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The incisive branch of the inferior alveolar nerve is a vital anatomical structure within the anterior mandible that has not been thoroughly defined and outlined in reports in the literature until recent years. Advances in radiological imaging, particularly the widespread use of cone-beam computed tomography has allowed for accurate visualization of the mandibular incisive canal (MIC) and its associated incisive branch of the inferior alveolar nerve. Surgical damage to the MIC, which could result in hemorrhage and sensory disturbance, may occur in commonly practiced oral and maxillofacial procedures, such as chin bone harvesting, implant placement, fracture repair and removal of pathologic entities of the anterior mandible. Knowledge of both the presence, dimensions and location of the incisive branch is a vital component to pre and peri-operative planning of oral and maxillofacial surgeries performed within the mandible, particularly within the interforaminal zone. In this article, the terminology, anatomy, imaging, surgical consideration, and pathology of the incisive branch will be discussed.

A variety of shapes has been reported for the roots and root canals of maxillary first premolars. The purposes of the present study were to determine branching and shapes of the roots of maxillary first premolars, as well as age-related changes using slice images obtained with cone-beam computed tomography (CBCT) for dental use. CBCT-reconstructed images of 125 cases that included maxillary first premolars were used as subjects. Slice images at the cervical one-third, center, and apical one-third positions of the root were prepared. Root branching and number of root canals was determined at each measurement position in the images. The subjects were divided into three groups: younger than 30 years, 30 to 50 years, and over 50 years. The root canal morphology was compared among these age groups. Single-rooted premolars were the most frequent. As for number of root canals, a single-canal premolar was observed at the position of the cervical one-third in 33.6%, at the center in 35.2%, and at the apical one-third in 56.0%. Thereafter the subjects were divided into groups by age, namely, younger than 30 years, 30 to 50 years, and over 50 years old, and it was revealed that the ratio of the two-canal type increased with age. In regard to tooth morphology, it was confirmed that the two-canal type shows more frequent occurrence with aging in maxillary first premolar. Based on our findings, we consider that CBCT can be useful for determining the root canal morphology with complicated shapes.

Knowledge of the variant anatomy of the intradural venous sinuses is important to anatomists and clinicians alike. Herein, we report a cadaveric case of the rare venous sinus of Kelch, which some have believed is a remnant of the cranio-orbital sinuses. To our knowledge, only one other cadaveric case has been reported in the extant medical literature. Clinically, knowledge of such a variant venous sinus can minimize misdiagnoses such as when anatomical variations are noted on imaging. Surgically, such an understanding can avoid intraoperative complications such as iatrogenic hemorrhage.

We present a rare case of external carotid artery-vertebral artery anastomosis via the ascending pharyngeal artery, diagnosed upon cadaveric dissection. The ascending pharyngeal artery gave rise to a branch to the hypoglossal canal, which is a variation of a true persistent fetal hypoglossal artery. Knowledge of persistent carotid-vertebrobasilar anastomoses is important as these fetal vessels can contribute significantly to the posterior cerebral circulation. Only 10 cases of external carotid artery-vertebrobasilar artery anastomoses have been reported to our knowledge, and our case presents the first cadaveric dissection of this rare variation.

A familiarity with common approaches to the wrist and their associated anatomy is essential for any surgeon operating in this area. Such knowledge reduces the likelihood of iatrogenic injury to adjacent structures; enabling the surgeon to progress purposefully and with confidence through an operation, to reveal underlying pathology. Furthermore, it is a favourite topic for the fellowship examiner. This article provides a description of the common dorsal, volar, radial and ulnar approaches to the carpus and distal radius. Safe corridors for external fixation are also considered. Additionally, clinical pearls are included for each approach, to enable the surgeon to avoid common pitfalls.

Porotic hyperostosis (PH) is the expansion of the cranial diploë, generating ‘hair-on-end’ appearance on X-rays. This condition is extremely rare and had a prevalence of 0.08%. It is alternatively known as cribra orbitalia (CO) when the orbital roof is affected. In this study, we describe the gross morphology of two skulls affected by PH and CO. The first skull belonged to a 41-year-old female previously diagnosed with beta thalassemia. The skull was affected by excessive PH and CO. The second skull, belonging to a 35-year-old male diagnosed with unspecified thalassemia, showed PH without CO. The etiology of PH and CO is discussed. In conclusion, PH and CO are extremely rare, and are of significant importance for radiologists and anatomists when interpreting radiographs or encountering unusual gross morphology of the skull.

The external carotid plexus is a combination of postganglionic sympathetic fibers derived from the superior cervical ganglion. This plexus travels along the external carotid artery and continues onto the artery's branches. The external carotid plexus plays an important role in innervating the mid and lower face. Therefore, implications to the plexus may result in facial abnormalities. Herein, we review the anatomy, function, and review its clinical applications.

The vertebral column (spinal column, spine, or backbone) forms the central axis of the body's skeleton. It supports the skull superiorly and participates in the formation of the pelvis inferiorly. The vertebral column comprises the following five regions in cephalocaudal sequence: cervical, thoracic, lumbar, sacral and coccygeal. The vertebral column contains the spinal cord within the vertebral canal, protecting the spinal cord from external trauma. Optimal medical and surgical management of spinal disease is crucially dependent on accurate clinical and radiological diagnosis, which in turn, are reliant on a sound understanding of the structural and functional anatomy of the vertebral column. In this article a general description of the articulated vertebral column is followed by a description of the morphology of representative vertebrae from the vertebral regions.

The latest development in the anterior lumbar interbody fusion (ALIF) procedure is its application in the lateral position to allow for simultaneous posterior percutaneous screw placement. The technical details of the lateral ALIF technique have not yet been described. To describe the surgical anatomy relevant to the lateral ALIF approach we performed a comprehensive anatomical study. In addition, the preoperative imaging, patient positioning, planning of the skin incision, positioning of the C-arm, surgical approach, and surgical technique are discussed in detail. The technique described led to the successful use of the lateral ALIF technique in our clinical cases. No lateral ALIF procedure needed to be aborted during these cases. Our present work gives detailed anatomical background and technical details for the lateral ALIF approach. This teaching article can provide readers with sufficient technical and anatomical knowledge to assist them in performing their first lateral ALIF procedure.

The anatomy of the eyelids and periorbital region is delicate. The individual anatomic variations determine each person's eyelid appearance and function. It is essential that every surgeon that evaluates and treats the aesthetic conditions of patients desiring periorbital enhancement understands the association of anatomy and diagnosis. Each periorbital aesthetic diagnosis has an anatomic basis, and knowledge of the applied anatomy allows a targeted treatment plan. This article outlines the layered anatomy with its clinical significance for the eyelids and periorbital region. Specific examples are used to illustrate the applied anatomy. A contemporary treatment plan for each anatomic problem is given.

Understanding anatomic variations in neurovascular structure inside the femoral triangle is crucial for regional anesthesiologists performing femoral nerve block. During routine dissection of a cadaver, an ascending branch of the lateral circumflex femoral artery with an anomalous course passing through the femoral nerve, specifically the posterior division, was identified inside the femoral triangle on the left thigh. The novel variation identified in this study occurred in an early stage of prenatal development. Recognition of this anatomic variation will be helpful for reducing unexpected complications during the femoral nerve block and the tensor fascia latae flap. Penetration of the posterior division of the femoral nerve by the arterial branch might cause pain or paresthesia of the medial aspect of the leg in the distribution of the saphenous nerve.

Background Contention exists amongst anatomists, clinicians and surgeons about how much anatomical knowledge medical students need, although what is taught should be aligned with current surgical practice. The aim of this study was to explore the scope of recent advances in applied anatomy as highlighted in the ANZ Journal of Surgery in each of the surgical specialties. Methods The 2018 volume of the ANZ Journal of Surgery was narrowed to 254 articles by applying the search term 'anatomy'. The main topic was extracted from each paper. The content of the paper was assessed for 'novel description' or 'novel application' of anatomical knowledge and classified accordingly. Results Most papers with an anatomical focus were from general surgery, which focused on surgical techniques, outcomes and management. Vascular surgery had the highest percentage of papers with a novel description and application of anatomy. Although cardiothoracic and paediatric surgery had no papers with a novel description of anatomy, novel applications of anatomy were a focus in each speciality. Conclusion The trend towards novel applications of anatomical knowledge in all surgical specialties should encourage medical schools to shape their anatomy curricula in tandem with such advances as they evolve. The high proportion of novel applications and descriptions of anatomy in general surgery indicates continued growth as a benchmark of anatomical understanding. Vascular surgery's proportion of novel application and description of anatomy may change the way students will learn vascular anatomy to incorporate endovascular, radiologically based approaches.

The pathogenesis of Chiari 1 malformations has been explained in several different ways, but extensive evidence suggests a relationship between loss of volume within the posterior cranial fossa and Chiari 1 presentations. It is important to be able to differentiate Chiari 1.5 from Chiari 1 malformations as they have similar clinical presentations, but the latter have progressed further and are characterized by caudal herniations of the brain stem through the foramen magnum. Despite the similarities of presentation, Chiari 1.5 malformations have greater rates of complications following posterior decompression surgeries, which are typically performed to relieve ventral compression. An improved understanding of the odontoid synchondroses could lead to better understanding of Chiari malformations and lead to improved treatment of patients with these presentations. Here we present a rare case of an accessory odontoid synchondrosis in a patient with a Chiari 1.5 malformation and ventral compression.

This article is a concise description of the applied topographical anatomy of the heart, emphasizing those aspects of cardiac functional anatomy that are essential to clinical cardiac examination.

The transverse cervical nerve arises from anterior rami of the second and third cervical spinal nerves via the cervical plexus. We present a case of a left duplicated transverse cervical nerve with a duplicated external jugular vein in a 72-year-old female cadver. The transverse cervical nerve bifurcated into two branches, i.e., superficial and deep branches, lateral to the sternocleidomastoid muscle. The superficial branch ran lateral to the duplicated external jugular vein and gave a cutaneous branch to the area below the great auricular nerve and cutaneous branches to the skin of the neck. The deep branch ran medial to the duplicated external jugular vein, joined the anterior branch of the superficial transverse cervical nerve and cervical branch of the facial nerve, and terminated into the skin. This case adds to the growing data on individual variability that should be considered when operating on the anterolateral neck.

Preservative dorsal hump surgery is an old approach that has revitalized recently. Preservation rhinoplasty aims to shape the existing structures instead of resection/reconstruction approaches. A thorough understanding of the applied anatomy of the nose is the backbone of preservative hump surgery. In preservative hump surgery keystone works as a joint, and by lowering this joint the hump is eliminated.

BACKGROUND: Physis is the weakest structure in the skeleton of a child and a frequent site of an injury or fracture. A physeal fracture presents a unique challenge in the management as the sequalae of such an injury could lead to growth disturbances. METHODS: In this review, mainly focussing on traumatic physeal injuries, the authors discuss the applied anatomy, different fracture patterns, clinical assessment and management of physeal fractures in children. RESULTS: Discussion on acute physeal injuries as well as physeal arrest and approach to its management is presented. Past attempts for treatment of physeal injuries and recent advances in their management is also discussed. CONCLUSION: The ideal approach to treat physeal injuries should take into account the location of injury, age of the patient, fracture type and growth potential of the involved physis. Prompt diagnosis and physeal-respecting treatment techniques are important.

Trabeculae or septations in the transverse sinus can have potentially life-threatening clinical significance. The current study demonstrates trabecula/septum patterning within the transverse sinus with measurements and distribution data supplemented by imaging, and describes the possible etiology of idiopathic intracranial hypertension and turbulent blood flow in the transverse sinus. Twenty-four sides from 12 cadaveric heads, all fresh-frozen, were used (five males, seven females; age at death 65–91 years, mean 79.1 years). The length and diameter of the transverse sinus were measured along with the number and locations of septations/trabeculae and their tensile strength. The mean length of the transverse sinus was 68.43 mm on the right side and 74.31 mm on the left. A total of 42 septations were found in the 24 transverse sinuses. The number of septations per side ranged from zero to four with a mean of 1.75. The septations were located in the proximal 1/3 in 54.8% (23/42), the middle 1/3 in 21.4% (9/42), and the distal 1/3 in 23.8% (10/42). The work presented here furthers our understanding of transverse sinus anatomy, including its detailed internal architecture. The measurements can provide a technical guide for neurosurgeons and influence instrument selection when a large thrombus forms or anchors in one of these trabeculae or septa and necessitates treatment.

At present, there is no photographic evidence of splitting of the trapezius and sternocleidomastoid muscles (SCMs), which share a common anlage that extends caudally toward the limb bud in the embryo at a length of 9 mm. Therefore, the aim of the present study was to identify which structures divide the caudal end of the common anlage at the first sign of splitting into two muscles. In 11 mm-long specimens, the SCM and trapezius muscles were identified as a single mesenchymal condensation. In 15 and 18 mm-long specimens, the SCM and trapezius muscles were separated and extended posteriorly and lymphatic tissues appeared in a primitive lateral cervical space surrounded by the SCM (anterior). In 21 mm-long specimens, the lymphatic vessels were dilated and the accompanying afferents were forming connections with the subcutaneous tissue through a space between the SCM and trapezius muscles. In 27 mm-long specimens, cutaneous lymphatic vessels were evident and had entered the deep tissue between the SCM and trapezius muscles. Vascular dilation may be viewed as a result of less mechanical stress or pressure after muscle splitting.

There are many reported anatomical variations of the mandibular canal. Consequently, there is great variation in the retromolar area, such as the quantity, size, and location of the retromolar foramen (RMF), the bony entrance of the retromolar canal (RMC). These variations allow for different accessory innervations to the mandibular molars and their adjacent buccal tissue because the RMC contains neurovascular bundles. Consideration of these anatomical variations is crucial for avoiding complications in anesthesia, implant placement, and surgery. However, the rarer canal types are often only imaged by computed tomography (CT) or cone beam computed tomography (CBCT). We present a rare case with bilateral RMF and a unilateral trifid mandibular canal in a cadaver.

Duplication of the odontoid process remains a rare developmental pathology that is underrepresented in the current literature. As the pivot point for the craniovertebral junction, the odontoid process is vital for the integrity of the atlanto-axial joint and the ability of the head and cervical spine to rotate correctly. The pathogenesis being incompletely understood, it has been proposed that odontoid process duplication involves faulty sclerotome migration and disruption of the axis ossification center. Patients presenting with this pathology usually have associated structural abnormalities. A detailed anatomical and embryological understanding of the odontoid process is necessary for successful management and treatment of patients presenting with odontoid process duplication. We present a rare case of a patient with a duplicated odontoid process in association with C2–C3 fusion, incomplete anterior arch of C1, variant inferior bony process of the transverse process of C1, and enlarged right jugular foramen.

Variations of the pectoralis major muscle are commonly seen. However, during the routine dissection of an adult male cadaver, an apparently uncommon muscular variant was identified. In this cadaver, the sternal heads of the left and right pectoralis muscles crossed the midline and interdigitated with one another. In addition, the clavicular heads of both pectoralis major muscles were separated from the remaining parts of the muscles. Such anatomical variants such be kept in mind by clinicians and surgeons during patient evaluation and treatment.

Purpose of Review To provide the reader with a clear overview of facial anatomy as it relates to injection of botulinum toxin. Recent Findings The review suggests the presentation of multiple combinations of facial musculature, with the forehead, glabellar, and nasal base areas as particular areas of variation. Differences in musculature result in different wrinkling patterns; with age, these changes first become apparent in the upper face, particularly in the forehead and glabellar area. Summary Botulinum toxin is well suited to achieve the optimal outcome: it is popular, safe, and non-invasive and presents with few adverse effects. Though limited, when adverse effects do arise these are primarily related to poor injection technique, often fuelled by poor anatomical knowledge. For clinicians to achieve the best outcomes with botulinum toxin use, an understanding of the facial muscles’ anatomy, actions, and interactions is key. This paper discusses the broad and intricate detail regarding the key target muscles of botulinum toxin, based on both literature review and cadaveric dissection carried out by the authors.

In this paper, the authors discuss the embryology and anatomy of the choroidal fissure, as well as the pathophysiology and treatment of cerebrospinal fluid cysts of this structure. Understanding its anatomical relations to nearby structures plays an essential role during brain surgeries. With the advancement and availability of imaging techniques, lesions of the choroidal fissure are often found incidentally. Patients are usually asymptomatic or exhibit symptoms that do not correlate with anatomical location or do not require surgical treatment. The choroidal fissure is a key landmark used during brain surgery. Therefore, a comprehensive understanding of it and nearby anatomical structures is essential. Choroidal fissure cysts can be found incidentally, and well-known key features will allow one to differentiate them from other lesions. Surgical treatment should be reserved for symptomatic patients while asymptomatic patients should be monitored.

Here we report a case of inferior alveolar nerve (IAN), which had variability in its formation. IAN was formed by dual roots, which were branching out from the posterior division of mandibular nerve. The observed roots were forming a loop around the pterygoid part of arteria maxillaris (MA). One of the roots was superficial to the MA and the other was deep to it. It is believed that this type of morphological variation in the formation of IAN can have clinial implications, which include compression by adjacent structures and nerve entrapment. The knowledge of this variation is important to anaesthesiologists and dentists, while administering local anaesthesia. This is also enlightening to the maxillofacial surgeons, neurologists and radiologists.

The sheath and prepuce are anatomically simple yet vital parts of the mating apparatus of the bull. They are also susceptible to a range of insults, and pathology of these structures is a common cause of infertility in both Bos taurus and Bos indicus bulls. Significant individual and breed-based variation occurs in the looseness of the skin, the presence and development of preputial muscles, the relative position of the opening to the cranial preputial muscles, the length of the prepuce, and the prominence of the umbilicus. Individual and breed-based susceptibility to different conditions is associated with these anatomical variations. Regardless of the cause, pathology of the prepuce generally results in sepsis, prolapse, stenosis or adhesions or a combination. Clinical examination should be aimed at determining the extent of these processes and the amount of healthy prepuce which would remain following successful treatment. The inclusion of evaluation of sheath conformation in the form of a sheath score is recommended. Current scoring systems do not reflect the diversity of predisposing factors to morbidity and may therefore fail to accurately reflect the risk of morbidity. A more detailed scoring system has been proposed. Further refinement of this system is outlined, consisting of a composite of scores for depth, umbilical skin fold, prepuce eversion, and distance from cranial muscle to opening (the 'Y' factor). Validation against actual bull performance is indicated to develop a valid and useful risk-management tool for use in evaluating sheath conformation.

It is well known that the most common sites for venous access are the superficial veins of the upper limb, particularly dorsal metacarpal veins and median cubital vein. Although dorsal metacarpal veins are the first choice for venous cannulation, there is scarce information about their anatomic variation. Hence, detailed anatomical information about these veins will improve the anatomic knowledge of the health care providers. Subsequently, this study was designed to study the dorsal metacarpal veins and to determine the most prominent dorsal metacarpal vein. A cross sectional study of 402 subjects (804 hands), was prepared to study the superficial veins on the dorsum of the hand among Jordanian students and staff of one of the major governmental medical colleges in Jordan, by using infrared illumination system. The obtained data was analyzed according to sex, sidedness, and handedness. Six locations of the most prominent dorsal metacarpal veins were identified. There was a significant relation between both females and males and the most prominent dorsal metacarpal vein (P=0.01). For the first time this study identified the most common location of the most prominent dorsal metacarpal vein in the fourth intermetacarpal space.

The straight sinus is a division of the dural venous sinuses, found beneath the splenium of the corpus callosum. At the internal occipital protuberance, it comes together with the superior sagittal sinus and transverse sinus to form the torcular Herophili. It functions as a major site of venous drainage for the cerebellum, inferior sagittal sinus, and vein of Galen. Many morphological variations have been reported involving the angulation, positioning, and number of straight sinuses present. Patients with Chiari II and III malformations have been observed to have a high incidence of anatomical variation with their dural venous sinuses, including vertically oriented straight sinuses. Additionally, there is a high rate of hydrocephalus in this patient population. Herein, we report a vertically oriented straight sinus in a child.

A number of studies have previously shown variations of inferior alveolar, however, only a few reports focused on nearby the foramen ovale. In a formalin fixed cadaver, we identified three minor branches (anterior, middle, and posterior branches) arising from the main trunk of the mandibular nerve adjacent to the foramen ovale, passing lateral to the maxillary artery (MA), and joining the inferior alveolar nerve. The diameter of the branches was 0.68 mm, 1.43 mm, and 0.40 mm, respectively. The branches traveled inside the lateral pterygoid muscle (LPM) or between the LPM and tensor/levator veli palatini. Moreover, all of the branches were superficial to MA. Knowledge of such a variation might be helpful to dentists during, for example, anesthetic blockade and various oral surgeries.

Caudal regression syndrome (CRS) is a rare congenital variation. A high incidence of renal and genitourinary malformations has been observed in patients with CRS, with the most common being neurogenic bladder and renal agenesis. We report a rare case report documenting both CRS and a pelvic kidney found during a diagnostic magnetic resonance imaging. Although renal anatomy variants are found in patients with CRS, a pelvic kidney is normally not part of the constellation of findings in this malformation. As seen in our patient, a pelvic kidney should be considered in patients suspected of having CRS.

The knowledge about detailed morphology and relation of saphenous nerve is important to obtain successful saphenous nerve regional blocks to achieve pre- and post-operative anesthesia and analgesia, nerve entrapment treatments and to avoid damage of saphenous nerve during knee and ankle surgeries. The literature describing detailed morphology of saphenous nerve is very limited. We dissected 42 formalin fixed well embalmed cadaveric lower limbs to explore detailed anatomy, relation and mode of termination of saphenous nerve and measured the distances from the nearby palpable bony landmarks. The average distance of origin of saphenous nerve from inguinal crease was 7.89±1.42 cm, the distance from upper end of medial border of patella to saphenous nerve at that level was 8.11±0.85 cm, distance from tibial tuberosity was 7.53±0.98 cm and from midpoint of anterior border of medial malleolus was 0.45±0.14 cm. Saphenous nerve provided two infrapatellar branches at the level of mid to lower limit of patellar ligament in 90% cases. It was in close contact or adhered to great saphenous vein across the lower 2/3rd of leg lying either anterior, posterior or deep to the vein. The saphenous nerve terminated by bifurcating proximal to medial malleolus in majority of cases though no obvious bifurcation was observed in 9.52% cases. The detailed morphology, relations and the distances from palpable bony landmarks may be helpful for clinicians to achieve successful saphenous nerve block and to avoid saphenous nerve damage and related complications during orthopedic procedures.

Transverse abdominis plane (TAP) blocks, over the past decade, have emerged as a reliable tool in multimodal analgesia. Although they block only the somatic component of pain, studies have still revealed a consistent benefit in the first 24-48 hours after surgery in terms of pain scores and overall opioid consumption. The safety and dependability has increased with ultrasound usage. The aim of this review is to help the reader appreciate the applied anatomy required for a TAP block and its congeners, to standardize its nomenclature, and to help choose between variants of a TAP block and its complications and safety profile.

There is dearth of information on the biometry, clinical and applied anatomy of the head region, general morphology on the indigenous breed of sheep in particular, hence led to the motivation behind this study. This study gives the first biometric description of the skull of Yankasa indigenous breed of sheep in Nigeria. Twenty-five heads (5 [0 – 6 months], 5 [6 months – 1 year], 5 [1 – 2 years], 5 [2 – 3 years] and 5 [ 3 years and above]) were collected from purposively and randomly sampled Yankasa male sheep from a slaughter slab and processed for biometrical investigation. Several biometrical measurements were recorded from each of the 25 skulls. From these, simple descriptive statistical analysis was obtained. The values obtained from these groups were increasing with ages. This study has described the biometric characteristics of the Yankasa sheep and concludes that a contribution for comparative model for other African local ovine breeds in general and Nigerian ovine breeds in particular has being made. Being the first study of its kind in Nigeria, it makes a significant contribution to a better understanding of the Yankasa sheep skull. It is envisaged that the results obtained in this study will be useful as baseline data in anatomical and archaeological studies.

The presentation and management of bladder, ureteric and urethral injuries during and following urogynaecology surgery are discussed. Applied anatomy is reviewed, and the surgical management of injuries diagnosed intra- and post-operatively is discussed.

Background Medical education has recognised the importance of anatomy teaching. Limitations in applied anatomy knowledge exist among obstetrics and gynaecology (O&G) trainees. This study aims to evaluate the knowledge of O&G trainees in applied anatomy and study-associated factors. Materials and methods The questionnaire-based study involved O&G trainees between 1/8/2019 and 1/12/2019. Data collected included age, gender, evaluation of medical school anatomy course, attendance at applied anatomy workshops, operating theatre workload, and senior colleagues’ demonstration of anatomy during operating sessions. Results There were 271 trainees recruited with a mean age of 29.3 years, and 80.1% rated the value of medical school anatomy courses as average or above average. Furthermore, 90.8% never attended applied anatomy workshops. In addition, 9.6% and 62% of first- and fifth-year trainees rated their knowledge as either good or very good, and 41.7% reported that anatomy demonstrations by senior doctors happened sometimes. The overall score of applied anatomy knowledge was significantly higher in higher training years, with attendance at applied anatomy lectures, with more operating workloads, and when senior doctors demonstrate anatomy more often during operating sessions. Conclusions Deficiencies in knowledge existed. Factors which may improve knowledge include more applied undergraduate anatomy courses, more frequent operating sessions, attending anatomy workshops, and more senior colleagues’ demonstration of anatomy during surgeries.

The nerve to the mylohyoid muscle has been well studied but there are no specific anatomical landmarks for identifying it. Therefore, we aimed to identify anatomical landmarks for localizing the nerve to the mylohyoid muscle in the submandibular region. Sixteen sides from eight embalmed Caucasian cadaveric heads were used in this study. The mean age at the time of death of the specimens was 80.3 years. The anterior and posterior bellies of the digastric muscle, submental artery, and mylohyoid muscle were dissected to verify their relationships with the nerve to the mylohyoid muscle. The nerve to the mylohyoid muscle was found medial to the submental artery, lateral to the anterior belly of the digastric muscle, and anterior to the posterior border of the mylohyoid muscle on all sides. Herein, we identified what we term the mylohyoid triangle. This anatomical region can help localize the nerve to the mylohyoid muscle.

The scalp is anatomically described as having five layers: Skin, SubCutaneous tissue, Aponeurosis, Loose areolar tissue and Pericranium (SCALP-a well known and useful acronym). Functionally however this can be considered as two layers—a deeper layer of pericranium and areolar tissue (which is attached to the skull), upon which sits a mobile superficial layer comprised of skin, subcutaneous tissue and the galea aponeurotica. It is between these two layers that the scalp moves and blood can collect—a scalp or subgaleal haematoma. Most scalp lacerations extend the full thickness of the upper layer.

The trachea, bronchus and esophagus are all locate in the mediastinum. Mediastinumis generic is a term of the organs, structures and connective tissues between the right and the left mediastinum pleura. Figures 20.1 and 20.2 illustrates the relationship among the trachea, the bronchi and the esophagus clearly. Set sternal angle as bounder line, divide the mediastinum into upper mediastinum (Fig. 20.3) and inferior mediastinum. The inferior mediastinum contains three parts whose bounder is pericardium, anterior, middle and posterior parts. The trachea settles at the upper mediastinum, and the esophagus settle at the post mediastinum.

Treatment of fractures about the hip in the elderly necessitates a deep knowledge about the hip joint and surrounding structures. Bony anatomy, muscular attachments, capsular boundaries, and vascular supply all greatly affect the outcome of fracture care and should be well understood to provide optimal patient care. In the aging population, characteristics of bone quality, shape, and healing potential change; thus, treatment strategies change as well. The risk of avascular necrosis of the femoral head is of primary concern in this population to avoid pain, dysfunction, and additional surgery. Surgical treatment aims to maintain physiologic reserve with minimal disruption of soft tissue when possible to expedite recovery and improve outcomes.

Since prevention of injury is of paramount importance, a thorough familiarity with the anatomy and related research methodologies of the biliary system is essential. The technologies developed to produce both physical and virtual three-dimensional (3D) modelling have greatly enhanced the learning process and contribute significantly to patient safety.

Contains fulltext : 235787.pdf (Publisher’s version ) (Open Access) Anatomical examinations have been designed to assess topographical and/or applied knowledge of anatomy with or without the inclusion of visual resources such as cadaveric specimens or images, radiological images, and/or clinical photographs. Multimedia learning theories have advanced the understanding of how words and images are processed during learning. However, the evidence of the impact of including anatomical and radiological images within written assessments is sparse. This study investigates the impact of including images within clinically oriented single-best-answer questions on students' scores in a tailored online tool. Second-year medical students (n = 174) from six schools in the United Kingdom participated voluntarily in the examination, and 55 students provided free-text comments which were thematically analyzed. All questions were categorized as to whether their stimulus format was purely textual or included an associated image. The type (anatomical and radiological image) and deep structure of images (question referring to a bone or soft tissue on the image) were taken into consideration. Students scored significantly better on questions with images compared to questions without images (P < 0.001), and on questions referring to bones than to soft tissue (P < 0.001), but no difference was found in their performance on anatomical and radiological image questions. The coding highlighted areas of "test applicability" and "challenges faced by the students." In conclusion, images are critical in medical practice for investigating a patient's anatomy, and this study sets out a way to understand the effects of images on students' performance and their views in commonly employed written assessments.