Anatomia, Volume 1, Issue 2 (December 2022) – 11 articles

Neuroblastoma-like schwannoma is known as a rare unusual variant of schwannoma with difficulties of differential diagnosis with neuroblastoma, Ewing sarcoma/peripheral neuroectodermal tumor and other cutaneous small round cell tumors. Herein, we describe a neuroblastoma-like schwannoma that was presented as a painless lesion on the dorsal side of the left hand in a 39-year-old woman. Composed collagen fibers in the central core of rosettes and diffuse expression of S100 protein in the tumor cells found in the biopsy specimens confirmed the Schwann cell origin of the tumor. Full article

Background: The flexor digitorum brevis tendon to the fifth digit is frequently absent, and this absence is typically an incidental discovery during dissection or surgical studies. This study aimed to assess the frequency of a missing flexor digitorum brevis tendon in a Hispanic population for the first time, the association between the absence of the flexor digitorum brevis tendon, variables such as sex and ethnicity, and the functional implications of an absent tendon. Methods: Our sample consists of 30 cadavers whose feet were dissected and examined for the presence or absence of the digiti minimi tendon. Results: We found no significant relationship between the presence or absence of the tendon to sex or ethnicity. However, due to a lack of significant effects on human ambulation from the absence of this tendon, and the ability of adjacent muscles to adapt to its absence, the absence of this tendon might become increasingly prevalent over time. Conclusions: Knowledge of the frequency of flexor digitorum brevis variations concerning the demographic characteristics of patients would be of clinical importance for tendon repair, tendon transfer to correct deformities such as claw toe or hammer toe, or soft tissue reconstruction in foot surgery. Full article

Detailed knowledge about the normal anatomy and its variations is a necessity in good clinical and surgical practice. The case we are reporting here shows a rare configuration origin of the superior thyroid, lingual and facial arteries arising directly from a pentafurcated common carotid artery. A fresh frozen latex-infiltrated cadaver was dissected. The superior thyroid artery, the lingual artery and the facial artery were found to be directly detached from the common carotid artery as terminations of the five terminal rami variations. The current classifications of anatomical variants are discussed in detail in relation to this case. Full article

In this paper, we want to refute the notion that the microbiota should be considered an organ, given that an organ comprises tissue of similar or different embryological origin, while the microbiota is a pool of different microbial species originating individually from single replications and not from a common ancestral cellular element. Hence, we would like to propose a new morphological interpretation of its nature, based on the comprehensive context in which these microbes live: a muco-microbiotic layer of hollow organs, such as the airways and the bowel. The above concept should represent not only a new terminological annotation but also a more accurate portrayal of the physiology and pathophysiology of these organs. Indeed, a better understanding of the biological nature of this part of the human body can help scientists develop more specific experimental protocols, potentially leading to the establishment of better therapeutic strategies. Full article

The distal radius, one of the frequent sites of upper extremity fractures, includes unique anatomy referred to as the volar rim. Few studies have addressed its interindividual differences. Additionally, implants for osteosynthesis must match the anatomical structures to prevent soft tissue invasion, but no implants have focused on that so far. In this study, three-dimensional surface models were created from CT images of 101 cases. Analysis of the distal radius, including the volar rim anatomy, was performed to design plates to minimize the discrepancy between the bone anatomy and the implant. The results showed that there were considerable interindividual differences in the morphology of the distal radius, particularly in the degree of palmar protrusion of the volar rim. A moderate correlation between the width of the distal radius and the shape of the volar rim was demonstrated. Considering that variations in plate width are available for treatment of normal distal radius fractures and that the shape of the volar rim changes in correlation with the width of the bone, we infer that simply adding volar rim shape information to the current variations should suffice in preventing complications. We conclude that individualized design according to the shape of the volar rim is unnecessary in fracture surgery. Full article

The objectives of this study were to identify and correlate orofacial anatomy discrepancies as biometric data and the impact of its rehabilitation as an educational, forensic approach to human identification. An observational and retrospective cohort study was performed on cephalography and photographic exams of a clinical database. The clinical reports were randomly selected according to inclusion and exclusion criteria, reviewed, and interpreted according to the anatomical features. The anatomic features analyzed for human identification compare pre- and post-medical intervention data. The challenging anatomical area was the lower one-third of the face. In an extreme forensic condition, identification should consider the medical history for a positive and accurate conclusion. Full article

Computed tomography (CT) angiography is the main method for the initial evaluation of cerebral circulation in acute stroke. A comprehensive CT examination that includes a review of the three-dimensional and maximum-intensity projection images of the main intra and extracranial arteries allows the identification of most abnormalities and normal variants. Anatomical knowledge of the presence of any normal variants, such as fenestration, duplications, and persistent fetal arteries, plays a crucial role in the diagnosis and therapeutic management of acute stroke. However, the opposite is also true. In fact, sometimes it is the clinical picture that allows weighing how relevant or not the alteration found is. Therefore, in this review, a concise representation of the clinical picture attributable to a given arterial vessel will be included. Full article

The “cleidooccipital branches” are integral muscular branches of the sternocleidomastoid muscles (SCM), as well as the trapezius muscles, which construct the anterior and posterior borders of the posterior triangle of the neck, respectively. The term “cleidooccipital muscle”, in the literature, generally describes the accessory muscle, which is proximally attached to the middle portion of the clavicle, separate from the clavicular attachment of the SCM or trapezius muscle, and crosses the posterior triangle of the neck obliquely. With proximity to either the trapezius or the SCM, the accessory cleidooccipital muscles can be divided into posterior and anterior accessory cleidooccipital muscles, respectively. At present, most of the descriptions in the literature associated with the accessory cleidooccipital muscles concern the posterior accessory cleidooccipital muscles. The anterior accessory cleidooccipital muscles are mostly recognized as a proximal clavicular-head-sided supernumerary variation of the SCM. We propose a new classification of these muscles, with nomenclatures to help researchers to differentiate the cleidooccipital branches or muscles from one another. Introducing this classification, we hope that more clarity can be achieved when addressing the so-called “cleidooccipital muscle” in the future. Full article

EduTech (Education and Technology) has drawn great attention in improving education efficiency for non-face-to-face learning and practice. This paper introduced a blended gross anatomy class using both virtual reality (VR) devices and traditional programs alongside a practice-based cadaver dissection and in-class observation. The class allowed the students to get hands-on experience with both practical practice and VR operations to identify the biochemical aspects of the disease-induced internal organ damage as well as to view the three-dimensional (3D) aspect of human structures that cannot be practiced during the gross anatomy practice. Student surveys indicated an overall positive experience using VR education (satisfaction score over 4 out of 5, Likert scale question). There remains room for improvement, and it was discussed with the results of the essay-based question survey. Formative evaluation results showed that the students who trained in blended anatomy classes with VR set-ups received higher scores (85.28 out of 100, average score) than only cadaver-based anatomy class (79.06 out of 100, average score), and this result represents that the hybrid method could improve the academic efficiency and support the understanding of the 3D structure of the body. At present, VR cannot totally replace actual cadaver dissection practice, but it will play a significant role in the future of medical education if both students and practitioners have more VR devices, practice time, and a more intuitive user-friendly VR program. We believe that our paper will greatly benefit the development of EduTech and a potential new curriculum item for future medical education. Full article

Dissection in anatomy teaching is key in medicine; however, a debate is underway about whether it complements well a modern curriculum in the digital era. We aimed to determine whether a short add-on dissection practise facilitates learning of the gross anatomy relative to studying it with just prosection, plastic models, and digital 3D atlases. We tested the hypothesis that dissection, even if brief, benefits both aptitudes and attitudes with respect to anatomy learning. A total of 106 1st year medical students studied the musculoskeletal system with prosection and models and a 3D digital atlas (5 h). Of these, 52 had a further 2 hours self-directed dissection session (a handout was provided with instructions) while the reminder 54 students, who lacked the experience of dissection, formed the control group. Academic grades and student satisfaction were evaluated. The dissection group obtained 10% higher grades in anatomy (F_1,51 = 12.71, p < 0.001) and were highly satisfied with the dissection session (Likert scale 0–5, median = 4, IQR = 3.5), also rating the sessions as particularly motivating (median = 4, IQR = 4.4). We conclude that human body dissection, even for a limited time, has a positive impact on human anatomy grades in 1^st year medical students, and is valued and motivating. Full article

Background: The deltoid is the muscle that forms the rounded contour of the shoulder. Anatomically, it seems to be made up of three different sets of fibers. The three anatomical portions in which the deltoid muscle are typically divided into the anterior (clavicular), the mean (acromial), and the posterior (spinal). Different variations of the deltoid muscle have been described in the literature. The analysis and knowledge of these anomalies are essential for surgeons and anatomists. Methods: A total of 21 specimens (12 women and 9 men) were used with a 10% formaldehyde solution. All specimens were dissected bilaterally (the classical dissection methodology was used). Results: In one corpse, an additional bilateral belly of the deltoid muscle was found. It was observed that this additional muscular belly was related to the fascial tissue of the deltoid muscle and its muscle fibers take origin from the middle third of the inferomedial bands of infraspinatus fascia. In addition, the belly attaches to the posterior belly of the deltoid muscle. The deltoid muscle and the additional belly were innervated by the axillar nerve, which is a lateral terminal bouquet of the posterior fascicle of the brachial plexus. Conclusions: This new variation of the deltoid muscle must be considered by surgeons, as well as abnormal conditions in terms of compartment syndrome involving the shoulder. Therefore, consideration of this variant is necessary for the correct diagnosis and treatment of trauma or other shoulder pathology that may be refractory to standard treatments. Full article