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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.

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.

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.

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.

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.

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.

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.

Selection and dissection of recipient site vessels is critical for a successful free tissue transfer. This chapter describes the applied anatomy and various surgical approaches to exposing the deep inferior epigastric vessels for use as recipient in microsurgical reconstruction.

The face is the most important area of the entire body when assessing one’s physical beauty and attractiveness. The face itself is composed of numerous cosmetic subunits. The eyes and periocular region, in particular, play a very important role in aesthetics as well as expression of one’s mood. As the population continues to age, the number of cosmetic procedures performed annually continues to increase. While a great number of the procedures are in the noninvasive realm such as injectables, blepharoplasty was the fifth most common surgical procedure performed in 2018 based on the American Society for Aesthetic Plastic Surgery (Surgery, T. A. S. f. A. P., Cosmetic (Aesthetic) Surgery National Data Bank, 2018). Blepharoplasty is a relatively simple procedure that has minimal downtime for patients and can provide a significant impact in restoring the youthfulness of the face.

Ultrasound guidance technique currently represents the gold standard for regional anesthesia. In particular for lower extremity blocks, compared to anatomical landmark or localization technique with nerve stimulation, the ultrasound technique shows a modest improvement in block onset and quality. However, current literature lacks large size randomized trials and heterogeneity exist in various blocks. This chapter aims to present a comprehensive review of relevant applied anatomy of lower extremity, anatomical, and ultrasound-guided techniques for each block, and clinical implications of most commonly performed lower extremity blocks.

Introduction: Endoscopic thyroidectomy (ET) has been successfully established as an excellent surgical approach. This study summarizes and describes the crucial anatomical landmarks for clinical ap...

Anatomy as an indispensable part of the medical curricula, offering impeccable knowledge, prepares the students to enter the practical atmosphere. The aim of this study was to evaluate the clinical application of anatomy courses of the medical students in Zanjan University of Medical Sciences. This cross-sectional study was conducted in 2015 with census sampling on all clinical students (trainees and interns). To collect feedback from students, the questionnaire designed by researchers was used. The Likert rating scale of very high, high, medium, low, and very low was considered and scores of 5 (very high) to 1 (very low) were applied. Data were analyzed by SPSS software. Among the courses of anatomy, trunk anatomy has the greatest impact on clinical courses of medical students (P

Purpose: Since different subspecialties are currently performing a variety of upper facial rejuvenation procedures, and the level of knowledge on the ocular and periocular anatomy and physiology is different, this review aims to highlight the most important preoperative examinations and tests with special attention to the eye and periocular adnexal structures for general ophthalmologist and specialties other than oculo-facial surgeons in order to inform them about the fine and important points that should be considered before surgery to have both cosmetic and functional improvement. Methods: English literature review was performed using PubMed with the different keywords of “periorbital rejuvenation”, “blepharoptosis”, “eyebrow ptosis”, “blepharoplasty”, “eyelid examination”, “facial assessment”, and “lifting”. Initial screening was performed by the senior author to include the most pertinent articles. The full text of the selected articles was reviewed, and some articles were added based upon the references of the initial articles. Included articles were then reviewed with special attention to the preoperative assessment of the periorbital facial rejuvenation procedures. Results: There were 254 articles in the initial screening from which 84 articles were found to be mostly related to the topic of this review. The number finally increased to 112 articles after adding the pertinent references of the initial articles. Conclusion: Static and dynamic aging changes of the periorbital area should be assessed as an eyelid-eyebrow unit paying more attention to the anthropometric landmarks. Assessing the facial asymmetry, performing comprehensive and detailed ocular examination, and asking about patients' expectation are three key elements in this regard. Furthermore, taking standard facial pictures, obtaining special consent form, and finally getting feedback are also indispensable tools toward a better outcome. Keywords: Blepharoplasty, Cheek, Eyebrow, Eyelid, Lifting, Rejuvenation

The human face is composed of small functional and cosmetic units, of which the eyes and periocular region constitute the main point of focus in routine face-to-face interactions. This dynamic region plays a pivotal role in the expression of mood, emotion, and character, thus making it the most relevant component of the facial esthetic and functional unit. Any change in the periocular unit leads to facial imbalance and functional disharmony, leading both the young and the elderly to seek consultation, thus making blepharoplasty the surgical procedure of choice for both cosmetic and functional amelioration. The applied anatomy, indications of upper eyelid blepharoplasty, preoperative workup, surgical procedure, postoperative care, and complications would be discussed in detail in this review article.

GARLA is an anatomy curriculum that combines dissection with applied anatomy. A two-week intensive dissection Boot-Camp is followed by a tripartite curriculum consisting of Gross Anatomy using a mixed reality headset, radiology, and physical exam/ultrasound skills. Student feedback has generally been positive.

The superior laryngeal artery is the principal artery supplying the laryngeal mucosa, musculature, and glands. Knowledge of variations in the origin of superior laryngeal artery could prove to be very useful during reconstructive surgeries of the larynx, partial laryngectomy, laryngeal transplantation, and also during procedures like super-selective intra-arterial chemotherapy for laryngeal and hypolaryngeal cancers. However, relatively few studies have been done on the superior laryngeal artery in comparison to its clinical importance. The present study was aimed at documenting the prevalence of variable origin of the superior laryngeal artery within the carotid triangle. Sixty hemi-necks obtained from 30 South Indian cadavers were dissected and studied for variations in the origin of superior laryngeal artery. It was observed that the superior laryngeal artery took origin from superior thyroid in 91.7% cases. Variable origin from the external carotid artery was noted in 5% cases. The superior laryngeal artery was found to arise from the lingual artery in one case alone (1.7%). In addition to the above findings, a very rare variation of superior laryngeal artery arising from the ascending pharyngeal (1.7%) was also observed in the hemi-neck of one cadaver. All the variations that were observed were unilateral and on the left side. These findings may help provide further insight to the anatomists, radiologists and surgeons and can help improve performances during surgical manipulations of the larynx.

The 19th century Russian surgeon Nikolay Ivanovich Pirogov believed passionately in the importance of anatomy for surgeons. His interest in anatomy began as a medical student in Moscow. After graduating in 1828 Pirogov entered the postgraduate German-Baltic University of Dorpat (now Tartu in the Republic of Estonia) where he studied anatomy and surgery. After completing his study, he remained to research the consequences of ligation of the aorta in a series of animal experiments, which formed the core of his doctoral thesis. He wanted to determine the feasibility of aortic ligation as a treatment for patients with an aneurysm of the aorta or iliac artery. He discovered that success was only likely when the aorta was ligated between the two mesenteric arteries and the ligature gradually tightened, an approach surgically difficult in humans. Pirogov then spent 2 years at the Charite Hospital in Berlin before returning to Russia. In 1841, he was appointed Professor of Applied Anatomy and Surgery at the Imperial Medico-Surgical Academy in Saint Petersburg. He instituted the teaching of microscopy and histology to the medical curriculum and in 1846 formed the Institute for Applied Anatomy within the academy, where in addition to teaching medical students future teachers of anatomy in Russia were trained. Pirogov published extensively on anatomy, including several anatomical atlases, the most notable his three-dimensional atlas of topographical anatomy published in four volumes between 1852 and 1859. Today Pirogov's contributions to anatomy are remembered in a number of anatomical structures named after him. Clin. Anat., 33:714-730, 2020. (c) 2019 Wiley Periodicals, Inc.

Decompressive craniectomy (DC) and cranioplasty are common operations which appear deceptively straightforward. However, there are many potential pitfalls and complications of these operations most of which can be avoided with an experienced neurosurgeon involved, careful planning, anticipation of the risks, meticulous surgical technique and assiduous post-operative care. This chapter outlines the relevant applied anatomy, the general and specific complications of these operations and presents strategies for avoidance of these complications. The common complications of DC are postoperative haemorrhage, hydrocephalus, delayed subdural effusion and syndrome of the trephined. The common complications of cranioplasty are resorption of the bone flap, subflap hematoms and infection. We advocate early cranioplasty following DC once brain swelling has subsided and before the longer term complications of DC have developed. Paradoxical herniation following DC and massive brain swelling following cranioplasty are uncommon life-threatening complications which the neurosurgeon should be aware of.

Rectal anatomy is one of the most challenging concepts of visceral anatomy, even though currently there are more than 23,000 papers indexed in PubMed regarding this topic. Nonetheless, even though there is a plethora of information meant to assist clinicians to achieve a better practice, there is no universal understanding of its complexity. This in turn increases the morbidity rates due to iatrogenic causes, as mistakes that could be avoided are repeated. For this reason, this review attempts to gather current knowledge regarding the detailed anatomy of the rectum and to organize and present it in a manner that focuses on its clinical implications, not only for the colorectal surgeon, but most importantly for all colorectal cancer-related specialties.

The reconstruction of femoral length (FL) from fragmentary femora is an essential step in estimating stature from fragmentary skeletal remains in forensic investigations. While regression formulae for doing this have been suggested for several populations, such formulae have not been established for Ghanaian skeletal remains. This study, therefore, seeks to derive regression formulae for reconstruction of FL from fragmentary femora of skeletal samples obtained from Ghana. Six measurements (vertical head diameter, transverse head diameter, bicondylar breadth, epicondylar breadth, sub-trochanteric anterior-posterior diameter, and sub-trochanteric transverse diameter) were acquired from different anatomical portions of the femur and the relationship between each acquired measurement and FL was analyzed using linear regression. The results indicated significantly moderate-to-high correlations (r=0.580-0.818) between FL and each acquired measurement. The error estimates of the regression formulae were relatively low (i.e., standard error of estimate, 13.66-19.28 mm), suggesting that the discrepancies between actual and estimated stature were relatively low. Compared with other measurements, sub-trochanteric transverse diameter was the best estimate of FL. In the absence of a complete femur, the regression formulae based on the assessed measurements may be used to infer FL, from which stature can be estimated in forensic investigations.

Nikolay Pirogov qualified as a physician from Moscow University in 1828 and then studied surgery and anatomy at University of Dorpat. He developed new surgical techniques, including the eponymous osteoplastic foot amputation. His application of scientifically based techniques extended surgery from a craft to a science. During the Crimean War he initiated the deployment of women as nurses and used triage for dealing with mass casualties. His textbook on field surgery became the standard reference on the subject and his principles remained virtually unchanged until the Second World War. Pirogov died on 5 December 1881 at his estate in Vishnya.

During the strengthening and weakening procedures of intraocular muscles, distance of insertion from the sclerocorneal junction is an important determinant in the identification of muscles. During repositioning of the aponeurosis of the muscles, it is desired that the width should not change in order to avoid diversion of forces. Available anatomic studies on insertions of extraocular muscles are few, date back to early twentieth century and have been conducted on mostly white population. The present study is an attempt to document the insertions of recti and oblique muscles in Indian population. Forty eyeballs were removed from orbit. Insertion of recti and obliqui were cleaned and eyeballs were perfused with normal saline to regain the volume (hence shape and size) before recording observations. Insertion of recti and obliqui muscles were observed under various study parameters. The distance of insertion of recti from the limbus were found to be 7.3 mm, 8.06 mm, 8.71 mm, and 8.74 mm for medial, inferior, lateral, and superior rectus, respectively. The superior oblique was aponeurotic and found to be more variable in mode of insertion as compared to inferior oblique which had a fleshy and relatively constant insertion. The observations on insertion of recti and obliqui as obtained in present study differ from earlier studies to the tune of 1-1.5 mm. This may be attributed to adoption of method of reperfusion of eyeball before recording observations thus maintaining size close to in vivo. The observations are expected to be closer to actual.

The most efficient and cost-effective approach for the diagnosis of pleural exudates remains uncertain and is a subject of controversy. Essential factors to be considered include the respective diagnostic yields of thoracocentesis, closed pleural biopsy, and thoracoscopy. The role of endoscopic ultrasound (EUS) of the esophagus as a modality for the evaluation of pleural exudates has not yet been evaluated. The applied anatomy of the pleura has been discussed. The techniques involved in the EUS imaging of different aspects of the pleura in normal cases and in cases with pleural effusion are elaborated. The practical application of this knowledge can be useful in EUS-guided sampling of the pleural wall, pleural nodules, and in cases of pleural effusion.

Intraosseous access is a method for providing vascular access in resuscitation of critically ill and injured patients when traditional intravenous access is difficult or impossible. There is a lack of detailed description for the landmark for the insertion point in the literature. The aim of this study was to determine the exact location for intraosseous access. Radiographic computed tomography (CT) images of a total of 50 dry tibia bones were obtained. With 5-mm intervals, for all transverse images and by selecting transverse section, measurements were taken from the thickness of the cortex at anterior margin and mid-line medial surface, distance from anterior margin, and mid-line medial surface of the tibia to the posterior wall of medullar cavity, distance from anterior margin and mid-line medial surface of the tibia to the posterior surface of the tibia. The thinner part of the cortex of the tibia and the larger width of the medullar cavity is at 0.5 cm below the tibial tuberosity in the midline of the medial surface. The application region for proximal tibia access and landmark and most suitable insertion point for intraosseous infusion should be at level 0.5 cm below the tibial tuberosity in the midline of the medial surface. It was recommended that standard length for intraosseous canule should be 17 mm except for the thickness of skin. In conclusion, presented study provides certain localization for intraosseous access and standard length for intraosseous canule and this will be more effective in using this technique. Clin. Anat. 31:593-597, 2018. © 2017 Wiley Periodicals, Inc.

Liver hanging maneuver (LHM) is an important technique in liver surgery. However, applied anatomy of the retrohepatic tunnel for the surgical approach in Chinese population needs further study. In this study, to explore the basic anatomy of retrohepatic tunnel and its clinical application in a Chinese population, a total of 32 formalin-fixed cadavers were dissected, related parameters were measured, and their clinical applications were discussed. The length of the retrohepatic tunnel was (60.6 ± 9.9) mm. The width of the retrohepatic tunnel superior opening was (13.8 ± 3.9) mm. The width of the retrohepatic tunnel inferior opening was (15.2 ± 7.4) mm. The hepatic short vessels were distributed along the middle and lower 1/3 of hepatic inferior vena cava (HIVC), with a slight predominance on its left wall. A few hepatic short vessels were distributed along the upper 1/3 of the HIVC. We concluded: the anatomy of the retrohepatic tunnel provides a basis for use of LHM in liver surgery; more hepatic short vessels from hepatic caudate lobe can be preserved via right approach. The retrohepatic tunnel can be used as a good surgical approach in liver surgery; its application also has important significance in laparoscopic minimally invasive liver surgery.

Background\ud The rheumatologist relies heavily on clinical skills to diagnose diverse conditions, something that is correlated with one's knowledge of clinical anatomy. More recently, rheumatology has offered further career flexibility with opportunities to develop skills such as joint injection and musculoskeletal (MSK) ultrasound, both of which require a sound understanding of anatomy. Currently, there are no formal strategies to support competency‐based anatomy learning in rheumatology in the UK. This study aimed to evaluate an innovative applied anatomy course utilizing cadaveric material, targeted at clinicians practising in rheumatology and MSK medicine.\ud \ud Methods\ud A new course was developed for rheumatologists, rheumatology trainees and allied health professionals practising rheumatology and MSK medicine, with the principal focus being on applied MSK anatomy. A questionnaire was given to course attendees and a mixed methods approach of evaluation used. Descriptive statistical data analysis was performed.\ud \ud Results\ud The course received overall positive feedback and statistically significant improvements in levels of confidence in anatomy (mean 52.35–83.53, p < 0.0001), injections (mean 57.65–81.18, p < 0.0001), examination of the upper limb (mean 60.59–76.47, p < 0.0001) and examination of the lower limb (mean 58.24–77.65, p < 0.0001). Course attendees also favoured a peer‐assisted and multidisciplinary learning approach.\ud \ud Conclusions\ud This study lends support for the use of cadaveric material in the teaching of postgraduate anatomy to rheumatologists. It has demonstrated a continual need for hands‐on and interactive anatomy training in an ever‐advancing digital world. To be successful, cadaveric learning should not be viewed in a purely ‘pre‐clinical’ setting, but instead integrated with postgraduate learning.

The identification of mastoidal emissary veins is of importance in the neurosurgical practice to diagnose abnormal and normal structures. In the present study, the objectives were to estimate the prevalence rate of mastoidal emissary foramina in the temporal bones of the adult skull and to study their number and morphology. The present study included 48 adult human skulls which were obtained from the gross anatomy laboratory of our institution. The mastoid parts of 96 temporal bones were macroscopically observed for the prevalence, number and morphology of the emissary foramina. It is observed that, the mastoidal emissary foramen was present in 88 temporal bones (91.7%) of our specimens. The foramen was observed single in 60 temporal bones (62.5%), double in 22 bones (22.9%), and triple in 6 temporal bones (6.2%). The mastoidal emissary foramen was absent in 8 (8.3%) temporal bones. The foramen was bilaterally absent in 3 (3.1%) skulls. It was unilaterally absent in 2 (2.1%) skulls and both were on the left side. The mastoidal emissary vein is prevalent in a large number (91.7%) of cases. It was observed that the accessory mastoidal emissary foramina were present in 29.1% of cases. Recognition of the mastoid emissary veins and accessory mastoid emissary veins during the otologic surgery is critical to avoid the significant bleeding. In the neurosurgical practice, the knowledge is important due to variability in the number of mastoidal emissary veins and their connection to the venous sinuses.

“Surgical Insights for the Non-surgeon,” or SINS, is composed of several short chapters intended to cover fundamental surgical knowledge for non-surgeons. The authors focus on surgical pearls, operative insights, and applied anatomy. In Chapter 7 of this series, the authors address the liver and portal veins; their discussion includes anatomy, surgeries, and transplantation.

Hypospadias urethroplasty is considered difficult as the complications and unfavourable results are not uncommon. At the turn of the century, due to a better understanding of applied anatomy of hypospadias, new techniques were developed which significantly brought down the complication rate. However unfavourable results are still disturbing. An algorithm for selection of surgery has been presented. Forty three secondary surgeries were performed over 3 years for correction of unfavourable results. The urethrocutaneous fistula was the most common (21%) followed by meatal stenosis (14%) and narrow neourethra (14%). Common unfavourable results have been discussed. On the basis of experience with a large number of hypospadias urethroplasty ‘tips to avoid or minimise unfavourable results’ have been presented. However, one should assess the final outcome of urethroplasty using hypospadias objective scoring evaluation.

Assessing risk and avoiding complications in breast reduction requires a meticulous history, systematic physical examination, management of expectations, and careful consideration and execution of operative technique. Attention should be paid to comorbidities. Shape, symmetry, contours, scar location, skin quality, nipple-areolar complex (NAC) shape, NAC position relative to inframammary fold, and NAC position relative to the volume of the breast should be evaluated. Because complications cannot always be anticipated, informed consent is a vital part of managing expectations. Intraoperative considerations include blood pressure control, limiting tension, delayed healing and tissue loss, and using applied anatomy to avoid malposition and asymmetry.

“Surgical Insights for the Non-surgeon,” or SINS, is composed of several short chapters intended to cover fundamental surgical knowledge for non-surgeons. The authors focus on surgical pearls, operative insights, and applied anatomy. In Chapter 2 of this series, the authors outline tubes, drains, and ostomies, including their indications and possible complications.

“Surgical Insights for the Non-surgeon,” or SINS, is composed of several short chapters intended to cover fundamental surgical knowledge for non-surgeons. The authors focus on surgical pearls, operative insights, and applied anatomy. Chapter 1 of the series presents surgical definitions.

“Surgical Insights for the Non-surgeon,” or SINS, is composed of several short chapters intended to cover fundamental surgical knowledge for non-surgeons. The authors focus on surgical pearls, operative insights, and applied anatomy. In Chapter 5 of this series, the authors discuss the small bowel – its anatomy, its obstruction, and small bowel/mesenteric ischemia.

“Surgical Insights for the Non-surgeon,” or SINS, is composed of several short chapters intended to cover fundamental surgical knowledge for non-surgeons. The authors focus on surgical pearls, operative insights, and applied anatomy. In Chapter 4 of this series, the authors discuss stomach anatomy, hiatal hernia, peptic ulcer disease, and gastric surgery.