Fluoroscopic angiography in the gross anatomy dissection laboratory: Visualizing the aortic arch and its branches in a cadaver

Vogt, Keith M.; Kauh, Courtney Y.; Holder, David M.; DePhilip, Robert M.

doi:10.1002/ca.21080

Cited by 3 publications

(5 citation statements)

References 33 publications

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“…Without an opportunity to dissect a human body, we would have never learned about this variation in so much depth, nor would we have had the opportunity to experience the process of anatomical research. Our study and that of Vogt et al (2011) provide novel examples of how valuable clinically-relevant cadaveric dissection is in medical education.…”

Section: Embryology and Molecular Geneticsmentioning

confidence: 93%

“…Although the presence of an ARSA has been well documented in the literature (Atay et al, 2006;Bednarkiewicz et al, 2003;Chaoui et al, 2005;Easterbrook, 1992;Inman et al, 2008;Kim et al, 2009;Ramaswamy et al, 2008;Simek et al, 2008;Tubbs et al, 2004;), few studies have described how finding one can be used as an educational strategy to facilitate learning in medical students. Recently, Vogt et al (2011) eloquently described how a group of medical students discovered an ARSA, used a fluoroscope to obtain images of the variant, and then correlated the images with computed tomography scans of the chest that were taken during the cadaver's life. The ingenuity of this study was that it demonstrated to the students how difficult it can be to recognize a variant with modern diagnostic imaging (Vogt et al, 2011).…”

Section: Embryology and Molecular Geneticsmentioning

confidence: 99%

“…Recently, Vogt et al (2011) eloquently described how a group of medical students discovered an ARSA, used a fluoroscope to obtain images of the variant, and then correlated the images with computed tomography scans of the chest that were taken during the cadaver's life. The ingenuity of this study was that it demonstrated to the students how difficult it can be to recognize a variant with modern diagnostic imaging (Vogt et al, 2011). In the present study, we also found an ARSA and used it as a springboard to investigate the embryology and molecular genetics of the variant.…”

Section: Embryology and Molecular Geneticsmentioning

confidence: 99%

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IN THE GROSS ANATOMY LABORATORY: A REVIEW OF THE EMBRYOLOGY AND MOLECULAR GENETICS OF THE ABERRANT RIGHT SUBCLAVIAN ARTERY. En el laboratorio de Anatomía macroscópica: Revisión de la embriología y genética molecular de la arteria subclavia derecha aberra

Chappell

Panchani

Barksdale

et al. 2016

Rev Arg de Anat Clin

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La disección del cadáver embalsamado de una mujer de 66-años por los estudiantes de medicina de primer año de anatomía general, reveló la presencia de una arteria subclavia derecha aberrante (ASDA) de trayecto retroesofágico. La prevalencia de una ASDA en la población normal es del 0.2-2.0%. Se ha reportado que la ASDA tiene una asociación con varias deformidades congénitas, tales como el síndrome de Down, Kommerell divertículo, y varias otras anomalías. No es común asociar síntomas clínicos con la ASDA, sin embargo, el síntoma más común es la disfagia lusoria. Hemos descubierto que la ASD se originó desde la porción más distal del arco aórtico en una posición retroesofágica. Medidas pertinentes de las arterias se grabaron y un análisis para obtener información clínica, genética, y embriológica acerca de la ASDA se realizó. Como en la mayoría de los casos, el curso de la ASDA fue entre el esófago y la columna vertebral. Se ha demostrado que una región en el cromosoma humano 22 (22q11) está involucrada en el desarrollo normal de los vasos del arco aórtico. Este artículo ilustra cómo el descubrimiento de una variante a través de la disección da pie a estudiantes de medicina a aprender y repasar la literatura, sobre la embriología y la genética molecular, sobre anomalías del arco aórtico y sus correlaciones clínicas. Dissection of a 66-year-old female embalmed cadaver by medical students in a first-year gross anatomy course revealed the presence of an aberrant (retroesophageal) right subclavian artery (ARSA). The prevalence of an ARSA is between 0.2-2.0% in the normal population. ARSA has been reported to have an association with various congenital deformities, such as Down syndrome, Kommerell diverticulum, and various other anomalies. Clinical symptoms are usually not associated with ARSAs but when present, the most common symptom is dysphagia lusoria. We discovered that the RSA originated from the most distal portion of the aortic arch in a retroesophageal position. Relevant measurements of the vessel were recorded and a review was conducted to obtain clinical, genetic, and embryological information about the ARSA. As in the majority of cases, the course of the ARSA was between the esophagus and the vertebral column. A region on human chromosome 22 (22q11) has been shown to be involved in normal development of the aortic arch vessels. This paper illustrates how discovery of a variant via dissection prompted medical students to learn and review the literature of aortic arch anomalies and their clinical correlations.

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Section: Embryology and Molecular Geneticsmentioning

confidence: 93%

Section: Embryology and Molecular Geneticsmentioning

confidence: 99%

Section: Embryology and Molecular Geneticsmentioning

confidence: 99%

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IN THE GROSS ANATOMY LABORATORY: A REVIEW OF THE EMBRYOLOGY AND MOLECULAR GENETICS OF THE ABERRANT RIGHT SUBCLAVIAN ARTERY. En el laboratorio de Anatomía macroscópica: Revisión de la embriología y genética molecular de la arteria subclavia derecha aberra

Chappell

Panchani

Barksdale

et al. 2016

Rev Arg de Anat Clin

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“…

We thank Dr. Muresian (2011) for his complimentary critique of our article (Vogt et al, 2011) and his comments that extend the discussion of this anatomical variation. He emphasizes the fact that an aberrant right subclavian artery does not have a singular appearance in all individuals but rather can have a range of diameters, a variety of courses, and an appearance that can change over time, as in the evolving pathology of atherosclerosis.

…”

mentioning

confidence: 95%

Reply: Aberrant right subclavian artery and fluoroscopy in the dissection laboratory

et al. 2011

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We thank Dr. Muresian (2011) for his complimentary critique of our article (Vogt et al., 2011) and his comments that extend the discussion of this anatomical variation. He emphasizes the fact that an aberrant right subclavian artery does not have a singular appearance in all individuals but rather can have a range of diameters, a variety of courses, and an appearance that can change over time, as in the evolving pathology of atherosclerosis. He cites references for each of these facts.Since we submitted our report, we have discovered another instance of an aberrant right subclavian artery in the teaching laboratory. We were prepared this time to search for some of the accompanying anatomical variations that Dr. Muresian mentions in his letter, for example, a right-sided termination of the thoracic duct, a bicuspid aortic valve, and aberrant branching of the vertebral arteries. It was clear to the students that the discovery and study of anatomical variations in the laboratory allow them to extend their observations and to take fuller advantage of the rich learning experience of dissection and of the gift to the students of their ''first patient.''Over the years that we have been teaching anatomy in the dissection laboratory, we hear less frequently the complaint from students that the anatomy they are uncovering in their dissections does not match that seen in their anatomical atlases. We attribute this change to an expectation, set by us as instructors early in the course, that variation is to be anticipated and something to be deciphered as a problem-solving exercise.Dr. Muresian concludes his letter with a comment that the comparison we made between data from the patient's previous medical records and information obtained through dissection and other postmortem studies attach even greater value to the donor's gift and to the experience of student dissection. As personalized health care becomes the standard of care, and treatment is tailored to the individual's unique anatomy and genomics, dissection-coupled with history taking through the donor's family and reference to medical records-helps to prepare students to approach each of their future patients as a unique individual. We agree fully with Dr. Muresian's comment that ''... implementation of such programs on a larger scale, would greatly contribute to the development of the medical sciences.' ' We add here that because of the unique and extended relationship we had with the donor who was the case study in our article, we took the opportunity to personally deliver the cremated remains to the family, thus bringing a personal element of closure to the family and us.

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“…The article by Vogt et al (2011) offers to the reader some important aspects and details, which warrant particular consideration.…”

mentioning

confidence: 99%

Aberrant right subclavian artery and fluoroscopy in the dissection laboratory

Mureşian¹

2011

Clinical Anatomy

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Fluoroscopic angiography in the gross anatomy dissection laboratory: Visualizing the aortic arch and its branches in a cadaver

Cited by 3 publications

References 33 publications

IN THE GROSS ANATOMY LABORATORY: A REVIEW OF THE EMBRYOLOGY AND MOLECULAR GENETICS OF THE ABERRANT RIGHT SUBCLAVIAN ARTERY. En el laboratorio de Anatomía macroscópica: Revisión de la embriología y genética molecular de la arteria subclavia derecha aberra

IN THE GROSS ANATOMY LABORATORY: A REVIEW OF THE EMBRYOLOGY AND MOLECULAR GENETICS OF THE ABERRANT RIGHT SUBCLAVIAN ARTERY. En el laboratorio de Anatomía macroscópica: Revisión de la embriología y genética molecular de la arteria subclavia derecha aberra

Reply: Aberrant right subclavian artery and fluoroscopy in the dissection laboratory

Aberrant right subclavian artery and fluoroscopy in the dissection laboratory

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