Anatomia, Volume 2, Issue 1 (March 2023) – 10 articles

Forearm extensor muscle variations can be diverse and, in some instances, rare. During a routine anatomical dissection of human cadaveric donors during the 2021 first-year medical gross anatomy course and 2021 graduate nursing advanced anatomy course at the Uniformed Services University of the Health Sciences, bilateral agenesis of the extensor carpi ulnaris muscle was noted in one 70-year-old white male donor. This variation is described as extremely rare in the literature. The presence of an extensor indicis et digiti medii tendon, a variant of the extensor indicis tendon, appeared to be evident in post-dissection photographs on the left hand. The presence of a duplicated extensor indicis proprious tendon appears to be evident on the right hand. However, further inspection of this region was impeded as the body was sent for cremation prior to the variation being identified. The presence of various juncturae tendinum was also noted bilaterally. Reported prevalence of extensor indicis muscle variants ranges from 0.75% to 13%, depending on the specific type or grouping of variations observed. Knowledge of variations in the extensor compartment of the forearm and wrist is crucial for orthopedic surgeons and specialists. Alteration of surgical approaches may be necessary if such a variation is present. Such variations can be options for grafts, resulting in minimal functional change to the grafted area due to the continued existence of other muscles performing similar functions. Knowledge of such variations, and alternative, synonymous names for them, is also important for anatomy instructors, who may need to assist students in identifying these rare variations during anatomical dissection. Full article

Background: Fundamental knowledge of the anatomy and physiology of the inner ear is necessary to understand otologic diseases and therapeutic strategies. Aim: Evaluate the inter- and intraindividual variability of the modiolar position in relation to vestibular landmarks and cranial morphology on computed tomography scans (CT scan). Methods: Thirty CT scans of normal temporal bones (25 adults, 5 children) were analyzed after multiplanar reconstruction (MPR). The measurements for each ear included the angle of each semicircular canal (SCC) made by a line passing through the chosen plane and a line passing between the apex and the ampulla of the SCC studied and the angle of the modiolus in the transverse and sagittal planes. Results: Intraindividual asymmetries with a moderate to good right/left correlation were observed for the lateral SCC in the transverse plane, posterior SCC in the frontal plane, and the superior SCC in the sagittal plane and for the modiolus in the transverse plane. Conclusions: An anatomical variability in the cochlea, independent of other surrounding anatomical elements, seems to exist, but the SCCs seem to remain symmetrical. Significance: The orientation of the modiolus is an important knowledge to acquire during presurgical planning prior to transmodiolar auditory nerve implantation. Full article

Conventional anatomical models and cadaveric specimens can be time-consuming and resource intensive for any anatomical institute. In recent years, there has been a push for more flexible and varied approaches to teaching, including problem-based and computer-aided learning, which includes web-based anatomical models or the use of three-dimensional visualization technology. With advances in hardware, autostereoscopic (AS) 3D screens have become more affordable, portable, and accessible to individuals, not just institutes. At King’s College London (KCL), we developed the Virtual Anatomy and Histology (VAH) platform—an online resource which focuses on perspective volumetric 3D viewing of medical scan data and 3D models to facilitate the online teaching and learning of anatomy. This paper presents the features of VAH and details a study that was conducted in 2022, to evaluate the VAH 3D AS viewer configured with The Looking Glass Portrait (TLG) (Looking Glass, New York, NY, USA) 8-inch AS display. We tested the hypothesis that using an AS display can improve spatial understanding of cardiovascular anatomy. A cardiovascular 3D textured model was used from our gallery to carry out a spatial test. Twenty current healthcare students at King’s participated in the study and completed a structured questionnaire. Results showed that 47.6% and 52.4% of participants agreed and strongly agreed, respectively, that identifying anatomical structures was easier in 3D compared to 2D. Qualitative feedback was positive as most students found King’s VAH and TLG display “useful for people who need help with spatial understanding” and that “it was a good tool to test your anatomical knowledge”. In conclusion, based on the quantitative results and feedback, we are optimistic that King’s VAH and portable AS displays can be beneficial in anatomy education. With the increasing availability of such systems and competitive pricing, this technology is likely to have a significant impact in education in coming years. Full article

A morphological study of the skeletal specimen of Canis lupus L. from an archeological dig of Agnano (Pisa) (Fauna Laboratory, Department of Archaeological Sciences, University of Pisa, Italy) that is chronologically placed in the Wurm period (last glaciation) was done to perform an anatomical comparison between this wild ancestor and osteological specimens of Canis familiaris L. present in the Veterinary Anatomy Museum (University of Pisa). Marked morphological differences in the splanchnocranium (nasal bone, zygomatic arch and orbital angle), neurocranium (sagittal crest) and temporomandibular joint (due to different developments of the masticatory muscles) are highlighted on the wolf specimen compared to those in the domestic dog specimens present in Museum. The appendicular skeletal bones of the wolf show anatomical features similar to those of dog bone specimens, confirming their belonging to the same family (Canidae). This result confirms that domestication has almost exclusively affected the anatomical features of the skull that have changed due to the difference in dietary approach between wolves and dogs. Full article

The Locomotor System Anatomy (LSA) course, placed in the first semester of the first year of the new Master’s degree in Medicine and Surgery High Technology (MSHT) at the Sapienza University of Rome, was integrated with surgical and bioengineering content. This study investigated the educational value and the students’ perceptions of the effectiveness of these two types of integration, comparing surgical integration (SI) with engineering integration (EI). Anatomy knowledge and students’ opinions attending the LSA course in MSHT degree (n = 30) were compared with those of students (n = 32) attending another medical and surgery course not comprising EI. Data show that students in the MSHT course like in-depth SI much more than in-depth EI. However, those who like in-depth SI also like in-depth EI. Significant differences were in anatomy knowledge between the two groups in the three sections of the test. There was no significant correlation between the three test scores and the levels of liking, while there was a significant correlation between students liking SI and those liking EI. A statistically significant correlation was also found in students who correctly responded to questions on the head and trunk, with students responding correctly to questions on the upper limbs. This study will be important in optimizing the deepening of SI and EI in the LSA course. Full article

The cerebellum is an encephalic region classically known for its central role in the control of movement, although recent research has revealed its involvement in other cognitive and affective tasks. Several different pathologies are known to affect this structure, causing a wide range of behavioral and gait impairments. Intriguingly, although the neurodegenerative factors affect all Purkinje cells of the cerebellum uniformly, certain neurodegeneration patterns can be distinguished, in which some Purkinje cells persist longer than other cell types. Specifically, there is a cerebellar region, lobe X, which is more resistant to different types of neurodegeneration, regardless of the injury. Degeneration patterns of the cerebellum have been described in several models, but this review goes further, as it aims at describing a phenomenon not so described: the resistance of the lobe X to neurodegeneration. For this purpose, the main models of cerebellar degeneration will be reviewed and a common origin for the lobe X resistance will be sought. Full article

Human brain atlases are tools to gather, present, use, and discover knowledge about the human brain. The developments in brain atlases parallel the advances in neuroanatomy. The brain atlas evolution has been from hand-drawn cortical maps to print atlases to digital platforms which, thanks to tremendous advancements in acquisition techniques and computing, has enabled progress in neuroanatomy from gross (macro) to meso-, micro-, and nano-neuroanatomy. Advances in neuroanatomy have been feasible because of introducing new modalities, from the initial cadaveric dissections, morphology, light microscopy imaging and neuroelectrophysiology to non-invasive in vivo imaging, connectivity, electron microscopy imaging, genomics, proteomics, transcriptomics, and epigenomics. Presently, large and long-term brain projects along with big data drive the development in micro- and nano-neuroanatomy. The goal of this work is to address the relationship between neuroanatomy and human brain atlases and, particularly, the impact of these atlases on the understanding, presentation, and advancement of neuroanatomy. To better illustrate this relationship, a brief outline on the evolution of the human brain atlas concept, creation of brain atlases, atlas-based applications, and future brain-related developments is also presented. In conclusion, human brain atlases are excellent means to represent, present, disseminate, and support neuroanatomy. Full article

This study evaluates ultra-low-dose computed tomography (ULDCT) protocols concerning the detectability of pulmonary nodules. The influence of tube current settings, kernels, strength levels of third-generation iterative reconstruction algorithms, and pitch was investigated. A chest phantom with artificial spherical nodules of different densities and diameters was examined with a third-generation dual-source CT. Scanning and post-processing protocols, tube current levels, and ultra-high and non-high pitch modes were applied. Images were reconstructed with filtered back-projection (FBP) or advanced model-based iterative reconstruction (ADMIRE) algorithms. Sharp (Bl57) or medium-soft (Br36) convolution kernels were applied. The reading was performed by an experienced and an inexperienced reader. The highest observer sensitivity was found using a non-high pitch protocol at tube currents of 120 mAs and 90 mAs with the sharp kernel and iterative reconstruction level of 5. Non-high pitch protocols showed better detectability of solid nodules. Combinations with the medium-soft kernel achieved slightly higher observer sensitivity than with the sharp kernel. False positives (FP) occurred more often for subsolid nodules, at a tube current level of 120 mAs, and with the sharp kernel. A tube current level of 90 mAs combined with the highest iterative reconstruction level achieved the highest accuracy in lung nodule detection regardless of size, density, and reader experience. Full article

Flaminio Rota was a 16th century anatomist and medical figure at the University of Bologna. He was highly praised, despite his poor scientific production. As a matter of fact, Rota competed with scientific activities in different anatomical arguments, but he did not publish any important research. Nevertheless, we know the principal results of his scientific activity because indirect information can be found in other publications, where some of his studies were emphasized by his contemporary colleagues. Henning Witte even mentioned Rota as a very famous Italian medical figure, together with Galilei and Santorio. On the other hand, Rota was a highly esteemed teacher. The best evidence of his recognition is well-documented in the Palace of Archiginnasio in Bologna, where Rota’s teaching activity was praised with six memorial epigraphs. In the south-eastern outskirts of Bologna, there is an 18th century villa, including a more ancient annex, that belonged to Rota. At this location, the upper parts of the walls and the ceiling are decorated with a pictorial cycle illustrating medical scenes. In this paper, we theorize regarding his scientific thinking by analyzing the pictorial cycle he commissioned. Full article