Clinical Anatomy 29:78–103 (2016)

Meeting Abstracts Abstracts Presented at the American Association of Clinical Anatomists (AACA) 32nd Annual Meeting June 9-12, 2015, Henderson, Nevada ABBATIELLO1, THOMAS, MALCOLM ANTOINE1, PETER ABRAHAMS1,2 1St Georges University school of medicine, WI, USA; 2Warwick University Medical school, Coventry, West Midlands CV4 7AL, United Kingdom Art and anatomy, Vitruvian man- Two sexes INTRODUCTION. Closer inspection of Leonardo da Vinci’s Vitruvian man, strongly suggest the portrayal of both sexes. Craniofacial structures, breast development, pubic hair, and female reproductive organs; are the features which, on careful inspection give us clues to the portrayal of the female sex which has previously been overlooked. Recent interest was sparked in the asymmetry of the groin region, it being attributed to an inguinal hernia. A closer look suggests that this might in fact be an ovary. In the context of modern anatomical knowledge of the female anatomy this may be missed. We therefore aimed to separate the individual features of the Vitruvian man in an attempt to assess the degree of sexual dimorphism. RESOURCES. A comprehensive review of da Vinci’s anatomical studies reveals staggering synchronicity with his understanding and the uniqueness of his stylized rendering of female anatomy further establishes the correlation. The eminent da Vinci scholar Martin Kemp has described the Vitruvian man in part as “philosophical anatomy”; in this regard da Vinci’s direct reference to Plato’s Soul mate creates a contextual imperative for gender duality. DESCRIPTION. da Vinci’s study of motion and superimposition is attributed to account for the asymmetry and multiple limbs; it would be na€ıve to consider this an exclusion of his other fascinations, and rather than limit the potential of his genius we garner further reverence for his masterful abilities. For over five centuries Leonardo da Vinci’s inclusion of the female anatomy has been over looked; this radical reinterpretation supports a deeper appreciation of the artists intentions. Clearly there is more to be explored of ancient art and its relevance to anatomy. SIGNIFICANCE. This novel interpretation may lead us to an undiscovered a dynamic representation of the human body in one of the most iconic anatomical drawings ever created.

ABDEL MEGUID1, EIMAN M., AND AMANY E. AGAWANY2 1 Centre of Biomedical Sciences Education, Queen’s University Belfast, BT7 1NN, United Kingdom; 2 Department of Anatomy, Faculty of Medicine, University of Alexandria, Egypt An anatomical study of the arterial and nerve supply of the infrahyoid muscles INTRODUCTION. Infrahyoid myocutaneous flap is of interest in head and neck reconstruction surgery given its versatility, and the quality of its cosmetic results. It represents the golden standard for reconstruction of extensive defects after resection of cancer. There are no sufficient references on the arterial supply to infrahyoid muscles. This information would be beneficial to improve the quality of surgical reconstructions as it will aid surgeons in planning their operations. METHODS. Fourteen cadavers were unilaterally dissected. The cadavers were injected with red latex. The cervical arterial pedicle, and the neural supply of the sternohyoid (SH), sternothyroid muscle (STM) and superior belly of omohyoid (OM) were identified. The superior thyroid artery (ST) and ansa cervicalis (AC) were examined as they are the main supply for the infrahyoid myocutaneous flap. The length of the arterial pedicles was measured to evaluate their potential application in reconstructive surgery. SUMMARY. For the SH, two arterial pedicles originated from the ST and supplied it in 57.1%. The inferior pedicle was absent in 42.9%. As regards the STM, one arterial pedicle from the ST supplied its upper end in 57.1% of cases. In 14.3% of cases, the inferior thyroid artery also supplied it. As regards OM, two C V

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arterial pedicles originated from the ST and supplied its upper and lower ends in 64.3% of cases. SH usually had a double nerve supply from AC. In 57.1% of cases, its superior part was innervated by the nerve to the superior belly of OM. In 35.7% of cases, it received direct branches from AC. As regards STM, in 71.4% of cases, a common trunk arose from the loop and supplied the inferior part of both the SH and STM. The nerve supply to superior belly of OM originated from the AC below the loop. CONCLUSIONS. These data will be useful for surgeons as precise knowledge of the location of vascular pedicles is required for the successful transposition of a myocutaneous flap.

AL HARBI1, YASSER. A AND QUENTIN A. FOGG1,2 1 Laboratory of Human Anatomy, School of Life Sciences, University of Glasgow, Glasgow, G128QQ, UK; 2Centre for Human Anatomy Education, Monash University, Melbourne, Australia 3800 Morphological and statistical descriptions of the trapezium and 1st metacarpal bones INTRODUCTION. The trapeziometacarpal joint is amongst the most common sites for degenerative arthritis. One factor responsible for this is its shallow joint surface combined with a large range of motion. The articulating surfaces between the trapezium and 1st metacarpal are unique. The joint surface is saddle-shaped and allows thumb motion in radial-ulnar and dorso-palmar planes as well as some rotation. This study aims to describe how the shape of these surfaces (and associated landmarks) vary within a sample population. METHODS. Fifty dry cadaver trapezium and 1st metacarpal bones (25 right and 25 left) of unknown age and sex were used. 3D modelling was rendered in a virtual space using a digital microscribe and modeled/ analysed using three different programmes (Rhinoceros 5.0, Amira, and Landmark). The greatest and least length and width of both articulating surfaces were assessed in 3D. A comparison between the results of different software was made. SUMMARY. Both the trapezium and the 1stmetacarpal could be reduced to having five critical points that accurately define variations across the sample population. There were no significant differences between different software results. CONCLUSION. The statistical shape model of trapezium and 1st metacarpal give quantitative descriptions of the variations of bone shape. The models were reliably produced in various programmes and provided detailed and exciting visualisations of this joint. These variations will help explain different soft tissue arrangements (esp. ligament attachments) and motion patterns. Better understanding of potential correlations between skeletal variation and soft tissue supports may help the prevention and diagnosis of injuries and degeneration of this vulnerable joint. These data provide a clinically useful and engaging means of describing and viewing the trapeziometacarpal joint.

AL SAFFAR1, RADI A. AND QUENTIN A. FOGG1,2 1 Laboratory of Human Anatomy, School of Life Sciences, University of Glasgow, Glasgow, G128QQ, UK; 2Centre for Human Anatomy Education, Monash University, Melbourne, Australia 3800 Palmar triquetrumhamate ligaments determined by lunate type INTRODUCTION. The ligaments of the wrist are highly variable and poorly described; this is more extreme on the ulnar side of the wrist. Previous studies highlighted the potential differences within the ligaments of the wrist but no consensus has been reached. Poor tissue description and inconsistent use of terminology hindered the reproducibility of the results. This study aims to establish clear definition and

Meeting Abstracts quantitative description of the key palmar ligaments around the triquetrum-hamate joint categorised by lunate type. METHODS. Fiftythree embalmed and 10 unembalmed cadaveric specimens were dissected blind to lunate type. Individual ligamentous fascicles were traced under 6x magnification. A digitiser was used to reconstruct a 3D model of each wrist and to map the ligamentous attachment sites. Length, width and area of each ligament in addition to the area of each attachment were reported. SUMMARY. Variable patterns of ligamentous attachments were identified. Differences were not only obvious between samples but also between the right and left counterparts. While the type I wrists were predominantly identified with triquetrum-hamate-capitate complexes, the type II wrist were characterised by an extra segmental attachment between the triquetrum and hamate. There were no significant differences between the quantitative data obtained from the embalmed and unembalmed specimens (p>0.05). CONCLUSIONS. The current study demonstrated variable ligamentous patterns that suggest different bone restraints and variable patterns of motion. These findings should be complemented with an extensive histologic analyses of the entheses to determine the mechanically significant attachments. Future studies will be dedicated to studying the functional variability of these ligaments in relation to bone morphology.

AL SAFFAR1, RADI A. AND QUENTIN A. FOGG1,2 1 Laboratory of Human Anatomy, School of Life Sciences, University of Glasgow, Glasgow, G128QQ, UK; 2Centre for Human Anatomy Education, Monash University, Melbourne, Australia 3800 Quantitative analysis of triquetrum-hamate entheses INTRODUCTION. Accurate identification of ligamentous structures is reliant upon defining their attachments. Specific attachment sites and their functional properties within the wrist joint have been a source of a debate in recent literature. This study aims to quantitatively investigate the ligamentous attachments around the palmar aspect of the triquetrum-hamate joint. METHODS. Fifty-three embalmed and 10 unembalmed cadaveric wrist specimens were dissected. The palmar ligaments around the triquetrum-hamate joint were investigated. Tissue was removed in blocks that contained each ligament. The blocks were processed and stained using a modified Masson’s Trichrome technique. Each enthesis area was measured from serial histological sections using ImageJ software. SUMMARY. Different patterns of ligamentous attachments have been identified. All entheses were well demarcated and predominantly fibrocartilaginous. The mean indexed area of each enthesis was significantly larger than the mean indexed area of capsular attachment (p 0.05) was found between the left and right side of each skull or cadaver. Only the supra-zygomatic approach from the frontozygomatic angle towards the pterygopalatine fossa (method B) exhibited no statistical significance when other measurements made on the skulls and cadavers were compared. Method A, a supra-zygomatic approach from the midpoint on the lateral border of the orbit, as well as method C, an infra-zygomatic approach with an entry at a point on a vertical line extending along the lateral orbit wall, showed statistical significant differences during measurement comparison. CONCLUSION. On the basis of these findings method B produces the most consistent data and supports the clinical findings recently reported.

BRUECKNER-COLLINS1, JENNIFER, PAUL KLEIN2, LESLEE MARTIN2, SUSAN SAWNING2, CRAIG ZIEGLER2, EMILY CARR2, ANN SHAW2 AND AMY HOLTHOUSER2 1 Anatomical Sciences and Neurobiology; 2Undergraduate Medical Education Office, University of Louisville School of Medicine, Louisville, KY 40202, USA Tracking peer professionalism measures in preclinical medical students INTRODUCTION. Professionalism is a key competency in gross anatomy instruction, as evidenced by the 2006 special issue of Clinical Anatomy. However, there is a paucity of studies addressing medical students’ ability to evaluate peers’ professionalism in anatomy laboratory and to longitudinally track professionalism attributes into year 2. This study longitudinally compared 160 preclinical medical students’ peer professionalism evaluations in 2 small group settings (year 1 anatomy lab and year 2 team based learning (TBL) sessions) for 2013-14 and 2014-15. METHODS. Students were evaluated by their small group peers on a scale (0-3) on 5 professionalism domains (teamwork; honor/integrity; caring/compassion/communication; respect; responsibility/accountability) at midterm and end of semester in years 1 and 2. Statistical comparisons were made between the formative and summative anatomy ratings and between the summative anatomy and midterm TBL ratings. SUMMARY. Anatomy professionalism evaluations showed an increase from an average ranking of 2.49 at midterm to 2.6 at the end of the semester (p