Am Roberts

Human Anatomy: Let the students tell us how to teach

Anatomy teaching methods have evolved as the medical undergraduate curriculum has modernized. Traditional teaching methods of dissection, prosection, tutorials and lectures are now supplemented by anatomical models and e‐learning. Despite these changes, the preferences of medical students and anatomy faculty towards both traditional and contemporary teaching methods and tools are largely unknown. This study quantified medical student and anatomy faculty opinion on various aspects of anatomical teaching at the Department of Anatomy, University of Bristol, UK. A questionnaire was used to explore the perceived effectiveness of different anatomical teaching methods and tools among anatomy faculty (AF) and medical students in year one (Y1) and year two (Y2). A total of 370 preclinical medical students entered the study (76% response rate). Responses were quantified and intergroup comparisons were made. All students and AF were strongly in favor of access to cadaveric specimens and supported traditional methods of small‐group teaching with medically qualified demonstrators. Other teaching methods, including e‐learning, anatomical models and surgical videos, were considered useful educational tools. In several areas there was disharmony between the opinions of AF and medical students. This study emphasizes the importance of collecting student preferences to optimize teaching methods used in the undergraduate anatomy curriculum. Anat Sci Educ 7: 262–272.

The inferior hypogastric plexus: A different view

Summary The morphology of the inferior hypogastric plexus has been demonstrated in a series of dissections of nulliparous cadavers. Each cadaver was embalmed in a solution containing a significant proportion of methanol which preserved the pliability of the tissues enabling the nerve plexi to be clearly demonstrated. These structures are not normally encountered during general gynaecological surgery and clinicians are often unaware of the possible consequences of injury during vaginal delivery or sustained constipation. Denervation of pelvic organs, with subsequent reinnervation over the medium term, may account for a variety of obstetric and gynaecological syndromes.

New light on old shoulders: palaeopathological patterns of arthropathy and enthesopathy in the shoulder complex

Rotator cuff disease represents the most common cause of modern shoulder pain and disability. Much of the clinical literature on rotator cuff disease focuses on subacromial impingement and supraspinatus tendinopathy, although other patterns of lesions are also recognised. Rotator cuff disease has received relatively little attention in palaeopathological literature, but signs relating to subacromial impingement have been reported. Given the variety and patterns of lesions that are recognized clinically as rotator cuff disease, this study aimed to investigate whether a similarly wide range of lesions could be identified in human skeletal remains. Degenerative changes in surfaces around the shoulder were recorded in a sample of 86 skeletons. The resultant data were assessed using both simple descriptive statistics and exploratory factor analysis. Degenerative changes characteristic of modern subacromial impingement formed a minor underlying pattern in the data. The predominant underlying variable in the data represented an association between lesser tuberosity, bicipital sulcus and glenohumeral degenerative changes. This pattern reflects recent reports in the clinical literature highlighting the prevalence of subscapularis tendinopathy, and also supports a pathoaetiological model of progression from subscapularis to long head of biceps to glenohumeral involvement. The degenerative changes seen at the non‐articular, fibrocartilaginous entheses on the humeral tuberosities were similar to those seen in subchondral bone in osteoarthritis.

The use of μCT technology to identify skull fracture in a case involving blunt force trauma

A 40-year-old man was admitted to hospital with a scalp wound but died 22 days later after unsuccessful treatment. Initial assessment of the cranial fragments removed during surgery revealed fine fracture lines on the endocranial surface, and a dark arcuate line on the ectocranial surface. To investigate the extent of the fractures a μCT scan of the fragments was taken, examined in 3D, and compared to plain radiographs. Some fractures were found to extend through the full thickness of the skull. This case presents a novel application of μCT technology to forensic radiology.