Who is the Teacher and Who is the Student? The Dual Service- and Engaged-Learning Pedagogical Model of Anatomy Academy.

Anatomy Academy is a simultaneous service-learning experience for preprofessional school undergraduate students and preclinical professional students acting as classroom paraprofessional teachers (Mentors), and engaged-learning experience for fourth to sixth grade elementary school children (Students). Using didactic and kinesthetic active learning teaching strategies in small-group classroom environments, Mentors taught anatomy, physiology, and nutrition concepts to Students. In this study of the program's early years (2012-2014), overall objectives of improving Mentors' pedagogical confidence; and Students' science interest, science knowledge, and exercise self-efficacy were assessed. Mentors showed (89% response of 595 surveyed) improvement in content delivery (P < .001), student engagement (P < .001), classroom management (P < .001), and professionalism (P = .0001). Postprogram Mentor reflections were categorized into 7 major themes that demonstrated personal growth through the service-learning opportunity: (1) realization of an ability to make a difference in the world now; (2) acknowledgment of the importance of listening in teaching; (3) recognition that lives can and will change with "a little love"; (4) insight into the effectiveness of guiding Students through material rather than lecturing; (5) awareness of the value of respect in the learning environment; (6) cognizance of the power of individualized attention to motivate Students; and (7) reflection of one's own personal growth through the open influence of Students. Students showed (88% response of 1259 surveyed) improvement in science knowledge (P = .014) and exercise self-efficacy (P = .038), but not science interest (P = .371). Thus, while Students are learning more science and becoming more aware of their health, we need to be more overt in our presence as scientists in the educational arena.

Unilateral absence of ascending and transverse trapezius fibers accompanied by mild thoracic scoliosis: a case report

During routine anatomical dissection at the David Geffen School of Medicine at UCLA, a variation of partial unilateral trapezius muscle absence was found in a 95-year-old Caucasian female. A broad sheet of aponeurosis originating from all thoracic vertebrae completely replaced the ascending fibers of the left inferior trapezius muscle. Transverse fibers of the left trapezius muscle appeared hypotrophied and were sparsely distributed within the aponeurosis. Descending fibers of the left trapezius muscle were comparable to the right side. The main clinical finding was a grossly visible 5-degree thoracic scoliosis toward the intact trapezius muscle. No other significant abnormalities in musculature or anatomy could be found. While others have reported on unilateral, bilateral, complete, and partial absence of trapezius muscle, to our knowledge this case is unique from those previously reported in the literature

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Probabilistic mapping of the cervical sympathetic trunk ganglia.

The goal of this study was to create a heat map indicating the probabilistic location of major ganglia of the cervical sympathetic trunk (CST). Detailed dissections of human cadaveric specimens, followed by spatial registration and analysis of the cervical sympathetic ganglia in the neck and upper thorax regions (C1-T1) were performed in 104 neck specimens (both sides from 52 cadavers). Unbiased parametric mapping, visualized with a heat map, revealed a general pattern of two major ganglia located on both sides of the neck: The superior cervical ganglion (SCG) was located 80-90 mm superior to the point at which the vertebral artery entered the transverse foramen (VA-TF); the stellate ganglion (SG) was located approximately 10 mm inferior to the VA-TF in 80% of our sample, or surrounding the VA-TF in the remaining 20% of our sample. In between these ganglia, a highly variable number of smaller and less prevalent ganglia were present on either side of the neck. The middle ganglia on the right side of the neck were located closer to the SCG, possibly indicative of the middle cervical ganglion. On the left side the middle ganglia were located closer to the SG, perhaps indicative of the vertebral ganglion or the inferior cervical ganglion. Individual specimens could be classified into one of seven different patterns of cervical trunks. The results may help surgeons and anesthesiologists more accurately target and preserve these structures during medical procedures.

A heat map of superior cervical ganglion location relative to the common carotid artery bifurcation.

BACKGROUND: Determining the superior cervical ganglion's precise anatomical location for local anesthetic block, when stellate block is not feasible or is contraindicated, is difficult. METHODS: We dissected the superior cervical ganglion in 60 embalmed cadaveric specimens. Multiple regressions determined whether subject characteristics predicted the distance between the superior cervical ganglion and common carotid artery bifurcation and the superior cervical ganglion dimensional width and area. Based on these regressions, we mapped the ganglion and common carotid artery bifurcation using a pseudocolor statistical heat map. RESULTS: The statistical model significantly predicted the superior cervical ganglion-common carotid artery bifurcation distance (P = 0.01), and the superior cervical ganglion dimensional width (P = 0.02). CONCLUSION: This study determined that the common carotid artery bifurcation is a good landmark for localizing the superior cervical ganglion for anesthetic block.

Cervical variations of the phrenic nerve.

OBJECTIVES/HYPOTHESIS: Selective reinnervation of the posterior cricoarytenoid muscle with a single phrenic nerve rootlet has been shown to restore physiologic motion in animal models. However, clinical translation of this work is challenged by the limited knowledge of the cervical anatomy of the phrenic nerve. STUDY DESIGN: Prospective collaborative study. METHODS: Dissection of 111 cadaveric necks (88 embalmed and 23 unembalmed) from 56 cadavers. RESULTS: The mean (standard deviation) lengths of unembalmed cadaver C3, C4, and C5 nerve rootlets were 3.9 (2.4), 3.6 (2.6), and 0.5 (0.8) cm, respectively. Embalmed cadavers had shorter C3 and C4 phrenic nerve rootlet lengths than unembalmed cadavers (P = .02 and P = .03, respectively). There was no difference in mean nerve rootlet length based on sex, body height or weight, or side of dissection. A total of eight unique phrenic nerve rootlet patterns were identified. The most common pattern consisted of phrenic with single C3 and C4 rootlets with an immeasurable C5 rootlet, which was present in 30 of 111 (26%) of the necks. The classic three branching pattern of single C3, C4, and C5 rootlets was found in 25 of 111 (22%) of the necks. Six of 111 (5%) of the dissections displayed accessory phrenic nerves arising from the C3, C4, or C5 anterior rami. A χ(2) analysis showed no difference between side or sex and frequency of pattern. CONCLUSIONS: The present study demonstrates the wide variability within the cervical anatomy of the phrenic nerve.

A 12-year follow-up study of psychiatric symptomatology among cocaine-dependent men.

This prospective longitudinal study examines patterns of psychiatric symptomatology among men admitted to treatment for cocaine dependence in 1988-1989. Study participants were interviewed at treatment intake, and at 1 year, 2 years and 12 years after treatment. The Hopkins Symptom Checklist-58 (SCL) and Natural History Interview were administered at the 4 time points. Of the 266 study participants interviewed at the 12-year follow-up, 138 (52%) had been cocaine abstinent for 5 years or more. Repeated measures ANOVA assessed changes in SCL scores over time for cocaine-abstinent and non-abstinent men. Both groups had similarly high mean SCL scores at treatment intake, and reductions in symptom severity 1 year after treatment. By 12-year follow-up, the abstinent group reported significantly lower SCL scores than the non-abstinent group on 4 of the 5 symptom measures. Additionally, cocaine-abstinent men reported lower rates of depressive and psychotic disorders, and lower use of psychopharmacologic and inpatient treatment than non-abstinent men. These findings suggest that severe psychiatric symptomatology persists among individuals unable to achieve a stable recovery from cocaine dependence.