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1.
Adv Exp Med Biol ; 1397: 55-77, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36522593

RESUMO

Anatomical knowledge is central to the advancement of biomedical research and clinical practice and provides the underpinning foundations for many clinical examinations and processes. Anatomy is a very practical and three-dimensional subject, requiring learners to be able to visualise structures within the body and how they interact with each other. Typically, this is taught through a combination of lectures and practical laboratories in which students can interact with human cadaveric material to gain an appreciation of real-life anatomy, often commenting on how these lab sessions really bring their lectures to life.Like so many things, the teaching of anatomy on university campuses became severely restricted with the arrival of the COVID-19 pandemic in March 2020. Staff and students were no longer able to attend universities and body donation programmes were halted. This brought with it both challenges and opportunities to redevelop digital anatomy education. This chapter will discuss the different teaching approaches taken to delivery anatomy education at the University of Glasgow in three different programmes: (1) Bachelor of Science Honours (BSc Hons) degree in Anatomy, (2) the Glasgow Access to Medicine Programme (GAP), and (3) the undergraduate Bachelor degree in Medicine (MBChB). These three programmes were selected as they each teach anatomy to undergraduate students but the teaching methods, class sizes, and student backgrounds for each is very different. In discussing the different approaches taken and reflecting on staff and student feedback on these experiences, we hope to provide not just a record of the unprecedented and rapid changes to education during this time but also to offer some thoughts on how lessons might be learned as we return to on-campus teaching.


Assuntos
COVID-19 , Estudantes de Medicina , Humanos , Pandemias , Aprendizagem , Universidades
2.
J Vis Commun Med ; 45(3): 160-168, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35227138

RESUMO

Abdominal Aortic Aneurysms (AAA) are asymptomatic with advanced age and male sex being risk factors. Due to their significant mortality rate, the NHS AAA Screening programme was introduced in 2012. However, this is not as well-supported compared to other programmes. When it comes to AAA and its screening, health information is also available from different sources potentially leading to confusion. Based on this, our aim was to develop a prototype mobile application on AAA and its screening, centralising all key information, for the general public. Another aim was to assess the app's usability and impact (i.e. users' perceptions about screening attendance and knowledge of AAA). 24 participants completed a pre-app questionnaire followed by app testing and a post-app questionnaire. Ethical approval was granted from the Glasgow School of Art. 75% of participants had never heard of AAA and 92% had never heard of its screening. After app use, the participants' AAA knowledge significantly increased (Z = -4.318, p < 0.001). App use and opinion of screening attendance were also statistically associated (X1[1, n = 24] = 6.857, p < 0.05). The app's usability was rated positively in the USE questionnaire. Research is needed on public health apps regarding their impact on screening uptake and public knowledge.


Assuntos
Aneurisma da Aorta Abdominal , Aplicativos Móveis , Aneurisma da Aorta Abdominal/diagnóstico , Aneurisma da Aorta Abdominal/prevenção & controle , Humanos , Masculino , Saúde Pública , Medicina Estatal , Reino Unido
3.
Med Sci Educ ; 31(2): 893-895, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-34457931

RESUMO

Medical curricula encompass two practical-based teaching categories with likelihood of identifying incidental findings (unexpected and previously undiagnosed findings with potential health implications) in live models for demonstration purposes. One relates to clinical skills involving peers and simulated or volunteer patients. The other involves laboratory sessions, with live models, for the purposes of demonstrating scientific principles. As educationalists, it is our professional and ethical duty to have guidance on how to manage incidental findings. In this commentary, we have outlined our best practice guidelines formalised as a written policy exploring consent, debriefing, and the teachers' role. Our aim was to develop an 'easy-to-follow' standardised mechanism.

4.
Clin Anat ; 34(5): 802-809, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-33904628

RESUMO

Ultrasound-guided regional anesthesia involves visualizing sono-anatomy to guide needle insertion and the perineural injection of local anesthetic. Anatomical knowledge and recognition of anatomical structures on ultrasound are known to be imperfect amongst anesthesiologists. This investigation evaluates the performance of an assistive artificial intelligence (AI) system in aiding the identification of anatomical structures on ultrasound. Three independent experts in regional anesthesia reviewed 40 ultrasound scans of seven body regions. Unmodified ultrasound videos were presented side-by-side with AI-highlighted ultrasound videos. Experts rated the overall system performance, ascertained whether highlighting helped identify specific anatomical structures, and provided opinion on whether it would help confirm the correct ultrasound view to a less experienced practitioner. Two hundred and seventy-five assessments were performed (five videos contained inadequate views); mean highlighting scores ranged from 7.87 to 8.69 (out of 10). The Kruskal-Wallis H-test showed a statistically significant difference in the overall performance rating (χ2 [6] = 36.719, asymptotic p < 0.001); regions containing a prominent vascular landmark ranked most highly. AI-highlighting was helpful in identifying specific anatomical structures in 1330/1334 cases (99.7%) and for confirming the correct ultrasound view in 273/275 scans (99.3%). These data demonstrate the clinical utility of an assistive AI system in aiding the identification of anatomical structures on ultrasound during ultrasound-guided regional anesthesia. Whilst further evaluation must follow, such technology may present an opportunity to enhance clinical practice and energize the important field of clinical anatomy amongst clinicians.


Assuntos
Pontos de Referência Anatômicos , Anestésicos Locais , Inteligência Artificial , Competência Clínica , Ultrassonografia de Intervenção/métodos , Humanos
5.
Clin Anat ; 34(1): 5-10, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32020693

RESUMO

INTRODUCTION: Instrumenting the anterior abdominal wall carries a potential for vascular trauma. We previously assessed the presence, position, and size of the anterior abdominal wall superior and inferior (deep) epigastric arteries with computed tomography (CT). We now present a study using ultrasound (US) assessment of these arteries, to evaluate its use for real time guidance of percutaneous procedures involving the rectus sheath. MATERIALS AND METHODS: Twenty-four participants (mean age 67.9 ± 9 years, 15 M:9 F [62:38%]) were assessed with US at three axial planes on the anterior abdominal wall: transpyloric plane (TPP), umbilicus, and anterior superior iliac spine (ASIS). RESULTS: An artery was visible least frequently at the TPP (62.5 - 45.8%), compared with the umbilicus (95.8-100%) and ASIS (100%), on the left, χ2 (2) = 20.571; p < .001, and right, χ2 (2) = 27.842; p < .001, with a moderate strength association (Cramer's V = 0.535 [left] and 0.622 [right]). Arteries were most commonly observed within the rectus abdominis muscle at the level of the TPP and umbilicus, but posterior to the muscle at the level of the ASIS (95.8-100%). As with the CT study, the inferior epigastric artery was observed to be larger in diameter, start more laterally, and move medially as it coursed superiorly. CONCLUSIONS: These data corroborate our previous results and suggest that the safest level to instrument the rectus sheath (with respect to vascular anatomy) is at the TPP. Such information may be particularly relevant to anesthetists performing rectus sheath block and surgeons during laparoscopic port insertion.


Assuntos
Parede Abdominal/irrigação sanguínea , Parede Abdominal/diagnóstico por imagem , Artérias Epigástricas/anatomia & histologia , Artérias Epigástricas/diagnóstico por imagem , Ultrassonografia , Parede Abdominal/cirurgia , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
6.
Clin Anat ; 34(2): 170-177, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32239537

RESUMO

INTRODUCTION: The classification of the accessory nerve (CN XI) remains a source of debate; its exact function has not been fully elucidated having also an atypical morphology for a cranial nerve. A better insight into its anatomical and physiological features is of clinical relevance. The aim was to conduct a review of 18th and 19th century books from the Royal Medical/Surgical Colleges in Scotland, United Kingdom. A contextual historical analysis of the depictions and descriptions of the accessory nerve could provide insight into the disparity in the current descriptions. MATERIALS AND METHODS: Online archive catalogues were systematically searched and, during site visits, resources were formally and contextually analyzed, with the information then thematically analyzed. The themes were discussed against a widely known reference textbook of the era. RESULTS: Based on the thematic analysis, the resources were categorized either as practical anatomy books or field-specific anatomy books including neuroanatomy atlases. This intended use, along with the target audience, influenced the scope and detail of information, typically with general anatomy for students in the practical resources, and specialist information in the field-specific resources. The authors' professional background also influenced the way the accessory nerve was described and/or depicted, with surgeons/physicians placing emphasis on the clinical aspects. Content variations could also be attributed to communication restrictions of the era, and associated purchasing costs. CONCLUSIONS: Although scientific advances are nowadays disseminated at a faster pace, actively bridging the gap between anatomical sciences and clinical research is still needed when considering the accessory nerve to further elucidate the mysteries of this structure.


Assuntos
Nervo Acessório/anatomia & histologia , Nervo Acessório/fisiologia , Anatomia/história , Livros/história , História do Século XVIII , História do Século XIX , Humanos , Escócia
8.
Acta Anaesthesiol Scand ; 64(10): 1422-1425, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32698252

RESUMO

BACKGROUND: Emergency front of neck airway access by anaesthetists carries a high failure rate and it is recommended to identify the cricothyroid membrane before induction of anaesthesia in patients with a predicted difficult airway. We have investigated whether a marking of the cricothyroid membrane done in the extended neck position remains correct after the patient's neck has been manipulated and subsequently repositioned. METHODS: The subject was first placed in the extended head and neck position and had the cricothyroid membrane identified and marked with 3 methods, palpation, 'laryngeal handshake' and ultrasonography and the distance from the suprasternal notch to the cricothyroid membrane was measured. The subject then moved off the table and sat on a chair and subsequently returned to the extended neck position and examinations were repeated. RESULTS: Skin markings of all 11 subjects lay within the boundaries of the cricothyroid membrane when the subject was repositioned back to the extended neck position and the median difference between the two measurements of the distance from the suprasternal notch was 0 mm (range 0-2 mm). CONCLUSION: The cricothyroid membrane can be identified and marked with the subject in the extended neck position. Then the patient's position can be changed as needed, for example to the 'sniffing' neck position for conventional intubation. If a front of neck airway access is required during subsequent airway management, the patient can be returned expediently to the extended-neck position, and the marking of the centre of the membrane will still be in the correct place.


Assuntos
Cartilagem Cricoide , Cartilagem Tireóidea , Humanos , Intubação Intratraqueal , Pescoço/diagnóstico por imagem , Palpação , Cartilagem Tireóidea/diagnóstico por imagem , Cartilagem Tireóidea/cirurgia , Ultrassonografia
9.
Adv Exp Med Biol ; 1262: 203-216, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32613585

RESUMO

Game-based applications (apps) and serious games enable educationalists to teach complex life sciences topics. Gamification principles (i.e. challenges, problem solving, critical thinking) improve learners' motivation and can also help science communicators discuss important scientific subjects and their real-world context in an effective, enjoyable manner. The aim of this study was to design, develop and evaluate a science communication game-based app, entitled Collect the Bones, Avoid the Cones, on human skull anatomy for use in public engagement activities with younger audiences. Specifically, the app contextualised three-dimensional (3D) skull anatomy within a narrative about cycling and helmet safety. The app was tested at the Glasgow Science Centre, with ethical approval from the Glasgow School of Art, to assess its potential pedagogical value, in terms of pre- and post-app knowledge and confidence, and general user evaluation. In total, 50 participants were recruited (mean age 15.6 ± 1.647, range 7-64) with 62% of participants aged 7-12. Usability and educational value were rated highly with 70% of participants agreeing they could use the app without any external instructions and 90% agreeing they understand the anatomy of the skull better after app use. The enjoyability of the game was also positively perceived with 94% of participants agreeing they enjoyed the game. Although there was no statistical significance in pre- and post-app knowledge scores, there was a statistically significant increase in players' confidence relating to skull anatomy (pre-app: 3.00 ± 1.265, post-app: 4.00 ± 1.00, Z = -5.111, p < 0.001). These results provide promising insight into the potential of game-based apps for public engagement in anatomical sciences. Future research on how the app influences attitudes towards helmet use in different demographic groups would be valuable in identifying its full pedagogical potential.


Assuntos
Educação em Saúde , Resolução de Problemas , Jogos de Vídeo , Adolescente , Osso e Ossos , Criança , Comunicação , Educação em Saúde/métodos , Educação em Saúde/normas , Humanos , Motivação , Crânio/anatomia & histologia , Jogos de Vídeo/estatística & dados numéricos
10.
Adv Exp Med Biol ; 1262: 217-237, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32613586

RESUMO

Knowledge of the anatomy of the skull and its bones forms an important part of the understanding required for the study and practice of safe clinical dentistry. The use of serious games in healthcare education is well-documented, but there is comparatively little evidence for their use in dental education. Intrinsically integrated rewards are a game mechanic that can be motivational for serious game users. A research gap was identified in the delivery of skull anatomy education to dental undergraduate students via a serious game with intrinsically integrated rewards. A serious game, titled Visualisation Studio Sim, was developed with Unity, featuring three-dimensional models and assets designed and modified with 3ds Max and Instant Meshes. Two versions of the game were built, one with the addition of intrinsically integrated rewards and one without it, and the game versions were tested by a convenience sample to gather open-ended feedback on the usability and suitability of the game mechanic for dental undergraduate education. Feedback suggested that it was straightforward to interact with the skull models but that the rewards were not as well integrated into the flow and immersion of the game as intended, and the game might not have been as challenging as desired for the intended cohort warranting future refinements in these aspects.


Assuntos
Educação em Odontologia , Crânio , Estudantes de Odontologia , Jogos de Vídeo , Educação em Odontologia/métodos , Retroalimentação , Humanos , Motivação , Crânio/anatomia & histologia , Jogos de Vídeo/normas
11.
Adv Exp Med Biol ; 1235: 35-52, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32488635

RESUMO

Functional connectivity magnetic resonance imaging (fcMRI), performed during resting wakefulness without tasks or stimulation, is a non-invasive technique to assess and visualise functional brain networks in vivo. Acquisition of resting-state imaging data has become increasingly common in longitudinal studies to investigate brain health and disease. However, the scanning protocols vary considerably across different institutions creating challenges for comparability especially for the interpretation of findings in patient cohorts and establishment of diagnostic or prognostic imaging biomarkers. The aim of this chapter is to discuss the effect of two experimental conditions (i.e. a low cognitive demand paradigm and a pure resting-state fcMRI) on the reproducibility of brain networks between a baseline and a follow-up session, 30 (±5) days later, acquired from 12 right-handed volunteers (29 ± 5 yrs). A novel method was developed and used for a direct statistical comparison of the test-retest reliability using 28 well-established functional brain networks. Overall, both scanning conditions produced good levels of test-retest reliability. While the pure resting-state condition showed higher test-retest reliability for 18 of the 28 analysed networks, the low cognitive demand paradigm produced higher test-retest reliability for 8 of the 28 brain networks (i.e. visual, sensorimotor and frontal areas); in 2 of the 28 brain networks no significant changes could be detected. These results are relevant to planning of longitudinal studies, as higher test-retest reliability generally increases statistical power. This work also makes an important contribution to neuroimaging where optimising fcMRI experimental scanning conditions, and hence data visualisation of brain function, remains an on-going topic of interest. In this chapter, we provide a full methodological explanation of the two paradigms and our analysis so that readers can apply them to their own scanning protocols.


Assuntos
Mapeamento Encefálico/normas , Encéfalo/fisiologia , Imageamento por Ressonância Magnética/normas , Descanso/fisiologia , Humanos , Reprodutibilidade dos Testes
12.
Neurol Sci ; 41(6): 1633-1635, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31970577

RESUMO

PURPOSE: Hyperintensities are common in neuroimaging scans of patients with mild acute focal neurology. However, their pathogenic role and clinical significance is not well understood. We assessed whether there was an association between hyperintensity score with diagnostic category and clinical assessments/measures. METHODS: One hundred patients (51 ± 12 years; 45:55 women:men), with symptomatology suggestive of short duration ischemia referred for magnetic resonance imaging, were prospectively recruited in NHS Grampian between 2012 and 2014. Hyperintensities were quantified, on T2 and FLAIR, using the Scheltens score. RESULTS: The most frequent diagnosis was minor stroke (33%), migraine (25%) and transient ischemic attack (17%). The mean total Scheltens score was 28.49 ± 11.93 with all participants having various loads of hyperintensities. Statistically significant correlations between hyperintensity scores and clinical assessments/measures (age, systolic blood pressure, pulse pressure, MoCA) at the global level were also reflected regionally. These provide further supporting data in terms of the robustness of the Scheltens scale. CONCLUSION: Hyperintensities could serve as a diagnostic and prognostic imaging biomarker for patients, presenting with mild acute focal neurology, warranting application of automated quantification methods. However, larger cohorts are required to provide a definitive answer especially as this is a heterogenous group of patients.


Assuntos
Ataque Isquêmico Transitório/diagnóstico por imagem , Transtornos de Enxaqueca/diagnóstico por imagem , Acidente Vascular Cerebral/diagnóstico por imagem , Idoso , Biomarcadores , Feminino , Humanos , Ataque Isquêmico Transitório/fisiopatologia , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Transtornos de Enxaqueca/fisiopatologia , Prognóstico , Estudos Prospectivos , Índice de Gravidade de Doença , Acidente Vascular Cerebral/fisiopatologia
13.
Anat Sci Educ ; 13(2): 158-167, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31091009

RESUMO

The supplementation of lecture-based anatomy teaching with laboratory sessions, involving dissection or anatomical specimens, is commonly used. Hands-on dissection allows students to handle instruments correctly while actively exploring three-dimensional anatomy. However, dissection carries a potential risk of sharps and splash injuries. The aim of this study was to quantify the frequency rate of such cases per 1,000 student-hours of dissection and identify potential factors than might influence safety in anatomy laboratories. Data were retrospectively collected from September 2013 to June 2018 at the University of St Andrews, Scotland, UK. Overall, 35 sharps injuries were recorded in undergraduate medical students, with a frequency rate of 0.384 and no splash cases. A statistically significant, moderate negative association between year of study and frequency rate (rho(25) = -0.663; P < 0.001) was noted. A statistically significant difference in the frequency rate between different semester modules (χ2 (4) = 13.577, P = 0.009) was observed with the difference being between Year 1 Semester 2 and Year 3 Semester 1 (P = 0.004). The decreasing trend with advancing year of study might be linked to increasing dissecting experience or the surface area of the region dissected. The following factors might have contributed to increased safety influencing frequency rates: single-handed blade removal systems; mandatory personal protective equipment; and having only one student dissecting at a given time. The authors propose that safety familiarization alongside standardized training and safety measures, as part of an evidence-based culture shift, will instill safety conscious behaviors and reduce injuries in anatomy laboratories.


Assuntos
Ferimentos Penetrantes Produzidos por Agulha/epidemiologia , Estudantes de Medicina/estatística & dados numéricos , Anatomia/educação , Dissecação , Humanos , Estudos Retrospectivos
14.
Clin Anat ; 33(3): 350-354, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31444816

RESUMO

Multiple medical interventions require percutaneous instrumentation of the anterior abdominal wall, all of which carry a potential for vascular trauma. We assessed the presence, position, and size of the anterior abdominal wall superior and inferior (deep) epigastric arteries to determine the safest site with respect to vascular anatomy of the rectus sheath. In a review of 100 arterial phase, contrast-enhanced abdominal computed tomography scans, anterior abdominal wall arteries were assessed bilaterally at three axial planes: transpyloric, umbilicus, and anterior superior iliac spine (ASIS). The mean age of patients was 69.2 years (SD ± 15), with 62 male and 38 female. An artery was visible least frequently at the transpyloric plane (5%), compared with the umbilicus (72-79%) and ASIS (93-96%), on the left (χ2 (4) = 207.272; P < 0.001) and right (χ2 (4) = 198.553; P < 0.001), with a moderate strength association (Cramer's V = 0.588 (left) and 0.575 (right)). The arteries were most commonly observed within the rectus abdominis muscle at the level of the umbilicus and ASIS on both sides (62-68%). The inferior epigastric artery was observed to be larger in diameter, start more laterally, and move medially as it travelled superiorly. These data suggest that the safest site to instrument the rectus sheath, with respect to vascular anatomy, is at the transpyloric plane. This information on anatomical variation of the anterior abdominal wall vasculature may be of particular interest to anesthetists performing rectus sheath block and surgeons during laparoscopic port insertion. Clin. Anat. 33:350-354, 2020. © 2019 Wiley Periodicals, Inc.


Assuntos
Parede Abdominal/irrigação sanguínea , Parede Abdominal/diagnóstico por imagem , Artérias Epigástricas/diagnóstico por imagem , Reto do Abdome/irrigação sanguínea , Reto do Abdome/diagnóstico por imagem , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Laparotomia/instrumentação , Masculino , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios X
15.
Adv Exp Med Biol ; 1156: 1-11, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31338774

RESUMO

Ultrasound is a well-established medical imaging technique with pioneering work conducted by Professor Ian Donald and his colleagues at the University of Glasgow, from the mid-1950s onwards, in terms of introducing it as a diagnostic tool in the field of obstetrics and gynaecology. Since then, ultrasound has been extensively used in clinical and research settings. There are few imaging techniques that have undergone such a fast and thriving evolution since their development. Nowadays, diagnostic ultrasound benefits from two-dimensional (2D), three-dimensional (3D), four-dimensional (4D), and a variety of Doppler modes with technologically advanced transducers (probes) producing images of high anatomical fidelity. In the future, there may even be a place for ultrasound in molecular imaging allowing for visualisation at the microscale. Ultrasound is characterised by real-time non-invasive scanning, relative ease of administration, and lack of ionising radiation. All of these features, make ultrasound an appealing option in educational settings for learning topographic anatomy and potentially enhancing future clinical practice for vocational learners. Sophisticated, but relatively inexpensive, portable handheld devices have also contributed to point-of-care ultrasound (POCUS) becoming the norm for bedside and pre-hospital scanning. It has been argued that ultrasound will become the next stethoscope for healthcare professionals. For this to become a reality, however, training is required on increasing familiarity with knobology, correct use of the machine and transducers, and accurate interpretation of anatomy followed by identification of pathologies. The above require incorporation of ultrasound teaching in undergraduate curricula, outwith the realm of opportunistic bedside learning, accompanied by consideration of ethical topics such as the management of incidental findings and careful evaluation of its pedagogical impact cross-sectionally and longitudinally.


Assuntos
Anatomia , Currículo , Educação de Graduação em Medicina , Ultrassonografia , Anatomia/educação , Anatomia/tendências , Currículo/tendências , Educação de Graduação em Medicina/tendências , Pessoal de Saúde/educação , História do Século XX , História do Século XXI , Humanos , Ultrassonografia/história , Ultrassonografia/tendências
17.
Adv Exp Med Biol ; 1205: 79-92, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31894571

RESUMO

This book chapter draws on the arts and humanities to discuss how object-based teaching using historical collections can be re-birthed, re-developed, and implemented in higher education settings for the exploration of challenging topics, including medical ethics, within the context of anatomical sciences. Although the authors have focused on the above discipline, the chapter showcases its versatility and adaptability to other areas including vocational degrees such as medicine, dentistry, and nursing. A model lesson plan has been discussed in detail based on 'objects' related to three separate but strongly linked themes: Women as Academics, Women as Artists, and Women as Portrayed as the Subjects of Dissection in Anatomical Art. This is a novel approach that discusses how the combination of existing collections of rare books, rich  in anatomical illustrations, and museum artefacts can be used in a meaningful and structured way to encourage conversations amongst learners while promoting awareness about sensitive topics and increasing confidence in communication. The authors have drawn from personal past experience and the current literature to discuss the above aims and critically explore logistical issues that may be associated with the identification of suitable 'objects'. The authors' ultimate goal is to introduce a concise and easy to adapt 'how to guide' for educationalists who have an interest in the integration of arts and humanities in vocational and science curricula.


Assuntos
Arte , Currículo , Ciências Humanas , Medicina , Comunicação , Feminino , Humanos , Mulheres
18.
Clin Anat ; 32(3): 390-395, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30536834

RESUMO

Regional anesthesia relies on a sound understanding of anatomy and the utility of ultrasound in identifying relevant structures. We assessed the ability to identify the point at which the superficial peroneal nerve (SPN) emerges through the deep fascia by ultrasound on 26 volunteers (mean age 27.85 years ± 13.186; equal male: female). This point was identified, characterized in relation to surrounding bony landmarks (lateral malleolus and head of the fibula), and compared to data from 16 formalin-fixed human cadavers (mean age 82.88 years ± 6.964; equal male: female). The SPN was identified bilaterally in all subjects. On ultrasound it was found to pierce the deep fascia of the leg at a point 0.31 (±0.066) of the way along a straight line from the lateral malleolus to the head of the fibula (LM-HF line). This occurred on or anterior to the line in all cases. Dissection of cadavers found this point to be 0.30 (±0.062) along the LM-HF line, with no statistically significant difference between the two groups (U = 764.000; exact two-tailed P = 0.534). It was always on or anterior to the LM-HF line, anterior by 0.74 cm (±0.624) on ultrasound and by 1.51 cm (±0.509) during dissection. This point was significantly further anterior to the LM-HF line in cadavers (U = 257.700, exact two-tailed P < 0.001). Dissection revealed the nerve to divide prior to emergence in 46.88% (n = 15) limbs, which was not identified on ultrasound (although not specifically assessed). Such information can guide clinicians when patient factors (e.g., obesity and peripheral edema) make ultrasound-guided nerve localization more technically challenging. Clin. Anat. 32:390-395, 2019. © 2019 Wiley Periodicals, Inc.


Assuntos
Tornozelo/inervação , Pé/inervação , Nervo Fibular/anatomia & histologia , Adulto , Idoso , Anestesia por Condução/métodos , Tornozelo/cirurgia , Cadáver , Dissecação , Fáscia/anatomia & histologia , Feminino , Fíbula/anatomia & histologia , Pé/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Dor Pós-Operatória/prevenção & controle , Nervo Fibular/diagnóstico por imagem , Estatísticas não Paramétricas , Ultrassonografia , Adulto Jovem
19.
Surg Radiol Anat ; 41(3): 265-274, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30570676

RESUMO

PURPOSE: Groin injury, sportsman's groin and inguinal disruption (ID) refer to a diffuse chronic groin pain syndrome that has significant impact on athletes and is often unresponsive to conservative management. The ID aetiology is poorly understood but may involve weakness of the inguinal ligament attachments or the posterior inguinal canal wall or the tendons of adductor longus and rectus abdominis. We discuss the literature in which the inguinal ligament was directly targeted for ID management in athletic populations. Secondarily, we discuss the anatomical reclassification of the inguinal ligament to a tendon based on the above information. METHODS: This was a qualitative review of the published literature, in English, from January 2007 to February 2017. RESULTS: Five research papers, including 264 patients, were appraised. In patients with ID, tears were identified in the inguinal ligament, and to relieve pain, the surgical treatment of the ligament by tenotomy was shown to be beneficial. Techniques such as radiofrequency denervation involving the inguinal ligament and ilioinguinal nerve were also shown to relieve symptoms in athletes. CONCLUSIONS: This qualitative review has specifically focused on the literature directly targeting the inguinal ligament in ID which is a relatively unexplored management approach. When treated as a tendon, the inguinal ligament appears to be an appropriate ID therapeutic target. Integrated studies and randomised clinical trials will promote a better understanding of the role of the inguinal ligament and its tendinous properties in ID and provide a foundation for evidence-based management of chronic groin pain in athletes.


Assuntos
Traumatismos em Atletas/cirurgia , Dor Crônica/cirurgia , Virilha/anatomia & histologia , Virilha/lesões , Ligamentos/anatomia & histologia , Ligamentos/lesões , Humanos , Denervação Muscular/métodos , Tenotomia
20.
J Anat ; 233(1): 98-105, 2018 07.
Artigo em Inglês | MEDLINE | ID: mdl-29663381

RESUMO

With an ever-expanding use of cross-sectional imaging for diagnostic and therapeutic purposes, there has also been an increase in the need for exposure to such radiological and anatomical views at the undergraduate and postgraduate level to allow for early familiarisation with the relevant anatomy. Cadaveric cross-sections offer an excellent link between the two-dimensional radiological images and the three-dimensional anatomical structures. For such cross-sections to be useful and informative within educational settings, they need to be: (i) safe for students and trainees to handle and (ii) robust enough to withstand repeated handling; as well as (iii) displaying anatomy clearly and accurately. There are various ways in which cross-sections can be prepared and presented; plastinated, potted, vacuum-sealed or unmounted. Each of these approaches has advantages and disadvantages in terms of technical complexity, cost and quality. As an alternative to the above methods and their limitations, we propose the presentation of cadaveric cross-sections in a transparent polyester resin. This technique has been used extensively in craft and artistic industries, yet it is not publicised in anatomy teaching settings. The sections were layered in polyester resin contained within a mould. The set resin required finishing by sanding and polishing. The final cross-sections were safe to handle, durable and maintained excellent anatomical relationships of the contained structures. The transparency of the set resin was water-clear and did not obstruct the visibility of the anatomy. The cost of the process was found to be significantly lower, requiring less infrastructure when compared with alternative methods. The following trivial technical difficulties were noted during the resin-embedding process: trapped air causing organs to float; retained water in the anatomical specimens creating bubbles and discoloration; and microbubbles emerging from the solution affecting the finished surface. However, solutions to these minor limitations have been discussed within the paper with the aim of future proofing this technique. The sections have been used in undergraduate medical teaching for 4 years and they have shown no signs of degradation or discoloration. We believe that this method is a viable and cost-effective alternative to other approaches of displaying cross-sectional cadaveric material and will help students and trainees bridge the gap between the traditional three-dimensional anatomy and two-dimensional images.


Assuntos
Anatomia/educação , Currículo , Educação de Graduação em Medicina/métodos , Inclusão em Plástico/métodos , Plastinação/métodos , Cimentos de Resina , Cadáver , Técnicas Histológicas/métodos , Humanos
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