We as medical students initiate our medical career with visits to human anatomy class. At this point of time we appreciate the uniqueness of the individual human body. Several years later as you become proficient in regional anesthesia a visit to anatomy cadaveric class is nostalgic and rewarding.
The feeling of the various tissues can now be appreciated during our needling techniques. Encountering the first rib during my first paraesthesia supraclavicular blind (traditional) technique, way back in 1994, and projecting the needle tip placement with a three dimensional view of the supraclavicular was necessarily because of frequent visits to the cadaver supraclavicular area.
The enormous variations of the plexuses and nerves that are visualized creating a permanent image in our cortex, difficult to erase. Ofcourse we do have ultrasound at our disposal but the infrequent inability to get a plantar flexion and extension with a neurostimation drove me back to the cadaver lab revealing a high sciatic division. No computer is programmed to convey the anamolies encountered in formerly living person.
I firmly believe that research through anatomical dissection and correlation of our studies is superior to information gained through medical imaging and textbooks.
Why would there be a surge in cadaveric fascial plane studies? To begin with the TAP, followed by the Quadratos and Erector Spinae everyones turning back to the human cadlab.
Can medical imaging and newer technologies that throw up beautiful images supplemented by schematic diagrams demonstrate the variations and anamolies in fascial planes? Can they demonstrate the entrapment of cutaneous nerves?
The three dimensional images imprinted in our cortex are long lasting then the two dimensional image thrown up on the screen. It would be a great disservice to the future of regional anesthesia if cadavers are replaced with imaging technologies.
An interaction with a cadaver is a must!
If I wouldn’t be travelling thousands of miles to learn the theil cadavers in Graz and Barcelona, I would be sitting on my computer with some unknown unspecified images instead!
Results1 showed that the human cadaver laboratory offered a significant advantage over the multimedia simulation program. the findings in this study raise concerns that incorporating multimedia simulation into cadaveric anatomy base. It’s a real challenge to meve from traditional cadaveric base to a simulation world.
I can conclude thus: ‘a picture is worth a thousand words, but a specimen is worth a thousand pictures.’
Andrew J. Saltarelli, Cary J. Roseth, William A. Saltarelli. Human cadavers vs. multimedia simulation: a study of student learning in anatomy. Anat Sci Educ7:331–339.
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