Perhaps we don’t know what we thought we knew: Why clinicians need to re-visit and re-engage with clinical anatomy

Cornwall, Jon

doi:10.4066/amj.2013.1676

Cited by 7 publications

(3 citation statements)

References 8 publications

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“…Teaching the gross anatomy of complex structures such as the anterior optic pathways to students is a challenging task [ 26 ] and some authors have suggested that clinical anatomy should be continuously reappraised in light of the findings of the newest research methods [ 27 ]. In particular, three-dimensional (3D) visualizations offered by DTI tractography can be used not only for clinical assessment but also for teaching complex anatomy, based on both standard atlas representations and individual variation (as shown in Figure 1 ).…”

Section: Discussionmentioning

confidence: 99%

Multishell Diffusion MR Tractography Yields Morphological and Microstructural Information of the Anterior Optic Pathway: A Proof-of-Concept Study in Patients with Leber’s Hereditary Optic Neuropathy

Manners

Gramegna

Morgia

et al. 2022

IJERPH

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Tractography based on multishell diffusion-weighted magnetic resonance imaging (DWI) can be used to estimate the course of myelinated white matter tracts and nerves, yielding valuable information regarding normal anatomy and variability. DWI is sensitive to the local tissue microstructure, so tractography can be used to estimate tissue properties within nerve tracts at a resolution of millimeters. This study aimed to test the applicability of the method using a disease with a well-established pattern of myelinated nerve involvement. Eight patients with LHON and 13 age-matched healthy controls underwent tractography of the anterior optic pathway. Diffusion parameters were compared between groups, and for the patient group correlated with clinical/ophthalmological parameters. Tractography established the course of the anterior optic pathway in both patients and controls. Localized changes in fractional anisotropy were observed, and related to estimates of different tissue compartments within the nerve and tract. The proportion of different compartments correlated with markers of disease severity. The method described allows both anatomical localization and tissue characterization in vivo, permitting both visualization of variation at the individual level and statistical inference at the group level. It provides a valuable adjunct to ex vivo anatomical and histological study of normal variation and disease processes.

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Section: Discussionmentioning

confidence: 99%

Multishell Diffusion MR Tractography Yields Morphological and Microstructural Information of the Anterior Optic Pathway: A Proof-of-Concept Study in Patients with Leber’s Hereditary Optic Neuropathy

Manners

Gramegna

Morgia

et al. 2022

IJERPH

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“…It has been found that clinicians either say they require least Anatomy or they diagnose with overconfidence of without knowing necessary and sufficient Anatomy. The clinicians guiding/exercising clinical Anatomy for clinical analysis often have neither the time to update anatomical knowledge nor remember it to the required level as "Perhaps we don't know what we thought we knew: Why clinicians need to revisit and re-engage with clinical anatomy" [8]. Specialty practitioners dealing with more critical patients suffering from more complex and advanced diseases, certainly, require more precise diagnosis to explore macro/microstructural distortion/deformation to be manipulated by medicines.…”

Section: Diagnosismentioning

confidence: 99%

Is inadequate anatomical knowledge on the part of physicians hazardous for successful clinical practice?

et al. 2022

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PurposeThe physicians say that the least anatomy is required for clinical practice. But the disease causes anatomical distortions or variations in structures impairing functions of organs and systems. So, the diagnosis and analysis of treatment of disease depend on interwoven inter-relationship among Anatomy, Physiology, Pathology, Radiology and clinical sciences. Consequently, the upcoming doctors are to be cultivated sufficient anatomy. Therefore, the objective of this study is to analyze viewpoints of medical students, faculties and practitioners regarding degree of need of Anatomy in clinical practice. Methods A feedback survey has been carried out among students and faculties to seek their views on the need of Anatomy in clinical practice using two hypotheses. Hypothesis 1 defines the degree of need of Anatomy ('most essential', 'essential' and 'least essential') in clinical practice based on answers of questionnaire by medical students and faculties, whereas hypothesis 2 assigns weights depending on knowledge and experience of the feedback providers. The means/weighted means of views have been statistically analyzed. Additionally, the literature survey was carried out on the demand, necessity, importance, usefulness and applicability of Anatomy in clinical practice. Results Our statistical analysis revealed that Anatomy is 'most essential' for clinical practice. In literature survey too, the inadequate knowledge of anatomy among medical students leads to poor comprehension of clinical practice. So, anatomy is most essential for clinical practice. Conclusion Sound knowledge of Human Anatomy is most essential during medical practice for Physicians.

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“…'Work in progress' describes areas where anatomical knowledge remains incomplete and/or controversial and includes acquiring a more detailed understanding of the anatomy of the extremes of age; resolving or refining disputed descriptions of regional anatomy, such as the pelvic floor (unifying the differing perspectives of colorectal and urological surgeons, obstetricians and radiologists) and the cervical deep fascia; updating anatomical terminology with reference to consensus papers produced by surgical groups and attitudinally correct cardiac terminology; acknowledging that textbooks tend to describe the youthful anatomical average, embracing evidence-based anatomy and undertaking meta-analyses of anatomical databases (Cornwall, 2013;Roy et al 2015); recognising the ranges of normal anatomical variation, e.g. in assessing dermatome distribution in the lower limb (Lee et al 2008) or the prevalence of vascular variations (Schmidt et al 2008).…”

Section: What Now?mentioning

confidence: 99%

A brief history of topographical anatomy

Standring

2016

Journal of Anatomy

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This brief history of topographical anatomy begins with Egyptian medical papyri and the works known collectively as the Greco-Arabian canon, the time line then moves on to the excitement of discovery that characterised the Renaissance, the increasing regulatory and legislative frameworks introduced in the 18th and 19th centuries, and ends with a consideration of the impact of technology that epitomises the period from the late 19th century to the present day. This paper is based on a lecture I gave at the Winter Meeting of the Anatomical Society in Cambridge in December 2015, when I was awarded the Anatomical Society Medal.

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Perhaps we don’t know what we thought we knew: Why clinicians need to re-visit and re-engage with clinical anatomy

Abstract: EDITORIALPlease cite this paper as: Cornwall J. Perhaps we don't know what we thought we knew: Why clinicians need to re-visit and re-engage with clinical anatomy. AMJ 2013, 6, 6, 339-340. http//dx.

Cited by 7 publications

References 8 publications

Multishell Diffusion MR Tractography Yields Morphological and Microstructural Information of the Anterior Optic Pathway: A Proof-of-Concept Study in Patients with Leber’s Hereditary Optic Neuropathy

Multishell Diffusion MR Tractography Yields Morphological and Microstructural Information of the Anterior Optic Pathway: A Proof-of-Concept Study in Patients with Leber’s Hereditary Optic Neuropathy

Is inadequate anatomical knowledge on the part of physicians hazardous for successful clinical practice?

A brief history of topographical anatomy

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