Getting physical with medical education:Exercise based virtual anatomy review classes for medical students

The benefits of regular physical activity are well known.Yet,few studies have examined the effectiveness of integrating physical activity(PA)into curricula within a post-secondary setting.To investigate the incorporation of PA into medical curriculum,we developed a series of optional exercise-based review sessions designed to reinforce musculoskeletal(MSK)anatomy course material.These synchronous sessions were co-taught by a group fitness instructor and an anatomy instructor.The fitness instructor would lead students through both strength and yoga style exercises,while the anatomy instructor asked questions about relevant anatomical structures related to course material previously covered.After the sessions,participants were asked to evaluate the classes on their self-reported exam preparedness in improving MSK anatomy knowledge,PA levels,and mental wellbeing.Thirty participants completed surveys;a majority agreed that the classes increased understanding of MSK concepts(90.0%)and activity levels(97.7%).Many(70.0%)felt that the classes helped reduce stress.The majority of respondents(90.0%)agreed that the classes contributed to increased feelings of social connectedness.Overall,medical students saw benefit in PA based interventions to supplement MSK course concepts.Along with increasing activity levels and promoting health behaviours,integrating PA into medical curriculum may improve comprehension of learning material,alleviate stress and foster social connectivity among medical students.

Avian hippocampus:Recent advances in anatomy and physiological functions

The avian hippocampus,akin to its mammalian counterpart,plays a critical role in cognitive and physiological processes despite notable structural differences.Initially thought to be less developed,recent studies over the past two decades have revealed it as a complex brain region essential for diverse functions in both laboratory and free-living birds.This review synthesizes current knowledge on the avian hippocampus’organization,functionality,and neurophysiological significance.We first examine its anatomical structure and neuronal connectivity,comparing it with the mammalian hippocampus.We then highlight how its volume,neuronal density,and neurogenesis support spatial memory and navigation,influencing behaviors such as migration,food storing,brood parasitism,and homing.Beyond spatial functions,the avian hippocampus mediates emotion and stress physiology through interactions with the endocrine system,particularly via glucocorticoid receptors.It also influences spatial memory through sex hormones,especially estradiol,with local estrogen production through aromatase activity enhancing memory and plasticity.Therefore,the avian hippocampus serves as a central neural hub,integrating sensory information with internal states to facilitate essential behaviors and responses to external environmental stimuli.This review underscores the progress made in understanding this brain structure’s roles,highlighting conserved neurophysiological functions across vertebrate taxa.

Wood anatomy chronologies of Scots pine in the foothills of the Western Sayan(Siberia)

Recent methodological advances in quantitative wood anatomy have provided new insights into the climatic responses of radial growth at the scale of cell structure of tree rings. This study considered long-term chronologies of tracheid measurements, indexed by a novel approach to separate their specific climatic responses from signal recorded in cell production(closely reflected in tree-ring width). To fill gaps in understanding the impact of climate on conifer xylem structure, Scots pine(Pinus sylvestris L.)trees > 200 years old were selected within the forest-steppe zone in southern Siberia. Such habitats undergo mild moisture deficits and the resulting climatic regulation of growth processes. Mean and maximum values of cell radial diameter and cell wall thickness were recorded for each tree ring.Despite a low level of climatogenic stress, components of cell chronologies independent of cambial activity were separated to obtain significant climatic signals revealing the timing of the specific stages of tracheid differentiation. Cell expansion lasted from mid-April to July and was impacted similarly to tree-ring width(stimulated by precipitation and stressed by heat), maximum cell size formed late June. A switch in the climatic responses of mean anatomical traits indicated transition to latewood in mid-July. Secondary wall deposition lasted until mid-September, suppressed by end of season temperatures. Generally, anatomical climatic responses were modulated by a less dry May and September compared with summer months.

Is fluoroscopy-free single-use flexible ureteroscopy a feasible treatment for kidney stones with abnormal renal anatomy?

ObjectiveThis study aimed to evaluate the feasibility of the fluoroscopy-free single-use flexible ureteroscopy procedure in the treatment of kidney stones with abnormal renal anatomy compared to normal renal anatomy.MethodsForty patients with abnormal (Group A) and 80 patients with normal (Group B) renal anatomy who had 10–20 mm renal stones were included. They were treated with LithoVue single-use flexible ureteroscopy (Boston Scientific, Marlborough, MA, USA) after ureteric dilatation by two different size semi-rigid ureteroscopes. This technique was chosen as the aim was to exclude any ureteric pathology (e.g., stone or stricture), confirm the placement of a safe guidewire, avoid balloon dilatation of the ureter, and achieve safe insertion of a 12 Fr, 35/45 cm ureteric access sheath with optical and tactile sign and without fluoroscopy image for guidance.ResultsThe mean ages were 43 years and 45 years in Group A and Group B, respectively. The mean stone burden was 14.62 (standard deviation: 5.35) mm^(3) and 14.79 (standard deviation: 4.58) mm^(3) in Group A and Group B, respectively. There is no significant difference between both groups according to the mean operative time, hospital stay, or stone-free rate. The stone-free rate was about 93% in both groups when the stone size was between 10 mm and 15 mm, and less than 54% when the stone size was more than 15 mm to 20 mm. In the majority of cases (80.0% in Group A and 92.5% in Group B), we completed the procedure without fluoroscopy. The perioperative complication rates were comparable in the two groups.ConclusionFluoroscopy-free single-use flexible ureteroscopy, when performed by expert urologists, is a feasible treatment for pre-stented patients with kidney calculi of ≤15 mm with abnormal renal anatomy.

Novel techniques of liver segmental and subsegmental pedicle anatomy from segment 1 to segment 8

BACKGROUND Laparoscopic anatomical liver resection has become more challenging because some subsegmental Glissonean pedicles are hard to dissect.Here,we introduce how to dissect every(sub)segmental Glissonean pedicle from the first porta hepatis and perform standardized(sub)segmentectomy[from segment 1(S1)to S8].AIM To summarize our methods of laparoscopic anatomical segmental and subseg-mental liver resection.METHODS The Glisson sheath and liver capsule were separated along the Laennec mem-brane.The Glissonean pedicle could be isolated and transected with little or no parenchymal damage through this extra-Glissonean dissection approach.The basin of the(sub)segment was determined by the ischemia demarcation line or indocyanine green staining.The hepatic vein or intersegmental vein was also used to guide the plane of parenchymal transection.RESULTS All segmental or subsegmental pedicles or even the pedicle of the cone unit could be dissected along the Laennec membrane using our novel technique through the first porta hepatis.The dorsal branches of S8,the branches of S4a and the paracaval portion branches(b/c vein)of the caudate lobe were the most difficult to dissect.CONCLUSION The novel techniques of liver segmental and subsegmental pedicle anatomy is feasible for laparoscopic liver resection and can help accurately guide(sub)segmentectomy from S1 to S8.

Opinions of Students on the Contribution of the DIVA 3D Virtual Dissection Table to the Teaching of Anatomy at the Faculty of Medicine and Odontostomatology of Bamako

Objective: Study the contribution of the DIVA 3D dissection table in the teaching of anatomy at the Faculty of Medicine and Odontology of Bamako. Material and Methods: This was a qualitative study carried out from November 1 to December 30, 2023 at the clinical and morphological anatomy laboratory of the Faculty of Medicine and Odontostomatology of Bamako. Included in this study were students who participated in practical and tutorial sessions. The variables studied during this study were: the previous performance of dissection on a cadaver by the students, the opinion of the students on dissection on a cadaver, the replacement of dissection on a cadaver by virtual dissection in the absence of a body, the level student satisfaction. Results: We surveyed 130 participants. The average age was 22 ± 0.2 years with extremes of 17 and 29 years. 95.3% of participants were students. According to 66.7% of participants, virtual dissection is a good palliative in the absence of a corpse. 95.3% of participants found using the virtual dissection table easy with an average of 7.88 ± 1.4. The overall assessment was well rated by 99.3% of participants. Conclusion: According to the results of this study, the virtual dissection table should be improved by integrating commented videos. The use of the DIVA 3D virtual dissection table during practical and tutorial sessions is well appreciated by the students. We believe that the teaching of anatomy using 3D digital technology should be included in the study programs of the Faculty of Medicine and Odontostomatology.

Development and application of digital assistive teaching system for anatomy

Background Anatomy is a required course for all medicine-related industries.In recent decades,the teaching quality and effect of anatomy have been compromised by factors including a decrease in human body specimens,dampened enthusiasm for the discipline,reduced teaching hours of anatomy,scale expansion of medical education,and obstacles in performing field autopsies and observations.Methods Based on China's digitalized visible human research achievements,this article extracts the boundary information of anatomic structures from tomographic images,constructs three dimensional(3D)digital anatomical models with authentic texture information,and develops an anatomy assistive teaching system for teachers and students based on the knowledge points of anatomy,to meet the anatomy teaching requirements of different majors at various levels.Results This scientific,complete,and holistic system has produced over 60003D digital anatomical models,5000 anatomy knowledge points,50 anatomical operation videos,and 150 micro demonstration classes,with teaching contents for different majors and levels,such as systematic anatomy,topographic anatomy,sectional anatomy,anatomy of motion,and virtual anatomical operation table.Ranging from network terminals,desktops,touchscreen 3D displays,desktops,and projection 3D volumetric displays to augmented reality,its diversified interactive forms meet the requirements for a learning environment in different settings.Conclusions With multiple teaching and learning links covered,such as teaching environment,teaching resources,instructional slides,autonomous learning,and learning effect evaluation,this novel teaching system serves as a vital component and a necessary resource in anatomy teaching and functions as an important supplement to traditional anatomy teaching.Applied and promoted in most medical colleges and schools in China,this system has been recognized and approved by anatomy teachers and students,and plays a positive role in guaranteeing the effect and quality of anatomy teaching.

Fruit Anatomy of sect. Paracamellia with Reference to Their Significance of Germplasm Resources Exploitation

[Objective] To utilize the germplasm resources,new systematic evidence for the classification of sect.Paracamellia,genus Camellia is found in this article.[Method] Fruit anatomy of 10 species representing sect.Paracamellia was investigated.And the main component of sect.Paracamellia in the genus Camellia was studied by MVSP software.[Result] The exocarp was thin;mesocarp was broad,having a large number of stone cells;endocarp was lignified,and separated easily from seed.The principle components analysis suggested that the distance between species was far,showing far relation;the current study did not support the formation of Camellia grijsii（C.grijsii）and Camellia yuhsienensis（C.yuhsienensis）,Camellia shensiensis（C.shensiensis）should not be recognized as a variety of C.yuhsienensis.In addition,it also proved Ming＇s combining of Camellia confusa（C.confusa）and Camellia kissi（C.kissi）was unnatural.[Conclusion] The study provided theoretical basis for the development and application of sect.Paracamellia in the genus Camellia.

A Preliminary Study on Anatomy of the Stem and Leaf of Premna microphylla Turcz.

[Objective] This study was to reveal the anatomic structure of Premna microphylla Turcz.stem and leaf.[Method] Using plant anatomy method,we performed anatomic analysis of Premna microphylla Turcz.stem and leaf.[Result] The stem of Premna microphylla Turcz.is axially symmetric organ,its primary structure consists of three parts of epidermis,cortex and vascular cylinder.The petiole consists of epidermis,cortex and vascular cylinder,of which epidermis is a layer of cells with cuticle and epidermal hair.The sun leaf in Premna microphylla is dorsi-ventral leaf,wich is consist of palisade tissue and spongy tissue;while its shade leaf of Premna microphylla almost are isobilateral leaf.[Conclusion] Our results provided reference for further the exploitation and utilization of Premna microphylla Turcz.resources.

Modeling and simulation of an anatomy teaching system

Specimen observation and dissection have been regarded as the best approach to teach anatomy,but due to the severe lack of anatomical specimens in recent years,the quality of anatomy teaching has been seriously affected.In order to disseminate anatomical knowledge effectively under such circumstances,this study discusses three key factors(modeling,perception,and interaction)involved in constructing virtual anatomy teaching systems in detail.To ensure the authenticity,integrity,and accuracy of modeling,detailed three-dimensional(3D)digital anatomical models are constructed using multi-scale data,such as the Chinese Visible Human dataset,clinical imaging data,tissue sections,and other sources.The anatomical knowledge ontology is built according to the needs of the particular teaching purposes.Various kinds of anatomical knowledge and 3D digital anatomical models are organically combined to construct virtual anatomy teaching system by means of virtual reality equipment and technology.The perception of knowledge is realized by the Yi Chuang Digital Human Anatomy Teaching System that we have created.The virtual interaction mode,which is similar to actual anatomical specimen observation and dissection,can enhance the transmissibility of anatomical knowledge.This virtual anatomy teaching system captures the three key factors.It can provide realistic and reusable teaching resources,expand the new medical education model,and effectively improve the quality of anatomy teaching.

Henry Vandyke Carter (1831-1897): the forgotten co-author of Gray’s Anatomy

Henry Vandyke Carter(1831–1897),physician and illustrator from Saint George’s Hospital in London,England.He worked with Henry Williamson Gray(1827–1861)on anatomical dissections and Carter’s illustrations contributed significantly to the success of the Treaty of Anatomy,Descriptive and Surgical.Henry Carter never achieved any credit or royalty for his work.This book is currently regarded as one of the most influential human anatomy textbooks.The paper aims to present a brief review of Henry Carter’s contributions to the medical field.

The Role of Anatomical Specimens in the Teaching of Anatomy

characteristics,complex content,and it is difficult to understand.In view of the nature of the subject,many different models and specimens are required during teaching,increasing the difficulty of its teaching.Although the mode of medical teaching is constantly updating,anatomical specimens are still important in the teaching of anatomy,as they help students to understand the organs,their positions,and structural forms as well as to better grasp the theoretical aspect.In addition,anatomical specimens and medical students contact condition can affect the teaching effect.Therefore,it is imperative to give full play to the role of anatomical specimens in anatomy teaching to improve the teaching effect.This paper summarizes the research on the use of anatomical specimens in the teaching of anatomy.

Current status of endoscopic retrograde cholangiopancreatography in patients with surgically altered anatomy

Endoscopic retrograde cholangiopancreatography(ERCP)in patients with surgically altered anatomy must be performed by a highly experienced endoscopist.The challenges are accessing the afferent limb in different types of reconstruction,cannulating a papilla with a reverse orientation,and performing therapeutic interventions with uncommon endoscopic accessories.The development of endoscopic techniques has led to higher success rates in this group of patients.Device-assisted ERCP is the endoscopic procedure of choice for high success rates in short-limb reconstruction;however,these success rate is lower in long-limb reconstruction.ERCP assisted by endoscopic ultrasonography is now popular because it can be performed independent of the limb length;however,it must be performed by a highly experienced and skilled endoscopist.Stent deployment and small stone removal can be performed immediately after ERCP assisted by endoscopic ultrasonography,but the second session is needed for other difficult procedures such as cholangioscopy-guided electrohydraulic lithotripsy.Laparoscopic-assisted ERCP has an almost 100%success rate in longlimb reconstruction because of the use of a conventional side-view duodenoscope,which is compatible with standard accessories.This requires cooperation between the surgeon and endoscopist and is suitable in urgent situations requiring concomitant cholecystectomy.This review focuses on the advantages,disadvantages,and outcomes of various procedures that are suitable in different situations and reconstruction types.Emerging new techniques and their outcomes are also discussed.

Anatomy and influence of the splenic artery in laparoscopic spleen-preserving splenic lymphadenectomy

AIM: To investigate the splenic hilar vascular anatomy and the influence of splenic artery(Sp A) type in laparoscopic total gastrectomy with spleen-preserving splenic lymphadenectomy(LTGSPL).METHODS:The clinical anatomy data of 317 patients with upper- or middle-third gastric cancer who underwent LTGSPL in our hospital from January 2011 to December 2013 were collected. The patients were divided into two groups(concentrated group vs distributed group) according to the distance between the splenic artery's furcation and the splenic hilar region. Then, the anatomical layout, clinicopathologic characteristics, intraoperative variables, and postoperative variables were compared between the two groups.RESULTS: There were 205 patients with a concentrated type(64.7%) and 112 patients with a distributed type(35.3%) Sp A. There were 22 patients(6.9%) with a single branch of the splenic lobar vessels, 250(78.9%) with 2 branches, 43(13.6%) with 3 branches, and 2 patients(0.6%) with multiple branches. Eighty sevenpatients(27.4%) had type?Ⅰ?splenic artery trunk, 211(66.6%) had type Ⅱ, 13(4.1%) had type Ⅲ, and 6(1.9%) had type Ⅳ. The mean splenic hilar lymphadenectomy time(23.15 ± 8.02 vs 26.21 ± 8.84 min; P = 0.002), mean blood loss resulting from splenic hilar lymphadenectomy(14.78 ± 11.09 vs 17.37 ± 10.62 m L; P = 0.044), and number of vascular clamps used at the splenic hilum(9.64 ± 2.88 vs 10.40 ± 3.57; P = 0.040) were significantly lower in the concentrated group than in the distributed group. However, the mean total surgical time, mean total blood loss, and the mean number of harvested splenic hilar lymph nodes were similar in both groups(P > 0.05 for each comparison). There were also no significant differences in clinicopathological and postoperative characteristics between the groups(P > 0.05).CONCLUSION: It is of value for surgeons to know the splenic hilar vascular anatomy when performing LTGSPL. Patients with concentrated type Sp A may be optimal patients for training new surgeons.

Anatomy of the lateral ligaments of the rectum: A controversial point of view

The existence and composition of the lateral ligaments of the rectum (LLR) are still the subjects of anatomical confusion and surgical misconception up to now. Since Miles proposed abdominoperineal excision as radical surgery for rectal cancer, the identification by "hooking them on the finger" has been accepted by many surgeons with no doubt; clamping, dividing and ligating are considered to be essential procedures in mobilization of the rectum in many surgical textbooks. But in cadaveric studies, many anatomists could not find LLR described by the textbooks, and more and more surgeons also failed to find LLR during the proctectomy according to the principle of total mesorectal excision. The anatomy of LLR has diverse descriptions in literatures. According to our clinical observations, the traditional anatomical structures of LLR do exist; LLR are constant dense connective bundles which are located in either lateral side of the lower part of the rectum, run between rectal visceral fascia and pelvic parietal fascia above the levator ani, and covered by superior fascia of pelvic diaphragm. They are pathways of blood vessels and nerve fibers toward the rectum and lymphatic vessels from the lower rectum toward the iliac lymph nodes.

Innovations and techniques for balloon-enteroscopeassisted endoscopic retrograde cholangiopancreatography in patients with altered gastrointestinal anatomy

Endoscopic retrograde cholangiopancreatography(ERCP) remains challenging in patients who have undergone surgical reconstruction of the intestine.Recently,many studies have reported that balloonenteroscope-assisted ERCP(BEA-ERCP) is a safe and effective procedure.However,further improvements in outcomes and the development of simplified procedures are required.Percutaneous treatment,Laparoscopy-assisted ERCP,endoscopic ultrasoundguided anterograde intervention,and open surgery are effective treatments.However,treatment should be noninvasive,effective,and safe.We believe that these procedures should be performed only in difficult-to-treat patients because of many potential complications.BEA-ERCP still requires high expertiselevel techniques and is far from a routinely performed procedure.Various techniques have been proposed to facilitate scope insertion(insertion with percutaneous transhepatic biliary drainage(PTBD) rendezvous technique,Short type single-balloon enteroscopes with passive bending section,Intraluminal injection of indigo carmine,CO2 inflation guidance),cannulation(PTBD or percutaneous transgallbladder drainage rendezvous technique,Dilation using screw drill,Rendezvous technique combining DBE with a cholangioscope,endoscopic ultrasound-guided rendezvous technique),and treatment(overtube-assisted technique,Short type balloon enteroscopes) during BEA-ERCP.The use of these techniques may allow treatment to be performed by BEA-ERCP in many patients.A standard procedure for ERCP yet to be established for patients with a reconstructed intestine.At present,BEA-ERCP is considered the safest and most effective procedure and is therefore likely to be recommended as firstline treatment.In this article,we discuss the current status of BEA-ERCP in patients with surgically altered gastrointestinal anatomy.

A handy review of carpal tunnel syndrome:From anatomy to diagnosis and treatment

Carpal tunnel syndrome(CTS) is the most commonly diagnosed disabling condition of the upper extremities. It is the most commonly known and prevalent type of peripheral entrapment neuropathy that accounts for about 90% of all entrapment neuropathies. This review aims to provide an outline of CTS by considering anat-omy, pathophysiology, clinical manifestation, diagnostic modalities and management of this common condition, with an emphasis on the diagnostic imaging evaluation.

Tooth anatomy risk factors influencing root canal working length accessibility

The aim of this study was to analyze the specific influence of root canal anatomy on the accessibility of working length during root canal therapy. Four hundred seventy-six root canal therapy cases （amounting to a total of 1 005 root canals） were examined. The anatomy risk factors assessed in each case included： tooth type （tooth location）, root canal curvature, and root canal calcification, as well as endodontic retreatment. The investigation examined the correlation between each of these anatomic factors and the working length, with statistical analysis consisting of Chi-square tests and multiple logistic regression analysis. In an independent factor analysis, tooth type （tooth iocation）, root canal curvature, canal calcification, and endodontic retreatment were determined to be the primary risk factors. In a multiple-factor regression model, root curvature and canal calcification were found to most significantly influence root canal working length accessibility （P〈0.05）. Root canal anatomy increases the difficulty of root canal preparation. Appropriate consideration of tooth anatomy will assist in accurate determination of preparation difficulty before instrumentation. This study alerts clinical therapists to anatomical factors influencing the working length accessibility, and allows for a direct estimate of success rate given in situ measurements of tooth factors during the root canal treatment procedure.

Crucial anatomy and technical cues for laparoscopic transabdominal preperitoneal repair: Advanced manipulation for groin hernias in adults

Groin hernias include indirect inguinal, direct inguinal, and femoral hernias. Obturator and supravesical hernias appear very close to the groin. High-quality repairs are required for groin hernias. The concept of "tension-free repair" is generally accepted, and surgical repairs with mesh are categorized as "hernioplasties". Surgeons should have good knowledge of the relevant anatomy. Physicians generally focus on the preperitoneal space, myopectineal orifice, topographic nerves, and regional vessels. Currently, laparoscopic surgery has therapeutic potential in the surgical setting for hernioplasty, with laparoscopic transabdominal preperitoneal(TAPP) repair appearing to be a powerful tool for use in adult hernia patients. TAPP offers the advantages of accurate diagnoses, repair of bilateral and recurrent hernias, less postoperative pain, early recovery allowing work and activities, tension-free repair of the preperitoneal(posterior) space, ability to cover obturator hernias, and avoidance of potential injury to the spermatic cord. The disadvantages of TAPP are the need for general anesthesia, adhering to a learning curve, higher cost, unexpected complications related to abdominal organs, adhesion to the mesh, unexpected injuries to vessels, prolonged operative time, and as-yet-unknown long-term outcomes. Both technical skill and anatomical familiarity are important for safe, reliable surgery. With increasing awareness of the importance of anatomy during TAPP repair, we address the skills and pitfalls during laparoscopic TAPP repair in adult patients using illustrations and schemas. We also address debatable points on this subject.

Postcranial Anatomy of the Mesozoic Dalinghosaurus (Squamata): Evidence from a New Specimen of Western Liaoning

The postcranial skeleton of a new specimen of the long-tailed lizard Dalinghosaurus longidigitus was excavated from the Yixian Formation in Lingyuan, western Liaoning. The new specimen provides more anatomical information about this species, especially about the anterior dorsal vertebrae, shoulder girdle and forelimbs. This lizard can be included within the clade Scleroglossa by its 27 or more presacrals, moderately long pubis, and gently notched distal end of tibia. But the detailed systematic position for this taxon remains undetermined. The features of the much longer hind limbs and pes compared with forelimbs and manus, metatarsal Ⅳ longer than Ⅲ, pedal phalanges robust, and penultimate phalanx not longer than other phalanges etc. suggest that this lizard was a running and ground swelling animal.