Cross Sectional Anatomy of the Pelvis and Perineum –A Dissection Approach to Increase Anatomical Knowledge

Abstract

The complexity of both female & male pelvic cavities and perineum is evident in the complex spatial organization of structure and function, vascular supply, innervations, and internal organs1. Given the limited dissection time, a large portion of learning has been focused on learning pelvis and perineum from prosections, hemisections, models, and resources made publicly available. Currently also, many dissection manuals detail methods that do not guarantee successful visualization of the entire pelvic cavity and perineum. Moreover, we recognize the shift towards multi‐modal teaching such as the use of interactive virtual dissections and 3‐D models visualization in anatomical education2. However, we attempt to retain the classical approach to clinical anatomy with the use of gross dissection and to maximize the experience of a first‐year medical student by relying on donors’ bodies. We suggest that a cross‐sectional modified dissection approach of the pelvic cavity and perineum would reveal anatomical landmarks, tissues, musculature, vasculature, and innervations to the same detail captured from radiological imaging and thus increase student knowledge of cross‐sectional anatomy.We created a modified dissection protocol of the pelvic cavity using a cross‐sectional anatomy approach. We used a 2‐man crosscut saw to separate the pelvic cavity from the trunk and lower limbs into cross‐sectional slices. A cross‐section above the bifurcation of the abdominal aorta highlighted structures of internal and external iliac vasculature, pelvic musculature, and sacral innervations matched to CT‐scans at the exact plane of orientation. A cross‐section below the anterior superior iliac spine (ASIS) highlighted the urogenital and anal triangle, reproductive organs, and pelvic cavity musculatures matched to MRIs at the same plane of orientation.There is promising educational advantage for first year medical students to utilizing a cross‐sectional dissection approach in conjunction with imaging to visualize spatial complexity of the pelvic cavity. This practical approach allows medical students to develop fluency in spatial organization when dissecting and to map structures on relevant imaging commonly encountered in clinical practice including CT, MRIs, and ultrasound. Though there are no publications of a similar pelvic cavity and perineum dissection approach, we anticipate a growing trend towards cross‐sectional anatomy as a teaching model for radiological imaging3. We aim to complete multiple dissections with this dissection protocol using a specialized bandsaw and to propose the integration of cross‐sectional prosections into the clinical anatomy curriculum.1Hunter, L. D. and McHugh, K.M. A Novel Approach to Dissection of the Pelvis and Perineum for Professional Students. The Federation of American Societies for Experimental Biology (FASEB) Journal. 2018.2Boscolo‐Berto, R., Tortorella, C., Porzionato, A. et al. The additional role of virtual to traditional dissection in teaching anatomy: a randomised controlled trial. Surg Radiol Anat 43, 2021.3McLachlan J. C. New path for teaching anatomy: living anatomy and medical imaging vs. dissection. Anatomical Record—Part B: New Anatomist. 2004.