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Cold Spring Harbor Perspectives in... Nov 2020Understanding how the four-chambered mammalian heart is formed from a simple, looped tube remains challenging, notwithstanding the descriptive accounts left by... (Review)
Review
Understanding how the four-chambered mammalian heart is formed from a simple, looped tube remains challenging, notwithstanding the descriptive accounts left by generations of cardiac anatomists. Much of the difficulty lies in attempting to visualize an intricate series of morphological transformations through the restrictive lens of two-dimensional images derived from histology. Modern imaging methods offer a way to overcome this limitation by providing comprehensive and high-resolution image sets of the developing heart. We have used one such method, high-resolution episcopic microscopy (HREM), to obtain virtual three-dimensional (3D) models of successive stages in mouse heart development. Taking advantage of the ability afforded by 3D modeling to view each heart in any orientation or erosion plane, we provide an illustrated account of how the mouse heart divides into left and right ventricular chambers, and how each acquires its own distinct outflow vessel.
Topics: Animals; Heart Ventricles; Image Processing, Computer-Assisted; Imaging, Three-Dimensional
PubMed: 31988142
DOI: 10.1101/cshperspect.a037465 -
Cureus Oct 2022Cadaveric dissection is the most important learning tool in anatomy. Although many new modalities are coming up for learning anatomy, cadaveric dissection outstands all... (Review)
Review
Cadaveric dissection is the most important learning tool in anatomy. Although many new modalities are coming up for learning anatomy, cadaveric dissection outstands all of these as it helps students to visualize the human body and remains the most realistic way of learning anatomy. The cadavers are preserved using formalin, a potent disinfectant. Even after embalming in 5-10% formalin, the cadaver might still be infectious while using it in the dissection hall (anatomy department). Numerous bacterial species and infectious pathogens might still be seen despite using fixative agents. Several disease-causing agents may remain viable. Earlier reports suggest that there are cases where students and the working staff got infected by HIV, viral hepatitis, tuberculosis, and prion diseases. The main objective of this study is to determine if bacterial species could be recovered from cadavers that are formalin-fixed. Specific regions in the body such as the axilla, perineum, finger clefts, and oral and nasal cavities were chosen for microbiological examination to detect bacterial species. The presence of skin folds in these regions makes them potential sites for the growth of bacteria. Formalin-fixed cadavers can still act as regions for the growth of viable bacteria that can be pathogenic and affect the health of students and anatomists handling them. Proper care should be taken regarding this because students and anatomists working with these cadavers may get exposed to pathogenic organisms which may become harmful or sometimes life-threatening. Some precautions for proper dissemination of cadavers should be taken to provide a complete, safe, and healthy ambiance in the dissection hall.
PubMed: 36439597
DOI: 10.7759/cureus.30684 -
Animals : An Open Access Journal From... Jul 2019Leonardo da Vinci was one of the most influencing personalities of his time, the perfect representation of the ideal Renaissance man, an expert painter, engineer and... (Review)
Review
Leonardo da Vinci was one of the most influencing personalities of his time, the perfect representation of the ideal Renaissance man, an expert painter, engineer and anatomist. Regarding Leonardo's anatomical drawings, apart from human anatomy, he also depicted some animal species. This comparative study focused only on two species: Bears and horses. He produced some anatomical drawings to illustrate the dissection of "a bear's foot" (Royal Collection Trust), previously described as "the left leg and foot of a bear", but considering some anatomical details, we concluded that they depict the bear's right pelvic limb. This misconception was due to the assumption that the bear's (1st toe) was the largest one, as in humans. We also analyzed a rough sketch (not previously reported), on the same page, and we concluded that it depicts the left (forearm) and (hand) of a dog/wolf. Regarding Leonardo's drawing representing the horse anatomy "The viscera of a horse", the blood vessel arrangement and other anatomical structures are not consistent with the structure of the horse, but are more in accordance with the anatomy of a dog. In addition, other drawings comparing the anatomy of human leg muscles to that of horse pelvic limbs were also discussed in motion.
PubMed: 31295863
DOI: 10.3390/ani9070435 -
Surgical and Radiologic Anatomy : SRA May 2021The coracobrachialis muscle (CRM) originates from the apex of the coracoid process, in common with the short head of the biceps brachii muscle, and from the...
INTRODUCTION
The coracobrachialis muscle (CRM) originates from the apex of the coracoid process, in common with the short head of the biceps brachii muscle, and from the intermuscular septum. It inserts to the medial part of the humerus between the attachment of the medial head of the triceps brachii and the brachial muscle. Both the proximal and distal attachments of the CRM, as well as its relationship with the musculocutaneus nerve, demonstrate morphological variability.
MATERIAL AND METHODS
One hundred and one upper limbs (52 left, and 49 right) fixed in 10% formalin solution were examined.
RESULTS
Three main types, with subtypes, were identified. The most common was Type I (49.5), characterized by a single muscle belly with a classical origin from the coracoid process, medially and posteriorly to the tendon of the biceps brachii. Type II (42.6%), characterized by two heads, was divided into two subtypes (A-B) depending on its origin: Type IIA, where one head originated from the coracoid process posteriorly to the tendon of the biceps brachii and the second head from the short head of the biceps brachii, and Type IIB, in which both heads originated from the coracoid process; however, the superficial head fused with the insertion of a short head of the biceps brachii, while the deep head was directly originating. Finally, Type III (7.9%) was characterized by three heads: two originated from the coracoid process (superficial and deep), and the third from a short head of the biceps brachii. Two types of insertion and two types of musculocutaneous nerve (MCN) relative to CRM could be distinguished.
CONCLUSION
An adapted classification is needed for all clinicians working in this area, as well as for anatomists. The CRM demonstrates morphological variability in both its proximal and distal attachments, as well as the variable course of the MCN relative to the CRM. WHAT IS KNOWN ABOUT THIS SUBJECT "AND" WHAT THIS STUDY ADDS TO EXISTING KNOWLEDGE: Not much is known about the variability of coracobrachialis muscle. The present paper introduces a completely new classification, both clinical and anatomical.
Topics: Aged; Aged, 80 and over; Anatomic Variation; Anatomy, Regional; Cadaver; Coracoid Process; Dissection; Female; Humans; Humerus; Male; Middle Aged; Muscle, Skeletal
PubMed: 33564931
DOI: 10.1007/s00276-021-02700-1 -
Cureus Aug 2022The stomach is a site for various pathological conditions like congestive hypertrophic pyloric stenosis, peptic ulcer, gastroesophageal reflux disease (GERD), and...
The stomach is a site for various pathological conditions like congestive hypertrophic pyloric stenosis, peptic ulcer, gastroesophageal reflux disease (GERD), and carcinoma of the stomach. Further, for the treatment of obesity too, surgical manipulation of the stomach is done by a bariatric surgeon. With the availability of a wide range of diagnostic tools like barium meals, USG, CT scan, MRI, and endoscopy, it is possible to identify the variations in the position and shape of the stomach and developmental defects while diagnosing diseases. As thorough knowledge of stomach position and variations will help in preoperative planning and preventing inadvertent damage during surgeries, this topic was taken up for research. Aims and objectives This study aims to study the variations of the stomach in human cadavers and dead fetuses with regard to its length, shape, capacity, ends, curvatures, and mucosal folding and classify them into various groups. In addition, this study also aims to assess the pattern of growth of the stomach in fetuses. Material and methods The stomachs of 50 adult cadavers and 20 dead fetuses were studied by standard dissection method, concerning their topography, shape, level of the cardiac and pyloric orifice, cardiac angle, length of greater (GC) and lesser curvatures (LC), pyloric sphincter, volume, and mucosal folds. Results The stomach was located in the left hypochondriac quadrant in 78% of the samples and in relation to the 7th costal cartilage in 64%. The two main types of classification established were Type I (variation in position along the vertical axis) in 4% and Type II (variation in position along the transverse axis) in 14%. Type III classification comprised the variations in shape, with a J-shaped stomach in 58%, cylindrical in 20%, crescentic in 14%, and reversed L in 8%. The average length showed significant differences in males, 19±2.48 cm vis-a-vis females, 17.1±2.01 cm. In 66% of the cases, the cardiac orifice was to the left of the midline behind the 7th costal cartilage, and the pyloric orifice was to the right, 1.2 cm to the midline and in the transpyloric plane in 76%. The average GC and LC were 33.6±1.43 cm and 27±5.28 cm, respectively. GC was more significant in males. The average length and diameter of the pyloric canal were about 3.56±0.38 cm & 0.77±0.23 cm, respectively. The thickness of the pyloric sphincter did not show a significant gender difference. The average volume was 289.88±69.15 ml. Rugae were normally spaced in 68%, nearly spaced in 18%, and widely spaced in 6%. The fetal stomach measurements were significantly correlated to gestational age and showed linear growth. Conclusion The study of the morphology of the stomach and its variations are important not only to surgeons and anatomists but also to gastroenterologists. The linear growth of the stomach in embryos helps radiologists and obstetricians to diagnose intrauterine growth retardation (IUGR) and congenital anomalies early.
PubMed: 36185902
DOI: 10.7759/cureus.28517 -
EMBO Molecular Medicine Dec 2022Rudolf Virchow, the founder of cellular pathology, held that even when physical or chemical investigations yield the laws of physiology or medicine, the anatomist can...
Rudolf Virchow, the founder of cellular pathology, held that even when physical or chemical investigations yield the laws of physiology or medicine, the anatomist can still proudly state: This is the structure in which the law becomes manifest. In his words, "physiology presupposes anatomy." Pathological anatomy studies, at usual microstructural scales (approximately 1-100 μm), via light microscopic 2D histology, provided many insights into structure-function relationships of health and disease. For example, such studies established the progression of granulomas, bronchial erosions, microcavities, and destructive lung disease in tuberculosis. While histologic studies remain the cornerstone of such efforts, the advent of nano or micro-X-ray computed tomography (n/μCT) has now made it additionally possible to obtain 3D visualizations of soft and hard tissues, while preserving the tissue for additional investigations. This has applications for old as well as new diseases (Katsamenis et al, 2019; Tanabe & Hirai, 2021).
Topics: Microscopy; Research Design
PubMed: 36321564
DOI: 10.15252/emmm.202216876 -
Advances in Radiation Oncology 2022A radiation anatomist was trained and integrated into clinical practice at a multi-site academic center. The primary objective of this quality improvement study was to...
PURPOSE
A radiation anatomist was trained and integrated into clinical practice at a multi-site academic center. The primary objective of this quality improvement study was to determine whether a radiation anatomist improves the quality of organ-at-risk (OAR) contours, and secondarily to determine the impact on efficiency in the treatment planning process.
METHODS AND MATERIALS
From March to August 2020, all patients undergoing computed tomography-based radiation planning at 2 clinics at Memorial Sloan Kettering Cancer Center were assigned using an "every other" process to either (1) OAR contouring by a radiation anatomist (intervention) or (2) contouring by the treating physician (standard of care). Blinded dosimetrists reported OAR contour quality using a 3-point scoring system based on a common clinical trial protocol deviation scale (1, acceptable; 2, minor deviation; and 3, major deviation). Physicians reported time spent contouring for all cases. Analyses included the Fisher exact test and multivariable ordinal logistic regression.
RESULTS
There were 249 cases with data available for the primary endpoint (66% response rate). The mean OAR quality rating was 1.1 ± 0.4 for the intervention group and 1.4 ± 0.7 for the standard of care group ( < .001), with subset analysis showing a significant difference for gastrointestinal cases (n = 49; <.001). Time from simulation to contour approval was reduced from 3 days (interquartile range [IQR], 1-6 days) in the control group to 2 days (IQR, 1-5 days) in the intervention group ( = .007). Both physicians and dosimetrists self-reported decreased time spent contouring in the intervention group compared with the control group, with a decreases of 8 minutes (17%; < .001) and 5 minutes (50%; = .002), respectively. Qualitative comments most often indicated edits required to bowel contours (n = 14).
CONCLUSIONS
These findings support improvements in both OAR contour quality and workflow efficiency with implementation of a radiation anatomist in routine practice. Findings could also inform development of autosegmentation by identifying disease sites and specific OARs contributing to low clinical efficiency. Future research is needed to determine the potential effect of reduced physician time spent contouring OARs on burnout.
PubMed: 36092987
DOI: 10.1016/j.adro.2022.101009 -
Video-assisted Thoracic Surgery Jun 2023The anatomy of the lung was originally described based on data acquired from cadaveric studies and surgical findings. Over time, computed tomography (CT) and...
The anatomy of the lung was originally described based on data acquired from cadaveric studies and surgical findings. Over time, computed tomography (CT) and three-dimensional (3D) imaging techniques have been developed, allowing for reconstruction and understanding of lung anatomy in a more intuitive way. The wide adoption of 3D-CT imaging technology has led to a variety of anatomical studies performed not only by anatomists but also by surgeons and radiologists. Such studies have led to new or modified classification systems, shed light on lung anatomy from a useful surgical viewpoint, and enabled us to analyze lung anatomy with a focus on particular anatomical features. 3D images also allow for enhanced pre- and intra-operative simulation, improved surgical safety, enhanced educational utility, and the capacity to perform large-scale anatomical studies in shorter time frames. We will review here the key features of 3D-CT imaging of the lung, along with representative anatomical studies regarding (I) general lung anatomy, (II) anatomy of the right and left lobes, and (III) features of interlobar vessels. The current surge of 3D imaging analysis shows that the field is growing, with the technology continuing to improve. Future studies using these new and innovative methodologies will continue to refine our understanding of lung anatomy while enhancing our ability to perform safe and effective surgical resections.
PubMed: 37711275
DOI: 10.21037/vats-23-21 -
Anatomy & Cell Biology Sep 2023This study was conducted to investigate the clinical and anatomical importance of the relevant region from the perspective of surgical approaches by determining the...
This study was conducted to investigate the clinical and anatomical importance of the relevant region from the perspective of surgical approaches by determining the morphometric analysis of the craniocervical junction and foramen magnum (FM) region and determining their distances from important anatomical points. This research was carried out with 59 skulls found at the Anatomy Laboratories of Erciyes and Ankara Medipol University. Metric measurements of FM and condyle, FM shape, condyle-fossa relationship, and pharyngeal tubercle (PT) were made in mm-based dry bone samples of unknown age and sex. The distance between the anterior notches and the FM was 87.01±4.35, the distance between the anterior notches and the PT was 77.70±4.24, the distance between the PT-sphenooccipital junction was 13.23±2.42, and the FM index was 81.86±7.47. The anteroposterior and transverse lengths of FM were determined as 33.80±2.99 and 27.72±2.30, respectively. The morphometric and morphological data available regarding the craniocervical junction showed significant differences between populations. Comprehensive knowledge of this topic will provide a better approach to treat Arnold Chiari Malformation, FM meningiomas, and other posterior cranial fossa lesions. Therefore, we believe that FM and craniocervical junction morphology will be a guide not only for anatomists, but also for radiologists, neurosurgeons, ENT surgeons, and orthopedists.
PubMed: 37460407
DOI: 10.5115/acb.23.006 -
PloS One 2022Anatomy Nights is an international public engagement event created to bring anatomy and anatomists back to public spaces with the goal of increasing the public's...
Anatomy Nights is an international public engagement event created to bring anatomy and anatomists back to public spaces with the goal of increasing the public's understanding of their own anatomy by comparison with non-human tissues. The event consists of a 30-minute mini-lecture on the anatomy of a specific anatomical organ followed by a dissection of animal tissues to demonstrate the same organ anatomy. Before and after the lecture and dissection, participants complete research surveys designed to assess prior knowledge and knowledge gained as a result of participation in the event, respectively. This study reports the results of Anatomy Nights brain events held at four different venues in the UK and USA in 2018 and 2019. Two general questions were asked of the data: 1) Do participant post-event test scores differ from pre-event scores; and 2) Are there differences in participant scores based on location, educational background, and career. We addressed these questions using a combination of generalized linear models (R's glm function; R version 4.1.0 [R Core Team, 2014]) that assumed a binomial distribution and implemented a logit link function, as well as likelihood estimates to compare models. Survey data from 91 participants indicate that scores improve on post-event tests compared to pre-event tests, and these results hold irrespective of location, educational background, and career. In the pre-event tests, participants performed well on naming structures with an English name (frontal lobe and brainstem), and showed signs of improvement on other anatomical names in the post-test. Despite this improvement in knowledge, we found no evidence that participation in Anatomy Nights improved participants' ability to apply this knowledge to neuroanatomical contexts (e.g., stroke).
Topics: Anatomy; Brain; Curriculum; Dissection; Education, Medical, Undergraduate; Educational Measurement; Head; Humans; Students, Medical; Surveys and Questionnaires
PubMed: 35679263
DOI: 10.1371/journal.pone.0267550