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Lorenz Heister's "molar gland".

The buccal fat pad is a mass of specialized adipose tissue described in 1801 by famous French anatomist Xavier Bichat and referred to in medical literature as the "boule de Bichat." This study considered medical publications from 1538 to 1801 and found no descriptions of the buccal fat pad until 1727, when Lorenz Heister, anatomist and surgeon from Altdorf, Germany, first identified the "glandula molaris" and painted it in his Compendium Anatomicum, which appeared in several Latin editions during the eighteenth century.

Adipose Tissue↗

Do students have sufficient knowledge of clinical anatomy?

INTRODUCTION: Comparisons of anatomy knowledge levels of students from various curricula show either no differences or small differences to the detriment of innovative schools. To pass judgement on the general level of students' anatomy knowledge, we need an absolute standard. The purpose of this study was to compare students' levels of anatomy knowledge as measured by a case-based anatomy test with standards set by different groups of experts. METHODS: A modified Angoff procedure was used to establish an absolute standard against which the students' results could be evaluated. Four panels of 9 anatomists, 7 clinicians, 9 recent graduates and 9 Year 4 students, respectively, judged 107 items of an anatomy test. The students' results on these items were compared with the standards obtained by the panels. RESULTS: If the standard established by the panel of Year 4 students was used, 64% of the students would fail the test. The standards established by the anatomists, clinicians and recent graduates would yield failure rates of 42%, 58% and 26%, respectively. CONCLUSION: According to the panels' standards, many students did not know enough about anatomy. The high expectations that the Year 4 students appeared to have of their peers may contribute to students' uncertainty about their level of anatomy knowledge.

Anatomy↗

The discovery of encephalic arteries. From Johann Jacob Wepfer to Charles Foix.

Up until the 17th century, ideas surrounding the discovery of encephalic arteries were to remain largely influenced by the political and religious ideologies of the era. Parts of the encephalic arterial system have been called after several anatomists from this earlier period. From the 18th century onwards, scientists and doctors in particular, liberated themselves from the political and religious trends which had governed their work in previous centuries. Some progress was made by applying the clinico-anatomical method to neurology, but it was only at the end of the 19th century and the beginning of the 20th century that discoveries about encephalic arteries had gained ground. During the same period, anatomists in several countries were producing detailed descriptions of this arterial system. Moreover, this period saw the advent of the first generation of vascular neurologists, one of whom, Charles Foix, is considered as the founder of the discipline.

Cerebral Arteries↗

Prof-in-a-Box: using internet-videoconferencing to assist students in the gross anatomy laboratory.

BACKGROUND: The optimal learning environment for gross anatomy is the dissection laboratory. The Prof-in-a-Box (PiB) system has been developed where an anatomist using distance-learning technologies 'helps' students in a dissection laboratory at a different site. METHODS: The PiB system consists of: (1) an anatomist in his/her office with a computer and video camera; (2) a computer and 2 video cameras in the lab; (3) iChat AV software; (4) a secure server to host the PiB-student 'consultation'. The PiB system allows the students and faculty to interact via audio and video providing an environment where questions can be asked and answered and anatomical structures can be identified 'at a distance' in real-time. The PiB system was set up at a prosected cadaver and made available for student use during 'office hours'. RESULTS: 25-30% of the students used the PiB system. Anatomical structures were identified, questions answered and demonstrations given 'at a distance' using the system. Students completed an optional questionnaire about the PiB system at the end of the semester. Results of the questionnaire indicate that the students were enthusiastic about the PiB system and wanted its use to be expanded in the future. CONCLUSION: Many of the functions of a faculty member in the gross anatomy dissection laboratory can be performed 'at a distance' using the PiB system. This suggests that a geographically dispersed faculty could assist in providing instruction in the dissection labs at multiple medical schools without needing to be physically present.

Adult↗

Hepatic morphotypes. Their statistical individualization using ultrasonography.

The shape, topography, and vascular disposition of the liver depend on a subject's morphotype. The definition and classification of morphotypes was previously based on cadaver observation. In this study, 74 healthy adults (42 women, 32 males) were assessed using ultrasonographic parameters (hepatic diameters, xiphoid angle, orientation of the inferior face of the liver). The results were analyzed by discriminant analysis to differentiate the morphotypes. The three groups known by anatomists as breviligne (endomorphic), longiligne (ectomorphic), and normotype were again demonstrated and individualized in a significant manner. However, with the exception of the normotype group, fundamental differences were observed between our results and those of the anatomists. Ultrasonographic assessment shows that in the breviligne, the liver occupies the right hypochondrium and extends only slightly to the left of the midline; in the longiligne it extends into the left hypochondrium.

Female↗

An experiment in integrated teaching of anatomical sciences.

With the phenomenal expansion of knowledge in both basic and clinical sciences, it is absolutely essential to provide a sound foundation of anatomical sciences for the clinical teaching within the limited time available. Problems like shortage of qualified teachers in anatomy, isolation of anatomical sciences from the rest of the basic and clinical departments and multicentricity of sections of anatomical sciences urged us to apply an integrated system as tailored to our needs and limitations. By interdepartmental integration of gross anatomy, histology and embryology a more coordinated teaching has been achieved. Joint clinicoanatomical presentations by participation of anatomists in clinical teaching and clinicians in teaching of anatomy have not only upgraded the teaching but have also significantly reduced the problem of teachers shortage. These presentations are essentially directed towards illustrating the living anatomy, diagnostic anatomy, operative anatomy, applied embryology and microanatomy or the selected regions, with bearings on physical examination, pattern of the diseases, diagnostic and surgical procedures, genesis and treatment of congenital defects and neuroanatomical localisation of lesions. Fundamental basis of developmental and genetic defects are dealt with by a team of pediatrician, pediatric surgeon and the anatomists, with additional emphasis in the genesis of these defects and resultant disorders of function.

Anatomy↗

Changing anatomy education and introduction of self assessment of teacher performance in Japan.

The current curriculum reform is directed toward improvement of students' ability of clinical practice in primary care, and a substantial system of bedside learning is being extensively explored. Introduction of clinical clerkship necessarily forces qualitative changes in the teaching of basic medical sciences. A large number of Japanese medical schools is now attempting to establish a new educational system that makes it possible to change from "didactic education" by lectures and laboratory studies to "self learning education" by means of tutorials and other systems. In this context, Japanese anatomists are urgently requested to develop new and effective clinically oriented educational systems in teaching gross anatomy as a shift from the traditional teaching as a science of morphology. Evaluation of faculty staff's teaching achievement is about to start in many medical schools. Research activities can be evaluated quantitatively. In contrast, measurement of educational activities of faculty staff is very difficult, and all medical schools are devoted to construct effective and liable systems. Anatomy faculty is obliged to devote more time than that of other disciplines in education-related activities such as cadaver collection and associated business. How to evaluate adequately these invisible activities is an issue to be solved before the introduction of a self assessment system. Successful solutions to these issues are critical for production of future anatomists.

Anatomy↗

Anatomical information in radiation treatment planning.

We report on experience and insights gained from prototyping, for clinical radiation oncologists, a new access tool for the University of Washington Digital Anatomist information resources. This access tool is designed to integrate with a radiation therapy planning (RTP) system in use in a clinical setting. We hypothesize that the needs of practitioners in a clinical setting are different from the needs of students, the original targeted users of the Digital Anatomist system, but that a common knowledge resource can serve both. Our prototype was designed to help define those differences and study the feasibility of a full anatomic reference system that will support both clinical radiation therapy and all the existing educational applications.

Anatomy, Artistic↗

[The neuroanatomy of Juan Valverde de Amusco and medicine at the time of the Spanish renaissance].

Juan Valverde de Amusco (c. 1525-c. 1564) is considered to have been the most important Spanish anatomist of the XVI century. A follower of Vesalius, he increased and divulged knowledge of anatomy during the Renaissance and his book The history of the composition of the human body was printed in Rome in 1556. The objective of this paper is to study the neuroanatomy in this book and present unpublished biographical data and describe the main contributions of this Castilian doctor to the neurosciences, in the context of Spanish medicine during the Renaissance period. He was born in the town of Hamusco (today Amusco) in the province of Palencia, which belonged to the Crown of Castile. Juan Valverde emigrated to Italy to improve his scientific knowledge. He carried out anatomical studies using the then revolutionary method of direct observation, as opposed to the Galenic criteria of authority inherited from the Medieval period. He trained in Padua under Realdo Colombo and lived in Rome where he practiced medicine until his death, becoming deservedly famous. He did not return to Spain since in the Spanish universities of the time there was a mentality which was reactionary to modern anatomy. His works, published in Italy but in the Spanish language, give an idea of the power of the Crown of Castile in the Europe of that period. The book is profusely illustrated with the first illustrations ever published in the history of printing, drawn by Nicolas Beatrizet. The book was sold widely and was translated and reedited on many occasions, until well into the XVIII century. For the first time Valverde made precise references to the minor circulation. He was the first anatomist to describe the muscles for movement of the eye correctly and the intracranial course of the carotid arteries. In his work he made the first drawing of the stapes, described by the Valencian Luis Collado. Vesalius and Valverde contributed decisively to the beginnings of modern neuroanatomy. Thanks to them, the brain is no longer an organ unknown to science.

Anatomy, Artistic↗

Mondino's book and the human body.

The assertion that Mondino da Luzzi, the 14th Century Bolognese anatomist, was the first genuine human anatomist is questioned. Mondino's work is examined and his findings shown to be less than original. The investigations of surgeons, who conducted post mortem examinations during the 13th Century are highlighted, their contributions to anatomical science underscored, and their knowledge of human structure reexamined and evaluated.

Anatomy↗

[An outline of odontoiatry and odontology in the ancient world].

Dentistry was surely practiced in ancient Egypt, Mesopotamia, Phoenicia, Etruria, Greece and Rome, but odontology arose only with the dawn of Greek science. One may find the first references to a rational odontology only in the fragments of the Pre-socratic philosophers and in the Corpus Hippocraticum. Aristotle was the first to treat odontology under a comparative anatomo-physiological point of view. Celsus and Scribonius Largus got their matter from Hippocrates, Aristotle, the Hellenistic anatomists as well as from folk-traditions, but payed attention rather to dentistry than to odontology. Finally Galen gathered all the knowledge about odontology and dentistry from Hippocrates up to the Hellenistic anatomists and organized all the matter in his monumental teleologic and theological system, that was inherited by both the so called iatrosophists and the Byzantine physicians.

Dentistry↗

[The thyroid gland in Anothomia Mundini (1316)].

Andreas Vesalius described the human thyroid lobes very distinctly in his De humani corporis fabrica in 1543 calling them glandulae laryngis. Before him Leonardo da Vinci had depicted the human thyroid gland in his anatomical drawings. The first publication which could be called a textbook of human anatomy, because it was used as the basis for cathedral teaching in human anatomy for about two centuries, was the Anothomia of Mundinus Liucius, Mondino de'Liuzzi, published in 1316. In the chapter on the blood vessels of the neck he describes two glands, which he calls amigdalae, situated under the longitudinal muscles and below the larynx. Their function should be 1) to wet the trachea; 2) to fill the grove below the larynx because the neck was broader above due to the large larynx but much slender below because of the narrower trachea. And 3): they should function as a shield for the deep arteries and veins. Later anatomists at the beginning of the 15th and the 16th century, like Achillini, Massa and Zerbus, all used the text of Mundinus but obviously they tried to locate the glands of Mundinus to the tonsils apparently only because he used the denomination amigdalae. Berengario da Carpi, however, who was a much experienced anatomist, published a large treatise Commentaria super Anothomia Mundini in which he confirms the location of the glands of Mundini below the larynx. Obviously the two glands in the neck Mundinus mentions are the two thyroid lobes. According to his description they cannot be the tonsils because 1) of their location below the larynx, and 2) their function of adequating the appearance of the neck and 3) shielding, at least to some extent, the deep vessels in the neck. Before Mundini there is no similar description of the anatomy of the human neck in the literature, so what he describes must he based upon his own experience. Furthermore, he did the autopsies himself and did not use the assistance of a prosector as the professors after him used to do.

Books↗

Controlling the vocabulary for anatomy.

When confronted with the representation of human anatomy, natural language processing (NLP) system designers are facing an unsolved and frequent problem: the lack of a suitable global reference. The available sources in electronic format are numerous, but none fits adequately all the constraints and needs of language analysis. These sources are usually incomplete, difficult to use or tailored to specific needs. The anatomist's or ontologist's view does not necessarily match that of the linguist. The purpose of this paper is to review most recognized sources of knowledge in anatomy usable for linguistic analysis. Their potential and limits are emphasized according to this point of view. Focus is given on the role of the consensus work of the International Federation of Associations of Anatomists (IFAA) giving the Terminologia Anatomica.

Anatomy↗

[Operative outcome and experience in arteriovenous shunt at different sites].

OBJECTIVE: To summarize and analyze the influencing factors of both success and half-year patency rate of radial artery-cephalic vein arteriovenous fistula. METHODS: A retrospective analysis was made on the clinical data of 102 patients with chronic renal failure undergoing radial artery-cephalic vein arteriovenous shunt for hemodialysis during 7 years and the influence of different factors: sex, age, primary disease, incision site, and situations of vessels on the operative success rate and the half-year patency rate of the fistula was compared. RESULTS: No significant difference in the initial success rate of operation was found between the operations performed at the two different incision sites: at the wrist and at anatomist's snuffbox. However, the operation at the wrist was better than that at anatomist's snuffbox with regard to the half-year patency rate. Both operative success rate and half-year patency rate were not influenced by patient's sex, age, and primary disease. Anastomotic hyperplasia, condition of blood vessel and anastomotic technique were important factors influencing the operative failure and fistula occlusion. CONCLUSION: Correct selection of incision site is of key importance for both operative success and maintenance of half-year patency of radial artery-cephalic vein arteriovenous fistula. In addition, anastomotic hyperplasia, diameter and intimal smoothness of selected blood vessel, condition of run-off vessel, operative technique, anastomotic angle, distance between artery and vein, and patient's self-protection are also considered important influencing factors.

Adult↗

[Laurentius on anatomy].

Andreas Laurentius wrote Opera anatomica (1593) and Historia anatomica (1600). These books were composed of two types of chapters; 'historia' and 'quaestio'. His description is not original, but take from other anatomists. 'Historia' describes the structure, action and usefulness of the body parts clarified after dissection. 'Quaestio' treats those questions which could not be solved only by dissection. Laurentius cited many previous contradicting interpretations to these questions and choose a best interpretation for the individual questions. In most cases, Laurentius preferred Galen's view. Historia anatomica retained almost all the 'historia' and 'quaestio' from Opera anatomica, and added some new 'historia' and 'quaestio', especially in regard to the components of the body, such as ligaments, membranes, vessels, nerves and glands. Other new 'historia' and 'quaestio' in Historia anatomica concerned several topics on anatomy in general to comprehensively analyze the history of anatomy, methods of anatomy, and usefulness of anatomy. Historia anatomica reviewed what was anatomy by describing in 'historia' what was known and in 'quaestio' what was unresolved. Till now Laurentius's anatomical works have attracted little attention because his description contained few original findings and depended on previous books. However, the important fact that Historia anatomica was very popular in the 17th century tells us that people needed non-original and handbook style of this textbook. Historia anatomica is important for further research on the propagation of anatomical knowledge from professional anatomists to non-professionals in the 17th century.

Anatomy↗

Clinical and anatomical basis for the classification of the structural parts of liver.

Progress of diagnostic human's liver imaging (ultrasound, computerized tomography, magnetic nuclear resonance, etc.) stimulates development of modern liver surgery. Therefore, before and during the operation, surgeons and radiologists can determine the site and extent of liver damage, its relationship with blood vessels and ascertain which part of the liver should be resected. For this reason, physicians have to know anatomical and clinical peculiarities of the liver. Naming of the parts of this complex inner organ is still highly varied: parts, halves, lobes, divisions, sectors, segments, and subsegments. Our understanding and explanation of liver composition are still defined differently among anatomists, surgeons, and radiologists, thus not only confusing less experienced specialists, but also increasing probability of mistakes. Such lack of communication aggravates the design of an operation plan and its documentation, which frequently may even result in undesirable legal consequences. Unified terms among surgeons and radiologists are of importance not only in clinical settings of one country, but also on the international level (e.g. when comparing results of surgery). The smallest parts of the liver are defined using C. Couinaud's segmentation system, allowing for a precise identification of the site of liver damage, as well as to plan methods of segment resection that would protect the remaining hepatic tissue. The classification that best meets the needs of surgeons and radiologists was the one proposed by H. Bismuth. We suggest that this classification should also be used by our physicians who are engaged in diagnostics and treatment of hepatic diseases in their practice. We also discuss other classifications used worldwide (those proposed by J. Healey and P. Schroy, N. Goldsmith and R. Woodburne, C. Couinaud, and H. Bismuth) and present recommendations of global societies of anatomists and surgeons.

Bile Ducts, Intrahepatic↗

[Between science and moral injury--dead human bodies' treatment in anatomy and pathology during early modern times].

In this essay the history of anatomy and pathology between the 16th and the 19th century is focused under the two aspects of scientific development and of moral injury. In anatomy, which came along as a special field of theoretical medicine in 16th century, the human corpse was used as a suitable and to an increasing degree legitimate model of the healthy living body. About two hundred years later, even pathology started to be transformed into pathological anatomy. While anatomists were dealing with the structure of the healthy body pathological anatomists were interested in the morbid changes of the human corpse; the pathologist perceived the dead body as a static model of the dynamic pathological process in the living patient. Anatomy came along in the era of Renaissance and Humanism not least because of a close connection between science and the fine arts, whereas its practical relevance during the 16th and the 17th century resulted from a preparatory function for army surgery. The corpses of executed criminals, infanticides, and of unmarried mothers who had died from natural causes were often used for anatomical purposes including public autopsy. Pathological anatomy, however, unfolded its power not until the end of the 18th and the beginning of the 19th century when a new medical institution had been established: the clinic. The physical methods of examination such as percussion and auscultation of the patient's body could now be reviewed by the results of a post-mortem autopsy. The growing influence of pathological anatomy during 19th century medicine was reflected by a modified perception and evaluation of disease: The spatial dimensions of the visible findings received priority to the chronological development of the process of disease with the consequence of a heightened risk of separating the pathological structures from the suffering patient's biographical context. For the gain to scientism pathological anatomy had to tolerate a loss of reality, replacing the complexity of "heart and soul" by a reductionist model of the dead body.

Anatomy↗

Anatomy of the abdomen, back, and pelvis as displayed by magnetic resonance imaging: Part One.

In April 1986, magnetic resonance imaging (MRI) of the thorax and shoulder girdle was presented to the 99th Annual Meeting of the American Association of Anatomists. These images were the authors' first attempt to correlate the magnetic resonance display of the muscles and soft tissues of the chest in the coronal plane with surface gross anatomy. The original purpose of this study was to introduce the role of magnetic resonance imaging to anatomists, medical students, and the specialty of radiology. However, this approach has been expanded by imaging other sections of the body and applying the display of surface anatomy to augment the teaching of anatomy to surgical oncology, pathology, and kinesiology. This three-part article will display magnetic resonance images and will explain how magnetic imaging of the soft tissues can visually augment the teaching of gross anatomy without dissecting surface tissues.

Abdomen↗