Translational Research in Anatomy最新文献

Healthcare students perceive anatomy as a difficult subject to study, yet there is limited literature to explain why students think that anatomy is difficult to learn. Studies have assessed student opinion of anatomy teaching strategies, but there is no specific research regarding healthcare students' perception of pedagogical frameworks utilised in anatomy curricula. Considering the importance of student experience, the design of anatomy curricula should include the perspectives of students. Universal Design for Learning (UDL) is a framework which aims to optimise learning opportunities. There is no specific research on healthcare students' awareness or perception of UDL in anatomy curricula. A questionnaire was administered to first-year undergraduate medical, dental, occupational therapy (OT) and speech and language therapy (SLT) students studying anatomy. Demographic data and participants’ perception of UDL were gathered. The response rate was 83%. The majority of participants were female (69%) and studied medicine (59%). Ninety-seven percent of participants had not heard of UDL. After a brief explanation of UDL, 91% thought that UDL had been implemented in anatomy laboratory sessions and 52% thought UDL had been implemented in anatomy lectures. Although the majority of participants were not aware of UDL, they identified aspects of UDL in their anatomy curriculum. UDL helps create an inclusive learning experience. The discussion about the design and delivery of anatomy curricula should include the opinions and perspectives of healthcare students.

Background

The anterior and posterior bellies of digastric muscle act to facilitate components of phonation, jaw opening, and hyoid bone stabilization during swallowing. Variations in the digastric muscle within the submental triangle are well-documented in the literature. Ongoing and up-to-date reporting and knowledge of these variations is important from a clinical perspective.

Method

Routine human anatomical dissection of the anterior neck in a male donor revealed bilateral pairs of accessory muscles (n = 4) attached to and within the depth plane of right and left anterior bellies of digastric muscles.

Results

The case presented here is of a bilateral, tripartite digastric muscle variation within the submental triangle of an anatomical donor. Attachments and relationships were noted. Variant digastric muscles were found to be innervated by the nerve to the mylohyoid muscle and supplied by the submental artery, consistent with supply to the anterior belly of the digastric muscle.

Conclusion

The clinical relevance of these additional muscles primarily pertains to radiological evaluation and reconstructive surgical procedures in the submental region, as digastric muscle bellies serve as essential landmarks and potential targets. Describing anatomical variations is crucial for appropriate planning of interventions in this region.

Scoping reviews in forensic odontology and dental anthropometry provide valuable information. Several current studies indicate different three-dimensional (3D) scanning and digital technologies in clinical dentistry. However, there is a paucity of literature on the utilization and performance of 3D scanner technologies in forensic science and/or medico-legal settings. This study undertook a scoping review of the 3D technologies utilized while researching the applied anatomy of the dentition of modern human forensics. The objectives of this study were to identify which 3D technologies are/were used to determine best practices in usage for research of the dentition of humans and to identify the gaps and challenges faced in the utilization of 3D technologies in dental research covering the forensic domains. Twenty-four key phrases were used in this study to search four databases for the period 1973 to 2023. The initial search yielded 6782 articles, which was then reduced to 1043 after removing any duplicate articles. After title and abstract screening, 35 articles were featured, this was further reduced to 24 articles after applying the selection criteria. The results highlighted the following gaps and challenges faced in the utilization of 3D technologies in dental forensic research: the lack of utilization of 3D equipment for forensic application, as no studies were noted to have been conducted within an African context; a disparity between studies in the Northern and Southern hemispheres, with many studies concentrated in the European and Far East regions and a lack of 3D resources in Africa coupled with the lack of specialized personnel trained to utilize the equipment if available optimally. The scanning modality frequently appears is the 3D Cone Beam Computed Tomography (3D CBCT). Intraoral scans and 3D scanning of dental casts coupled with 3D Geometric Morphometrics were also noted to have been used.

During a routine dissection of a 99-year-old female cadaver we encountered the presence of bilateral supernumerary muscles in the pectoral region. The muscle originated on the anterior surface of the fourth rib and inserted onto the coracoid process and anterior glenohumeral joint capsule via an aponeurosis and was deduced to be the pectoralis intermedius muscle. The pectoralis minor muscle was found to have originated on ribs 2 to 4 anteriorly and inserted into the coracoid process of the scapuvdla thereby shifting cranially. The pectoralis intermedius muscle has controversial classifications and variable embryological origin theories, thus making it not only a rare muscle to encounter but a difficult one to categorize. The objective of this investigation was to study a rare case of bilateral pectoralis intermedius muscle aberrations and discuss its clinical significance.

Purpose

A real-life experience of the effects of a patulous Eustachian tube (ET) by one of the authors led to a search into this condition. This resulted in the ‘discovery’ of four eponymous anatomical structures related to the ET, the origins of which were not well known. The authors conducted a literature review to provide a historical account of this eponymous quartet as an homage to their contributions to the fields of anatomy and otology.

Methods

Applying ‘patulous Eustachian tube’ as the search criterium yielded a total of 258 articles on PubMed search, and 1930 on Google Scholar on September 19th, 2023. During this process, the search criterium was subsequently narrowed to the names of four physicians who were found to have an eponymous relationship to structures of the Eustachian tube: Ostmann, Rüdinger, Von Tröltsch and Weber-Liel. These researchers were individually investigated with consideration given to different variations in spelling. The findings were tabulated and are narrated in the discussion.

Results

Four eponymous anatomical structures closely related to the ET, being Ostmann fat pad, Rüdinger safety space/canal, Von Tröltsch fascia and Weber-Liel fascia were found. Ostmann fat pad was referenced most frequently. Although easily recognizable on histological slides, it is rarely mentioned in textbooks. Von Tröltsch, more popularly known for his various contributions to otolaryngology, lends his name to the salpingopharyngeal fascia. Weber-Liel is linked to the lateral fascia of the tensor veli palatini muscle. All four researchers were German physicians with a special interest in otology. The work of these individuals is presented as a snapshot of a remarkable time during the latter part of the nineteenth century.

Conclusion

Though the Eustachian tube has been discussed for centuries, four remarkable researchers contributed to the general knowledge of this structure during the nineteenth century. Paul Ostmann's fat pad of the Eustachian tube is the most referenced of the four, with little mention of Nikolaus Rüdinger's safety canal in the literature. Anton Von Tröltsch's salpingopharyngeal fascia and Friedrich Eugen Weber-Liel's fascia found between the medial pterygoid and tensor veli palatini muscles are eponymously linked without clear indication of the origin of these connections being found in the literature. The contribution of these physicians, however, extends beyond their work on the Eustachian tube and includes the creation of tools and the establishment of journals specific to furthering the body of work on otolaryngology. Recognition should be given to the names Ostmann, Rüdinger, Von Tröltsch and Weber-Liel for their accomplishments in increasing the knowledge of structures related to the eustachian tube.

Background

During a routine cadaver dissection, findings led to the recognition of Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome. MRKH is the second most common cause of primary amenorrhea in females. MRKH, also known as Müllerian aplasia, is a rare congenital disorder that is seen in 1 out of 5000 karyotypic females (46,XX). Patients with MRKH present with agenesis/aplasia of the uterus and the upper two thirds of the vagina. There are two different subtypes of MRKH. In Type I, only uterovaginal agenesis is seen. However, patients with MRKH Type II have uterovaginal agenesis including the absence of one or both fallopian tubes and ovaries, along with abnormalities of the kidney or skeleton. A subgroup of MRKH Type II is termed MURCS (Müllerian duct aplasia, renal aplasia, and cervicothoracic somite dysplasia) because of the severity of malformations seen in multiple extragenital organs including the kidney and skeleton. A patient with Type II is the rarest of the two subtypes occurring in 28–44 % of MRKH patients when compared to the occurrence of Type I, 56–72 %.

Methods/results

Routine dissection of embalmed 63-year-old Caucasian female cadaver and inspection of various anatomical systems revealed this donor had MRKH type II with MURCS. Herein, reports the anatomical manifestations of MRKH type II with MURCS.

Conclusion

Mayer-Rokitansky-Küster-Hauser syndrome (MRKH) is a rare congenital disorder that is seen in 1 out of 5000 karyotypic females (46, XX). Patients with MRKH present with agenesis/aplasia of the uterus and the upper two thirds of the vagina. The discovery of MRKH in this cadaver was found upon routine dissection. Such findings provide insight into the anatomical implications and organ compensation that can occur over time with this pathology.

Background

This review aims to explore the role of the alveolar antral artery and to contribute a combined data set pertaining to the artery's prevalence, diameter, and proximity of related structures.

Methods

A comprehensive literature review. Five databases were searched, namely: Web of Science, Scopus, MEDLINE-PubMed, EMBASE, CINHAL-Ultimate in September 2023. Collected and analyzed data included the prevalence and diameter of the alveolar antral artery, the diameter of the artery divided into groups of less than 1 mm, 1–2 mm, and more than 2 mm, and the distance between the artery and the alveolar ridge. The AQUA-tool was utilized to assess the quality of each study. The data was extracted and organized into comparison tables.

Results

50 articles met the inclusion criteria. The studies reported differences between genders regarding the included criteria. The review identified inconsistent nomenclature used to describe the alveolar antral artery, potentially leading to confusion or misinterpretation among researchers and clinicians. The literature discusses a variety of scenarios regarding the artery in surgical operations, including techniques for managing and preserving it.

Discussion

The literature highlights the importance of standardizing anatomical nomenclature for anastomosis and emphasizes the necessity for developing clinical guidelines in the management of the artery.

Background

The Gantzer muscle is an anatomical variant muscle that functions in flexion of the volar forearm. The prevalence and laterality of this muscle has been studied more recently in the literature. This study aimed to determine the prevalence and size of this muscle and tendon.

Methods

This was an observational study done from September 2021 to January 2022 at the University of North Texas Health Science Center in Fort Worth, Texas. Cadaveric dissection was conducted in the Department of Physiology and Anatomy. 50 pairs for a total of 100 forearms were dissected bilaterally in cadavers comprising 17 females (34 %) and 33 males (66 %) to identify the Gantzer muscle. The mean age at death was 68.8 years of age (range 40–91 years). When present, the dimensions of each Gantzer tendon were measured in millimeters using digital calipers. As a study of cadaveric specimens, this study was exempt from Institutional Review Board (IRB) approval.

Results

The Gantzer muscle was present in 62 of the 100 forearms (62 %). All 62 Gantzer muscles originated from flexor digitorum superficialis (FDS) (100 %). Of the 62 Gantzer muscles, 42 inserted distally into flexor pollicus longus (FPL) (72.5 %), while the remaining 17 muscles inserted distally into flexor digitorum profundus (FDP) (27.5 %). The tendons inserting into FDP had an average length of 65.495 mm, while those inserting into FPL had an average length of 16.353 mm (p = 0.002). The Gantzer muscle was present in 24 of the 33 male specimens (72.7 %) and 13 of the 17 female specimens (76.4 %). Of the 62 Gantzer muscles, 50 were present bilaterally (80.6 %), and there was no significant difference in bilateral occurrence between sexes (p = 0.189).

Conclusions

Our results suggest that the Gantzer muscle may be of sufficient size and present commonly enough in the general population to be considered as an alternative graft source for certain upper extremity reconstruction procedures in place of, or in addition to, palmaris longus, extensor toe tendons, and other commonly used tendon grafts. In this study, when palmaris longus was absent in a specimen, a Gantzer muscle was likely present, and may provide surgeons an alternative tendon graft source in the upper extremity without requiring additional incisions in the lower extremity for alternative tendon graft sources. Further biomechanical testing of the Gantzer tendon with comparisons to other common tendon graft sources is warranted.

In this study, complete Sacral Spina Bifida Occulta (SSBO) and Lumbosacral Transitional Vertebrae (LSTV) with their various subtypes based on the Castellvi classification were appraised in a South African population sample. Adult human skeletons representing the three largest South African population groups, namely South African African, South African of Mixed Ancestry; South African of European descent; both biological sexes; and age range between 21 and 90 years at death were evaluated for both spinal anomalies.

The number of preselected skeletons (n = 1798) from the largest collection in Africa of modern human skeletons (N = 2630) provided a strong representative South African sample. The observational study looked at lumbar and sacral vertebrae in each skeleton and any anomalous features were captured in an Excel spreadsheet.

Complete SSBO with no LSTV was observed in eight subjects (8/1798; 0.44 %), while incomplete SSBO was observed in one subject (1/1798; 0.06 %), and one individual (1/1798; 0.06 %) exhibiting complete SSBO with LSTV (Type IIIB, Castellvi classification). No significant differences were observed when comparing the prevalence of the LSTV with SSBO in the male and female groups of the different population affinity groups. The number of individuals with SSBO was found in more South African Africans than in the other population groups with no significant difference between groups.

This research revealed the simultaneous presence of two morphological anomalies (SSBO and LSTV) at the same vertebral segment that could result in low back pain. Variant morphology awareness is crucial for clinicians across all modalities to prevent misdiagnosis, leading to better treatment plans, and avoiding injury.