Clinical Anatomy最新文献

{"title":"Anatomy is the cynosure of medicine","authors":"R. Shane Tubbs","doi":"10.1002/ca.24230","DOIUrl":"10.1002/ca.24230","url":null,"abstract":"<p>Similarly, in 1680, the prominent London physician Edward Tyson (Figure 1) said, “Physick must certainly acknowledge Anatomy its best Cynosure.” With anatomy as the focus of each of our issues, this issue showcases papers on the parotid gland, sympathetic trunk, fibular artery, supraclavicular nerves, carpal tunnel, and the cavernous sinus.</p><p>Cunningham A.1975. The kinds of anatomy. Med Hist 19:1–19.</p><p>Tyson E. 1680. Phocaenea, or the anatomy of a porpess <i>dissected at Gresham College: with a preliminary discourse concerning Anatomy, and a Natural History of Animals</i>. London: B. Tooke.</p>","PeriodicalId":50687,"journal":{"name":"Clinical Anatomy","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ca.24230","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142331694","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":"Trans-obliquus inferior capitis course of the greater occipital nerve: A potential cause of occipital neuralgia?","authors":"Emma R Lesser, Emily M Persons, Marcela Herrera, Anthony Sanchez-Forteza, Silvia M Vergara, Chung Yoh Kim, Juan J Cardona, Keishiro Kikuchi, Yoko Tabira, Aaron S Dumont, Joe Iwanaga, R Shane Tubbs, Rarinthorn Samrid","doi":"10.1002/ca.24226","DOIUrl":"https://doi.org/10.1002/ca.24226","url":null,"abstract":"<p><p>Occipital neuralgia can be due to multiple etiologies. One of these is potential compression of the greater occipital nerve (GON). In this regard, one relationship of the GON, its course through the obliquus inferior capitis muscle (OIC), has yet to be well studied. Therefore, the current anatomical study was performed to elucidate this relationship better. In the prone position, the suboccipital triangle was exposed, and the relationship between the GON and OIC was documented in 72 adult cadavers (144 sides). The GON was found to pierce the OIC on four sides (2.8%), unilaterally in two cadavers and bilaterally in one cadaver. Two cadavers were male, and one was female. Histological samples were taken from GONs with a normal course around the OIC, and nerves were found to pierce the OIC. The GON of all four sides identified histological changes consistent with nerve potential compression (e.g., epineurial and perineurial thickening). This is also the first histological analysis of the trans-OIC course of the GON, demonstrating signs of chronic nerve potential compression. Although uncommon, entrapment of the GON by the OIC may be an underrecognized etiology of occipital neuralgia.</p>","PeriodicalId":50687,"journal":{"name":"Clinical Anatomy","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142331695","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":"A national survey on the use of ultrasound as an educational tool to complement anatomy teaching at UK medical schools.","authors":"Ansh Tandon, Joseph Moneim, Lauren Hector, Peter Fletcher, Ishpal Moonga, Sarah Fawcett, Helen Taylor, Cecilia Brassett","doi":"10.1002/ca.24229","DOIUrl":"https://doi.org/10.1002/ca.24229","url":null,"abstract":"<p><p>Our aim was to investigate the current use of ultrasound (US) in anatomy teaching across the UK, and to discover potential obstacles in its implementation in the undergraduate medical curriculum. An electronic survey consisting of 31 questions was distributed to anatomy course organizers at all 42 UK medical schools from June to October 2022. Both quantitative and qualitative data were obtained. Analysis of quantitative data was performed using frequency tables while responses to open-ended questions were analyzed individually by authors, and themes were extracted for presentation. There was a 100% response rate, with 23 (55%) medical schools using US in anatomy teaching. Of these, 17 (74%) schools taught normal US anatomy only, while 6 (26%) included pathology. Only 3 (13%) schools delivered weekly sessions, while 3 (13%) schools delivered monthly sessions and 17 (74%) held less frequent sessions. Of the 17 schools with hands-on sessions, these were delivered by radiologists in 6 schools, while sessions in other schools were facilitated by sonographers, other clinicians, students, and anatomy department staff. Students were able to operate US machines themselves in all 17 schools delivering hands-on teaching. Limitations in resources and trained staff as well as time constraints were cited as barriers for the introduction of US in anatomy teaching. Our results indicate that only just over half of all UK medical schools use US in anatomy teaching. As US is increasingly used in screening and diagnosis by various clinicians, learning how to use US early in the medical course would be beneficial. Identifying the barriers to introducing US in the anatomical curriculum is the first step towards the successful development of an US teaching programme.</p>","PeriodicalId":50687,"journal":{"name":"Clinical Anatomy","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142331693","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":"3D segmentation and quantitative analysis of age-related changes in the Hoffa fat pad using MRI.","authors":"Amit Benady, Summer Sofer, Roi' Gilad, Liat Tzoran, Ben Efrima, Solomon Dadia, Matias Vidra, Ehud Rath, Eyal Amar","doi":"10.1002/ca.24222","DOIUrl":"https://doi.org/10.1002/ca.24222","url":null,"abstract":"<p><p>The infrapatellar fat pad (IFP), also known as the Hoffa fat pad, is an essential structure in the knee joint with diverse functions and characteristics. Pathological changes in it can lead to anterior knee pain and impingement. The aim of this study was to investigate the relationship between age and Hoffa fat pad volume. A retrospective analysis was conducted on MRI scans of 100 individuals aged 10-80 years with no Hoffa fat pad pathology. The IFP was meticulously segmented on each sagittal and coronal MRI plane and its volume was calculated on the basis of the segmented boundaries. Correlation analysis was used to explore the relationships among age, sex, height, weight, and patella-related variables. Contrary to the hypothesis, there was no significant correlation between age and Hoffa fat pad volume. However, there were strong positive correlations between Hoffa fat pad volume and individuals' height, patellar height, and patellar ligament length. Multivariable linear regression analysis revealed that height, weight, patellar height, and patellar ligament length collectively explained 67% of Hoffa fat pad volume variability. These findings suggest that the Hoffa fat pad adapts to accommodate morphological changes in the knee joint as individuals grow taller. In conclusion, our study examined Hoffa fat pad volume in individuals across the age spectrum, using advanced imaging techniques to reveal the importance of considering height and knee-related variables for assessing Hoffa fat pad volume. This elucidates age-related volume changes and highlights the need for further research to understand its functional implications and interactions within the knee joint, with the aim of improving orthopedic interventions.</p>","PeriodicalId":50687,"journal":{"name":"Clinical Anatomy","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142300078","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":"Comparison of ultrasound assisted and intraoperative diameter measurement in acute appendicitis.","authors":"Y Doruk Bilgili,B Haluk Güvenç","doi":"10.1002/ca.24227","DOIUrl":"https://doi.org/10.1002/ca.24227","url":null,"abstract":"Detailed anamnesis and systematic physical examination are often relevant in the diagnostic routine of acute appendicitis. However, physicians are increasingly motivated to obtain radiological approval. Inherent limitations due to radiologists' experience and the presenting anatomy may result in contradictory outcomes between the described and intraoperative findings. In this study, a comparison of anthropometric measurements of the appendix vermiformis obtained by radiologists and surgeons in children with acute appendicitis is discussed. The external appendiceal diameter in 53 patients who underwent surgery between April 2022 and January 2024 was measured at three different anatomical locations during preoperative ultrasound and intraoperatively with the help of Vernier calipers. Appendectomy materials were classified into negative, acute, and complicated appendicitis subgroups on the basis of histopathological results. The widest median diameter, expressed in millimeters, was analyzed statistically in terms of diagnostic accuracy. Histopathological analysis revealed negative appendectomy in 15.1%, acute appendicitis in 66%, and complicated appendicitis in 18.8% of the patients. The median age at presentation was 11.4 years (4-17.3 years), and 45.3% of the patients were females. The average median appendiceal diameter was 7.8 ± 2.4 mm according to the caliper and 7.9 ± 2.7 mm according to ultrasound (p > 0.05). The evaluation by the caliper revealed a much smaller diameter in 19 patients than did ultrasound. The appendiceal diameter of eight documented negative appendectomy samples was 7 mm or greater. US failed to identify the presence of an appendicolith in 11 cases (20.8%), all of which were disclosed during histopathological evaluation. It is possible to conclude that ultrasound and intraoperative anthropometric measurements correlate according to our study. Diagnostic accuracy, however, which is individually based on ultrasound appendix diameter values greater than 6 mm, is controversial. It is clear that comparison and further reinterpretation of such anthropometric measurements in light of histopathological consequences may help diminish the frequency of negative and perforated appendectomies.","PeriodicalId":50687,"journal":{"name":"Clinical Anatomy","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142263145","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":"Infectious meningitis. Why are the leptomeninges preferentially involved? Electron microscopic insights.","authors":"André P Boezaart,Anna Server,Richard Shane Tubbs,Ana Carrera,Francisco Reina,Miguel A Reina","doi":"10.1002/ca.24228","DOIUrl":"https://doi.org/10.1002/ca.24228","url":null,"abstract":"In infectious meningitis, pathogens preferentially attack the leptomeninges (pia mater and arachnoid) rather than the pachymeninges (dura mater). This study aims to provide ultra-anatomical insights from our extensive collection of electron microscopy images and propose mechanisms, highlighting structures that favor the introduction, adherence, colonization, and proliferation of microorganisms leading to spinal meningitis. Over several years, we analyzed an extensive collection of transmission and scanning electron microscopy images of human spinal meninges captured in our laboratories. Upon examining 378 of those images, we identified potential sites for the iatrogenic or hematogenic introduction and adherence of microorganisms, as well as sites for their colonization and proliferation. These included the outer surface of the spinal dural sac, structures within the epidural space, and the spinal dural sac itself, which comprises compact dura mater with interwoven collagen fibers and tightly bound arachnoid cells. Also, the subdural (extra-arachnoid) compartment, consisting of fragile neurothelial cells prone to rupture under force, formed an acquired spinal subdural space, a new subarachnoid compartment, limited by arachnoid trabeculae, that surrounded the nerve roots and spinal cord and the pia mater. Macrophages, fibroblasts, mast cells, and plasma cells were also observed within the dura mater, arachnoid layer, arachnoid trabeculae, and pia mater. These images illustrate how the characteristics of the meningeal layers could contribute to bacterial adhesion and proliferation at various locations, inducing selective inflammation during (iatrogenic) spinal meningitis. In addition, the images help to explain why magnetic resonance imaging enhancement appears preferentially at specific sites.","PeriodicalId":50687,"journal":{"name":"Clinical Anatomy","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142263143","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":"Enhancing medical anatomy education with the integration of virtual reality into traditional lab settings.","authors":"Andres Neyem, Matías Cadile, Sebastián A Burgos-Martínez, Emilio Farfán Cabello, Oscar Inzunza, Macarena Soto Alvarado, R Shane Tubbs, Nicolás E Ottone","doi":"10.1002/ca.24213","DOIUrl":"https://doi.org/10.1002/ca.24213","url":null,"abstract":"<p><p>In medical education, traditional anatomy labs have relied heavily on the hands-on dissection of cadavers to teach the complex spatial relationships within the human body. However, the advent of virtual reality (VR) technology offers the potential for significantly enhancing this traditional approach by providing immersive, interactive 3D visualizations that can overcome some of the limitations of physical specimens. This study explores the integration of VR into a traditional gross anatomy lab to enrich the learning experience for medical students. Methods included the deployment of a VR application developed to complement the dissection process, featuring detailed 3D models of human anatomy that students could manipulate and explore digitally. Approximately 60 s-year medical students participated in the lab, where they engaged with both traditional dissection and the VR application. Results indicated that the VR integration not only increased engagement and satisfaction but also improved the students' ability to understand anatomical structures and their spatial relationships. Moreover, feedback from students suggested more efficient learning and retention than with traditional methods alone. We conclude that VR technology can significantly enhance medical anatomy education by providing an adjunct to traditional dissection, potentially replacing certain aspects of physical specimens with digital simulations that offer repeatable, detailed exploration without the associated logistical and ethical constraints.</p>","PeriodicalId":50687,"journal":{"name":"Clinical Anatomy","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142156500","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":"Three-dimensional assessment of subchondral arc and hip joint coverage angles in the asymptomatic young adult hip.","authors":"Holly D Aitken, Jessica E Goetz, Wyatt M Sailer, Dominic J L Rivas, Christine L Farnsworth, Vidyadhar V Upasani, Joshua B Holt","doi":"10.1002/ca.24221","DOIUrl":"https://doi.org/10.1002/ca.24221","url":null,"abstract":"<p><p>The primary objective of this study was to develop a custom algorithm to assess three-dimensional (3D) acetabular coverage of the femoral head based on surface models generated from computed tomography (CT) imaging. The secondary objective was to apply this algorithm to asymptomatic young adult hip joints to assess the regional 3D acetabular coverage variability and understand how these novel 3D metrics relate to traditional two-dimensional (2D) radiographic measurements of coverage. The algorithm developed automatically identifies the lateral- and medial-most edges of the acetabular lunate at one-degree intervals around the acetabular rim based on local radius of curvature. The acetabular edges and the center of a best-fit sphere to the femoral head are then used to compute the mean 3D subchondral arc angles and hip joint coverage angles in five acetabular octants. This algorithm was applied to hip models generated from pelvis/hip CT imaging or abdomen/pelvis CT angiograms of 50 patients between 17 and 25 years of age who had no history of congenital or developmental hip pathology, neuromuscular conditions, or bilateral pelvic and/or femoral fractures. Corresponding 2D acetabular coverage measures of lateral center edge angle (LCEA) and acetabular arc angle (AAA) were assessed on the patients' clinical or digitally reconstructed radiographs. The 3D subchondral arc angle in the superior region (58.0 [54.6-64.8] degrees) was significantly higher (p < 0.001) than all other acetabular subregions. The 3D hip joint coverage angle in the superior region (26.2 [20.7-28.5] degrees) was also significantly higher (p < 0.001) than all other acetabular subregions. 3D superior hip joint coverage angle demonstrated the strongest correlation with 2D LCEA (r = 0.649, p < 0.001), while 3D superior-anterior subchondral arc angle demonstrated the strongest correlation with 2D AAA (r = 0.718, p < 0.001). The 3D coverage metrics in the remaining acetabular regions did not strongly correlate with typical 2D radiographic measures. The discrepancy between standard 2D measures of radiographic acetabular coverage and actual 3D coverage identified on advanced imaging indicates potential discord between anatomic coverage and the standard clinical measures of coverage on 2D imaging. As 2D measurement of acetabular coverage is increasingly used to guide surgical decision-making to address acetabular deformities, this work would suggest that 3D measures of acetabular coverage may be important to help discriminate local coverage deficiencies, avoid inconsistencies resulting from differences in radiographic measurement techniques, and provide a better understanding of acetabular coverage in the hip joint, potentially altering surgical planning and guiding surgical technique.</p>","PeriodicalId":50687,"journal":{"name":"Clinical Anatomy","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142156501","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":"“Anatomy: Inferential and interpretational”","authors":"R. Shane Tubbs","doi":"10.1002/ca.24225","DOIUrl":"10.1002/ca.24225","url":null,"abstract":"<p>In this issue of <i>Clinical Anatomy</i>, the clinical anatomist can answer these questions based on a wide array of topics in our field, from education to research.</p><p>Cooke T. 1893. <i>A Plea For Practical Work in Anatomy</i>. London, Longmans &amp; Co.</p>","PeriodicalId":50687,"journal":{"name":"Clinical Anatomy","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ca.24225","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142141679","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":"Post-traumatic cauda equina concussion: Definition and description of the injury mechanism.","authors":"Ziya Asan, Hatice Saray","doi":"10.1002/ca.24214","DOIUrl":"https://doi.org/10.1002/ca.24214","url":null,"abstract":"<p><p>Despite being a prevalent clinical condition, cauda equina concussion has not been thoroughly elucidated in the literature. The aim of this study is to delineate the etiology and pathogenesis of cauda equina concussion and its associated clinical manifestations. Patients exhibiting clinical manifestations indicative of spinal cord injury and transient neurological deficits after spinal trauma were evaluated retrospectively. The pathogenesis was elucidated through correlating clinical presentations with radiological findings. Neurological deficits were categorized into two principal groups, symmetrical and asymmetrical. Non-penetrating fractures were classified to ascertain the relationship between the type of trauma and the ensuing neurological deficits. A cohort of 82 patients was diagnosed with cauda equina concussion. Among these, 58 had experienced vertical trauma resulting from falls, while 24 had encountered axial trauma in vehicular accidents. Stable spinal fractures were identified in 52 patients across multiple levels, whereas single-level fractures were observed in 30. Asymmetrical neurological deficits were detected in 51 (62.19%) patients, with a notably higher incidence among those subjected to vertical trauma (p < 0.014). The mean recovery time was 14.25 ± 15.16 h for sensory deficits and 11.25 ± 13.36 h for motor deficits in those patients. Notably, motor deficits resolved more expeditiously than sensory deficits in all cases presenting with both. Cauda equina concussion emerges as a frequently encountered clinical phenomenon attributable to the impact of high-energy vertical forces. Neurological deficits commonly manifest asymmetrically. The rapid resolution of neurological deficits presents challenges for the diagnostic process.</p>","PeriodicalId":50687,"journal":{"name":"Clinical Anatomy","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142141680","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}