CLINICAL ANATOMY is the Official Journal of the American Association of Clinical Anatomists and the British Association of Clinical Anatomists. The goal of CLINICAL ANATOMY is to provide a medium for the exchange of current information between anatomists and clinicians. This journal embraces anatomy in all its aspects as applied to medical practice. Furthermore, the journal assists physicians and other health care providers in keeping abreast of new methodologies for patient management and informs educators of new developments in clinical anatomy and teaching techniques. CLINICAL ANATOMY publishes original and review articles of scientific, clinical, and educational interest. Papers covering the application of anatomic principles to the solution of clinical problems and/or the application of clinical observations to expand anatomic knowledge are welcomed.

Student success in basic medical science courses is typically determined by their individual performance on examinations of various types. Previous research both within and outside medical education has shown that the use of educational assessment activities can increase learning as demonstrated by performance on subsequent examinations, a phenomenon known as the testing effect. Activities primarily designed and used for assessment and evaluation purposes can also be used as teaching opportunities. We developed a method for measuring and evaluating student accomplishment in a preclinical basic science course that incorporates both individual and collaborative efforts, encourages and rewards active participation, does not compromise the reliability of the assessment outcome and is perceived by the students as helpful and valuable. The approach involved a two-part assessment activity composed of an individual examination and a small group examination with each component differentially weighted in determining an overall examination score. We found that the method was successful in encouraging collaborative efforts during the group component and provided valid measures of student grasp of the subject matter. We describe the development and implementation of the method, provide data derived from its use in a preclinical basic science course and discuss factors to be addressed when utilizing this approach to ensure fairness and reliability of the outcome. We include brief summary comments from students regarding their impressions of the value of this method.

Rheumatoid arthritis (RA) is a recurrent chronic autoimmune disease, which is not only difficult to treat, but also has a great adverse impact on the physical and mental health of patients. The intestinal mucosa barrier has some relationship with RA and it consists of mechanical barrier, chemical barrier, immune barrier, and microflora barrier. It is a dynamic system that contributes to the stability of the intestinal environment by regulating the absorption of relevant substances from the lumen into the circulation, while limiting the passage of harmful substances. This article summarizes the connection between the intestinal mucosa barrier and RA, and proposes the role of relevant Chinese medicines on RA from the point of improving barriers, to provide new perspectives on the pathogenesis and therapeutic strategies of RA.

Human cadavers used for surgical training are embalmed using various methods to facilitate tissue storage and longevity while preserving the natural characteristics required to achieve high fidelity functional task alignment. However, there are no standardized means to evaluate the suitability of embalming solutions for this purpose. The McMaster Embalming Scale (MES) was developed to assess the extent to which embalming solutions allow tissues to achieve physical and functional correspondence to clinical contexts. The MES follows a five-point Likert scale format and evaluates the effect of embalming solutions on tissue utility in seven domains. This study aims to determine the reliability and validity of the MES by presenting it to users after performing surgical skills on tissues embalmed using various solutions. A pilot study of the MES was conducted using porcine material. Surgical residents of all levels and faculty were recruited via the Surgical Foundations program at McMaster University. Porcine tissue was unembalmed (fresh- frozen) or embalmed using one of seven solutions identified in the literature. Participants were blinded to the embalming method as they completed four surgical skills on the tissue. After each performance, participants evaluated their experience using the MES. Internal consistency was evaluated using Cronbach's alpha. Domain to total correlations and a g-study were also conducted. Formalin-fixed tissue achieved the lowest average scores, while fresh frozen tissue achieved the highest. Tissues preserved using Surgical Reality Fluid (Trinity Fluids, LLC, Harsens Island, MI) achieved the highest scores among embalmed tissues. The Cronbach's alpha scores varied between 0.85-0.92, indicating a random sample of new raters would offer similar ratings using the MES. All domains except odor were positively correlated. The g-study indicated that the MES is able to differentiate between embalming solutions, but an individual rater's preference for certain tissue qualities also contributes to the variance in scores captured. This study evaluated the psychometric characteristics of the MES. Future steps to this investigation include validating the MES on human cadavers. This article is protected by copyright. All rights reserved.

CLINICAL ANATOMY is the Official Journal of the American Association of Clinical Anatomists and the British Association of Clinical Anatomists. The goal of CLINICAL ANATOMY is to provide a medium for the exchange of current information between anatomists and clinicians. This journal embraces anatomy in all its aspects as applied to medical practice. Furthermore, the journal assists physicians and other health care providers in keeping abreast of new methodologies for patient management and informs educators of new developments in clinical anatomy and teaching techniques. CLINICAL ANATOMY publishes original and review articles of scientific, clinical, and educational interest. Papers covering the application of anatomic principles to the solution of clinical problems and/or the application of clinical observations to expand anatomic knowledge are welcomed.

The teaching of anatomy for physiotherapy differs from other health professions, and yet there is lack of guidance for the best practice in the literature, especially within the United Kingdom (UK). The present study aimed to provide the most effective pedagogical guidance for teaching a typical anatomy curriculum for a three-year BSc Physiotherapy degree program within the UK. The research design used a constructivist grounded theory where semi-structured interviews were conducted with eight registered physiotherapists teaching anatomy to undergraduate physiotherapy students within the UK. The study generated 72,292 words of qualitative data that were thematically analyzed using Saldaña's coding techniques until data saturation was reached. The results had three main components: a pedagogical backdrop composed of five pedagogical issues, pedagogical approaches with its three sub-components and pedagogical timings of phases of when anatomical teaching was conducted across the three undergraduate physiotherapy degree programs. The cognitive load theory (CLT) best explained the results through five main pedagogical principles: spiral curriculum strategies, visual anatomical imagery, kinesthetic anatomical skills, strategies for teaching clinical physiotherapy anatomy, and using anatomical principles for metacognition. The study proposes a new modified version of CLT which acknowledges that newly acquired knowledge is fragile in novice learners, who have limited long-term memory capacities, and subsequently require regular revisitations, and also acknowledges kinesthetic input and germane cognitive load metacognition strategies. The study recommends appointing anatomy theme leads to take responsibility for the spiral curriculum approach across the 3 years and to introduce explicit anatomy teaching during the later clinical years.

Clinical AnatomyVolume 36, Issue 2 p. C1-C1 ISSUE INFORMATIONFree Access Issue Information First published: 14 February 2023 https://doi.org/10.1002/ca.23904AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat Volume36, Issue2March 2023Pages C1-C1 RelatedInformation

During routine cadaveric dissection, Simonds et al. in 2019 found a previously undocumented ligament, which they termed the midline interlaminar ligament (MIL), in 24 out of 36 (76.5%) lumbar spinal levels. The MIL is an unpaired ligament located between and distinctly separate from the right and left ligamenta flava (LF). The purpose of this study was to identify the presence or absence of the MIL in the cervical, thoracic, and lumbar spinal regions and obtain detailed measurements of the ligaments' toughness (R) and elastic modulus (E). Intact preserved cadaveric vertebrae from C2 to the upper sacral region were dissected. Presence or absence of the MIL was documented, and length and width of each MIL were measured in situ. The R and E of the LFs from corresponding spinal segments were found for comparison. At least one MIL was observed in 90.3% (28) of specimens. Eighty-eight MIL's were observed out of 186 cervical intervertebral levels (0.5%), 371 thoracic intervertebral levels (5.9%), and 101 lumbar intervertebral levels (63.4%). The mean width and length of the MIL were 1.21 ± 0.36 and 16.37 ± 2.17 mm, respectively. The mean R of the MIL and the LF were 1390.27 and 2068.04 J m-2 , respectively. The mean E of the MILs and LFs was 46.78 ± 16.65 and 51.15 ± 21.68 MPa, respectively. Based on our findings, the MIL was present in the majority of vertebrae in our cadaveric population with a predominance for the lumbar region.

The jugular foramen harbors anatomically complex bony, venous and neural structures. It is closely associated with small canals including the mastoid, tympanic, and cochlear canaliculi, and the stylomastoid foramen. The minute intraosseous branches of Arnold's and Jacobson's nerves (<1 mm in length) remain difficult to study with current imaging techniques, and cadaveric dissection is the most reliable approach. Our aim was to examine the variations of Jacobson's and Arnold's canaliculi and nerves and to provide detailed cadaveric graphics. To reveal the anatomical structures of small canals around the jugular foramen, 25 sides of dry skulls and 14 sides of cadaveric heads were examined. Intraosseous branches varied more in Arnold's nerve than Jacobson's nerve. In our cadaveric dissection, all specimens formed a single canal for Jacobson's nerve connecting the jugular foramen to the tympanic cavity. The intraosseous course of Arnold's nerve varied in its communication with the facial nerve. A descending branch crossing the facial nerve was identified in five of 14 sides, an ascending branch in 13. In two specimens, an ascending branch clearly reached the base of the stapedius muscle. Classical anatomical studies of cadavers remain a supplementary tool for analyzing these tiny structures. The present study confirms Gray's findings of 1913. Variations of these nerves could be even more complex than previously reported. Our study provides additional information regarding the anatomy of Jacobson's and Arnold's nerves.