Knowledge Of Anatomy Research Articles

The Transcranial Approach for Parasellar Meningiomas

Patients with parasellar meningiomas often initially present with visual impairment. Understanding the surrounding anatomy is essential when preparing for surgery of parasellar meningiomas, as this region includes various crucial neurovascular structures. Historically, invasive craniotomy, such as the orthozygomatic approach or zygotomy, has often been attempted to access the region; however, the use of these invasive approaches has become less common, because of the accumulation of anatomical knowledge, as well as the development of surgical techniques and devices, including the endonasal endoscopic approach. Herein, we summarize how we perform surgery for parasellar meningiomas, and outline tips and pitfalls that could be useful for young residents and trainees who are new to the skull base field.

The importance of individualized and multiple landmarks for the identification of facial nerve trunk: a narrative review

The identification of the facial nerve trunk(FNT) is an important step in surgical procedures involving the parotid gland and adjacent structures to minimize the risk of inadvertent nerve damage which leads to facial muscle paralysis. Despite the availability of various anatomic landmarks such as the tragal pointer, posterior belly of digastric muscle, tympanomastoid suture, digastric branch of facial nerve and styloid process, no single landmark is perfect, with variations observed between individuals. Therefore, a comprehensive knowledge of facial nerve anatomy is essential for FNT identification. In this review, we tried to introduce clinically meaningful methods for the localization of facial nerve trunk. The preference of landmark could be changed by the major of the surgeon or the location of the tumor of the patients. Understanding the characteristics and drawbacks of the landmarks and choosing multiple landmarks that were convenient for surgeon would be necessary.

CONSIDERATIONS ON EMBRYOLOGY, ANATOMY AND CLASSIFICATION OF INGUINAL HERNIAS IN CHILDREN

Appropriate surgical treatment of inguinal hernia in children requires an extensive review of the embryological developmental and anatomical aspects of the inguinal canal and hernial sac. The given paper represents a broad survey of data from the literature, predominantly from recent years, and incorporates information on the knowledge of anatomy, embryology and classification of inguinal hernias, which have direct clinical implication in surgery for hernia, hydrocele and undescended testis in children.

Rapid volcanic ash entombment reveals the 3D anatomy of Cambrian trilobites.

Knowledge of Cambrian animal anatomy is limited by preservational processes that result in compaction, size bias, and incompleteness. We documented pristine three-dimensional (3D) anatomy of trilobites fossilized through rapid ash burial from a pyroclastic flow entering a shallow marine environment. Cambrian ellipsocephaloid trilobites from Morocco are articulated and undistorted, revealing exquisite details of the appendages and digestive system. Previously unknown anatomy includes a soft-tissue labrum attached to the hypostome, a slit-like mouth, and distinctive cephalic feeding appendages. Our findings resolve controversy over whether the trilobite hypostome is the labrum or incorporates it and establish crown-group euarthropod homologies in trilobites. This occurrence of moldic fossils with 3D soft parts highlights volcanic ash deposits in marine settings as an underexplored source for exceptionally preserved organisms.

The importance of anatomical knowledge and execution technique for optimizing strength training results: opinion article

Strength training is essential for maintaining and optimizing health and is an effective non-pharmacological resource in the treatment of various comorbidities. The repercussions revolve around the promotion of motivated adaptations due to the planning and structuring of the training program through the manipulation of variables such as intensity, volume, selection and order of exercises, weekly frequency, cadence, and amplitude. These include the manipulation of variables such as intensity, volume, exercise selection and order, recovery interval, weekly frequency, cadence, and amplitude. This study aims to discuss the importance of anatomical knowledge and the use of an appropriate execution technique, which must be applied in strength exercises. However, what can be observed in practice is a lack of methodology, as well as an undefined movement standard of exercises, which is based on the premise of improving body composition. In this context, the study points to the need for a more robust discussion on the movement standard and the application of an adequate execution technique in three exercises commonly prescribed in physical training programs. Implementing a proper execution technique based on origin, muscle and joint insertion and actions could optimize strength, hypertrophy, and weight loss results. And, since improving these components is related to a reduction in comorbidities, there is a need for studies that discuss the role of movement execution in greater depth. Thus, further research could evoke a debate on the feasibility of incorporating execution technique as the eighth variable in muscle strength training. Keywords: Physical exercise; physical training; body composition.

La rizotomía parcial sensitiva en la neuralgia del trigémino recurrente. Nuestra experiencia y revisión de la literatura

Background and objectiveTrigeminal neuralgia (NT) is a common pathology in neurosurgery. It can be classified as idiopathic or secondary to other pathologies, such as multiple sclerosis (MS). Several surgical treatments have been described, some of them being replaced by more modern techniques. Partial sensory rhizotomy (PSR), described by Dandy, is a technique replaced by other techniques due to its permanent side effects. We present our experience with this technique in patients with recurrent NT. Methods and materialsA retrospective review is carried out on five patients who underwent surgery at our center from 2018 to 2023 using the PSR technique. ResultsAll the patients intervened showed significant clinical improvement, except one patient who required reintervention due to uncontrolled pain. According to the Barrow Neurological Institute (BNI) scale, 80% (4/5) of patients showed improvement from gradeV to gradesI/II except for one of them. This patient suffered from MS. Additionally, one patient presented a corneal ulcer after surgery due to impairment of the corneal reflex. ConclusionIn our experience, PSR is a valid treatment option in selected patients with recurrent TN. It has a low incidence of complications with an adequate surgical technique and anatomical knowledge of the region. To the best of our knowledge, we are one of the few centers in Spain to publish our results with PSR in the last ten years. In our study, we report good results in pain control withdrawing medication in 80% (4/5) of the operated patients.

A Morphometric Study of the Femoral Nerve in the Thigh Region of the Malaysian Cadavers

Introduction: The femoral nerve is one of the vital nerves of the thigh region, which has importance in various fields of clinical areas, as well as in the field of Anatomy and the research areas. Femoral nerve blockade plays an important role in surgical interventions of the anterior thigh. Although the femoral nerve is superficial and easier to identify, a profound knowledge regarding the dimensions of the nerve is inevitable to perform successful surgeries and blockades. Objective: The describing study was an attempt to analyze the different dimensions of the femoral nerve in the thigh region of the Malaysian cadavers with relevant clinical implications, as there is a paucity of these studies involving Malaysian cadavers has been reported. Methods: This study had been conducted with the involvement of 78 adult lower limb specimens (cadaveric and disarticulated) of both genders and different ethnicity. Result: The average length of the femoral nerve from the inguinal ligament (IL) till its division and the width at the IL resembled the previous studies conducted on other geographical locations. The width at the division was similar to that of the IL level. The thickness at the IL was 1.32 ± 0.21 (right) and 1.29 ± 0.17 (left); and at the division was 1.50 ± 0.196 (right) and 1.43 ± 0.16 (left). The circumference of the nerve at the IL was 25.44 ± 1.26 (right) and 25.98 ± 0.89 (left); and that at the division was 25.65 ± 1.32 (right) and 25.66 ± 1.25 (left). Conclusion: The knowledge of the morphometric anatomy of the femoral nerve in the thigh region will not only assist neurologists and future researchers but also facilitate clinicians to prevent misdiagnoses and iatrogenic neurological damage.

Anatomical Variants of the Renal Veins and Their Relationship with Morphofunctional Alterations of the Kidney: A Systematic Review and Meta-Analysis of Prevalence.

Background: Variations in renal veins are quite common, and most people do not experience issues due to them. However, these variations are important for healthcare professionals, especially in surgical procedures and imaging studies, as precise knowledge of vascular anatomy is essential to avoid complications during medical interventions. The purpose of this study was to expose the frequency of anatomical variations in the renal vein (RV) and detail their relationship with the retroperitoneal and renal regions. Methods: A systematic search was conducted in the Medline, Scopus, Web of Science, Google Scholar, CINAHL, and LILACS databases from their inception until January 2024. Two authors independently carried out the search, study selection, and data extraction and assessed methodological quality using a quality assurance tool for anatomical studies (AQUA). Ultimately, consolidated prevalence was estimated using a random effects model. Results: In total, 91 studies meeting the eligibility criteria were identified. This study included 91 investigations with a total of 46,664 subjects; the meta-analysis encompassed 64 studies. The overall prevalence of multiple renal veins was 5%, with a confidence interval (CI) of 4% to 5%. The prevalence of the renal vein trajectory was 5%, with a CI of 4% to 5%. The prevalence of renal vein branching was 3%, with a CI of 0% to 6%. Lastly, the prevalence of unusual renal vein origin was 2%, with a CI of 1% to 4%. Conclusions: The analysis of these variants is crucial for both surgical clinical management and the treatment of patients with renal transplant and hemodialysis.

Newly revealed anatomy of the bucinator muscle: An anatomical and histological study

BackgroundCurrent anatomical knowledge of the origin of the bucinator muscle (BM), i.e., long thin attachments on the maxilla and mandible and the pterygomandibular raphe (PMR), is not supported by anatomical dissection of this muscle. The aim of this study was therefore to investigate the detailed morphology of the BM and associated structures and to discuss its function. MethodsThe anatomy of the BM and related structures was investigated in 15 cadaveric heads using a surgical microscope and histological analysis. ResultsThe inferior fibers of the BM originated from a small retromolar area (internal oblique line), which shared a common tendon with the deep tendon of the temporalis. The superior fibers of the BM originated from the maxillary tuberosity. The middle fibers originated the pterygoid hamulus. No PMR was identified in any of the specimens, but the border between the BM and superior pharyngeal constrictor muscle (SC) was clear because the muscle fibers followed different directions. Some horizontal fibers were continuous between the BM and SC. ConclusionsOur results suggest the need to revise established accounts of the origins of the bucinator (the maxillary tuberosity, conjoint tendon of the temporalis, and pterygoid hamulus without a pterygomandibular raphe. It also needs to be noted that some of its fibers merge directly with the SC.

Beyond the Aesthetics: Understanding Risks in Nonsurgical Rhinoplasty

Nonsurgical rhinoplasty (NSR), colloquially referred to as a "liquid nose job," is a procedure that employs injectable fillers to modify the shape and contour of the nose. This procedure is particularly suited to patients presenting with minor imperfections and nasal defects. The procedure typically entails the injection of hyaluronic acid-based fillers, which are preferred due to their reversibility and safety profile. Although rare, dangerous complications are possible, therefore it is important to be aware of the risks associated with performing NSR and how to recognise and manage them. This article examines a number of potential complications associated with the procedure, including minor side effects such as bruising and swelling, as well as more serious risks such as vascular obstruction, skin necrosis and blindness. It is evident that the practitioner's experience and anatomical knowledge are of paramount importance in order to minimise the aforementioned risks. The aim of this review is to delineate the potential hazards associated with NSR. It is imperative that both clinicians and patients are cognizant that NSR is not a risk-free procedure. Dissemination of information may facilitate the implementation of safer practices and superior outcomes in facial aesthetic procedures.

Endoscopic transcavernous approach for functional pituitary adenomas

BackgroundInvasion of the CS is one of the limiting factors for total resection for PitNet tumors with cure rates less than 30%. Extended approaches may be considered in selective and well-studied cases of secreting adenomas.MethodWe describe the key steps of the endoscopic transcavernous approach for functional pituitary adenomas with a video illustration. The surgical anatomy is described along with the advantages and limitations of this approach.ConclusionA detailed knowledge of CS anatomy and familiarity with this surgical approach acquired in the laboratory is essential. Proper instrumentation is critical to decrease the risks of vascular injury.

The effects of a Teddybear Hospital project on prescool childrens' knowledge and medical students' professionalism: a prospective cohort study.

The Teddybear Hospital (TH) Project is an effort to increase children's knowledge and decrease their anxiety. It is also intended to improve medical students' pediatric communication skills. This study evaluated the educational effects on participating preschool children and medical students. Preschool children were offered to bring their stuffed toys to the TH at our tertiary academic medical center. Medical students who had completed the pediatric surgery rotation staffed the TH, performed examinations, and interacted with the children. The children's knowledge of anatomy, medical equipment, and healthy lifestyle, along with their level of anxiety towards hospitalization, was assessed using pre- and post-interventional validated survey tools. Preschool peers who did not participate in the TH served as controls. Participating medical students were tested on professionalism and pediatric surgical knowledge during, and 3 weeks after the intervention, and compared to their non-participating peers. A total of 131 children (63 intervention, 68 control) and 48 medical students (16 intervention, 32 control) participated in the study. Children's state anxiety decreased by 0.98 points (95% Confidence Interval [CI] -0.3 to -1.8, P<0.001), while knowledge increased significantly on "healthy lifestyle" by 1.4 points (95% CI 1.01 to 1.79, P<0.05), on "medical equipment" by 4.5 points (95% CI 3.8 to 5.2, P <0.0001), and on "anatomy" by 5.05 points (95% CI 4.73 to 5.73, P<0.01). No changes were detected in any of the outcome measures in the control group. Medical students' objective professionalism increased by 4.2 points (95% CI 1.58 to 6.80, P<0.01) compared to non-participant medical students. The tests did not show an increase in the medical students' pediatric surgical knowledge. Preschool participation in a TH increased knowledge and decreased anxiety regarding hospitalization and medical personnel. It also helped medical students to playfully acquire medical professionalism.

Pulmonary Vein Morphology in Patients Undergoing Catheter Ablation of Atrial Fibrillation.

Variations in the anatomy of pulmonary veins can influence selection of approaches of atrial fibrillation catheter ablation. Therefore, preprocedural evaluation and knowledge of pulmonary veins anatomy is crucial for proper mapping and the successful ablation of atrial fibrillation. The aim of this observational study was to assess CT angiography scans and perform detailed analysis of pulmonary veins morphology in patients scheduled for catheter ablation of atrial fibrillation. CT angiography was performed in 771 individuals (223 females, 548 males, mean age 58.4 ± 10.7years). Pulmonary veins anatomy was evaluated using 3D models. The patterns used for evaluation included typical anatomy with four separate pulmonary veins, a common left ostium, and various types of accessory veins either alone or in combination with common left ostia. An anatomical variant with common left ostium was observed as the most prevalent anatomy (44%). The typical variant was observed in 34.8% of patients. Accessory pulmonary veins were observed predominantly on the right side. The prevalence of anatomical variants did not differ between sexes with the exception of the unclassifiable category U (4.4% vs. 9%, p < 0.05). Our study shows that a considerable number of atypical anatomies is present in patients undergoing AF catheter ablation. This knowledge may influence the choice of instrumentation. The data could be possibly helpful also in development of new ablation techniques.

Different anatomic patterns of the indirect tendon of the rectus femoris

PurposeThe rectus femoris forms the anterior portion of the quadriceps muscle. It has a proximal tendinous complex, which is constituted by a direct tendon, an indirect tendon, and a variable third tendon. Direct and indirect tendons converge into a common tendon. The purposes of this study are to add anatomical knowledge about the proximal tendinous complex and describe anatomical variants of the indirect tendon and, on these basis, categorize different anatomical patterns.MethodIn this study, 48 hemipelvis from bodies donated to the Universitat Autònoma de Barcelona have been dissected to examine the proximal tendinous complex of the rectus femoris.ResultsThe following anatomical variants of the indirect tendon were described: inferior aponeurotic expansion in 23/48 cases (47.9%); superior aponeurotic expansion in 21/48 cases (43.7%); and an unusual origin of the myotendinous junction of the rectus femoris in the free portion of the indirect tendon in 19/48 cases (39.6%). On the basis of the aponeurotic expansions, the following anatomical patterns of the indirect tendon were defined: standard (19/48 cases, 39.6%), superior and inferior complex (15/48 cases, 31.2%), inferior complex (8/48 cases, 16.7%), and superior complex (6/48 cases, 12.5%).ConclusionWe can categorize four different anatomical patterns of the indirect tendon, three of which are complex. We suggest that complex patterns can cause an increased stiffness of the indirect tendon and so be considered non-modifiable risk factors for rectus femoris injuries. Finally, it would be useful to identify complex patterns and perform injury prevention actions through specific physical preparation programs.

Anatomy, Diagnosis, and Clinical Management of Deep Neck Space Infections

Any surgeon providing care to patients with congenital, oncologic, infectious, or traumatic processes impacting the head and neck should have an intimate knowledge of the local anatomy. The complex fascial system in this region results in a series of loosely and tightly bound spaces that can both harbor and/or facilitate the rapid spread of infections through these fascial planes and potential spaces. Deep neck space infections may occur spontaneously from cutaneous, lymphatic, odontogenic, otologic, salivary gland, sinus, and hematogenous sources or develop as the result of surgical/iatrogenic manipulation. These infections are typically polymicrobial, involving a mixture of Gram-positive cocci, Gram-negative rods, and beta-lactam-resistant anaerobes commonly found in the oropharyngeal flora. Other populations, such as immunocompromised or hospitalized patients, are particularly vulnerable to infection by certain opportunistic and antibiotic-resistant pathogens. Understanding the deep neck anatomy is crucial for predicting the spread of infection and guiding treatment strategies. The superficial and deep cervical fascial planes form a series of compartments and spaces including the retropharyngeal, danger, prevertebral, carotid, parapharyngeal, submandibular, sublingual, parotid, masticator, temporal, and infrahyoid spaces. Despite their rarity in the post-antibiotic era, deep neck space infections pose a significant threat as they progress rapidly and can quickly lead to life-threatening complications. Delayed clinical presentation is common due to the compartmentalization by fascial planes, therefore early recognition requires a high index of suspicion, thorough clinical examination, and diagnostic imaging studies, typically contrast-enhanced computed tomography (CECT). Treatment requires a multidisciplinary approach, including advanced airway management, administration of empirical broad-spectrum antibiotics, and surgical drainage when indicated. This review provides a comprehensive overview of deep neck space anatomy and its defining fascial planes, as well as discussions on epidemiology, specific microbiology, clinical presentation, diagnosis, antibiotic selection, and surgical treatment options.

Impact of 3D virtual reality on teaching and learning human anatomy among undergraduate students

Objective: To assess how impact 3D-VR is in improving the retention of human anatomy knowledge among undergraduate students compared to traditional methods. Methodology: This convergence mixed method study was carried out in anatomy department of HBS Medical and Dental College, Islamabad, from February to December 2023. The study was evaluated learning outcomes, specifically knowledge retention score in short-term and long-term, in undergraduate students by 3D-VR vs traditional models. Additionally, it sought to capture experience of students and perspectives by 3D-VR teaching and learning method. Results: The post-test score (indicative of short-term knowledge retention) by 3D-VR in both groups of male and female was significant high than traditional method (p ? 0.001). 3D-VR also achieved significant high follow-up score (indicative of long-term knowledge retention) in both groups compared to traditional method. While the knowledge score in all tests of 3D-VR and traditional method for females was high than males. Post-test score (indicative of short-term knowledge retention) and follow-up score (indicative of long-term knowledge retention) in 3D-VR method of females was significant high than males (p ? 0.001). Conclusion: 3D-VR is effective method for knowledge retention in short-term and long-term in undergraduate students. Undergraduate students demonstrated 3D-VR as a learning method that offers substantial advantages for studying human anatomy versus traditional method.

Virtual sketching-based dental anatomy module improves learners' abilities to use computer-aided design to create dental restorations and prostheses.

Dental anatomy education for dental technology students should be developed in alignment with digital dental laboratory practices. We hypothesized that a virtually assisted sketching-based dental anatomy teaching module could improve students' acquisition of skills essential for digital restoration design. The second-year dental technology curriculum included a novel virtual technology-assisted sketching-based module for dental anatomy education. Pre- and post-course assessments evaluated students' skill sets and knowledge bases. Computer-aided design (CAD) scores were analyzed after one year to assess how the skills students developed through this module impacted their subsequent CAD performance. Participants who undertook the dental sketching-based teaching module demonstrated significantly improved theoretical knowledge of dental anatomy, dental aesthetic perception, and spatial reasoning skills. A partial least squares structural equation model indicated that the positive effects of this module on subsequent CAD performance were indirectly mediated by dental aesthetic perception, spatial reasoning, and practice time. A virtually assisted sketching-based dental anatomy teaching module significantly improved students' acquisition of skills and knowledge and positively mediated dental technology students' CAD performance.

Upper Cervical Spine Injuries — A Secondary Publication

Objectives: Based on anatomical knowledge of the upper cervical spine, it is necessary to be familiar with the classification, diagnosis, and treatment strategies currently used clinically for upper cervical spine injuries. Summary of literature review: Upper cervical spine injuries are major injuries with potentially fatal consequences. The occipitocervical junction, which is composed of several structures, protects the brain and cranial nerves. We need to know the mechanism of each type of damage, and in particular, we must understand the anatomy of the occiput, atlas, and axis, as well as the definitions of landmarks of the positional relationships among all structures. Materials and methods: This study reviewed the latest literature on upper cervical spine injuries. Results: In occipital condyle fractures and atlanto-occipital injuries, we should understand how to evaluate instability and the treatment methods according to each classification. In atlas injuries, it should be evaluated whether the transverse atlantal ligament has been damaged. In axis fractures, it is necessary to understand the surgical method according to the shape of the odontoid fracture. Conclusions: Knowledge of soft tissue and bony structural relationships in the upper cervical spine is required for the diagnosis and treatment plan of upper cervical injuries.

Validation of a deep-learning modular prototype to guide novices to acquire diagnostic ultrasound images from urinary system

ImportanceArtificial intelligence (AI) application in guiding the acquisition of ultrasonography images represents a pioneering field of research. A new developed hybrid deep-learning (DL) algorithm, trained on more than high quality 60.000 curated and labelled reference images (distilled from a set of more than 600.000 abdominal ultrasound images) from La Paz Hospital, can provide real-time prescriptive guidance for novice operators to obtain standard planes images of the target organs. ObjectiveThis study aims to evaluate the capability of novice users to acquire diagnostic-quality abdominal ultrasound images of the urinary system using the deep-learning (DL)-based guiding research prototype provided by GMV. DesignSetting, and Participants: This prospective diagnostic study was conducted within the facilities of an academic hospital. A cohort of 24 technically-oriented volunteers, lacking prior knowledge in anatomy or medicine and without experience in conducting ultrasound examinations, was recruited. After a brief training session focused on various organs, each pair of volunteers performed scans of each other's urinary system, exclusively guided by AI support. These scans were subsequently repeated by experienced sonographers using identical ultrasound equipment but without AI assistance. Four radiologists, each with decades of experience, independently and blindly assessed the quality of each acquisition. ResultsOver 90.6 % of the images scanned by volunteers were identified as valuable clinical picture, using only an AI-based guidance system. This is nearly comparable to the results achieved by experienced radiologists, who attained a 98.6 % success rate. ConclusionsThis deep-learning (DL) prototype enables novices lacking experience in ultrasonography to acquire diagnostic ultrasound images suitable for subsequent expert evaluation. The modular prototype works on a large range of ultrasound device models and vendors. This advancement has the potential to extend the application of ultrasound beyond traditional clinical environments, particularly in situations requiring immediate anatomical and functional interrogation, as well as in resource-limited settings.

Enhancing surgical expertise: 3D anatomy’s role in residency programs

Current virtual reality (VR) technology allows for the creation of instructional video formats that incorporate three-dimensional (3D) stereoscopic footage. Combined with 3D anatomic dissection, any surgical procedure or pathology can be represented virtually to supplement anatomical learning and surgical preoperative planning. The aim of this study was to evaluate the impact of virtual reality anatomical teaching. A prospective case-control study was performed. After a prerequisite anatomical knowledge assessment, participants were randomized in two groups: stereoscopic anatomical teaching program versus classic teaching with anatomical and surgical books of thoracic brachial outlet syndrome, and its related anatomy. Then, students completed a written anatomical test to assess their basic knowledge in vascular anatomy. Pre- and post-test performances were analyzed with independent t-tests for total score assessing basic anatomical knowledge, anatomical relationships and clinical inference. Before performing the teaching, the 20 students included were homogenous in term of total exam mark in abdominal aorta (mean 78,78% vs 76,34%) and carotid artery evaluations (mean 78,57% vs 74,76%). After the course, there statistical differences (p&lt;0,05) between the stereoscopic-3D.video group (n= 10, 90%) and classical-teaching group concerning the total exam mark, descriptive anatomy, anatomical relationships and clinical inference skills. All the students thought this method seemed indispensable to their anatomical training course (100%). The teaching video with 3D stereoscopy seems to be a useful and complementary teaching tool that is approved by the residents themselves. In a future study, it will be necessary to evaluate the contribution of this teaching in the long term.