Clinical Anatomy最新文献

{"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}

{"title":"Topographical Anatomy of the Superficial Peroneal Nerve: A Cadaveric Study on Anatomical Patterns and Clinical Implications.","authors":"Kyu-Lim Lee, Soo-Bin Kim, KyeongSik Yoon, Hee-Jin Kim","doi":"10.1002/ca.24275","DOIUrl":"https://doi.org/10.1002/ca.24275","url":null,"abstract":"<p><p>The notable anatomical variability of the superficial fibular nerve (SFN) affects clinical and surgical procedures that involve it. The aim of this study was to analyze the course and branching patterns of the SFNs relative to bony landmarks to provide foundational data for surgical precision and thereby minimize iatrogenic injuries. Thirty-four embalmed Korean cadavers were dissected. The points at which the SFN (1) pierced through the crural fascia and (2) bifurcated into the medial and intermediate dorsal cutaneous nerves were measured from the lateral malleolus and fibula. The SFN piercing point was located at an average of 89.6 ± 30.8 mm (range: 26.5-153.8 mm) above the lateral malleolus and 14.7 ± 3.6 mm (range: 7.1-21.5 mm) horizontally from the fibula. In 32 specimens, the SFN pierced the fascia and then bifurcated, but in the other two cases it bifurcated before piercing the fascia. The bifurcation point was identified at an average height of 40.8 ± 20.1 mm and a horizontal distance of 25.1 ± 7.5 mm from the fibula. There was significant anatomical variability in the trajectory and branching patterns of the SFN. These findings underscore the importance of precise anatomical knowledge for minimizing complications during foot and ankle surgeries. This study provides a foundation for preoperative planning and clinical application around the SFN.</p>","PeriodicalId":50687,"journal":{"name":"Clinical Anatomy","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055906","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":"Lazarus Sign, a Misnomer to an Anatomical Spinal Reflex.","authors":"Sabrina Costantini, Joe Iwanaga, Trifon Totlis, Nihal Apaydin, Marios Loukas","doi":"10.1002/ca.24279","DOIUrl":"https://doi.org/10.1002/ca.24279","url":null,"abstract":"<p><p>The Lazarus sign is a well-documented spinal reflex observed in brain-dead patients, characterized by involuntary upper limb movements that can resemble voluntary gestures. Initially described during the 1980s, this phenomenon has contributed to ongoing discussions about the physiological basis of spinal reflexes and their role in assessing brain death. The Lazarus sign was once considered a diagnostic challenge, but recent research reports confirm that it originates solely from the spinal cord, independent of brainstem or cortical activity. However, recent studies also suggest that spinal reflexes in brain-dead patients, including the Lazarus sign, can be more variable than previously thought, occurring in multiple limb regions beyond the upper limbs. Prolonged survival in brain-dead patients exhibiting the Lazarus sign has also raised new questions about its physiological significance. Its recognition has helped refine brain death criteria, ensuring accurate diagnoses and minimizing misinterpretations in critical care and organ donation settings. PubMed-indexed studies and backward citations were reviewed. Studies were included if they explicitly described spinal reflexes in brain-dead patients, examined neurophysiological mechanisms, or provided clinical observations on the Lazarus sign. Exclusion criteria included studies focusing solely on brainstem activity without considering spinal reflexes or case reports lacking detailed methodology. These investigations explored the prevalence, neurophysiological mechanisms, and clinical significance of the Lazarus sign. Research highlights its variable presentation, its occurrence in up to 40% of brain-dead patients, and its potential to be misunderstood by families and healthcare providers. The sign does not indicate residual brain function, but it reinforces the need for clear communication in end-of-life care. Future research should focus on standardizing diagnostic protocols, educating clinicians, and addressing ethical concerns. Integrating this knowledge into brain death assessments will enhance clinical decision-making and patient management.</p>","PeriodicalId":50687,"journal":{"name":"Clinical Anatomy","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144057136","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":"Anatomical Basis of the Palatal Injection Technique for Pulpal Anesthesia of Maxillary Teeth.","authors":"Sergey Kabak, Joe Iwanaga, Yuliya Melnichenko, Ruslan Mekhtiev, Nina Savrasova","doi":"10.1002/ca.24277","DOIUrl":"https://doi.org/10.1002/ca.24277","url":null,"abstract":"<p><p>The aim of this study was to assess the effectiveness of palatal injection for managing the pulpal pain of unilateral maxillary teeth from central incisor to second premolar and to establish the anatomical basis for this technique. For this prospective observational study, 62 patients (aged 18-70 years) were included. They had been treated for carious dentine lesions, receiving prosthodontic, endodontic treatment, or extraction of any tooth/teeth in the region from central incisor to second premolar. A total of 100 teeth were treated. Cone-beam computed tomography (CBCT) scans were analyzed preoperatively to identify accessory canals (ACs) (≥ 0.5 mm in diameter) associated with canalis sinuosus (CS). The anesthetic was injected into the area of the target tooth or adjacent tooth next to the palatal openings of the AC(s) into the submucosa of the anterior hard palate. The effectiveness of anesthesia was confirmed by pulp tester readings and a survey using the Verbal descriptor and Likert scales before and during treatment. Pulpal anesthesia was successful in 100% of the treated vital teeth. In all cases, openings of ACs originating from the CS were identified on CBCT scans. Three patients underwent bilateral dental treatment under unilateral anesthesia. The bilateral communications of the CS in the midline of the upper jaw were identified in the CBCT scans of these patients. The authors have established the palatal alveolar foramen injection (PAFI) technique. Injection of an anesthetic solution into the area of the openings of CS on the palate (i.e., palatal alveolar foramina) induces pulpal anesthesia of adjacent target teeth with 100% efficiency. PAFI requires less of the anesthetic solution and is the ideal technique for restorative and prosthodontic treatment involving anterior teeth because it does not cause numbness of the lip and face.</p>","PeriodicalId":50687,"journal":{"name":"Clinical Anatomy","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144023334","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":"Incorporating Clinical Examination Skills Into a Preclinical Anatomy Course: A Method for Facilitating Engagement and Interest","authors":"Aysha Alani,&nbsp;Justin O'Leary,&nbsp;Andrew Stieb,&nbsp;John P. McNamara,&nbsp;Michael F. Nolan","doi":"10.1002/ca.24276","DOIUrl":"10.1002/ca.24276","url":null,"abstract":"<p>Anatomy instruction is enhanced when students are engaged and interested in course material, and the relevance of the subject matter to their academic success and professional careers is emphasized. We developed a learning activity for a pre-clinical anatomy course using the clinical skills of inspection and palpation of a cadaver donor to demonstrate the value of those skills in learning anatomy and to facilitate anatomical understanding in a format similar to that used in clinical practice. Students were instructed to inspect and palpate various anatomical structures and relationships on their donor cadavers to identify features that could help in recognizing potential abnormalities, understanding disease mechanisms, and learning the anatomical bases of certain medical interventions and surgical procedures. Using these techniques, a tumor mass involving the medial end of the clavicle was identified. Student interest was increased, which led to further study and subsequent pathological identification of the tumor as a rare osteochondroma. We found that the addition of inspection and palpation as methods for learning human anatomy in the dissection laboratory, methods not commonly used, facilitated both engagement and interest in a particular area of the subject. Students also developed a respect for their donors, viewing them as their first patients. In light of the diversity in lifestyles, medical conditions, and causes of death within donor populations, we believe the approach described here can contribute greatly to the value of human anatomy courses that use cadaver donors.</p>","PeriodicalId":50687,"journal":{"name":"Clinical Anatomy","volume":"38 7","pages":"791-795"},"PeriodicalIF":2.3,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ca.24276","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143789363","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":"“Anatomy…is a science which has revealed man's body to himself”","authors":"R. Shane Tubbs","doi":"10.1002/ca.24278","DOIUrl":"10.1002/ca.24278","url":null,"abstract":"<p>One hundred thirty years ago, Thomas Armitage (1819–1896) wrote, “The three great branches which man loves to study in himself are his organization, his vital functions, and his moral and intellectual powers.” He specifies, “Anatomy…is a science which has revealed man's body to himself in detail, and therefore always commands his interest” (Armitage <span>1895</span>).</p><p>In this issue of <i>Clinical Anatomy</i>, we offer the reader papers that explore the organization of the human body, including topics such as the tibial collateral ligament and neck of the left atrial appendage. Educational papers include one on practicing dentists' perceptions of what and how dental students are taught gross anatomy. Technical papers that will undoubtedly be of interest include how ChatGPT can be used to create case-based multiple-choice questions for anatomy exams and a systematic review of the roles of Artificial Intelligence in teaching anatomy (Figure 1).</p>","PeriodicalId":50687,"journal":{"name":"Clinical Anatomy","volume":"38 4","pages":"407-408"},"PeriodicalIF":2.3,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ca.24278","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781768","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":"Comparing the Anatomy of the Lateral Femoral Cutaneous Nerve in Patients With and Without Meralgia Paresthetica: A Systematic Review and Meta-Analysis","authors":"Jacob M. Johnson,&nbsp;Simbarashe J. Peresuh,&nbsp;Joseph E. Nassar,&nbsp;Michael Shipp,&nbsp;Joseph A. Gil,&nbsp;Julia A. Katarincic","doi":"10.1002/ca.24273","DOIUrl":"10.1002/ca.24273","url":null,"abstract":"<div>\u0000 \u0000 <p>The anatomical variations of the lateral femoral cutaneous nerve (LFCN) are well documented, with several studies hypothesizing that specific variants may increase the LFCN's susceptibility to meralgia paresthetica (MP). This systematic review and meta-analysis aimed to compare the prevalence of LFCN anatomical variations among limbs with and without MP. It also sought to determine if the LFCN's cross-sectional area (CSA) on ultrasound differed between limbs with and without MP. PubMed, SCOPUS, CINAHL, and Cochrane databases were used to query publications from inception to June 13, 2024. Included studies had a population of living patients, with or without the diagnosis of MP, and reported on the LFCN's exit from the pelvis, branching patterns, distance from the anterior superior iliac spine (ASIS), and/or CSA on ultrasound. Eighteen studies were included, nine retrospective and nine prospective, with a total of 1512 nerves. The LFCN in limbs with MP was closer to the ASIS (<i>p</i> &lt; 0.01) and the MP limbs had a higher percentage of nerves exiting the pelvis lateral to or over the ASIS (<i>p</i> &lt; 0.01) when compared to healthy limbs. The CSA was larger in the nerves affected by MP compared to the unaffected nerves (<i>p</i> &lt; 0.01). The results demonstrate that specific anatomical variations of the LFCN, where the nerve courses in a more lateral or superficial position, may increase its susceptibility to developing MP. The differences in nerve CSA also show the potential utility of ultrasound as a diagnostic adjunct for MP.</p>\u0000 </div>","PeriodicalId":50687,"journal":{"name":"Clinical Anatomy","volume":"38 5","pages":"540-551"},"PeriodicalIF":2.3,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143744299","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 Septal Swell Body: An Anatomic Misnomer","authors":"William E. Bolger,&nbsp;Zachary Upchurch,&nbsp;Maria Manuela Chemas-Velez,&nbsp;Tatyana Khan,&nbsp;Matthew Mobily","doi":"10.1002/ca.24266","DOIUrl":"10.1002/ca.24266","url":null,"abstract":"<div>\u0000 \u0000 <p>Several recent publications describe a “septal swell body” within the nasal cavity. We review the corresponding sinonasal anatomy and revisit early anatomical descriptions to assess whether this designation is an “anatomical misnomer” and if the classic anatomical nomenclature should be preserved. Citations for the septal swell body and synonyms were searched using PubMed and Cochrane Library databases from inception until December 31, 2023. Classic anatomy articles and historical medical textbooks were also reviewed for references to the regional anatomy and nomenclature. Our database search revealed a variety of anatomical terms for the septal or nasal swell body. However, classic historical anatomical texts that predate the introduction of modern database searches used the terms <i>tuberculum septi</i> or septal tubercle. Accurate knowledge of paranasal sinus anatomy is key in surgery. Precise nomenclature, based on official terms and named anatomical entities, makes communication clear, which is essential for surgical training, medical education, and patient care. Changing anatomical nomenclature and terminology if the existing terms are not wrong can lead to confusion, misunderstanding, anatomical jargon, and misnomers. We recommend the use of <i>tuberculum septi</i> or its English translation “septal tubercle” to denote the thickened area of normal anterior septal anatomy described herein. We also underscore a limitation of modern electronic literature searches in anatomical research.</p>\u0000 </div>","PeriodicalId":50687,"journal":{"name":"Clinical Anatomy","volume":"38 5","pages":"532-539"},"PeriodicalIF":2.3,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143722572","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}