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Clinical neuroanatomy module 5 years’ experience at the School of Medicine of Padova

  • Teaching Anatomy
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Abstract

Macroscopic anatomy of the brain is scheduled during the last meeting of the Short Course of Dissection, an optional course for second-year medical students at the School of Medicine of Padova, following the official 44 h of lectures of Neuroanatomy. The aim of the present study was to ascertain the value of brain dissection in retention of neuroanatomical knowledge by medical students. An anatomical questionnaire was given to second-year students in the years 2002–2006, aiming at evaluating their initial neuroanatomical background. Administered twice, at the beginning and end of the last meeting of the optional course, the questionnaire consisted of three diagrams, showing the base, the convexity of the brain, and an axial section of the cerebrum. For each diagram, ten anatomical structures were selected, according to their clinical importance. Students then followed a worksheet for external examination of the brain and cutting. The teacher presented three examples of pathologies causing elevated intracranial pressure, and indicated their locations on the relative cerebral structures. At the end of the meeting, the same questionnaire was given again. To evaluate long-term retention of information, it was also given to third-year students. The questionnaire revealed improved knowledge of neuroanatomy in a mean of 57% of students, especially as regards the axial section (72%), with respect to that of the brain base (43%) and convexity (40%). After 1 year, long-term assessment of information retention showed that 65% of the group which had followed the dissection course correctly answered with respect to the control group (40%), and even better (87.5%) as regards anatomical details presented in their clinical aspects. The main guidelines in planning the clinical neuroanatomy module were: (1) selection of anatomical landmarks of importance from the clinical viewpoint; (2) identification of pathologies which involve the above anatomical landmarks; (3) relationships between morphology and pathology enhancing anatomo-clinical importance.

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Notes

  1. Virchow’s method: an incision is made at the level of the posterior portion of the corpus callosum as far as the ventricular cavity. Through the foramens of Monro the corpus callosum is cut and posteriorly reversed. The hemispheres are cut with an incision, with medial concavity, leaving the basal ganglia at the centre. Further incisions are carried out in the semioval centres with medial concavity. The basal ganglia are examined through multiple sections inclined of 45° on the horizontal plane and 45° on the sagittal plane. The cerebellum is examined with an anteroposterior cut on the vermis, with the aim of separating the two hemispheres, and then each hemisphere is examined through an horizontal cut starting from the former and directed from the inside to the outside. Other transversal and parallel incisions are performed at the level of the pons and medulla oblongata [5].

  2. Method of Pitres: the cerebellum and brainstem are first separated. Six frontal and vertical cuts are made, directed parallel to the sulcus of Rolandus, from the convexity to the base in a cranio-caudal direction: prefrontal, peduncle-frontal, frontal, parietal, peduncle-parietal and occipital sections. The brain slices are oblique, from above to below and from back to front [5].

  3. Method of Flechsig: this consists of a single cut of the cerebrum on the transverse plane, 1 cm above the sulcus of Sylvius [5].

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Acknowledgments

The authors are grateful to Giuliano Carlesso for skilful technical assistance.

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Authors and Affiliations

  1. Section of Anatomy, Department of Human Anatomy and Physiology, University of Padova, Via A. Gabelli 65, 35127, Padova, Italy

    Veronica Macchi, Andrea Porzionato, Carla Stecco & Raffaele De Caro

  2. Section of Pathologic Anatomy, Department of Medical Diagnostic Sciences and Special Therapies, University of Padova, Padova, Italy

    Anna Parenti

Authors
  1. Veronica Macchi
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  2. Andrea Porzionato
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  3. Carla Stecco
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  4. Anna Parenti
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  5. Raffaele De Caro
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Correspondence to Raffaele De Caro.

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Macchi, V., Porzionato, A., Stecco, C. et al. Clinical neuroanatomy module 5 years’ experience at the School of Medicine of Padova. Surg Radiol Anat 29, 261–267 (2007). https://doi.org/10.1007/s00276-007-0201-9

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  • DOI: https://doi.org/10.1007/s00276-007-0201-9

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