Kaan Yücel M.D., Ph.D.

14. September 2011 Wednesday

INTRODUCTION TO ANATOMY

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What is anatomy?Types of anatomyWho learns anatomy?Why anatomy?

The importance of learning anatomy as a future medical doctorHow to learn anatomyFamous anatomy textbooks and atlasses History of anatomy & anatomy education in the worldHistory of anatomy education in Turkey Research in anatomyAnatomical PositionAnatomical PlanesAnatomical Variations

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“anatomia, anatome” Latin and Ancient Greek origin.

ana-= up temnein, tome=to cut

Anatomy means “cutting up, cutting through”.

What is anatomy, anyway?

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The term human anatomy comprises a consideration of the various structures which make up the human organism.

In a restricted sense it deals with the parts which form the fully developed individual and which can be rendered evident to the naked eye by various methods of dissection.

HistologyEmbryology

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Types of anatomyThe three main approaches to studying anatomy are regional, systemic, and clinical (or applied), reflecting the body's organization and the priorities and purposes for studying it.

In systematic anatomy, various structures may be separately considered.The organs and tissues may be studied in relation to one another in topographical or regional anatomy.

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Regional anatomy (Topographical anatomy)

Considers the organization of the human body as major parts or segments: a main body, consisting of the head, neck, and trunk (subdivided into thorax, abdomen, back, and pelvis/perineum), and paired upper limbs and lower limbs.

All the major parts may be further subdivided into areas and region.

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Surface anatomy

An essential part of the study of regional anatomy.

Provides knowledge of what lies under the skin and what structures are perceptible to touch (palpable) in the living body at rest and in action.

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Systematic AnatomyThe various systems of which the human body:Osteology—the bony system or skeleton. Syndesmology—the articulations or joints.Myology—the muscles. Angiology—the vascular system, comprising the heart, blood vessels, lymphatic vessels, and lymph glands.Neurology—the nervous system. The organs of sense may be included in this system.Splanchnology—the visceral system.

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Topographically the viscera form two groups, viz., the thoracic viscera and the abdomino-pelvic viscera.

The heart, a thoracic viscus, is best considered with the vascular system.

The rest of the viscera may be grouped according to their functions: (a) the respiratory apparatus; (b) the digestive apparatus; and (c) the urogenital apparatus.

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Clinical Anatomy

Clinical (applied) anatomy emphasizes aspects of bodily structure and function important in the practice of medicine, dentistry, and the allied health sciences.

It incorporates the regional and systemic approaches to studying anatomy and stresses clinical application.

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Who learns anatomy?In addition to physicians; Nurses Paramedics Medical secretaries Physiotherapists Radiology technicians Pharmacists Dentists Artists; painters Teachers (e.g., sports, kindergarten teachers) Chiropractors Medical Assistants Nursing Assistants Other

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Why anatomy? The importance of learning anatomy as a

future medical doctor

http://journals.lww.com/academicmedicine/fulltext/2005/04000/the_importance_of_anatomy_in_health_professions.8.aspx

To understand bodily function and how both structure and function are modified by disease.

To interpret the images that are produced by the sophisticated imaging techniques, such as CT, MRI, DTI.

To understand the pathway for targeting therapy to a specific site

To examine the patient properly

To communicate with the colleagues properly

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Physical Exam

InspectionPalpation

Percussion Auscultation

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How to learn anatomy

Etymologyc.1500, from L. cadaver "dead body (of men or animals)," probably from a perf. part. of cadere "to fall, sink, settle down, decline, perish«or from cadō (“I fall”) as a metaphor for "I die«

Cadaver: (Merriam Webster dictionary) from Latin, from cadere 'to fall'.A dead body; especially : one intended for dissection.

Dissection: (Oxford dictionary) from Latin dissectus, past participle of dissecare to cut apart, from dis- + secare to cut. The action of dissecting a body or plant to study its internal parts.

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How to learn anatomyProsection: A prosection is the dissection of a cadaver (human or animal) or part of a cadaver by an experienced anatomist in order to demonstrate for students anatomic structure.

In a dissection, students learn by doingIn a prosection, students learn by either observing a dissection being performed by an experienced anatomist or examining a specimen that has already been dissected by an experienced anatomist (etymology: Latin pro- "before" + sectio "a cutting)

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How to learn anatomyOther materials of learning human anatomy: Anatomy models Anatomy atlases (Pictures, drawings) Videos Textbooks Charts Etc.

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MOORESNELLGRAY’S ANATOMY

SOBOTTANETTER GRANT

Famous Anatomy Books & Atlases

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Anatomy TextbooksClinically Oriented AnatomyKeith L. Moore, Arthur F. Dalley II, Anne M. R. AgurFirst Edition, 1980Sixt (the most recent) Edition, 2010, Lippincott Williams & Wilkins Philadelphia, USA

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Clinical Anatomy by Regions Richard S. Snell 8th edition, 2007, Lippincott Williams & Wilkins Philadelphia, USA

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Clinical anatomy by systemsRichard S. Snell 2006, Lippincott Williams & Wilkins Philadelphia, USA

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Clinical anatomy for medical studentsRichard S. Snell 7th edition, 2000, Lippincott Williams & Wilkins Philadelphia, USA

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Gray’s Anatomy for StudentsWith STUDENT CONSULT Online AccessRichard L. Drake, A. Wayne Vogl ,Adam W. M. Mitchell2nd Edition, 2009

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Anatomy Atlasses

Sobotta - Atlas of Human Anatomy Single Volume Edition, Head, Neck, Upper Limb, Thorax, Abdomen, Pelvis, Lower LimbReinhard Putz2009, 14th Edition, Churchill Livingstone, Edinburgh, Scotland

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Netter’s Atlas of Human Anatomy, with Student Consult AccessFrank H. Netter2010, 5th Edition, Saunders, USA

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Grant’ Atlas of AnatomyJohn Charles Boileau GrantFirst publication date: 1943The most recent edition: Anne M.R. AgurArthur F. Dalley II2009, 12th Edition, Lippincott Williams & Wilkins Philadelphia, USA

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History of anatomy & anatomy education in the world

The development of anatomy as a science extends from the earliest examinations of sacrificial victims to the sophisticated analyses of the body performed by modern scientists.

It has been characterized, over time, by a continually developing understanding of the functions of organs and structures in the body.

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The field of Human Anatomy has a prestigious history, and is considered to be the most prominent of the biological sciences of the 19th and early 20th centuries.

Methods have also improved dramatically, advancing from examination of animals through dissection of cadavers to technologically complex techniques developed in the 20th century.

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Ancient anatomy

EgyptThe study of anatomy begins at least as early as 1600 BCE.

GreeceThe earliest medical scientist of whose works any great part survives today is Hippocrates, a Greek physician active in the late 5th and early 4th centuries BCE (460 - 377 BCE). Much of his work relies on speculation rather than empirical observation of the body.

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Galen

The final major anatomist of ancient times was Galen, active in the 2nd century.

Galen of Pergamon (modern-day Bergama, Turkey), was a prominent Roman (of Greek ethnicity) physician, surgeon and philosopher

His collection of drawings, based mostly on dog anatomy, became the anatomy textbook for 1500 years.

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Early modern anatomy The first major development in anatomy occurred at Bologna in the

14th to 16th centuries, where a series of authors dissected cadavers and contributed to the accurate description of organs and the identification of their functions.

Andreas VesaliusDe humani corporis fabrica (On the Fabric of the Human Body

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Early modern anatomy

A succession of researchers proceeded to refine the body of anatomical knowledge, giving their names to a number of anatomical structures along the way.

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17th and 18th centuries• The study of anatomy flourished in the 17th and 18th centuries.

• The advent of the printing press facilitated the exchange of ideas.

• The popularity of the anatomist was equal to the quality of his drawing talents, and one need not be an expert in Latin to take part.

• Many famous artists studied anatomy, attended dissections, and published drawings for money, from Michelangelo to Rembrandt.

• For the first time, prominent universities could teach something about anatomy through drawings, rather than relying on knowledge of Latin.

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19th century anatomy

During the 19th century, anatomists largely finalized and systematized the descriptive human anatomy of the previous century.

The discipline also progressed to establish growing sources of knowledge in histology and developmental biology, not only of humans but also of animals.

Extensive research was conducted in more areas of anatomy.

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Anatomy museums in Europe

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Body snatchers

Body murderers evenAnatomy murderThe most recent account of anatomy murders was in 1992, when a Colombian activist, Juan Pablo Ordoñez, claimed that 14 poor residents of Barranquilla, Colombia, had been killed to provide cadavers for the local medical school.

More @ http://www.epubbud.com/read.php?g=CQNTWMFC&p=1

Graveyard watchtower, New Calton Burying Ground, Edinburgh

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Burke and Hare murders

The Burke and Hare murders (also known as the West Port murders) were serial murders perpetrated in Edinburgh, Scotland, from November 1827 to October 31, 1828. The killings were attributed to Irish immigrants William Burke and William Hare, who sold the corpses of their 17 victims to provide material for dissection. Their purchaser was Doctor Robert Knox, a private anatomy lecturer whose students were drawn from Edinburgh Medical College.

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History of anatomy education in Turkey1. Pre-dissection period (1827-1841): Anatomy education was given theoretically. 2. Unmedicated cadaver period (1841-1908): Anatomy experts were appointed from abroad Sultan Abdülmecid has signed the imperical decree allowing dissections with the purpose of education.3. Medicated cadaver period (1908-present): In anatomy education by using the method of giving chemical substance through vein, cadavers began to be used initially without decaying in this period. As a result, scale of practice in anatomy education increased considerably.

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Research in Anatomy

In vivoIn vitro studies

Animal studiesClinical studies

Advanced imaging techniquesCT 80sMRI early 90sfMRI late 90s- 21st century

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Anatomical position All anatomical descriptions are expressed in relation to one

consistent position, ensuring that descriptions are not ambiguous.

One must visualize this position in the mind when describing patients (or cadavers), whether they are lying on their sides, supine (recumbent, lying on the back, face upward), or prone (lying on the abdomen, face downward).

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The anatomical position refers to the body position as if the person were standing upright with the:

Head, eyes, and toes directed anteriorly (forward) Arms adjacent to the sides with the palms facing anteriorly Lower limbs close together with the feet parallel.

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Anatomical PlanesAnatomical descriptions are based on four imaginary planes (median, sagittal, frontal-coronal, and transverse-axial) that intersect the body in the anatomical position.

Sagittal= New Latin sagittālis < sagitta (“arrow”)

Coronal= L. corona "crown, garland»

Axial = "pertaining to an axis,«

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The median plane, the vertical plane passing longitudinally through the body, divides the body into right and left halves.

Sagittal planes are vertical planes passing through the body parallel to the median plane.

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Frontal (coronal) planes are vertical planes passing through the body at right angles to the median plane, dividing the body into anterior (front) and posterior (back) parts.

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Transverse planes are horizontal planes passing through the body at right angles to the median and frontal planes, dividing the body into superior (upper) and inferior (lower) parts. Radiologists refer to transverse planes as transaxial, which is commonly shortened to axial planes.

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Anatomical Variations Anatomy books describe (initially, at least) the structure of

the body as it is usually observed in people—that is, the most common pattern.

However, occasionally a particular structure demonstrates so much variation within the normal range that the most common pattern is found less than half the time!

Variations in topographic position of the appendix.