Unilateral double facial artery: an anatomic variant and clinical implications.

Background: This paper reports a rare anatomical variant of the facial artery (FA) - namely, a double FA pattern - which has significant implications in a wide range of surgical and aesthetic medicine disciplines. Case: The study involves a case report and literature review of the FA and its variants. The case is that of a 61-year-old female cadaver with a unilateral FA variant branching pattern discovered during a cadaveric dissection for an anatomy course. Discussion: The dissection revealed an unusual supply of the typical FA distribution by two separate branches from either side of the maxillary artery. The first branch, termed FA1, followed a typical FA course arising from the external carotid to supply the lower portion of the face via lingual, inferior labial, and mental arterial branches. The second branch, termed FA2, arose superior to the maxillary artery near the origin of a typical transverse facial artery, to supply the upper portion of the face via superior labial, lateral nasal, and angular arterial branches. No direct communication between the two branches was observed grossly via dissection. The observed branching pattern has not previously been reported in literature and has critical implications for surgical planning and intervention. Conclusion: This study emphasizes the importance of understanding variant FA anatomy in procedures requiring precise anatomical knowledge of arterial supply to the face. Duplicate and/or secondary facial arteries necessitate careful consideration for their potential consequences on the success of surgery of the head and neck, dermal fillers, and embolization for epistaxis procedures.

Flashcards: The Preferred Online Game-Based Study Tool Self-Selected by Students to Review Medical Histology Image Content.

Medical students use several supplementary digital resources to support learning. Majority of these supplementary resources enhance learning by recall and repetition. A few examples of these resources are concept maps, flashcards (FCs), and self-testing tools. Traditionally, paper-based FCs are used in higher education. The concept of paper-based FCs is extended to the digital world in the form of electronic/web-based FCs. The use of electronic/digital flashcards has been reported to review course material in the medical school curriculum. Some of the medical school coursework requires students to acquire visual skills, for example, histology and pathology. Students, who do not have prior knowledge of the basic content on histology and pathology struggle to identify microscopic tissues and organs. Therefore, students look for other supplementary resources to support visual learning. Digital resources like Anki, Quizlet, and Osmosis provide study tools that support visual skills. A review of the literature revealed only a few publications pertaining to the use of digital testing tools for histology education in medical school curriculum. In the medical histology course at the Albert Einstein College of Medicine (Einstein), Bronx, NY, first-year medical students used a game-based platform (Quizlet) to review image-based histology course content in the form of four Quizlet study sets. Students chose from six Quizlet study tools (Flashcards, Learn, Speller, Test, Match, and Race/Gravity) to review the image-based course material and test their knowledge on accurate identification of histological images. The data on student usage of study tools was tracked and analyzed for 4 years (Graduating Classes of 2018 to 2021) to calculate: the total usage of the game-based study tools (Flashcards, Learn, Speller, Test, Match, and Race/Gravity) over the period of 4 years, total percent usage over 4 years of each game-based study tools (Flashcards, Learn, Speller, Test, Match, and Race/Gravity) in each of the four Quizlet study sets and to identify the preferred game-based study tool. The data showed a consistent year-on-year increase in usage of game-based study tools by 50% (M = 445 in 2018 compared to M = 849 in 2021). For the four Quizlet study sets the percent usage of each study tool Flashcards, Learn, Test, Match, Gravity, and Speller was tracked and combined across the four academic years. It was found that Flashcards were used significantly more frequently than any other tool and this was followed by Learn, Test, Match, Gravity, and Speller (p < 0.0001 using chi-square). The study concludes that flashcards are the preferred study tool used by students to acquire visual skills for identifying histological images and could be incorporated when designing online study tools.

Transition to Effective Online Anatomical Sciences Teaching and Assessments in the Pandemic Era of COVID-19 Should be Evidence-Based.

The world has changed rapidly since the emergence of the COVID-19 pandemic, and the education community has not been immune to these changes. With abrupt school closings and a rapid transition to online teaching and learning, the educational technologies have been stretched to their limits and pedagogic approaches blossomed. As the world strives to reestablish normalcy, it will be under the influence of the long-lasting impact of the pandemic. This manuscript provides recommendations for the online conversion of anatomical sciences curricula in health sciences programs. Strategic guidelines are emerging for building on these changes to enhance teaching and learning in the current pandemic era.

Integration of clinical anatomical sciences in medical education: Design, development and implementation strategies.

For the last 20 years, undergraduate medical education has seen a major curricular reform movement toward integration of basic and clinical sciences. The rationale for integrated medical school curricula focuses on the application of knowledge in a clinical context and the early ability to practice key skills such as critical thinking and clinical problem-solving. The method and extent of discipline integration can vary widely from single sessions to entire programs. A challenge for integrated curricula is the design of appropriate assessments. The goal of this review is to provide a framework for clinical anatomy educators with definitions of integration, examples of existing integration models, strategies, and instructional methods that promote integration of basic and clinical sciences.

Early and prolonged opportunities to practice suturing increases medical student comfort with suturing during clerkships: Suturing during cadaver dissection.

Medical students are expected to perform common procedures such as suturing on patients during their third-year clerkships. However, these experiences are often viewed by medical students as stressors rather than opportunities for learning. The source of this stress is the lack of instruction on common procedures prior to being asked to observe or perform the procedure on a patient. First-time exposures to procedures in stressful environments may result in decreased confidence in medical students and decrease the frequency with which they perform these procedures in the future. The authors sought to change this paradigm by: (1) introducing a suturing module to first-year medical students in the context of the anatomy dissection laboratory and (2) measuring its effects on student attitudes and behavior over the course of their third-year clerkships when they encounter patients. The authors found that early and prolonged introduction to suturing was associated with increased student confidence relative to suturing a patient. Participation in the suturing module was associated with increased student confidence in identifying suturing instruments (P < 0.001) and suturing patients (P = 0.013). Further it positively affected their behavior as demonstrated by increased performance of suturing events from students exposed to the suturing module. (P < 0.001) This study demonstrates that early and prolonged opportunities to practice a procedural skill in a low-stress environment increases student confidence during patient interactions and alters student behavior.

Axillobifemoral bypass: a brief surgical and historical review.

Peripheral artery disease (PAD) occurs when plaque accumulates in the arterial system and obstructs blood flow. Narrowing of the abdominal aorta and the common iliac arteries due to atherosclerotic plaques restricts blood supply to the lower limbs. Clinically, the lower limb symptoms of PAD are intermittent claudication, discoloration of the toes, and skin ulcers, all due to arterial insufficiency. Surgical revascularization is the primary mode of treatment for patients with severe limb ischemia. The objective of the surgical procedure is to bypass a blockage in an occluded major vessel by constructing an alternate route for blood flow using an artificial graft. This article presents information on aortoiliac reconstruction, with an emphasis on axillobifemoral bypass grafting.

Axillobifemoral Bypass Graft: A Student Dissection Experience.

As first-year medical students, we were excited, but nervous, to start the anatomy course. We were prepared to dedicate ourselves to the physical demands of dissection, and the hours of memorizing names and relations of countless anatomic features. We expected to leave the anatomy course with a comprehensive understanding of the human body that we would apply to our future studies and careers. We were not prepared, however, for the experience we had with our cadaver, Lucy.* Lucy was a small woman, but as we learned, she had endured a lot, physically and medically, in her 83 years of life. She had a pacemaker. She had coronary artery disease and a triple bypass procedure. She also had severe peripheral artery disease and had undergone at least one extraordinary surgical graft procedure to maintain blood flow into her lower extremities. The surprise of discovering a small piece of an axillobifemoral bypass graft and then continuing to uncover it, region by region, throughout the anatomy course, brought our dissection experience and our connection to Lucy to a more profound level than we could ever have anticipated. *The name Lucy was chosen as a pseudonym to protect the identity of the cadaver.