Kattil, Punnose K

Abstract Neuroanatomy remains a core competency in neurosurgical training, particularly in skull base education, where learners must integrate three‐dimensional spatial understanding, radiologic correlation, and stepwise procedural knowledge. Cadaveric dissection remains foundational, but adjunctive digital tools may strengthen repeated visualization and anatomical review. We describe the educational rationale and implementation of integrating stereoscopic teaching, a stepwise digital application, photogrammetry, and virtual reality within an established neurosurgical skull base curriculum. Within the Mayo Clinic cranial base course embedded in a broader longitudinal curriculum, four postgraduate year 4 neurosurgery residents participated in transcranial and endoscopic cadaveric dissections supported by stereoscopic lectures, workstation‐based tablet guidance, and immersive review using photogrammetry, virtual reality, and computed tomography/magnetic resonance imaging correlation. The integrated design aligned these modalities with course objectives in anatomical landmark recognition, operative corridor planning, radiologic‐anatomic translation, and stepwise procedural rehearsal. The educational contribution of this model lies in the intentional integration of digital adjuncts around cadaveric dissection rather than in a single technology alone. This multimodal sequence may support spatial understanding, procedural preparation, and competency‐oriented skull base training while extending review beyond the laboratory. Current evaluation is best interpreted as preliminary program evaluation rather than definitive learner‐outcome evidence. This model may offer a transferable approach for programs seeking to complement cadaveric education with emerging digital tools and provides a basis for future prospective evaluations using multiple low‐stakes assessment data points across the broader curriculum.

Gross anatomy is now delivered in curricula that are increasingly compressed and integrated with other areas of medical training. At the same time, digital resources and physical models have become more common as supplementary tools in anatomy education. These shifts have renewed interest in the distinctive educational value of donor-based learning and in how preservation methods should be aligned with clinically meaningful learning objectives. This narrative review examines the use of fresh human donor tissue in anatomy teaching and clinically oriented procedural training. It focuses on unembalmed, non-fixed, and fresh-frozen tissue, while soft-preserved tissue is considered mainly as contextual and comparative evidence. Literature searches were conducted in MEDLINE, Scopus, Web of Science, and ERIC databases for English-language human studies published from 2015 through early 2026, with backward citation to identify older landmark comparator papers. Because the preservation-explicit educational literature was limited and heterogenous, findings were synthesized narratively. Across the included literature, fresh tissue appears most educationally valuable when learning objectives depend on functional tissue behavior, including tissue palpation, percussion, tissue-plane recognition, ultrasound-guided anatomy, or realistic procedural handling. Available studies suggest benefits in selected knowledge and performance outcomes, especially in clinically oriented examination and postgraduate refresher courses. Comparator evidence indicates that soft-preserved tissue may provide a pragmatic alternative when programs need repeated access or broader curricular integration while still preserving more realistic handling than formal fixed donors. Formalin fixed tissue remains useful for durable structural teaching despite reduced functional realism. Overall, preservation methods should be treated as a curricular design decision rather than a neutral technical detail. Fresh tissue therefore has a defensible place in competency-based anatomy education when used selectively for tasks requiring high functional fidelity, although stronger evidence for long-term clinical transfer remains limited.

Fundamental to medical education, gross anatomy first introduces medical students to human mortality, often provoking stress. Sense of purpose, a key aspect of well-being, may serve as a protective factor. We studied students’ sense of purpose during an anatomy course, examining its links to performance, spirituality, and belief in an afterlife. Fifty medical students who took a 7-week gross anatomy course in 2022 or 2023 completed the Life Engagement Test at the beginning, middle, and end of the course. We collected other data including demographics, religious/spiritual beliefs, and previous exposure to body donors. Practical and final examinations assessed course performance. Strong sense of purpose at the three measurement points was positively correlated with practical exam performance (r = 0.40, P = .004; r = 0.44, P = .003; r = 0.30, P = .047, respectively) but not National Board of Medical Examiners’ anatomy subject exam performance. Staunch believers and non-believers in an afterlife maintained a stable sense of purpose, while students uncertain about the afterlife experienced a decline from the beginning to the middle of the course and even more to the end ( P = .046; P = .008, respectively). These students also had significantly lower practical examination performance as compared to other students (95% CI [−10.84, −0.52]). In conclusion, a strong sense of purpose predicts better performance in a 7-week anatomy course. Both believers and non-believers in an afterlife do well, but students wavering in their beliefs experience a declining sense of purpose and lower grades. Supporting these students when they confront human mortality, including in other contexts such as palliative care/hospice settings, may be beneficial.

We describe an unpredictable clinical scenario involving an intraoperative vascular injury during an elective total shoulder arthroplasty. Shortly into the procedure, the patient became acutely hypotensive due to frank hemorrhage. The patient experienced a complete transection of the third segment of the axillary artery caused by an unrecognized bone fragment, suspected to have dislodged into the joint space following a traumatic ground-level fall 12 months prior. Emergency vascular surgical intervention was required for hemostasis.

Introduction Superficial parasternal intercostal plane blocks have grown in clinical use for cardiac surgery as a targeted fascial plane block for median sternotomy. Despite this, there remains no consensus on technique for optimal parasternal spread of injectate. The primary objective of this cadaveric study was to evaluate parasternal spread of injectate of single versus two-level superficial parasternal intercostal plane injections with the needle tip positioned on the anterior surface of the costal cartilage. Methods We performed 10 single-level injections at T4 and 10 two-level injections at T3 and T5 on alternating sides in 10 fresh frozen cadavers. All injections were ultrasound guided with a parasagittal ultrasound probe orientation and an in-plane needle orientation. Anatomic dissections were performed immediately following injections. Results Parasternal spread of injectate was greater with two-level injections at T3 and T5 costal cartilages than with single-level injections at the T4 costal cartilage, with two-level injections consistently spreading to the T2–T5 intercostal spaces. Median (Q1, Q3) intercostal space spread for single-level injections was 2.0 (2.0–2.5). Median (Q1, Q3) intercostal space spread for two-level injections was 4.0 (4.0–4.375). Conclusions Two-level injections with the needle tip located on the anterior surface of the costal cartilage resulted in improved parasternal spread compared with single-level injections.

ABSTRACT Purpose: To determine and evaluate the distal forearm and wrist's cutaneous blood supply and vascular territories. Methods: Four cadaveric upper extremities were injected with a radiopaque, lead-based contrast agent through the brachial artery. After the lead-based contrast agent set, the cadaveric limbs underwent computed tomographic (CT) scanning to assess the perforators to the cutaneous skin of the distal forearm and wrist. High-resolution axial CT and three-dimensional reconstructions were generated to highlight perforating vessels stemming from their parent arteries. Subsequently, anatomic microdissections were performed to identify and trace the perforating vessels identified on CT. Results: CT analysis and anatomic microdissection demonstrated that the dorsal surface of the distal forearm and wrist are supplied by numerous perforators stemming predominantly from the anterior interosseous artery with some anastomotic contribution from the posterior interosseous, radial, and ulnar arteries. Perforators from the radial and ulnar arteries supply the volar surface. There are large anastomotic networks formed between the perforating vessels. Conclusions: The distal forearm and wrist have a robust anastomotic blood supply that has contributions from the anterior interosseous, posterior interosseous, radial, and ulnar arteries. Clinical relevance: The extensive perforator-derived blood supply to the skin likely accounts for the excellent soft tissue healing potential of the wrist following surgery utilizing multiple incisions. Highlights Distal radius fractures may require multiple incisions for anatomic reduction and fixation.Multiple incisions about the wrist are thought to predispose to wound complications and/or skin breakdown.The distal forearm and wrist have a robust anastomotic blood supply from the anterior interosseous, posterior interosseous, radial, and ulnar arteries.Multiple incisions do not necessarily predispose to wound complications given robust anastamosis.

Background: Aesthetic soft-tissue filler injections for lip enhancement are popular and performed throughout the world. When injecting lips with a cannula, as the cannula is advanced, resistance is perceived in consistent locations, potentially indicating boundaries between intralabial compartments. Objective: We aimed to investigate whether intralabial compartments exist and, if so, to describe their volumes, location, boundaries, and dimensions. Methods: This cadaveric study investigated a total of 20 human body donors (13 male, seven female) with a mean (SD) age at death of 61.9 years (23.9) and body mass index of 24.3 kg/m2 (3.7). The investigated cohort included 11 White donors, eight Asian donors, and one Black donor. Dye injections simulating minimally invasive lip treatments were conducted. Results: Independent of sex or race, six anterior and six posterior compartments in the upper and lower lip were identified, for a total of 24 lip compartments. Compartment boundaries were formed by vertically oriented septations that were found in consistent locations. The anterior compartments had volumes ranging from 0.30 to 0.39 cc; the posterior compartment volume ranged from 0.44 to 0.52 cc. The compartment volumes were larger centrally and decreased gradually toward the oral commissure. Conclusions: The volume and size of each of 24 compartments contribute to the overall appearance and shape of the lips. To achieve a natural lip shape preserving aesthetic outcome it may be preferable to administer the volumizing product using a compartment-respecting injection approach.