Objectives
The purpose of this study was to quantify the benefit of the incorporation of radiologic anatomy (RA), in terms of student training in RA seminars, cadaver CT scans and life-size virtual ...dissection tables on the learning success in general anatomy.
Methods
Three groups of a total of 238 students were compared in a multiple choice general anatomy exam during first-year gross anatomy: (1) a group (year 2015,
n
1
= 50) that received training in radiologic image interpretation (RA seminar) and additional access to cadaver CT scans (CT + seminar group); (2) a group (2011,
n
2
= 90) that was trained in the RA seminar only (RA seminar group); (3) a group (2011,
n
3
= 98) without any radiologic image interpretation training (conventional anatomy group). Furthermore, the students’ perception of the new curriculum was assessed qualitatively through a survey.
Results
The average test score of the CT + seminar group (21.8 ± 5.0) was significantly higher when compared to both the RA seminar group (18.3 ± 5.0) and the conventional anatomy group (17.1 ± 4.7) (
p
< 0.001).
Conclusions
The incorporation of cadaver CT scans and life-size virtual dissection tables significantly improved the performance of medical students in general gross anatomy. Medical imaging and virtual dissection should therefore be considered to be part of the standard curriculum of gross anatomy.
Key Points
• Students provided with cadaver CT scans achieved 27 % higher scores in anatomy.
• Radiological education integrated into gross anatomy is highly appreciated by medical students.
• Simultaneous physical and virtual dissection provide unique conditions to study anatomy.
Background
Changes in UK legislation allow for surgical procedures to be performed on cadavers. The aim of this study was to assess Thiel cadavers as high-fidelity simulators and to examine their ...suitability for surgical training.
Methods
Surgeons from various specialties were invited to attend a 1 day dissection workshop using Thiel cadavers. The surgeons completed a baseline questionnaire on cadaveric simulation. At the end of the workshop, they completed a similar questionnaire based on their experience with Thiel cadavers. Comparing the answers in the pre- and post-workshop questionnaires assessed whether using Thiel cadavers had changed the surgeons’ opinions of cadaveric simulation.
Results
According to the 27 participants, simulation is important for surgical training and a full-procedure model is beneficial for all levels of training. Currently, there is dissatisfaction with existing models and a need for high-fidelity alternatives. After the workshop, surgeons concluded that Thiel cadavers are suitable for surgical simulation (
p
= 0.015). Thiel were found to be realistic (
p
< 0.001) to have reduced odour (
p
= 0.002) and be more cost-effective (
p
= 0.003). Ethical constraints were considered to be small.
Conclusion
Thiel cadavers are suitable for training in most surgical specialties.
The senior year of undergraduate medical education has been scrutinized for lacking emphasis from educators and value for students. Surgical residency program directors and medical students have ...reported different sets of perceived weaknesses as surgical trainees enter residency. With this in mind, we developed a novel rotation for senior medical students pursuing surgical residency. The rotation incorporates practical didactics, robust skill and simulation training, and an enriching anatomy experience that entails dissections and operations on embalmed and fresh tissue cadavers. To our knowledge, this is the first reported formal training experience for medical students that involves working with fresh tissue cadavers, which have been described as effective models for live human tissue in the operating room. We describe our multifaceted curriculum in detail, discuss its organization, and elaborate on its potential value. We also provide detailed explanations of the curriculum components so that other surgical educators may consider adopting them.
Intraoperative rupture occurs in approximately 9.2% of all cranial aneurysm surgeries. This event is not merely a surgical complication, it is also a real surgical crisis that requires swift and ...decisive action. Neurosurgical residents may have little exposure to this event, but they may face it in their practice. Laboratory training would be invaluable for developing competency in addressing this crisis. In this study, the authors present the "live cadaver" model, which allows repetitive training under lifelike conditions for residents and other trainees to practice managing this crisis.
The authors have used the live cadaver model in 13 training courses from 2009 to 2014 to train residents and neurosurgeons in the management of intraoperative aneurysmal rupture. Twenty-three cadaveric head specimens harboring 57 artificial and 2 real aneurysms were used in these courses. Specimens were specially prepared for this technique and connected to a pump that sent artificial blood into the vessels. This setting created a lifelike situation in the cadaver that simulates live surgery in terms of bleeding, pulsation, and softness of tissue.
A total of 203 neurosurgical residents and 89 neurosurgeons and faculty members have practiced and experienced the live cadaver model. Clipping of the aneurysm and management of an intraoperative rupture was first demonstrated by an instructor. Then, trainees worked for 20- to 30-minute sessions each, during which they practiced clipping and reconstruction techniques and managed intraoperative ruptures. Ninety-one of the participants (27 faculty members and 64 participants) completed a questionnaire to rate their personal experience with the model. Most either agreed or strongly agreed that the model was a valid simulation of the conditions of live surgery on cerebral aneurysms and represents a realistic simulation of aneurysmal clipping and intraoperative rupture. Actual performance improvement with this model will require detailed measurement for validating its effectiveness. The model lends itself to evaluation using precise performance measurements.
The live cadaver model presents a useful simulation of the conditions of live surgery for clipping cerebral aneurysms and managing intraoperative rupture. This model provides a means of practice and promotes team management of intraoperative cerebrovascular critical events. Precise metric measurement for evaluation of training performance improvement can be applied.
The near ubiquitous presence of numerical simulation has made case‐specific calculations of body temperatures following death possible so that accurate calculations of body temperatures can provide ...valuable information for estimating the time of death and can aid in forensic investigations. Here, a computational approach is described that has been validated against multiple, independent, and experimental investigations. The approach only requires one subjective input parameter (the heat transfer coefficient). A simple algorithm serves as a guidepost to the selection of this parameter. The algorithm incorporates clothing and the space in which the body is housed. Heat transfer coefficients that range from h = 2 W/m2/°C for bodies that are heavily clothed to h = 9 W/m2/°C for bodies that are nude (in air). The method also requires setting of ambient temperature conditions (ambient temperature)—however, that input is often available. The paucity of inputs makes this technique remarkably easy to employ. The new method is also able to calculate cadaver cooling rates for situations where the cadaver is in a timewise or spatially changing thermal environment (diurnal temperature variations, bodies partially submerged in water, changes to weather, insolation, etc.). Results from the present calculations are compared with a large body of measurements from the literature; it was found that the predictions and measurements were in excellent agreement, regardless of the ambient temperature conditions and the nature of the clothing of the body. This new calculation approach can be used with reasonable accuracy for determining cadaver cooling and time since death.
Current anatomical knowledge of the origin of the bucinator muscle (BM), i.e., long thin attachments on the maxilla and mandible and the pterygomandibular raphe (PMR), is not supported by anatomical ...dissection of this muscle. The aim of this study was therefore to investigate the detailed morphology of the BM and associated structures and to discuss its function.
The anatomy of the BM and related structures was investigated in 15 cadaveric heads using a surgical microscope and histological analysis.
The inferior fibers of the BM originated from a small retromolar area (internal oblique line), which shared a common tendon with the deep tendon of the temporalis. The superior fibers of the BM originated from the maxillary tuberosity. The middle fibers originated the pterygoid hamulus. No PMR was identified in any of the specimens, but the border between the BM and superior pharyngeal constrictor muscle (SC) was clear because the muscle fibers followed different directions. Some horizontal fibers were continuous between the BM and SC.
Our results suggest the need to revise established accounts of the origins of the bucinator (the maxillary tuberosity, conjoint tendon of the temporalis, and pterygoid hamulus without a pterygomandibular raphe. It also needs to be noted that some of its fibers merge directly with the SC.
Posterior variants of abdominal wall block include the quadratus lumborum type I, quadratus lumborum type II and quadratus lumborum transmuscular blocks. Our objectives were to compare the spread of ...injectate and nerve involvement, after conducting blocks using ultrasound guidance in soft embalmed cadavers.
After randomization, an experienced anaesthetist conducted three quadratus lumborum 1, three quadratus lumborum 2 and four transmuscular blocks on the left or right sides of five cadavers. All cadavers were placed in the lateral position and the quadratus lumborum muscle seen using a 3–9 MHz ultrasound probe placed in the flank. For each block, a 20 ml mixture of 17.75 ml water, 2 mls latex and 0.25 ml India ink was injected. The lumbar region and abdominal flank were dissected 72 h later.
We conducted 10 blocks. Two quadratus lumborum 1 and two quadratus lumborum 2 blocks were associated with spread of dye within the TAP plane. One quadratus lumborum 1 block spread to the deep muscles of the back and one quadratus lumborum 2 block dispersed within the subcutaneous tissue surrounding the abdominal flank. All transmuscular quadratus lumborum blocks spread consistently to L1 and L3 nerve roots and within psoas major and quadratus lumborum muscles.
Consistent spread to lumbar nerve roots was achieved using the transmuscular approach through the quadratus lumborum.
Introduction and hypothesis
The high prevalence of pelvic organ prolapse (POP) in women requires attention and constant review of treatment options. Sacrospinous ligament fixation (SSLF) for apical ...prolapse has benefits, high efficacy, and low cost. Our objective is to compare anterior and posterior vaginal approach in SSLF in relation to anatomical structures and to correlate them with body mass index (BMI).
Methods
Sacrospinous ligament fixation was performed in fresh female cadavers via anterior and posterior vaginal approaches, using the CAPIO®SLIM device (Boston Scientific, Natick, MA, USA). The distances from the point of fixation to the pudendal artery, pudendal nerve, and inferior gluteal artery were measured.
Results
We evaluated 11 cadavers with a mean age of 70.1 ± 9.9 years and mean BMI 22.4 ± 4.6 kg/m
2
. The mean distance from the posterior SSLF to the ischial spine, pudendal artery, pudendal nerve, and inferior gluteal artery were 21.18 ± 2.22 mm, 17.9 ± 7.3 mm, 19.2 ± 6.8 mm, and 18.9 ± 6.9 mm respectively. The same measurements relative to the anterior SSLF were 19.7 ± 2.7 mm, 18.6 ± 6.7 mm, 19.2 ± 6.9 mm, and 18.3 ± 6.7 mm. Statistical analysis showed no difference between the distances in the two approaches. The distances from the fixation point to the pudendal artery and nerve were directly proportional to the BMI.
Conclusions
There was no difference in the measurements obtained in the anterior and posterior vaginal approaches. A direct correlation between BMI and the distances to the pudendal artery and pudendal nerve was found.
PDF
