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Imaging
Published in Peter Houpt, Hand Injuries in the Emergency Department, 2023
The technician will use the appropriate technique if the request is done clearly. A CT scan is indicated in case of comminuted intra-articular fractures, scaphoid fractures or to assess complex luxations. Ultrasound is a suitable medium for demonstrating foreign bodies. Arthroscopy can be used in the acute stage to help in the reduction of intra-articular radial fractures. The knowledge of surface anatomy related to the X-ray image is important (Figures 4.1–4.5).
Examination of the Ulnar Side of the Wrist
Published in J. Terrence Jose Jerome, Clinical Examination of the Hand, 2022
Samuel Cohen-Tanugi, R Glenn Gaston
The examiner must intimately know the anatomy of the wrist and be able to visualize where the structures lie under the skin – this is what is meant by “surface anatomy.” Figure 10.6(a) and (b) are illustrations of what the examiner should be able to visualize in their “mind's eye” when looking at the patient's hand and wrist. The authors recommend that the reader practice palpating these structures on themselves while reading through the following paragraphs. Start by identifying the pisiform (A4): It is the bony prominence immediately distal to the wrist flexion crease ulnarly. The FCU (A5) tendon inserts onto the pisiform and is easily palpated moving proximally along the ulnar volar wrist.
Technical Overview and Features of the Varian IDENTIFY™ System
Published in Jeremy D. P. Hoisak, Adam B. Paxton, Benjamin Waghorn, Todd Pawlicki, Surface Guided Radiation Therapy, 2020
Raymond Schulz, Chris Huyghe, Lisa Hampton, Delena Hanson, Michael Stead, Thomas Speck
Surface-guided positioning allows the therapist to observe and correct for all 6DOF patient movement. This is facilitated with the use of an ROI that is designated as an area of interest for surface tracking purposes. Color-coded virtual reality displays translational and rotational offsets between the reference and the live surface of patients’ surface anatomy onto a live video feed that can be used by the treatment team in the room to correct patient alignment before verification imaging and treatment. Once in position, the patient’s movement can be tracked to ensure they remain within the set tolerances during verification imaging and treatment. After position verification with radiographic imaging and any required couch shifts are applied, a temporary surface can be captured, creating a new baseline of the patient’s position for subsequent motion that may occur during treatment. When the patient moves out of tolerance, the handheld controller at the treatment console will provide an audible alarm. The therapist can then stop the beam. In scenarios where the linac is equipped with a motion management interface, IDENTIFY can issue a beam hold to automatically pause radiation delivery.
Development of a navigable 3D virtual model of temporal bone anatomy
Published in Journal of Visual Communication in Medicine, 2023
The plan was to develop an accurate 3D virtual model of the temporal bone with its complete surface anatomy, which would be easy to use by the students without any major cost. For this, a helical computed tomographic (CT) scan was used to acquire high-resolution images of cadaveric temporal bone in the standard DICOM (Digital imaging and communications in medicine) file format. These images served as building blocks for the construction of a three-dimensional model using the volume-rendering capabilities of 3D Slicer®. The process involved volume data management, cropping of the data set, and threshold painting to segment anatomical structures based on the intensity captured from different regions. Finally, the volumetric data was exported into .stl (an abbreviation for ‘stereolithography’) file format, which is one of the most common and widely supported methods of storing and viewing three-dimensional data in a compact form. To make it more accessible and interactive, the 3D virtual model was embedded into an HTML web page using Blender®.
Twelve tips for optimising medical student retention of anatomy
Published in Medical Teacher, 2022
There can be no doubt as to the importance of medical imaging and surface anatomy (Gupta et al. 2008; Orsbon et al. 2014; Yammine 2014). However, the reason incorporation of radiological and surface anatomy improves retention of anatomy is because both involve deeper processing which is proven to aid long-term storage of information (Nairne et al. 2008; Lieberman 2012; Soravia et al. 2016). Inclusion of radiological anatomy and surface anatomy in the anatomy curriculum is relatively straightforward, particularly as radiological anatomy is often already included as part of anatomy education in many medical schools (Jang et al. 2018). The teaching of surface anatomy is also widespread (Bergman et al. 2013) and despite complaints that surface anatomy is too time consuming, even body painting can be economical with regard to time and efficient for learning (Finn 2010). Incorporating surface anatomy in the curriculum is justified not only for its clinical application (Leveritt et al. 2016), but also for its potential to enhance episodic memory through the personal activity of each individual (Hasselmo 2012). Since medical imaging is relevant to most internal structures, and surface anatomy to more superficial structures, almost all anatomy can benefit from this approach and it need not be restricted to specific body systems.
The importance of endoscopy in lacrimal surgery
Published in Expert Review of Ophthalmology, 2018
Akshay Gopinathan Nair, Swati Singh, Saurabh Kamal, Mohammad Javed Ali
Recent studies in neurosurgery have deployed the use of ‘enhanced visualization’, also known as ‘augmented reality’. Augmented reality was developed to highlight vulnerable deeper structures overlaid on top of the surgical field in an attempt to make surgery safe. To achieve this final outcome, the preoperative image data are displayed with relevant anatomical structures being segmented and highlighted (in some cases by coloring). These processed data are then, anatomically superimposed onto the operative field to provide additional information regarding the surface anatomy for the surgeon. This has been used in visceral surgery, neurosurgery, and more recently in ENT surgery [63]. New visualization techniques for endoscopic ENT surgeries have been developed, which show the target structures and instrument positions within the endoscopic video image [64]. Furthermore, the surgeon can assess the distance to the target region intraoperatively as well. These ‘image-enhanced endoscopic systems’ are an exciting new development which can make surgery safer and potentially maximize outcomes. These technological breakthroughs are critical in ensuring that endoscopic lacrimal surgery become safer with better outcomes. With more ophthalmic plastic surgery fellowship programs incorporating structured training in endoscopic lacrimal surgery, the popularity and the safety of endoscopic lacrimal surgery by ophthalmologists is expected to increase [7,65,66].