Clinical Anatomy最新文献

Effective anatomy education is critical for preparing medical students for clinical tasks such as surgical planning and radiological interpretation. Traditional chalkboard teaching and modern 3D printed models offer distinct approaches, yet their comparative pedagogical impact remains underexplored. This study evaluates chalkboard, 3D printed model, and hybrid teaching methods to optimize anatomy learning for clinical applications like coronary artery mapping and neurosurgery planning. A quasi-experimental study involved 120 undergraduate medical students randomly assigned to three groups (n = 40 each) for a 15-week intervention: chalkboard (lectures with 2D diagrams), 3D printed models (hands-on learning with patient-specific models, e.g., 3D printed heart for angioplasty), and hybrid (integrating both, model-first sequence). Outcomes were assessed via a 20-item anatomy quiz (skeletal, cardiovascular, neuroanatomy, muscular domains), a 30-item pre- and post-activity questionnaire (5-point Likert scale, knowledge, engagement, clarity), qualitative interviews (n = 28, hybrid group), and the Pedagogical Visualization Index (PVI). Data were analyzed using ANOVA, paired t-tests, and thematic analysis. The hybrid group outperforms others, with superior knowledge gain (81.8%, p < 0.001), engagement (4.4 ± 0.4), clarity (4.6 ± 0.3), and PVI (0.830) compared to 3D models (PVI: 0.720) and chalkboard (PVI: 0.543), excelling in cardiovascular (84%, e.g., coronary artery mapping) and neuroanatomy (85%, e.g., cranial nerve localization). Model-first sequencing enhances outcomes (PVI: 0.86, p = 0.03). Qualitative themes (78%) emphasize visualization for clinical reasoning (e.g., femoral artery mapping for vascular surgery). Additionally, the hybrid method demonstrates versatility across specialties, with students achieving high clarity (4.7 ± 0.2) in neurosurgery (e.g., optic nerve tracing for aneurysm clipping), precision (88%) in radiology (e.g., lung segmentation for pulmonary embolism), and engagement (4.6 ± 0.2) in orthopedics (e.g., ACL reconstruction), supported by tactile feedback from 3D models like the knee and congenital heart models for pediatric surgery (clarity 4.9 ± 0.1). The hybrid method, leveraging 3D printed models, optimizes anatomy learning for clinical tasks, supporting adoption in resource-limited curricula. Future research should validate findings with larger cohorts and objective clinical assessments.

Paxton, a British surgeon, is best known for his influential anatomical textbook An Introduction to the Study of Human Anatomy (1831, 1844). Admitted as a Member of the Royal College of Surgeons in 1810 and later awarded an M.D. from the University of St Andrews in 1845, Paxton began his career as an army surgeon before establishing successful practices in Long Buckley, Oxford, and later Rugby. He also served as assistant-surgeon to the Oxfordshire militia. A skilled educator and writer, Paxton published several well-received medical works, including The Medical Friend (1843) and Living Streams (1855), and edited William Paley's Natural Theology. Known for combining anatomical precision with clear illustration and moral insight, Paxton was regarded as both a devoted physician and a man of deep religious conviction. He died at Ledwell House, Oxfordshire, in 1860 (Dictionary of National Biography 1895).

I believe both James Paxton and Matthew Baillie would have been avid readers of Clinical Anatomy. This first issue of 2026 contains interesting articles, including historical, educational, and original papers with relevance to the clinical anatomist. As always, we welcome comments from our readers on how to improve our Journal.

The greater omentum is a thin sheet-like abdominal organ sandwiched between the anterior abdominal wall and the intestines. It possesses adipose deposits, an epiploic vascular system, arcade-like vascular loops, and a significant number of omental milky spots, the name given to the immune/lymphatic cell clusters residing in its tissues. Observational and experimental evidence confirms that the omentum moves toward inflamed abdominal organs and surgical sites and invades via vascular and fibrous tissues, in order to isolate the area and launch an immune response. Correlated to this, direct evidence of omental growth in response to inflammatory chemokine stimuli has also been established. Further, it has been demonstrated that the metabolic activity of the milky spots, when engaged in such a response, increases 10-20 fold, along with increases in the number and size of the spots. A mechanism of chemotaxis has yet to be identified, but it is clear that the omentum is an important immunological organ that responds to inflammation and infection in the abdomen, both cellularly and physically. We propose that the blood vessels of the omentum act as a multi-pronged hydrostat system, engorging themselves and their capillaries with blood, responding to an inflammatory trigger like inflated fire hoses, and extending the organ across the abdomen. Thus, the omentum represents an unique mobile immune system that we believe warrants further focus in anatomical, clinical, immunological, and biomechanical research.

The use of human donor bodies for anatomical examination in the United Kingdom is regulated by the Human Tissue Authority (England, Wales, and Northern Ireland) and His Majesty's Inspector of Anatomy for Scotland. This study aimed to assess the variability of information provided to body donors and the associated consent forms across UK anatomy institutions. A total of 24 consent forms and information booklets were collected from all body donation programs across the UK. Building on previous research, each document was assessed against a checklist covering general information about the donation process, purposes and locations of body use, consent requirements, disposition of remains, and accessibility. The analysis revealed significant heterogeneity in the information provided. The findings suggest a need for standardization of body donation information and consent forms to ensure they meet ethical requirements for informed consent and to improve accessibility and inclusivity. Recommendations include ensuring consistency between information provided and consent forms, requiring confirmation of reading the information, standardizing age limits and medical condition statements, providing clear information for next of kin, and ensuring ethical oversight by institutional committees. Further research is needed on donors' perspectives regarding specific aspects of the donation process. These recommendations are proposed to provide a more consistent approach to sharing information about body donation, ultimately suggesting the development of a single, collaboratively produced form and information pack to minimize customization (and thus omissions).

Fractal geometry describes complex, self-similar patterns that repeat across spatial scales and is increasingly recognized as relevant in anatomical research. Indeed, the fractal organization is consistently observed in respiratory, cardiovascular, gastrointestinal, nervous, renal, hepatic, and dermatological systems. A comprehensive literature search was conducted on PubMed, Scopus, and Web of Science (1977 to March 2025) identifying peer-reviewed original articles, reviews, and conference proceedings addressing the fractal organization of human organs at macrostructural or microstructural levels, with structural–functional relationships and/or clinical applications. Studies were excluded if they lacked direct translational relevance to humans, were not peer-reviewed, or did not utilize explicit fractal methodology. Key findings highlight that bronchial tree fractal dimension (FD) correlates with airflow limitation in chronic obstructive pulmonary disease, while in the vascular system, retinal metrics reflect systemic microvascular health. Moreover, the fractal modeling of hepatic and renal hemodynamic models supports system-level interpretation. In the nervous system, cortical gyrification and neuronal dendritic FD are associated with cognitive capacity and disease progression. Gastrointestinal mucosal FD decreases in inflammatory and neoplastic conditions. Advances in multiscale imaging (e.g., micro-CT, MRI) and computational methods enable both in vivo and ex vivo assessment, although methodological heterogeneity remains a limiting factor. Overall, fractal analysis provides a quantitative and reproducible descriptor of anatomical complexity with demonstrated associations to functional performance and disease severity. Standardization of methodology, development of normative datasets, and validation in large prospective cohorts are essential for routine clinical practice.

Opinions on the meaning of the term fascia appear to have been diverging for the past quarter century. In 1998, the definition of fascia in the international standard anatomical nomenclature was narrowed by removing the term fascia superficialis. On the other hand, fascia researchers, who continue to widely accept the term superficial fascia, have progressively broadened their definition of fascia and proposed that fasciae constitute an anatomical system, the fascial system. Here we examine competing concepts from an anatomical perspective with the goal of finding a position that could lead to a consensus among anatomists, other biomedical scientists and health practitioners with an interest in fascia. We endorse a return to the traditional view that fasciae are fibrous membranes that compartmentalize and connect parts of the body, that they are primarily composed of sheets or sheaths of dense irregular connective tissue, and that they are not parts of well-defined organs. They are prominent components of the integument, musculature, lining of the body cavities, and extraperitoneal spaces. The proposal that fibrous membranous components of the skeleton and nervous system are also fasciae merits further study and discussion.

The scalene muscles represent a crucial muscle group in cervical anatomy, with significant clinical and functional implications. Despite their importance, studies on their embryonic and fetal development remain scarce. This study examined the morphogenesis of the scalene muscles bilaterally in 33 developing human specimens [66 sides from 12 embryos (Weeks 6-8) and 21 fetuses (Weeks 9-13)] using serial histological sections and conventional light microscopy. The scalene blastema appeared during Week 6 of development, comprising myoblasts, mesenchymal cells, and collagen fibers, and was surrounded by fibroblast-like cells and collagen fibers. The ventral rami of spinal nerves forming the brachial plexus, along with the subclavian artery, divided this blastema into two components: a medial portion (scalenus anterior muscle primordium), pierced by the phrenic nerve, and a lateral portion (scalenus medius muscle primordium), pierced by the dorsal scapular nerve and the branches forming the long thoracic nerve. The scalene triangle, through which these neurovascular elements pass, formed between the scalenus anterior and medius primordia. The scalenus minimus muscle was identified in 7 of 66 sides (10.6%). Our findings suggest that the scalene blastema originates from both hypaxial myotomes and sclerotomes of the cervical somites. The developmental relationship between the scalene blastema and adjacent neurovascular structures may help explain anatomical variations in this region with clinical significance. Furthermore, the insertion of the scalenus anterior muscle into the parietal pleura via the suprapleural membrane primordium provides new insight into its functional role in respiratory mechanics.

The buccomandibular space is a potential space located within the oral and maxillofacial regions. This morphological study aimed to provide a detailed anatomical description and ultrasonographic examination of the buccomandibular space and its adjacent structures, to discuss its clinical significance-particularly in relation to pathological conditions such as the spread of odontogenic infections, complications associated with antiaging injectables, and tumor invasion-and to offer valuable insights into the understanding and management of lower face treatment and rejuvenation. Anatomical dissection was performed on 28 facial halves, including 10 from five embalmed and 18 from nine fresh-frozen Korean adult cadavers. An ultrasonographic study was conducted on 12 facial halves of six healthy Korean adult participants. In addition, targeted intraoral polycaprolactone filler injection into the buccomandibular space was performed on two fresh-frozen hemifaces to simulate the expansion of the potential space, followed by ultrasonographic validation and intraoral dissection to confirm the filler-occupied area. The buccomandibular space was bounded by six anatomical boundaries. Ultrasonographic examination at three reference points in the lower third of the face identified adjacent muscular and vascular structures. This study presented various methods for clarifying the boundaries and adjacent structures of the buccomandibular space. The detailed anatomical insights gained in our study can enhance the understanding of the buccomandibular space, including its clinical relevance and anatomical relationships with adjacent structures. These findings may also improve the interpretation of ultrasonographic imaging for healthcare professionals and students in both clinical and educational settings.

Before the Civil War, there was little scientific research and no federally funded scientific research in America. William Hammond, a US Army surgeon, organized a small group of young Philadelphia-based physicians and established the Philadelphia Biological Society while on sick leave in December 1857. It was a short-lived society that promoted self-funded biomedical research. Hammond, after his appointment as Surgeon-General during the Civil War, realized that by utilizing his new top-down authority and military funding, he could conduct scientific research and envisioned producing an all-inclusive Medical and Surgical History of the War of the Rebellion. On May 21, 1862, Hammond ordered Union Army doctors to diligently collect and forward to him "all specimens of morbid anatomy, surgical or medical, which may be regarded as valuable … in the study of military medicine or surgery." The Army Medical Museum was established on August 1, 1862, to receive these materials. In addition to the officers in charge, the Museum required a small technical staff with highly specialized skills. A German immigrant anatomy technician who had been working at the University of Pennsylvania, Frederick Schafhirt, was hired as a "bone cleaner" on July 24, 1862. Soon, his sons Adolph and Ernest were working with him. Of the little that has been written about these colorful individuals, much is historically incorrect. This paper documents their lives and work at the Museum. Frederick Schafhirt was almost certainly the first federally funded research employee, and the Army Medical Museum represents the beginning of federally funded research in America.

At the 42nd Annual Meeting of the American Association of Clinical Anatomists (AACA) in Bellevue, Washington, June 2025, two inaugural events—the Clinical Anatomy Fireside Chat (CAFC) and the Clinical Anatomy Symposium: Head and Neck 2025 (CAS)—fostered rich dialogue on the evolving role and operational definition of clinical anatomy. Experts from various clinical and anatomical disciplines explored the meaning of clinical anatomy, highlighting the absence of a universal definition despite its frequent use in education and research. Through these interdisciplinary discussions, a consensus emerged: clinical anatomy is not defined solely by the possession of clinical credentials but by the integration of anatomical knowledge and clinical relevance, achieved most effectively through collaboration. Clinical anatomy education and research require different depths of clinical knowledge depending on the audience and objective, and meaningful collaboration can bridge gaps in expertise. The symposium further illustrated that high-quality clinical anatomy emerges from mutual respect and reciprocal insight between clinicians and anatomists. This article presents a consensus statement developed by AACA representatives and invited speakers, affirming that collaboration is not only foundational to the practice of clinical anatomy but also fundamental to its definition. These conclusions aim to guide future educational models, research strategies, and interdisciplinary partnerships in the field of clinical anatomy.