The purpose of this research is to obtain morphological information about the traveling route, branching pattern, and distribution within the tongue of the lingual nerve, all of which are important for oral surgical procedures. Using 20 sides from 10 Japanese cadaveric heads, we followed the lingual nerve from its merging point with the chorda tympani to its peripheral terminal in the tongue. We focused on the collateral branches in the area before reaching the tongue and the communication between the lingual and hypoglossal nerves reaching the tongue. The collateral branches of the lingual nerve were distributed in the oral mucosa between the palatoglossal arch and the mandibular molar region. Two to eight collateral branches arose from the main trunk of the nerve, and the configuration of branching was classified into three types. More distally, the lingual nerve started to communicate with the hypoglossal nerve before passing the anterior border of the hyoglossus muscle. Nerve communications were also found in the main body and near the apex of the tongue. A thorough understanding of the collateral branches near the tongue, and the communication with the hypoglossal nerve inside the tongue, will help to prevent functional disorders from local anesthesia and oral surgical procedures associated with the lingual nerve. Clin. Anat. 32:635–641, 2019. © 2019 Wiley Periodicals, Inc.

Background Discussions and investigations are being conducted in regard to the question of how, instead of acquiring specific kinds of expertise at university, students can instead be taught “generic skills,” which are the competencies for engaging in the everyday life of a working adult. Objectives This survey was aimed at assessing the impact of clinical practical training on generic skills from the perspective of student's own perceptions of personal growth. And we compared different three nursing colleges of the practical training methods to investigate the associations between generic skills and practical training methods. Design A text mining analysis study. Settings and participants The study was conducted with the participation of Japanese third-year students who had completed clinical practical training at three nursing colleges. Study period was December 2016 to February 2017. There were 242 participants in total, and valid responses were obtained from 216 participants. Methods We distributed an anonymous self-administered questionnaire. Data collected from open-ended responses was subjected to analysis using text mining methods. Results A total of 2,903 words were extracted as the result of analyzing text data for a total of 568 sentences. From the patterns in which the extracted words appeared, we were able to classify details reported by students about the areas where they recognized personal growth into nine categories. We found “teacher,” “now,” and “clinical instructor” among the characteristic words for School A, as well as “learn,” “records,” and “planning.” The terms extracted for School B included “acquired,” “communication,” and “consideration.” Terms extracted for School C included “perform,” “human,” and “action + can.” Conclusion Students perceive more growth in terms of generic skill competencies than in terms of expert knowledge or techniques. Project-based learning is associated with students' “ability to discover problems,” while experience-based practical training is associated with students' “ability to sustain action.”

The sinuatrial nodal branch (SANB) of the coronary artery is anatomically important as it irrigates the sinuatrial node. Past studies on the origin and route of the SANB in the human heart have produced discrepant findings. Therefore, in this study, we macroscopically investigated the origin, route, and distribution of the SANB in 293 human hearts. In addition, we examined the relationship between coronary artery dominance and the origin of the SANB. The SANB was found to have one branch in 267 specimens (91.2%), two branches in 25 specimens (8.5%), and three branches in one (0.3%) specimen. The SANB originated from the right coronary artery in 184 branches (57.5%) and from the left coronary artery (circumflex artery) in 136 branches (42.5%). Nine SANB routes were classified, all of which were distributed in the interatrial septum except for one heart with a type R3 SANB course, which was found to extend through the muscle layer of the interatrial septum into the septum. The composition of these courses could relate to the generation of the proepicardium in the amniote.

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Background and objectives: An anatomical site in the oral cavity can be used to trigger the jaw opening reflex in patients with pseudobulbar palsy who have difficulty opening the mouth. The site is located at the midpoint between the palatoglossal arch and pterygomandibular fold and medial to the retromolar pad. However, previous findings on the nerves innervating this particular area are inconsistent. Therefore, in this study, we carefully investigated the sensory nerves that innervate the area near the trigger point of the jaw opening reflex. Materials and methods: For the morphological investigation of sensory innervation in this area, in this study we exposed the cranial nerves in 26 halves of cadaver head and observed their distribution in soft tissue. Results: In all cases, several nerve fibers diverged anteroinferiorly from the lingual nerve located between its junction with the chorda tympani nerve and the junction with the communicating branch of the submandibular ganglion. These nerve fibers, thought to be the facial branches of the lingual nerve, innervated the mucosa in the vicinity of the palatoglossal arch, retromolar pad, and the lingual gingiva of the last molar which were near to the trigger point of the jaw opening reflex. Conclusion: The results suggest that the sensory nerve that induces the jaw opening reflex appears to be the branches to isthmus of fauces diverged from the lingual nerve.

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Background and objectives: In treatment of dental conditions and dental anaesthesiology, a thorough understaoding of course, directions and distribution of nerves and blood vessels supplying the tongue is extremely important. However, the morphology of the nerves supplying the tongue has not yet been fully understood. We applied comparative anatomical approach in order to observe innervation of the tongue in detail, with the focus on the distribution of the lingual nerves and its communication with the hypoglossal nerve. Material and methods: Ten adult human tongues with no grossly detectable abnormalities that were resected from cadavers donated for anatomical study and five monkey tongues were used. Specimens were immersed in water and dissected under a stereomicroscope, and gross examination of the morphology and directions of branches of the hypoglossal and lingual nerves, communicating branches between these two nerves, and their connection status was done. Observations: All branches shared common morphological characteristics: branches near the root of the tongue were relatively straight, while they meandered and formed loops nearer to the apex of tongue. In addition to the branch on the anterior muscle bundle of the hyoglossus muscle, which could be easily observed, there were two more communicating points (total of three communicating branches in both humans and Japanese macaques: in the inner part of the genioglossus muscle and the apex of the tongue). Conclusions: The levels of communicating nerve complexity between the hypoglossal nerve and the lingual nerve and the thickness of nerve fibers varied among individual subjects, but there was a common three-site communication pattern.

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