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Efforts to integrate the basic sciences into the ever-changing curriculum are a trending area of research in health professions education. Low-stakes, high-frequency assessment methods such as the progress test are now widely implemented in the United Kingdom and Northern Ireland as a means of furthering curricular integration toward contemporary goals of competency and professional identity formation. The anatomy educator's experience vis-à-vis these curricular changes is not well understood. This study aimed to explore how anatomy educators make sense of the shifting demands of their role. The interviews were semi-structured, particularly concerned with the phenomenon of teachers adapting to the complexity of their learning environment. The study used interpretative phenomenological analysis (IPA) to focus on the lived experiences of participants coping with the phenomena in question: how do anatomy educators make sense of the learning environment in the United Kingdom? Interviews were transcribed verbatim and interpreted inductively, identifying four key themes: confidence through connectedness, variations in appraisals of curricular integration, managing expectations to perform in paradoxical situations, and the emergence of innovative teaching. Results point to the learning environment as a complex system and highlight the importance of feeling support from and connection to colleagues, enabling individual educators to develop confidence, meet the top-down demands of changing curricula, and experience personal identity development and uncertainty tolerance within their role. This IPA study offers insight into the lived experiences of anatomy educators whose experiential interpretations of a complex and changing curriculum can uniquely inform stakeholders in health professions education.

The role of anatomical variability in safe clinical practice is underappreciated. A lack of familiarity of anatomical variations is at the center of a multitude of medical and surgical errors. The recent rise in litigation due to such errors suggests that patient care may be compromised. This makes the knowledge of anatomical variation essential to medical education. Empirical studies were identified by searching several databases and repositories, and the Medical Education Research Quality Instrument (MERSQI) was used to assess study quality. Eight studies were eligible for this systematic review; three of which were conference abstracts. Thematic summary of these studies yielded six themes namely: (1) "importance of anatomical variation in medical education"; (2) "the ideal time to introduce anatomical variation in medical education"; (3) "important anatomical variations to include in medical education"; (4) "approaches to teaching anatomical variation"; (5) "assessing knowledge on anatomical variation"; (6) "barriers to including anatomical variation in medical education." Including anatomical variations in medical education would improve clinical reasoning and surgical outcomes. Following the completion of this review, three recommendations were made: (1) increasing the emphasis of anatomical variation in medical education; (2) developing more resources for anatomical variation education; (3) investigating the implications of lack of knowledge of anatomical variation in medical education through further research.

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.

Anatomical education has suffered from reduced teaching time and poor availability of staff and resources over the past thirty years. Clay-based modeling (CBM) is an alternative technique for teaching anatomy that can improve student knowledge and experience. This systematic review aimed to summarize and appraise the quality of the literature describing the uses, advantages, and limitations of CBM compared to alternative methods of teaching human gross anatomy to students or qualified healthcare professionals. A systematic search of Embase, MEDLINE, Scopus, and Web of Science databases was conducted, and the Medical Education Research Quality Instrument (MERSQI) was used to assess study quality. Out of the 829 studies identified, 12 papers met the inclusion criteria and were eligible for this review. The studies were of high quality, with a mean MERSQI score of 11.50/18. Clay-based modeling can be used to teach all gross anatomical regions, and 11 studies demonstrated a significant improvement in short-term knowledge gain in students who used CBM in comparison to other methods of learning anatomy. Eight studies that included subjective assessment showed that CBM is rated highly. However, some studies showed that students viewed CBM as juvenile and experienced difficulty making the models. Additionally, there is no evidence to suggest that CBM improves long-term knowledge. Clay-based modeling is an effective learning method for human gross anatomy and should be incorporated into the anatomists' toolkit. In the future, more randomized controlled studies with transparent study designs investigating the long-term impact of CBM are needed.

The bony pelvis is an irregular but complete bony ring made up of the right and left hip bones anterolaterally and the sacrococcygeal part of the vertebral column posteriorly. The two hip bones are firmly united anteriorly at the pubic symphysis, and together constitute the pelvic girdle. The pelvic girdle articulates with the femoral heads and thereby connects the vertebral column (axial skeleton) to the two femora (appendicular skeleton). The main functions of the pelvic girdle are to transmit weight from the upper body to the lower limbs during locomotion and while standing, and to support the weight of the upper body when seated or stationary. Another important function of the bony pelvis is to provide attachment for the powerful muscles (e.g. gluteal muscles) that act on the lower limb and those muscles that support the abdominal wall. The bony pelvis also provides ample protection to the many delicate viscera, vessels and nerves that lie within the pelvic cavity. Successful orthopaedic management of disruptions of the bony pelvis and management of associated injuries to intrapelvic viscera require a sound appreciation of the anatomy of the pelvic ring and pelvic cavity. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Advances in technology have led to significant developments in techniques for imaging the abdominal and pelvic organs, in both the elective and emergency surgical settings. Improvements in the quality and availability of imaging has had a profound effect on the delivery of high-quality surgical care and has improved outcomes by providing accurate preoperative diagnosis and staging, leading to a reduction in exploratory and futile operations, while permitting better planned precision surgery and a growing range of interventional radiology procedures. This article will describe the essential anatomical interpretation of the common radiological imaging techniques relevant to the abdomen and pelvis and describe the rationale for selection of the most appropriate imaging modality. [ABSTRACT FROM AUTHOR]

The oesophagus is the part of the digestive tract between the pharynx and stomach. The oesophagus is susceptible to several pathological conditions, both congenital and acquired, which may require surgical management. These include congenital oesophageal atresia, functional disorders such as achalasia cardia and hiatus hernia, corrosive strictures, traumatic oesophageal perforation, and oesophageal cancer. This article describes, in detail, those aspects of the topographical anatomy of the oesophagus which are of relevance to clinical diagnosis and surgical management. [ABSTRACT FROM AUTHOR]

The stomach is the most dilated portion of the muscular tube that forms the digestive tract. It is located between the oesophagus proximally, and the duodenum distally. Developmentally, the stomach is a derivative of the embryonic foregut, and this derivation is reflected in its arterial supply from the coeliac trunk – the artery to the foregut. Physiologically, the stomach acts simultaneously as a temporary food store, an organ of digestion, and a mechanism to control the rate of flow of digested food into the small intestine where absorption occurs. This article describes in detail the surgically relevant topographical anatomy of the stomach, including its blood supply and lymphatic drainage. [ABSTRACT FROM AUTHOR]

The biliary system or biliary tract is an elaborate system of coalescing channels which transports bile from the liver to the second part of the duodenum. The biliary system is divided for descriptive purposes into intrahepatic and extrahepatic parts. This article is confined to a description of the clinical and surgical anatomy of the extrahepatic biliary tract, comprising the right and left hepatic ducts, common hepatic duct, gallbladder and cystic duct and the common bile duct. Diseases of the extrahepatic biliary tract account for a considerable volume of abdominal surgical practice. These include metabolic, inflammatory, neoplastic, and congenital conditions. A detailed knowledge of the anatomy of the gallbladder and bile ducts and an awareness of the anatomical variations to which these structures are subject are essential to the conduct of safe and effective surgery involving the biliary tract, besides being of crucial importance to the accurate interpretation of radiological and ultrasound images of the extrahepatic biliary tract. [ABSTRACT FROM AUTHOR]

This article highlights the clinically and surgically relevant aspects of the anatomy of the liver. The liver is the largest organ in the human body. It can be divided functionally into eight hepatic segments, each with their own blood supply and bile outflow. Anatomically, however, it is divided into the right, left, caudate, and quadrate lobes. The porta hepatis, effectively the hilum of the liver, receives the hepatic artery, hepatic portal vein, right and left hepatic ducts, as well as lymphatic and autonomic nerves. [ABSTRACT FROM AUTHOR]

The large intestine comprises the caecum and appendix, colon, rectum, and anal canal from proximal to distal. Embryologically, the proximal half of the large intestine is derived from the midgut, while the distal half develops from the hindgut. This dual derivation is reflected in the difference in arterial supply to its proximal (superior mesenteric artery) and distal (inferior mesenteric artery) portions. Physiologically, the large intestine primarily functions to absorb water and essential electrolytes (sodium and chloride) from its luminal contents leaving the unabsorbed residue to be excreted as faeces. Fibre-optic colonoscopy and MRI and CT colonography allow detailed internal inspection of the large intestine with relative ease and with minimal discomfort. This article highlights the clinically and surgically relevant aspects of the anatomy of the caecum, appendix, and colon. [ABSTRACT FROM AUTHOR]

The rectum and anal canal are the terminal portions of large intestine and the entire gastrointestinal tract. They are thus readily accessible to direct inspection and examination. The rectum functions as a distensible reservoir for faeces, while the anal canal possesses a powerful muscular sphincter in its wall which is important in maintaining faecal continence. Diseases of the rectum and anal canal, both benign and malignant, account for a very large part of colorectal surgical practice worldwide. This article emphasizes the clinically and surgically relevant aspects of the anatomy of the rectum and anal canal. [ABSTRACT FROM AUTHOR]

For descriptive purposes, the urinary tract is divided into upper and lower parts. The kidneys and ureters make up the upper urinary tract with the urinary bladder and urethra forming the lower urinary tract. This article discusses the anatomy of the kidney and ureter highlighting key aspects that are of relevance to their function and to the surgeon. The article also includes a brief account of the anatomy of the suprarenal gland because of the close anatomical relationship between it and the upper urinary tract. [ABSTRACT FROM AUTHOR]

For descriptive purposes, the urinary tract is divided into upper and lower parts. The kidneys and ureters make up the upper urinary tract with the urinary bladder and urethra forming the lower urinary tract. In this article, a detailed description of the surgical and functional anatomy of the urinary bladder is followed by a description of the clinical anatomy of the female and male urethra. There then follows a brief description of the relevant anatomy of the prostate and seminal vesicles. While not strictly involved in the conduction of urine from the bladder to the exterior, the prostate and seminal vesicles are so intimately related (both topographically and functionally) to the urethra and bladder that no account of the lower urinary tract in the male would be complete without them. It is conventional therefore to regard the prostate and seminal vesicles as part of the lower urinary tract. [ABSTRACT FROM AUTHOR]

The pancreas is a large, retroperitoneal organ situated immediately behind the posterior wall of the lesser sac, in the floor of the supracolic compartment of the abdominal cavity. Although principally an exocrine gland, the pancreas also performs crucially important endocrine functions. Its deep location and its close topographical relationship to several vital structures make pancreatic surgery both challenging and hazardous. A sound appreciation of the topographical, vascular and ductal anatomy of the pancreas is fundamental to the successful surgical management of pancreatic cancers, congenital malformations of the pancreas and various surgical complications of acute pancreatitis. The spleen is the largest lymphoid organ in the body. It is situated deep in the left hypochondrium, wedged between the gastric fundus, left hemidiaphragm and left kidney. Trauma, lymphoid neoplasia, gastric cancers, portal hypertension and idiopathic thrombocytopenia may necessitate splenectomy. A sound knowledge of the surgical and functional anatomy of the spleen is essential if splenectomy is to be performed safely and effectively. [ABSTRACT FROM AUTHOR]

This article discusses the surgical anatomy of the hand highlighting key aspects that are of relevance to its function and to the surgeon. [ABSTRACT FROM AUTHOR]

The human breasts are paired mammary glands located on the anterior aspect of the thorax. They are more prominent in females after puberty and only rudimentary in males. This article will therefore focus primarily on the female breast, noting any issues of significance to the male breast as necessary. The article will cover the topographical anatomy including blood supply, the development of the breast, and the physiology of the breast in that order. [ABSTRACT FROM AUTHOR]

The nervous system is divided topographically into two parts: the central nervous system and the peripheral nervous system. From a functional perspective, however, the two systems are intimately connected and function in an integrated and coordinated manner. The central nervous system comprises the brain and spinal cord, while the peripheral nervous system is made up of the cranial and peripheral nerves and associated neurological structures. This article presents a broad and general overview of the structure and organization of the nervous system emphasizing several important functional features. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

The bony pelvis is an irregular but complete bony ring made up of the right and left hip bones anterolaterally and the sacrococcygeal part of the vertebral column posteriorly. The two hip bones are firmly united anteriorly at the pubic symphysis, and together constitute the pelvic girdle. The pelvic girdle articulates with the femoral heads and thereby connects the vertebral column (axial skeleton) to the two femora (appendicular skeleton). The main functions of the pelvic girdle are to transmit weight from the upper body to the lower limbs during locomotion and while standing, and to support the weight of the upper body when seated or stationary. Another important function of the bony pelvis is to provide attachment for the powerful muscles (e.g. gluteal muscles) that act on the lower limb and those muscles that support the abdominal wall. The bony pelvis also provides ample protection to the many delicate viscera, vessels and nerves that lie within the pelvic cavity. Successful orthopaedic management of disruptions of the bony pelvis and management of associated injuries to intrapelvic viscera require a sound appreciation of the anatomy of the pelvic ring and pelvic cavity. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Advances in technology have led to significant developments in techniques for imaging the abdominal and pelvic organs, in both the elective and emergency surgical settings. Improvements in the quality and availability of imaging has had a profound effect on the delivery of high-quality surgical care and has improved outcomes by providing accurate preoperative diagnosis and staging, leading to a reduction in exploratory and futile operations, while permitting better planned precision surgery and a growing range of interventional radiology procedures. This article will describe the essential anatomical interpretation of the common radiological imaging techniques relevant to the abdomen and pelvis and describe the rationale for selection of the most appropriate imaging modality. [ABSTRACT FROM AUTHOR]

In England, Wales, and Northern Ireland, people can choose to donate their bodies post-mortem to Medical School Anatomy Units. The body donation (BD) process is facilitated by anatomy unit staff (AUS). However, little is known about the extent and nature of AUS work with families, including when a body cannot be accepted. To address this gap, this paper draws on data from an ethnographic study, including a survey of 15 anatomy units (AUs) in England and Northern Ireland, a case study of one AU, 20 semi-structured interviews with 31 AUS and document analysis. We reveal the number of bodies (878) that are refused across AUs and examine how AUS deal with refusals. We argue that activities around refusals constitutes ‘over and above’ work for AUS, as it goes beyond their expected role. We suggest that this is done out of a duty of care, and is related to the discomfort of refusing the BD gift. Attention is given to the ‘over and above’ work of the AUS which allows for an exploration of gift relationships and emotion management in a new arena. We conclude with recommendations to address the lack of recognition and training around AUS refusal work. [ABSTRACT FROM AUTHOR]

The submental island flap has been increasing in popularity for both oncological and non-oncological reconstruction of the head and neck. However, the original description of this flap left it with the unfortunate designation as a lymph node flap. There has thus been significant debate on the oncological safety of the flap. In this cadaveric study the perforator system suppling the skin island is delineated and the lymph node yield of the skeletonised flap is analysed histologically. A safe and consistent approach to raising the perforator flap modification is described and the pertinent anatomy, and an oncological discussion with regards to the submental island perforator flap histological lymph node yield discussed. Ethical approval was received from Hull York Medical School for the anatomical dissection of 15 sides of cadavers. 6 x 4cm submental island flaps were raised following a vascular infusion of a 50/50 mix of acrylic paint. The flap size mimics the T1/T2 tumour defects these flaps would usually be used to reconstruct.The submental vascular anatomy, including length, diameter, venous drainage patterns, and the skin perforator system was documented. The dissected submental flaps were then histologically examined for the presence of lymph nodes by a head and neck pathologist at Hull University Hospitals Trust department of histology. The total length of the submental island arterial system, the distance from where the facial artery branches off from the carotid to the submental artery perforator entering the anterior belly of digastric or skin, averaged 91.1mm with anaverage facial artery length of 33.1mm and submental artery of 58mm. Vessel diameter for microvascular reconstruction was 1.63mm for the submental artery and 3mm for the facial artery. The most common venous anatomy drainage pattern was the submental island venaecomitantes draining to the retromandibular system then to the internal jugular vein. Almost half the specimens had a dominant superficial submental perforator allowing the ability to raise this as a skin only system. There were generally 2-4 perforators passing through the anterior belly of digastric to supply the skin paddle.73.3% (11/15) of the skeletonised flaps contained no lymph nodes on histological examination. The perforator version of the submental island flap can be safely and consistently raised with inclusion of the anterior belly of digastric. In approximately half the cases a dominant superficial branch allows for a skin only paddle. Due to the vessel diameter, free tissue transfer is predictable.Venous anatomy is variable and care needs to be taken when raising this flap. The skeletonised version of the perforator flap is largely devoid of nodal yield and on oncological review a 16.3% recurrence rate is equivalent to current standard treatment., (Copyright © 2023 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.)