across North American medical programs. A survey was sent to all 14 English-speaking Canadian and 135 of the 158 American accredited medical programs. The survey had a 100% response rate from Canadian programs and 43% from American programs. The results indicated that the mean time spent learning preclinical MSK anatomy varied widely across both Canadian (29.8 h ± 13.7, range 12–60, median 29, mode 12) and American (50.8 h ± 46.2, range 2–280, median 35, mode 30) programs, most of them integrating anatomy learning into the clinical learning environment (56%). All but one program reported using cadaveric-based instruction (99%) and the majority taught radiological correlates (94%) and surface anatomy (71%) within their curriculum. Diverse modes of instruction were used by all programs, but didactic lectures remained the most frequent form (89%). While a variety of learning resources were used to support student learning, the type of resource varied significantly, Canadian programs most commonly providing a “curriculum-specific” notes package (86%) and American programs most commonly requiring an anatomy atlas (84%). Summative and formative methods of evaluation were used by most programs (96%), final written examinations (79%) and ongoing in-course evaluation (81%) being most popular. The results serve to document the current state of preclinical MSK anatomy education within nationally accredited allopathic medical programs and to illustrate the wide variability of the learning environment. Future research should be directed at establishing consistent standards for preclinical MSK anatomy education and investigating the long-term effects on knowledge retention and clinical confidence.</p>","PeriodicalId":50687,"journal":{"name":"Clinical Anatomy","volume":"38 5","pages":"568-575"},"PeriodicalIF":2.3,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ca.24282","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144031284","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pulmonalis or Pulmonaris? It's Elementarius, My Dear Watson.","authors":"Paul E Neumann, Mélanie Houle, Stephen Russell, Lewis Stiles","doi":"10.1002/ca.24284","DOIUrl":"https://doi.org/10.1002/ca.24284","url":null,"abstract":"<p><p>The adjectival suffix -alis and its allomorph -aris are very common in the anatomical nomenclature; however, rules governing differential usage, such as -aris substituting for -alis following an -l-, leave many exceptions. Here, we report an empirical study of 985 adjectives with -alis and -aris suffixes used in Terminologia Anatomica (2nd ed.) and Terminologia Histologica to develop phonological rules that would have fewer exceptions. As a general rule, the default is -alis, but -aris after -l-, except with -r- between. This tripartite rule reduces the exceptions to < 10%, but this can be reduced to < 6% by limiting the distance over which the dissimilation effect of an -l- in the base is expected to operate. After consideration of precedents in classical, late, and medieval Latin, and derivatives in modern Romance and Germanic languages, we recommend the use of pulmonarius, elementarius, unitarius, pulparis, and lumbaris, and compound adjectives created from these words, in place of related adjectival forms that were previously used in anatomical Latin.</p>","PeriodicalId":50687,"journal":{"name":"Clinical Anatomy","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144046471","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Roles of Artificial Intelligence in Teaching Anatomy: A Systematic Review","authors":"Tanisha S. Joseph,&nbsp;Shelleen Gowrie,&nbsp;Michael J. Montalbano,&nbsp;Stephan Bandelow,&nbsp;Mark Clunes,&nbsp;Aaron S. Dumont,&nbsp;Joe Iwanaga,&nbsp;R. Shane Tubbs,&nbsp;Marios Loukas","doi":"10.1002/ca.24272","DOIUrl":"10.1002/ca.24272","url":null,"abstract":"<p>Anatomy education is a cornerstone of medical training and relies on cadaveric dissection and 2D illustrations. Technological advancements and integrated curricula have reduced the focus on detailed anatomy and challenged educators to engage Generation Z learners with interactive, tech-driven methods. Advanced imaging and artificial intelligence (AI) offer a solution, providing virtual dissection simulations and personalized learning tools that mimic 3D anatomy and adapt to individual student needs. Machine learning, a subset of AI, enhances this process by enabling predictive analytics, adaptive feedback, and tailored learning pathways based on performance data, significantly improving anatomical comprehension. Despite its benefits, AI integration raises concerns about over-reliance on technology, biases, and diminished human interaction in training. This review examines AI's transformative potential in anatomy education while emphasizing the need for balanced implementation and ethical oversight. A systematic review following PRISMA guidelines was conducted, utilizing PubMed and backward citation searches. The search yielded 56 studies, with 47 additional articles from citations, resulting in 61 included studies. These explored AI applications such as virtual dissection simulations, machine learning algorithms for adaptive feedback, and gamified learning experiences, which were shown to enhance engagement, personalize learning, and improve anatomical understanding. Concerns about over-reliance on AI and the loss of human interaction were also raised. AI has the potential to enhance anatomy education, but careful consideration of ethical and practical implications is essential. A balanced approach combining traditional methods with AI and robust oversight is crucial for effective integration.</p>","PeriodicalId":50687,"journal":{"name":"Clinical Anatomy","volume":"38 5","pages":"552-567"},"PeriodicalIF":2.3,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ca.24272","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143992879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}