Knowledge Of Anatomy Research Articles

A Comparative Analysis of Physical Therapy Anatomical Knowledge and Retention: Human Donor Dissection Versus Virtual Laboratory.

Despite a long history of using human donor dissection (HDD) for physical therapy (PT) anatomy education, there are no PT guidelines that require HDD. The purpose of this quantitative causal-comparative study was to determine if Doctor of Physical Therapy students who used HDD had different grades both within anatomy and within courses that require retention and application of anatomical knowledge (kinesiology and a foundational musculoskeletal course) compared with those who used virtual 3-dimensional anatomical software (VAS). Numerous factors affect the decision to use HDD within PT anatomy, and few PT studies have compared the effectiveness of VAS to HDD. All students who took anatomy in an entry-level PT program from 2018 to 2021 (232 total students, 115 who used HDD in 2018-2019 and 117 who used VAS in 2020-2021). Mann-Whitney tests were used to compare anatomy grades (course, written examination, and practical examination) and future grades in kinesiology and a foundational musculoskeletal course for students who used HDD or VAS. Physical therapy students who used VAS had statistically significant higher anatomy course grades (VAS 93.81% ± 4.99% to HDD 92.20% ± 4.53%) and higher practical examination grades (VAS 97.43% ± 2.91% to HDD 93.55% ± 4.39%) compared with those who used HDD. However, there were no significant differences between groups on written anatomy examinations (VAS 89.42% ± 7.21% to HDD 90.40% ± 4.94%), kinesiology grades (VAS 91.86% ± 4.52% to HDD 92.80% ± 4.27%), or foundational musculoskeletal grades (VAS 89.50% ± 3.89% to HDD 89.77% ± 3.83%). The causal-comparative study design prevents concluding that PT student grade differences were due exclusively to either anatomy laboratory method. It does provide preliminary evidence that the PT anatomy laboratory method did not practically affect anatomy performance or long-term application of anatomy knowledge in future coursework.

Fibre orientation atlas guided rapid segmentation of white matter tracts.

Fibre tract delineation from diffusion magnetic resonance imaging (MRI) is a valuable clinical tool for neurosurgical planning and navigation, as well as in research neuroimaging pipelines. Several popular methods are used for this task, each with different strengths and weaknesses making them more or less suited to different contexts. For neurosurgical imaging, priorities include ease of use, computational efficiency, robustness to pathology and ability to generalise to new tracts of interest. Many existing methods use streamline tractography, which may require expert neuroimaging operators for setting parameters and delineating anatomical regions of interest, or suffer from as a lack of generalisability to clinical scans involving deforming tumours and other pathologies. More recently, data-driven approaches including deep-learning segmentation models and streamline clustering methods have improved reproducibility and automation, although they can require large amounts of training data and/or computationally intensive image processing at the point of application. We describe an atlas-based direct tract mapping technique called 'tractfinder', utilising tract-specific location and orientation priors. Our aim was to develop a clinically practical method avoiding streamline tractography at the point of application while utilising prior anatomical knowledge derived from only 10-20 training samples. Requiring few training samples allows emphasis to be placed on producing high quality, neuro-anatomically accurate training data, and enables rapid adaptation to new tracts of interest. Avoiding streamline tractography at the point of application reduces computational time, false positives and vulnerabilities to pathology such as tumour deformations or oedema. Carefully filtered training streamlines and track orientation distribution mapping are used to construct tract specific orientation and spatial probability atlases in standard space. Atlases are then transformed to target subject space using affine registration and compared with the subject's voxel-wise fibre orientation distribution data using a mathematical measure of distribution overlap, resulting in a map of the tract's likely spatial distribution. This work includes extensive performance evaluation and comparison with benchmark techniques, including streamline tractography and the deep-learning method TractSeg, in two publicly available healthy diffusion MRI datasets (from TractoInferno and the Human Connectome Project) in addition to a clinical dataset comprising paediatric and adult brain tumour scans. Tract segmentation results display high agreement with established techniques while requiring less than 3 min on average when applied to a new subject. Results also display higher robustness than compared methods when faced with clinical scans featuring brain tumours and resections. As well as describing and evaluating a novel proposed tract delineation technique, this work continues the discussion on the challenges surrounding the white matter segmentation task, including issues of anatomical definitions and the use of quantitative segmentation comparison metrics.

Comparative evaluation of the Clearing technique and Cone-Beam Computed Tomography (CBCT) in assessing the root canal morphology of Mandibular First Premolars in the Bengali Population: An in-vitro study

Complete knowledge of the root canal anatomy is of prime importance for a successful endodontic treatment. Amongst the permanent teeth, the mandibular first premolar poses a challenge to the clinician due to its morphologic variations. The present study aimed to evaluate the root canal morphology of the mandibular first premolars according to Vertucci’s classification using clearing and cone beam computed tomography (CBCT) techniques. Material and Methods 100 mandibular first premolars extracted due to orthodontic purposes were scanned using CBCT. Following this the teeth samples were accessed, debrided with 5.25% sodium hypochlorite, decalcified using 5% nitric acid, and then dehydrated with increasing concentrations of isopropyl alcohol. Finally, the tooth samples were cleared with methyl salicylate solution and injected with methylene blue dye to allow canal visualization. Data obtained was analyzed by the weighted Kappa(κ) coefficient at a 5% significance level. Results Vertucci’s Type I followed by Type V had the highest prevalent rates according to both techniques. Seven samples were found that could not be classified under Vertucci’s system. 84% of the cases were classified similarly by both techniques(κ=0.82). Conclusions CBCT showed an almost perfect agreement with that of the clearing technique and can be a viable diagnostic modality to diagnose canal morphology. Key Words Clearing, Cone-beam computed tomography, Premolars, Root canal morphology

Updated cranial and mandibular description of the Late Cretaceous (Maastrichtian) baenid turtle Saxochelys gilberti based on micro-computed tomography scans and new information on the holotype-shell association

Saxochelys gilberti is a baenid turtle from the Late Cretaceous Hell Creek Formation of the United States of America known from cranial, shell, and other postcranial material. Baenid turtles are taxonomically diverse and common fossil elements within Late Cretaceous through Eocene faunas. Detailed anatomical knowledge is critical to understanding the systematics and morphological evolution of the group. This is particularly important as baenids represent an important group of continental vertebrates that survived the mass extinction event associated with the Cretaceous/Paleogene boundary. High-resolution micro-computed tomography scanning of the holotype skull reveals additional anatomical details for the already well-known Saxochelys gilberti. This includes the revision of some anatomical statements from the original description, but also detailed knowledge on internal anatomical features of the braincase and the description of a well-preserved axis (cervical vertebra 2). Our new detailed description and previous work on the shell and postcrania make Saxochelys one of the best-described, nearly complete baenid turtles, which are often only known from either isolated shell or cranial material. A revised phylogenetic analysis confirms the position of Saxochelys gilberti as a derived baenid (Eubaeninae) more closely related to Baena arenosa than to Eubaena cephalica.

A rare clinical case of a labyrinthine lesion: an endolymphatic sac tumor

Endolymphatic sac tumors are rare neoplasms originating from the endolymphatic epithelium of the intraosseous part of the endolymphatic duct and sac, typically characterized by slow growth and local destructive changes. We present a case of an endolymphatic sac tumor in a 28-year-old man who consulted an otoneurologist with complaints of progressive hearing loss and dizziness attacks and was referred for a CT scan of the temporal bones and MRI of the inner ear with delayed contrast enhancement. The data of otoneurological and radiological examinations before and after surgical treatment and the results of surgical treatment with histological verification of the tumor are presented. The objective of this case presentation is to demonstrate the usefulness of CT and MRI methods in detecting an endolymphatic sac tumor, to compare the results of otoneurological and radiological examinations and intraoperative and histological data followed by surgery. Radiological examination revealed a neoplasm of the right temporal bone with typical imaging characteristics of endolymphatic sac tumor. Surgery was performed, the mass was removed completely, and the endolymphatic sac tumor was histologically verified. Radiologic presentation includes a typically located area of bone destruction in the petrous part of the temporal bone in the area of the vestibular aqueduct, possibly with the spread of the tumor into the cerebellopontine angle, with a heterogeneous structure, with uneven contrast enhancement. Due to the rarity of this pathology, diagnosis in the early stages is often difficult, and for the correct interpretation of radiologic findings in patients with hearing loss and dizziness, knowledge of the normal anatomy of the temporal bone and awareness of rare variants of its lesions are of key importance. Timely examination of patients with suspected temporal bone lesions and correct diagnosis are the key to successful treatment and maintaining the quality of life in this group of patients.

Surgical repair of congenital aural atresia

Despite the ease, efficacy, predictability, and widespread availability of osseointegrated bone conduction hearing devices, surgical repair of congenital aural atresia (CAA) remains a viable and rewarding operation for patients, parents, and surgeons. Careful selection of patients using appropriate audiometry, detailed radiographic interpretation, and assessment of family understanding and child cooperability are the first steps toward a successful outcome. Intimate knowledge of outer, middle, and inner ear anatomy – both in the normally and abnormally developed ear - coupled with meticulous technique at each stage of the operation can yield outstanding hearing results with a clean, skin-lined, dry, patent ear canal. This chapter reviews the preoperative evaluation and steps of the atresia repair operation, including postoperative management, and provides both predictive and published data on hearing outcomes.

Airway label prediction in video bronchoscopy: capturing temporal dependencies utilizing anatomical knowledge.

Navigation guidance is a key requirement for a multitude of lung interventions using video bronchoscopy. State-of-the-art solutions focus on lung biopsies using electromagnetic tracking and intraoperative image registration w.r.t. preoperative CT scans for guidance. The requirement of patient-specific CT scans hampers the utilization of navigation guidance for other applications such as intensive care units. This paper addresses bronchoscope tracking by solely incorporating video data. In contrast to state-of-the-art approaches, we entirely omit the use of electromagnetic tracking and patient-specific CT scans to avoid changes in clinical workflows and additional hardware requirements in intensive care units. Guidance is enabled by means of topological bronchoscope localization w.r.t. a generic airway model. Particularly, we take maximally advantage of anatomical constraints of airway trees being sequentially traversed. This is realized by incorporating sequences of CNN-based airway likelihoods into a hidden Markov model. Our approach is evaluated based on multiple experiments inside a lung phantom model. With the consideration of temporal context and use of anatomical knowledge for regularization, we are able to improve the accuracy up to to 0.98 compared to 0.81 (weighted F1: 0.98 compared to 0.81) for a classification based on individual frames. We combine CNN-based single image classification of airway segments with anatomical constraints and temporal HMM-based inference for the first time. Our approach shows first promising results in vision-based guidance for bronchoscopy interventions in the absence of electromagnetic tracking and patient-specific CT scans.

CO-RELATION OF SUSHRUTOKTA NADI YANTRA AND MODERN SURGICAL INSTRUMENT: AN ANATOMICAL PERSPECTIVE

Ayurveda is the oldest medical system, and anatomy is one of the oldest modalities of the medical system. An-cient Indian scientists explored essential knowledge of practical anatomy. Neither in Sushruta nor in charak is there any indication of animal dissection; they perched about human dissection only, and the yantra used in it are also specially designed for human dissection only, which are now adapted by modern with different names. Dissection is the first milestone in the journey of being a doctor. Sushruta, the great sage surgeon, philosopher and teacher of ancient India, is renowned worldwide for his contribution to surgery. His conception of surgical instruments, description of quality, methods of manufacture and usage are unique, as there were no earlier com-prehensive descriptions of similar surgical instruments by any surgeon in India and the world. Sushruta was the first surgeon in the world to describe different types of surgical instruments, including endoscopes.

The anatomical variations of median nerve in Shiraz, Iran.

The origin and distribution of median nerve varies among the different individuals. The median nerve variations in axillary region were reported by many authors previously. Understanding of these variations is especially necessary for clinicians to prevent iatrogenic nerve damage. The current work aimed to evaluate the possible anatomical variations of median nerve in the axillary region in a sample of the Iranian cadavers (Shiraz, Fars). We dissected 26 upper limbs from 13 male cadavers to investigate the different variations of median and musculocutaneous nerves according to Venieratos and Anagnostopoulou classification. In 23.07% of specimens (n=6), the medial root united with 2 lateral roots and formed the median nerve proximal to the coracobrachialis muscle. In one case, a communicating branch separated from the musculocutaneous nerve distal to the coracobrachialis and connected to the median nerve in upper arm. Our results suggest that there are anatomical variations of the median nerve in terms of its origin and its communication with the musculocutaneous nerve in the population of southern Iran. The anatomical knowledge of the median nerve variations is important for clinicians to improve patient health outcome. Theses variations of the median nerve should be considered during surgical procedures of the axillary region and nerve block of the infra clavicular part of the brachial plexus.

Living and post-mortem CT scans in the gross anatomy lab: A study investigating differences in first-year medical students' exam performance and perceptions.

Basic competency in radiological imaging is essential for physicians to identify and manage diseases. An optimal place in which to include imaging in the medical curriculum is during anatomy as students can correlate the 3D anatomy from their body donors with the 2D cross-sectional anatomy. The goal of this project was to enhance first-year medical students' knowledge of cross-sectional imaging in the gross anatomy lab and to investigate whether there are benefits to learning cross sectional imaging via scans from body donors versus living individuals. Student participant performance was evaluated on laboratory practical examinations, CT image questions and spatial anatomical knowledge in the thorax and abdomen sections of gross anatomy. Students learned the cross-sectional imaging during dissections where they accessed the images relevant to their study on Pacsbin, a web-based Digital Imaging and Communication in Medicine viewer, via iPads. Results showed no statistically significant differences in practical examination scores, spatial anatomical knowledge, or identification of anatomical structures on CT image questions between participants who learned from images on body donors versus living individuals. In a questionnaire given at the end of the course, participants cited that the CT images improved their anatomical and imaging knowledge and that they felt better prepared to use imaging software and interpret diagnostic imaging results upon entering clerkships. While there were no differences in academic performance between the groups, positive outcomes regarding student perceptions of anatomical and imaging knowledge and preparedness for use of imaging software were identified in this study.

Learning functional human anatomy with a new interactive three-dimensional digital tool.

Human anatomy requires understanding spatial relationships among anatomical structures and is often perceived as difficult to learn by students. To overcome this concern, several digital tools exist with some strengths and limitations among which the lack of interactivity especially for complex functional anatomy learning. In this way, a new interactive three-dimensional tool called Antepulsio was designed. Antepulsio was assessed by comparing three groups of first year kinesiology students to test whether it is likely to favor functional anatomy learning during three training sessions spread over a week. The experiment was conducted during a real academic course. Laterality judgment, 3D spatial abilities and working memory abilities from all participants were previously collected to create three homogeneous groups: the active group (n = 17, 17.76 ± 0.56 years) interacted with Antepulsio, the passive group (n = 18, 17.89 ± 0.83 years) watched videos of Antepulsio while the control group (n = 15, 18.07 ± 0.80 years) performed a neutral activity unrelated to anatomy. Anatomy knowledge was also assessed during pretest, posttest, and retention test (8 weeks after the posttest). The most significant outcome of this study revealed that in case of better working visual memory, the active group outperformed the passive group between pretest and retention test (p < 0.01). In other words, Antepulsio tool is efficient only for students with high visuospatial working memory. These selective benefits of Antepulsio are discussed in terms of cognitive load, training duration and the necessary period of familiarization with the tool.

Advancements in epidural anesthesia for small animals: a comprehensive literature review

Epidural anesthesia is a loco-regional blocking technique used to prevent and control pain in pathological processes and surgical procedures, widely used in veterinary medicine. The present work aims at performing a detailed literature review, preferably of the last twenty years, on the various aspects of this technique, including anatomy of the epidural space and peculiarities in small animals, pharmacology and toxicology of the main local anesthetics used, methods for identifying the epidural space, as well as recommended doses, indications, contraindications, and complications of the procedure. With the development of this literature review, it was found that the volume, concentration, and mass of local anesthetics, in addition to knowledge of anatomy and pharmacology of local anesthetics, plays a key role in the success of the technique. Moreover, it was noticed that, with the advent of ultrasonography, the identification of the epidural space is more accurate, compared to other methods. It was concluded that epidural anesthesia is a safe procedure, but not free of possible complications and side effects, as well as any anesthetic procedure. Therefore, it is essential to evaluate each case individually, always valuing the welfare of the patient.

Four different models for simulation-based training of bronchoscopic procedures

BackgroundFlexible bronchoscopy procedures require detailed anatomical knowledge and advanced technical skills. Simulation-based training offers a patient-safe training environment that can be more efficient than patient-based training. Physical models are cheaper than virtual reality simulators and allow trainees to be acquainted with the equipment used in the clinic. The choice of a physical model for training depends on the local context. The aim of this study was to compare four different bronchoscopy models for flexible bronchoscopy training.MethodsThe BronchoBoy manikin, the Koken manikin, a human cadaver, and a preserved porcine lung were included in the study. Seven physicians experienced in bronchoscopy performed a bronchoscopic airway inspection, bronchoalveolar lavage (BAL), and tissue sampling on all four models with performance evaluated by observation and participant evaluation of models by questionnaire.ResultsNineteen segments were identified in all human anatomy models, and the only significant difference found was that only the Thiel embedded cadaver allowed all participants to enter RB1 with an instrument in the working channel (p = 0.001). The Thiel embedded cadaver and the BronchoBoy manikin had low fluid return on BAL (22 and 52 ml), whereas the Koken manikin and the preserved porcine lung had high return (132 and 134 ml), (p = 0.017). Tissue samplings were only completed in the preserved porcine lung and the Thiel embedded cadaver (p < 0.001).ConclusionsAn anatomically correct bronchoscopy is best simulated with the Koken manikin or the Thiel embedded cadaver. Bronchoalveolar lavage should be simulated with the Koken manikin or the preserved porcine lung. Tissue sampling procedures are best simulated using the Thiel embedded cadaver or the preserved porcine lung.

Examining the Forearm Intersection through Palpation and Ultrasonography.

Forearm intersection syndrome causes pain, swelling, and a rub at the dorsal distal forearm where the first extensor compartment muscles intersect with the second compartment tendons. Although primary care settings tend to treat mild cases, high-performance athletes may suffer from severe symptoms that require surgery. This proof-of-concept study aims to help detect the anatomical substrate of forearm intersection syndrome using palpation and ultrasonography when available. Five individuals were studied using independent palpation and ultrasonography to identify the first dorsal compartment muscles and the second dorsal compartment tendons. The distances between the dorsal (Lister's) tubercle of the radius and the ulnar and radial edges of the first dorsal compartment muscles were measured to determine the location and extent of the muscle-tendon intersection. The palpatory and ultrasonographic measurements were compared using descriptive statistics and the paired t-test. The mean distances from the dorsal tubercle of the radius to the ulnar and radial borders of the first dorsal compartment muscles were 4.0 cm (SE 0.42) and 7.7 cm (SE 0.56), respectively, based on palpation. By ultrasonography, the corresponding distances were 3.5 cm (SD 1.05, SE 0.47) and 7.0 cm (SD 1.41, SE 0.63). Both methods showed a similar overlap length. However, ultrasonography revealed a shorter distance between the dorsal tubercle of the radius and the ulnar border of the first compartment than palpation (p = 0.0249). Our findings indicate that a basic knowledge of anatomy should help health professionals diagnose forearm intersection syndrome through palpation and, if available, ultrasonography.

Video as an interventional tool for bridging the gap in anatomy knowledge of medical postgraduates

PurposeThe teaching and learning of anatomy has experienced a significant paradigm shift. The present study assessed the level of knowledge in anatomy in medical postgraduate students and explored the impact of interventions in the form of anatomical videos on knowledge obtained. An awareness of the importance of human anatomy for clinical skills was created to ensure a certain level of competence be achieved by the end of the anatomy course.Design/methodology/approachPostgraduate medical students were recruited from various specialties on voluntary basis. The first step was to conduct a preliminary screening exam to determine the level of anatomical knowledge. The students were then divided into two groups at random, one of which received no intervention (the control group), and the other of which watched the videos with content that was pertinent to the practical demonstrations (intervention). To assess the effects of the video intervention, a post-test was administered to all students.FindingsBoth spot tests (SPOTs) and short answer question (SAQ) components for scores of all the regions from the intervention groups were comparable to the scores obtained by the post-test control group, although the findings were not significant (p &gt; 0.05). However, the intervention group from the abdomen (ABD) region did perform significantly better (p &lt; 0.05) than the screening test score.Originality/valueThe results of the research study imply that interventions like anatomical videos can bridge the postgraduate trainee’s anatomy knowledge gap in a practical method which will immensely help in increasing their knowledge.

Availability and issues of 3D-printed skull models for veterinary anatomy laboratories from students' perspective before and during the COVID-19 pandemic.

Three-dimensional (3D)-printed models of bones are a convenient and durable alternative to real bone specimens, and they have been used in anatomy laboratories. It is necessary to identify the precise advantages of 3D-printed models from all perspectives; not only the improvement in students' knowledge of anatomy but also the students' assessment of such models. Here, students of veterinary medicine and animal science evaluated the reproducibility and effectiveness of 3D-printed models as a learning tool by completing our questionnaires, with a focus on their understanding of the skull-morphological differences among dog breeds. With the COVID-19 pandemic having obliged veterinary universities to provide courses online, we also investigated how the pandemic affected the students' evaluation of the 3D-printed models. The questionnaire results revealed that the animal science students were satisfied with the reproducibility of the 3D-printed models, but the veterinary students were not (they preferred to use real specimens). The skull differences were well understood by both types of students, indicating that 3D-printed models are effective for learning about rare skeletal specimens. The veterinary students who experienced the COVID-19 pandemic tended to choose real specimens more often than those who did not have this experience. Our results suggest that the use of 3D-printed models as an introduction and the use of real specimens in anatomy laboratory courses can be adequate for veterinary students. Together our findings suggest ways to improve the educational performance of 3D-printed models for veterinary students who need to understand the anatomy of many species.

Fabrication of Artificial Skin for Robotic Head Based on Silicone Rubber

In this study, artificial skin based on silicone rubber is introduced for a robot head of the same size and shape as an actual person. The artificial skin is described from designing to molding the skin for a robot head, which mimics a young woman’s head. Fabricated skin is different from regular masks because it has to cover the core mechanical systems and move together. Skin movements create emotions on the face and give the appearance of a robot head. The robot has the same expressive and oral capabilities as humans and is integrated with artificial intelligence platforms. The knowledge of head anatomy and the parameters of the operation of the head will be applied in the design and fabrication of core mechanical mechanisms and their covering skin. This study analyses the basic knowledge of skin anatomy as well as the fabricating steps to make artificial skin made of silicone rubber material. The knowledge of skin anatomy is the foundation to study and analyze the general characteristics of human skin such as elasticity, color, elasticity, etc. Manufacturing methods for artificial skin are researched and selected accordingly. Finally, the artificial skin is created to make the robot head’s expression more realistic. Experimental results showed that the robot meets design requirements, has an 89.83% accuracy rate of human identification of robot expressions, and is highly appreciated by users in interactive experiments.

A Virtual Reality Anatomy Model of the Temporal Bone in ORL Residency Training-Gain or Gadget?

Virtual reality (VR) appears to be a promising educational tool for otorhinolaryngology (ORL) residency training, as it allows for safe and effective practice immediate feedback and potential improvements in patient outcomes. Despite these advantages, VR has not yet been incorporated into residency training in ORL, which may be due to limited availability or validation and skepticism toward incorporation of new training methods. This study investigates whether a VR model of the temporal bone improves learning success for ORL residents in comparison to standard plastic models and whether it depends on surgeon's experience. We also included a subjective evaluation of the learning experience with both models. ORL residents and specialists at 2 German university hospitals were tested on their knowledge of temporal bone anatomy after training with either VR or standard plastic models. In addition, we compared knowledge of the temporal bone anatomy before- and after-VR training. Lastly, a subjective survey on the benefits and limitations of VR was conducted to assess participants' views on this new technology. About 85% of the participants considered VR to be better than conventional models and agreed that VR was a useful tool for teaching complex anatomy. Objective evaluation showed significant improvement in knowledge after using VR (before/after comparison), especially in participants with a higher level of preexisting knowledge. Direct comparison to conventional plastic models showed no superiority of the VR model. VR models in ORL are not only appealing and motivating for residents, but also objectively improve their anatomical knowledge, especially in advanced residency. In addition, VR-in contrast to the plastic model-offers opportunities for further development and optimization.

Associations of postural activities and knowledge for voice with breathing issues and voice-physical-disorders among lyric singers

Objectives/HypothesisThe purpose of this research was to study the associations of postural activities and knowledge of the voice of opera singers, recognized in the literature for the specificity of their posture. Additionally, the link between vocal pathologies and body pains on one hand, and posture control on the other hand was investigated. MethodsA questionnaire including 90 questions was distributed to singers in France and overseas during 6 months. Ninety-eight opera singers participated in the survey. Data were analyzed using Excel and Stata software. ResultsThe results showed that the singers who paid more attention to posture, postural work while singing, had knowledge of anatomy and postural role in singing voice, healthy lifestyle and good body habits, had less vocal discomfort and pathologies, a better vocal preservation and used more costo-abdominal breathing. On the other hand, knowledge of postural role and postural work was linked with pain and vocal fatigue. Furthermore, a preventive need was revealed concerning the providing of knowledge and skills to singers, but also to singing teachers, speech therapists and stage workers. ConclusionOur study shows that benefits were found in the voice quality of opera singers with anatomical and postural knowledge and who work on posture as part of their vocal work compared to others. Postural work and knowledge increase attention to body pain and vocal fatigue. These results can inform health care providers, opera singers and their teachers and performers of the benefits of posture on operatic voice quality. Accordingly, this study sparks new ideas for postural work and therapy in lyric voice.

Posterior Fossa Anatomy for Microvascular Decompression Surgery

In most microvascular decompression surgeries, surgical maneuvers are performed within normal anatomical structures without any neoplasms. Thus, detailed anatomical knowledge is essential to perform safe and efficient procedures. "Rule of 3" by Rhoton AL Jr. is helpful for understanding not only the anatomy of the posterior fossa but also the three neurovascular compression syndromes. The cerebellar arteries and posterior fossa veins have substantial variability, but a basic understanding of their typical patterns is useful to explore individual cases. To use adequate surgical approaches through the cerebellar tentorial or petrosal surface in individual trigeminal neuralgia surgeries, anatomical knowledge of the bridging veins on the tentorial(the bridging veins into the tentorial sinus)and petrosal surfaces(the superior petrosal vein)is crucial. Fissure openings help to minimize cerebellar retraction, similarly to the sylvian fissure dissection in supratentorial surgeries.