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Background: Knowledge of gross anatomy, as a basic core subject, is fundamental for medical students and essential to medical practitioners, particularly for those intending a surgical career. However, both medical students and clinical teachers have found a significant gap in teaching basic sciences and the transition into clinical skills. The authors present a Surgical Anatomy Course developed to teach the anatomical basis of surgical procedures with particular emphasis on laparoscopic skills while incorporating medical simulation. Materials and methods: An evaluation of the students’ satisfaction of the Surgical Anatomy Course was completed using a mix of multiple choice and open-ended questions, and a six-point Likert Scale. Questions were asked about the students’ perceived improvement in surgical and laparoscopic skills. Manual skills were assessed using a laparoscopic simulator. Results: Both evaluation of the course structure and the general impression of the course were positive. Most students believed the course should be an integral part of a modern curriculum. The course supported the traditional surgical classes and improved anatomical knowledge and strengthened students’ confidentiality and facilitated understanding and taking surgical rotations. Conclusions: A medical course combining the practical learning of anatomy and surgical-based approaches will bring out the best from the students. Medical students positively evaluated the Surgical Anatomy Course as useful and beneficial regarding understanding anatomical structure and relationship necessary for further surgical education. (Folia Morphol 2018; 77, 2: 279–285)
We have performed a study about the incidence of the atherosclerotic phenomenon in the human facial artery, having observed an increase with aging. We also have researched the role of the smooth muscle cells in its genesis, with morphological, ultrastructural and immunohistochemical techniques.
The morphological study of the development of “intimal thickenings” of the human uterine artery in physiological condition was performed on 72 uterine arteries obtained from foetuses from the 12th week of gestation up to birth. Our results indicate that intimal thickening is formed by the migration and displacement of mesenchymal cells around the site of origin of collateral vessel from uterine mesothelium. These cells firstly differentiate into the myoblasts and then into the myocites. During the development the internal limitans membrane separates the intimal thickening from the tunica media and the elastic fibres appearing inside possessing a muscle-elastic nature. The function of intimal thickenings is the regulation of local blood flow by means of the control of myocitic contractile capacity; these cells play a fundamental role in endothelium-intimal smooth muscle cell contact.
A retro-oesophageal course of the right subclavian artery is referred to as “arteria lusoria”. It may be related to severe compression of the trachea and oesophagus, typically resulting in impaired swallowing. The paper presents two patients with arteria lusoria, which in one patient was an aberrant right subclavian artery and in the other an aberrant left subclavian artery, originating from the right-sided aortic arch. In both cases the diagnosis was made with multi-slice computed tomography. The embryology of the anomalies and clinical status of the patients is discussed. Arteria lusoria should be considered in differential diagnosis in patients with dyspnoea and dysphagia. Multi-slice computed tomography allows this anatomical variant to be reliably visualised.
Spiegelian hernias account for less than 1% of all hernias diagnosed in the adult population. The most important factors in the proper diagnostic process are detailed physical examination combined with imaging procedures. Two cases of Spiegelian hernias are presented. The anatomical background of the pathology, as well as diagnostic procedures and surgical treatment, is discussed. (Folia Morphol 2009; 68, 3: 179–183)
Modern medical education faces a problem of combining the latest technology, procedures and information with classic teaching methods. Simulation is a technique, which replaces or amplifies doctor–patient experiences in controlled conditions and therefore evokes or replicates substantial aspects of the real world in a fully interactive manner. The basic course of anatomy in medical education could be recognised as the best example of implementing new educational techniques such as simulation, into the traditional medical curriculum. The PubMed database was searched using specific key words. Finally 72 articles were accepted and were divided into 3 basic categories of teaching methods: Category 1 — cadaveric dissection, Category 2 — simulator based education and Category 3 — other. A state of the art anatomical curriculum offers numerous possibilities and solutions including the oldest like cadaveric dissection and newest like simulators. Different simulation techniques are used with different intensity; however cadaveric dissection is still the most popular method. The second most frequent method is simulation-based training, in which North America is the leading country. The identification of anatomical structures during virtual surgical procedures or laparoscopic robotic procedures can be integrated into the traditional anatomy course. New technologies are supportive and beneficial in anatomy teaching however each excitement of new technologies sometimes should be tempered and evaluated for its usefulness in making the learning process constructive for students and their future practice. (Folia Morphol 2014; 73, 1: 1–6)
Background: The abdominal vessels show a number of abnormalities and pathologies knowledge of which is important during open as well as laparoscopic surgeries. One of the most common vessels which pattern has many variations is the coeliac trunk. The present study was undertaken on homogeneous population to assess morphology of the coeliac trunk and to evaluate the possible variability of its branches. Materials and methods: Standard abdominal multidetector computed tomography examinations were performed on a total of 1569 patients diagnosed by 2 radiologists independently; in case of doubts common assessment was performed. Results: The coeliac trunk followed the classic pattern in 92.7% of the cases (1455/1569 of patients). The gastrosplenic trunk was detected in 4.1% of cases (64/1569); the hepatosplenic trunk in 2.2% of cases (34/1569); the coeliac-mesenteric trunk was observed in 0.5% of cases (8/1569); the hepatogastric trunk in 0.2% of cases (4/1569); the splenomesenteric trunk was detected in 0.1% of cases (2/1569). In the next 0.1% the coeliac trunk was absent. The hepatosplenomesenteric and the coeliac-colic trunk were not observed in the study population. Conclusions: Vascular anatomical abnormality is usually asymptomatic hovewer, its preoperative knowledge is helpful to reduce complications like vascular bleeding when dissecting the hapato-pancreatic region. The coeliac trunk and its branches can be fast and easy evaluated in computed tomography exams performed due to various symptoms from abdominal cavity. (Folia Morphol 2015; 74, 1: 93–99)
Bowing of the interventricular septum (IVS) is a sign of severe pulmonary embolism (PE); however, it is affected by high interobserver variability. The aim of the study was to evaluate the application of volumetric reconstructions of the right ventricle for assessment of IVS position regarding its accuracy in identifying right ventricular dysfunction, as well as interobserver agreement in evaluating this sign. IVS bowing was evaluated with multiplanar reformations (MPR) and volumetric reconstruction (VR, volume rendering) by 2 observers. The accuracy of IVS bowing sign was better for VR-based assessment; however, it was not significantly better than the MPR-based evaluation. Interobserver agreement was found to be fair (kappa = 0.381) for the MPR-based grading of IVS position as normal or abnormal, while it was significantly better for the VR method (kappa = 0.629, p < 0.001). The VR-based method may improve utilisation of IVS bowing sign in patients with PE. (Folia Morphol 2013; 72, 2: 107–112)
Proper recognition of the particular structures that form the triangle of Calot is essential for the proper and safe performance of laparoscopic cholecystectomy. Proper recognition, ligation, and cut of the cystic duct and cystic artery with branches (dorsal and ventral) remain an integral condition for the removal of the gallbladder. Calot’s triangle, as an orientation structure, determines the most common location of the cystic artery. The triangle of Calot is one of the most variable regions of the abdomen in terms of anatomy. The aim of this study was to evaluate how important for surgery is the detailed anatomical recognition of the main branches of the cystic artery in Calot’s triangle during laparoscopic cholecystectomy. Relations of the main branches of the cystic artery were evaluated in 88 patients that underwent laparoscopic cholecystectomy at the Department of General Surgery of the District Specialistic Hospital of Lublin. The anatomical relations of cystic duct and artery were classified into typical and variant types. Significantly more frequently variants of cystic artery were observed in women. However, the time of the procedure was not significantly related with the type of cystic artery. (Folia Morphol 2009; 68, 3: 140–143)
Human anatomy is one of basic courses in medical education. It usually takes place during the first year of the medical school syllabus. However, the results of the course, if defined as profound anatomical knowledge, are not applied by the students until several years after the final anatomy examination. The aim of the study was to evaluate the anatomical knowledge of senior medical students. For this reason a survey was distributed among teachers responsible for clinical rotas. The results of the study were intended to give the answer to the question, “What do students remember several years after the anatomy examination?” as expressed by their clinical teachers. The questionnaire included four closed questions and one open question. The closed questions concerned general anatomical knowledge, whether the anatomy course should be extended and whether additional courses should be introduced and included a question about student knowledge of particular systems. The open question concerned ways of improving anatomical education. As a result of the survey it was observed that surgical specialists had a significantly lower opinion of the medical knowledge of their students than had medical specialists. Most of the suggestions for improving anatomical education were related to introducing clinical applications of anatomical knowledge.
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