Clinical Anatomy最新文献

Anatomy education is fundamental for medical and nursing students. There is a growing shift toward modern tools such as 3D applications, virtual dissection tables, and plastinated cadavers. This mixed-methods study at VinUniversity explored perceptions of these innovations. The quantitative component involved surveys of 142 students (131 medical, 11 nursing), achieving a 77.2% response rate, and the qualitative component included semi-structured interviews with all 12 anatomy faculty and nine students across cohorts, offering diverse insights into their experiences. The findings show that students value interactive tools for enhanced visualization and engagement, particularly the Complete Anatomy app and plastinated cadavers. Nursing students reported greater satisfaction with digital resources than did medical students (4.55 ± 0.69 vs. 4.04 ± 0.77, p = 0.026). Traditional lectures received lower ratings (3.44 ± 1.16 for medical vs. 4.45 ± 0.69 for nursing, p = 0.003). Students also emphasized the value of problem-based discussions (3.83 ± 1.05 for medical vs. 4.36 ± 0.81 for nursing, p = 0.10) and perceived anatomy as highly relevant to future practice (4.32 ± 0.92). Challenges included difficulty in applying digital anatomy to clinical scenarios, software crashes, and limited access. Faculty cited time constraints, insufficient institutional support, and the steep learning curve for integrating new tools. Many relied on self-directed learning, resulting in inconsistent implementation. Also, limited human resources hampered the efficiency of hands-on sessions. To optimize anatomy education, institutions should establish structured faculty training, improve technical infrastructure, and align curricula with innovative methods. A hybrid model combining digital tools with cadaveric dissection could offer the most comprehensive approach. Addressing these barriers can enhance learning outcomes and faculty engagement, especially in resource-limited settings. Future studies should explore long-term effects on student performance, clinical competence, and optimal integration strategies.

Pancreas shape features, derived from 3D segmentation of the pancreas, might be relevant to identifying subtle disease-related changes in the pancreas. This work utilized a retrospective sample of clinical contrast-enhanced CT examinations of 140 children < 18 years of age. Manual segmentations of the pancreas were used to extract radiomic shape features and perform statistical shape modeling using a partial least squares regression approach. Age, weight, height, body surface area, and body mass index each showed significant associations with volume, surface area, surface area to volume ratio, compactness, major axis length, minor axis length, least axis length, and area density. Elastic net regression models showed that demographic variables had strong predictive power (cross-validated r² 0.71-0.89) for pancreas volume, surface area, surface area to volume ratio, major axis length, minor axis length, and least axis length. In the analysis of shape modes, only the first partial least squares regression component accounted for a statistically significant amount of the demographic variance among participants (24.8% variance explained, p < 0.001), with significant loadings for age (p < 0.001), weight (p = 0.001), and height (p < 0.001). Our results are the first to characterize pancreas shape features in children with healthy pancreatic function and set the stage for future studies to understand how disease impacts pancreas shape, beyond global changes in volume, and how changes in shape might be used to diagnose and monitor disease.

Angina, commonly known as chest pain, is the primary symptom of ischemic heart disease and can also present as pain in the neck, shoulder, jaw, arm, or back. Noncardiac chest pain (NCCP) is a common disorder with various causes, marked by recurrent chest pain that mimics ischemic heart pain. While gastroesophageal reflux disease is recognized as the most common cause, the symptoms can also arise from musculoskeletal disorders of the chest wall and upper limbs. Although spinal dysfunction, Tietze syndrome, costochondritis, and slipping ribs have been associated with chest pain, the myofascial etiology of NCCP remains unclear and underdiagnosed. This review explores the structural myofascial continuum (MC) connecting the segments of the upper quadrant, including the neck, chest, and upper limbs. It also highlights the plausible role of the myofascial continuum in NCCP and its associated plethora of symptoms. Although studies have demonstrated myofascial expansions in which the deep fascia connects the various muscles of the upper quadrant, their role remains unclear. Painful symptoms concomitant with musculoskeletal chest pain arise from impairment of the myofascial continuum. Comprehending the intricate myofascial connections between the neck, chest, and upper limbs is crucial for clinicians seeking to improve the evaluation and treatment of NCCP.

In this issue of Clinical Anatomy, many articles go beyond the anatomy of just listing isolated facts and link them to broader biological principles or unifying concepts. Exciting offerings in this issue include the septal swell body, the role of AI in teaching anatomy, and an intriguing article on what we currently know about the body's ligaments.

Cooke T. 1893. A Plea for Practical Work in Anatomy. London: Longmans & Co.

Palmar digital skin, with its high density of epidermal sweat glands and unique stratum corneum, derives its autonomic innervation from peripheral nerves. Understanding the changes to these structures could serve as objective proxy markers following peripheral nerve injury and interventions to promote regeneration. There are limited data in humans for these measures, and normative reference ranges are yet to be defined. Light-based imaging techniques, such as optical coherence tomography (OCT), can detect quantifiable changes in these epidermal parameters. This study aimed to define the normal epidermal thickness and sweat duct density (SDD) of volar hand skin. A total of 53 healthy, non-injured participants, 21 males and 32 females, were enrolled. Two- and three-dimensional images of defined 1 × 1 mm areas of volar fingertip skin were obtained using OCT. The mean epidermal thickness and SDD were manually calculated. Results were compared across all digits and by age and gender. The 95% reference intervals for both parameters were also calculated. There was a significant (p < 0.0001) progressive reduction in epidermal thickness across the digits, from the thumb towards the little finger. Females had a significantly thinner (p = 0.011) epidermal layer in comparison to males. Sweat duct density was significantly lower (p < 0.030) in the thumb compared to the middle, ring, or little fingers. There was a general downward trend in the number of sweat glands per mm² with age (p < 0.0001). The reference interval for epidermal thickness was 0.37-0.79 mm, while for SDD the interval was 30-86 ducts/mm². This study has outlined normative differences in SDD and epidermal thickness in palmar digital skin. Our results can be used as control measures for prospective studies looking into the regenerative process following peripheral nerve injuries or identifying potential trauma to digital nerves.

Latissimus dorsi (LD) tendon transfer is widely used to treat irreparable rotator cuff tears, particularly in cases with posterosuperior and anterosuperior tear patterns. We conducted a comprehensive anatomical analysis of the attachment of the LD tendon to the humerus, focusing on its morphological patterns and morphometric features, which are critical for optimizing the surgery. Dissection of 32 LD tendons in 16 Korean cadavers revealed three insertion patterns: fully combined (40.6%), partially combined (34.4%), and fully separated (25.0%). The mean width, length, and thickness of the tendons were 48.4, 56.2, and 6.2 mm, respectively. There were significant asymmetries in tendon dimensions. There were also tendinous slips connecting the LD tendon to the triceps tendon, adjacent brachial fascia, coracoid process, and anterior joint capsule of the shoulder in nine specimens, emphasizing the anatomical variability relevant to surgical planning. These findings provide insights for determining surgical approaches on the basis of patient anatomy, and whether to use LD transfer alone or combined LD and teres major transfers. Understanding the anatomical variations will help to make interventions more precise, which in turn should enhance the efficacy of tendon transfer procedures and improve functional outcomes for patients with complex shoulder pathologies.