Anatomical Variations of ProfundaFemoris Artery in Indian Population

Background: Aim: To assess anatomical variations of profundafemoris artery in Indian population.Methods:45 embalmed lower extremities adult human cadavers age range of 30–65 years were recruited for the study. The femoral triangles were dissected with proper care to identify the profundafemoris and circumflex femoral arteries. Their source of origin, position, and distance were noted with the mid-inguinal point (MIP) as a reference point.Results:Side of profundafemoris artery (PFA) was postero- lateral in 60%, posterior in 30%, lateral in 5% and absent in 5%. Medial circumflex femoral artery (MCFA) had 65%, 15%, 12% and 8% and lateral circumflex femoral artery (LCFA) had 80%, 15%, 5% and 0% respectively. Origin of profundafemoris artery (PFA) was FA in 90% and common trunk with medial circumflex femoral artery in 10%. Origin of Medial circumflex femoral artery (MCFA) was FA in 55%, PFA in 40% and FA with common trunk with MCFA in 5%. Origin of lateral circumflex femoral artery (LCFA) was femoral artery in 70%, PFA in 20% and FA with common trunk with PFA in 10%. A significant difference was observed (P< 0.05).Conclusions:A thorough knowledge of variation of profunda femoral artery is of great importance and to avoid complications.

The “Fight Bite” Saline Joint Loading Test: Effectiveness in Detecting Simulated Traumatic Metacarpophalangeal Arthrotomies

Background: The saline load test is routinely used to recognize other joints’ traumatic arthrotomies; however, there are currently no studies evaluating the novelty of this test for metacarpophalangeal joints (MCPJs). This study aimed to investigate the effectiveness and sensitivity of saline load testing in identifying the traumatic arthrotomies of the MCPJs using human cadavers. Methods: This was a cadaveric study of 16 hands (79 MCPJs). Traumatic arthrotomies were created using 11-blade stab-incisions, followed by blunt probing into the joint on the radial or ulnar side of the flexed MCPJs. A 3-mL syringe was used to inject intra-articular methylene-blue-dyed saline from the contralateral side. The volume at saline extravasation was recorded. Test sensitivity and factors influencing extravasation volume were assessed. Results: The mean (range) volume injected to identify arthrotomy of all MCPJs was 0.18 mL (0.1-0.4 mL). The mean volume to identify MCPJ arthrotomy of the thumb, index, long, ring, and small fingers was 0.16 mL (0.1-0.3 mL), 0.19 mL (0.1-0.3 mL), 0.21 mL (0.1-0.4 mL), 0.17 mL (0.1-0.3 mL), and 0.16 mL (0.1-0.3 mL), respectively. Cadaver age, laterality, and joint range of motion were not significantly associated with the injected volume at extravasation( P > .05, each). Injection volumes of 0.3 and 0.32 mL were required to detect arthrotomies at 95% and 99% sensitivities across all MCPJs. None of the MCPJs required > 0.4 mL to detect arthrotomy. Conclusions: Saline joint loading volumes to detect traumatic arthrotomy were similar for all MCPJs. Injection volumes of 0.32 mL is suggested for 99% sensitivity. Our findings provide the first report, to our knowledge, on intra-articular injection volumes expected to detect an arthrotomy of MCPJ. This is critical for further validation using in vivo clinical studies.

Decellularization Following Fixation of Explanted Aortic Valves as a Strategy for Preserving Native Mechanical Properties and Function

Mechanical or biological aortic valves are incorporated in physical cardiac simulators for surgical training, educational purposes, and device testing. They suffer from limitations including either a lack of anatomical and biomechanical accuracy or a short lifespan, hence limiting the authentic hands-on learning experience. Medical schools utilize hearts from human cadavers for teaching and research, but these formaldehyde-fixed aortic valves contort and stiffen relative to native valves. Here, we compare a panel of different chemical treatment methods on explanted porcine aortic valves and evaluate the microscopic and macroscopic features of each treatment with a primary focus on mechanical function. A surfactant-based decellularization method after formaldehyde fixation is shown to have mechanical properties close to those of the native aortic valve. Valves treated in this method were integrated into a custom-built left heart cardiac simulator to test their hemodynamic performance. This decellularization, post-fixation technique produced aortic valves which have ultimate stress and elastic modulus in the range of the native leaflets. Decellularization of fixed valves reduced the valvular regurgitation by 60% compared to formaldehyde-fixed valves. This fixation method has implications for scenarios where the dynamic function of preserved valves is required, such as in surgical trainers or device test rigs.

Lamb head as a training model for septoplasty and rhinoplasty

Background: Septoplasty and rhinoplasty are difficult operations to learn and teach. Many modalities have been proposed to make the teaching process of these operations easier. In this study, it was investigated if lamb heads were good training models to teach septoplasty and rhinoplasty to trainees or experienced surgeons. Methods: In the first part of the study, 21 lamb heads were dissected according to a dissection protocol and several anatomical distances were measured in order to compare them with human cadavers. In the second project 8 lamb heads were dissected and different preservation rhinoplasty techniques were practiced. Results: The study on 21 lamb heads used showed that the lateral crura were 17.8 x 11.6, average interdomal distance was 8.1 mm, average domal width was 3.7 mm. The average length of the upper lateral cartilages was 31.1 mm laterally and 21.2 medially. The average length of the nasal bones was 63.9 mm and the width was 16 mm. In the second part of the study 8 lamb heads were used to experience where high strip techniques were used in 5 and Cottle technique in 3. Conclusion: This study revealed that lamb head should be considered as an excellent training model for septoplasty and rhinoplasty. Its very low cost, ease of availability, and close similarity to the human cadavers can be counted as the main advantages. This study also proved that it was not only a tool for beginners, but also a very helpful tool for experienced surgeons to try new methods.

Cadaveric Study of Anatomical Variations of Renal Arteries

Introduction: Anatomical variations of renal artery are important to prevent complications during renal transplant surgery or renal angiography. Of this additional renal artery is the most common. Materials and methods: The present study was conducted in 80 kidneys of 40 adult human cadavers in Department of Anatomy, Siddhartha Medical College, Vijayawada over a period of 4 years (2017 to 2021) during educational dissections. Results: Accessory renal arteries are observed in the present study. Origins of these accessory renal arteries are noted along with their entry point into the kidneys. These results were compared with previous studies. Conclusion: Prior knowledge of these variations is important to prevent complications during surgical and angiographic interventions. Keywords: Renal arteries, Accessory renal artery, Aberrant renal artery, Upper pole, Lower pole, Hilum.

Development of an original method for the repair of paracolostomy hernias

The proposed surgical procedure was studied on six unfixed male human cadavers. The removal of the end colostomy and paracolostomy hernia with subsequent intra-abdominal implantation of a previously prepared hernioprosthesis from the xenopericardium were modeled on the corpses. The use of the proposed method for the repair of paracolostomy hernias, including the use of a xenopericardial plate as an endoprosthesis according to an original technique, has shown its consistency and prospects for use on clinical material. Further studies associated with the use of the proposed technique of paracolostomy hernia repair in clinical practice seem promising. Key words: Colostomy, paracolostomy hernia, implantation, hernioprosthesis, xenopericardium.

Evaluation of external stabilization of type II odontoid fractures in geriatric patients—An experimental study on a newly developed cadaveric trauma model

Background Along with the growing geriatric population, the number of odontoid fractures is steadily increasing. However, the effectiveness of immobilizing geriatric odontoid fractures using a cervical collar has been questioned. The aim of the present study is to analyze the physiological and pathological motion in odontoid fractures and to assess limitation of motion in the cervical spine when applying a cervical collar. Methods Motion analysis was performed with wireless motion tracker on unfixed geriatric human cadavers. First, a new geriatric type II odontoid fracture model was developed. In this model, the type II odontoid fracture is operated via a transoral approach. The physiological and pathological flexion and lateral bending of the cervical spine resulting from this procedure was measured. The resulting motion after external stabilization using a cervical collar was analyzed. Results The new geriatric type II odontoid fracture model was successfully established using seven unfixed human cadavers. The pathological flexion of the cervical spine was significantly increased compared to the physiological flexion (p = 0.027). Furthermore, the flexion was significantly reduced when a cervical collar was applied. In case of flexion the mean remaining motion was significantly reduced (p = 0.0017) from 41° to 14°. For lateral bending the mean remaining motion was significantly reduced (p = 0.0137) from 48° to 18°. Conclusions In case of type II odontoid fracture, flexion and lateral bending of the cervical spine are increased due to spinal instability. Thus, if an odontoid fracture is suspected in geriatric patients, the application of a cervical collar should always be considered since external stabilization can significantly reduce flexion and lateral bending.

Teaching Human Anatomy: A Comparison of In-Person and Online Learning Programs

Background: The COVID-19 pandemic created challenges in providing anatomy instruction to allied health professions. Human anatomy laboratory classes often rely on human cadavers as instructional material. At some institutions, the anatomical instructional method shifted to online resources. It was essential to compare online methods to those used in the traditional cadaver-based curriculum to determine efficacy. A technique was devised to compare these two approaches. The working hypothesis was that virtual human anatomy models are equally effective to traditional methods in providing anatomy instruction to allied health students. Methods: Students enrolled in this study participated in a human anatomy course delivered either in-person or virtually via Aclan’s Anatomy, NetAnatomy, and Anatomy TV. The instructional design was the same except that the in-person learning group participated in a real-time cadaver anatomy lab, while the virtual learning group utilized online models and simulations. Students were assessed using the same three written tests and three laboratory examinations. Results: Student demographics and evaluation outcomes were presented, and no significant differences concerning sex or educational program between the two student cohorts were identified. Post hoc testing revealed no statistically significant differences between student cohort and test-type. The three-way interaction between test type, test number, and cohort was not significant. Conclusions: The findings confirmed the hypothesis. There were no statistically significant differences between the test performance of human anatomy students who received online training versus those who participated in in-person classroom instruction. These results suggest that human anatomy can be taught effectively using an online format.