[Anatomy of the liver: what you need to know]

Virtual Dissection by Ultrasound: Probe Handling in the First Year of Medical Education

OBJECTIVES

The aim of the present study was to assess the educational plan of first-year students of medicine by analyzing their scores in ultrasound body scanning.

METHODS

Since 2009, the San Paolo Medical School (Milan, Italy) has vertically integrated the study of anatomy with ultrasound-assisted virtual body dissection. Three modules were supplied: musculoskeletal system, heart and abdomen pelvis. 653 first-year students were trained. The students alternated as mutual model and operator. A skillfulness score was assigned to each student. The scores were consequently listed. Nonparametric exact multiple contrast tests were employed to determine relative group effects.

RESULTS

Statistical analysis showed that: no gender-related differences were found (0:49; p=0.769); peer learners performed less well than peer tutors (0.677; p=0); between modules, scores in the musculoskeletal system (pMS=0.726) tend to be higher (p<0.001) than those obtained in the heart and abdomen pelvis (pH=0.398; pAP=0.375 p=0.270); significant differences were found compared to the beginning of the project's academic year.

CONCLUSION

The students considered this didactic course an engaging and exciting approach. Acceptance of peer teaching was extraordinarily high. Autonomous exercitation allowed the students to improve self-criticism and enhance their own skills. The level of expertise obtained by peer tutors and by peer learners can be considered satisfactory. The main objective of training future physicians on personal stethoechoscope with the necessary competence seems to have been successfully started.

Liver segmentation: practical tips

The liver segmentation system, described by Couinaud, is based on the identification of the three hepatic veins and the plane passing by the portal vein bifurcation. Nowadays, Couinaud's description is the most widely used classification since it is better suited for surgery and more accurate for the localisation and monitoring of intra-parenchymal lesions. Knowledge of the anatomy of the portal and venous system is therefore essential, as is knowledge of the variants resulting from changes occurring during the embryological development of the vitelline and umbilical veins. In this paper, the authors propose a straightforward systematisation of the liver in six steps using several additional anatomical points of reference. These points of reference are simple and quickly identifiable in any radiological examination with section imaging, in order to avoid any mistakes in daily practice. In fact, accurate description impacts on many diagnostic and therapeutic applications in interventional radiology and surgery. This description will allow better preparation for biopsy, portal vein embolisation, transjugular intrahepatic portosystemic shunt, tumour resection or partial hepatectomy for transplantation. Such advance planning will reduce intra- and postoperative difficulties and complications.

Anatomy research of coeliac trunk of Wistar rats

AIM: To describe and illustrate systematically the anatomy of the Wistar rats to facilitate the selection of catheters and performance of studies in this animal.

METHODS: Ten Wistar rats' coeliac trunk courses, relationships and applications in experiment were studied using vascular casting and gross anatomy analysis. Their diameter and length were measured with a vernier caliper.

RESULTS: The celiac trunk originated at the anterior or right aspect of the abdominal aorta just below the diaphragm pillars, ascended close to the aorta and branched into the common hepatic, left gastric and splenic arteries. It was relatively longer than that in humans, but without non-cystic artery. In our limited specimens, there was little variation about the coeliac trunk.

CONCLUSION: In this study, we successfully describe the Wistar rat coeliac trunk's regional anatomy, measure their diameters and lengths, and facilitate the selection of catheters and performance for future study.