A unilateral accessory flexor carpi ulnaris muscle observed during cadaveric dissection.

Musculature anomalies in the upper limb are common and may result in limb posture deformities or compression neuropathies. In this study, we describe a rare case of accessory flexor carpi ulnaris muscle observed during dissection of the forearm as part of a graduate gross anatomy course.

Novel Branching Pattern of the Common Fibular Nerve: Emergence of the Superficial Fibular Nerve Within the Anterior Crural Compartment.

Distal to its origination from the sciatic nerve, the common fibular (peroneal) nerve divides into the superficial and deep fibular (peroneal) nerves. Whereas the deep fibular nerve continues its course into the anterior compartment, the superficial fibular nerve (SFN) usually arises near the fibular neck and projects distally within the lateral crural compartment before entering the superficial fascia proximal to the ankle. In this report, we describe a unilateral case where the SFN arises within the anterior crural compartment and remains there for the remainder of its course deep to the deep fascia of the leg. Surgeons should be aware of anomalies such as this, for example, when performing fasciotomies to avoid inadvertently damaging an anomalously placed SFN.

The fibularis digiti quinti tendon: A cadaveric study with anthropological and clinical considerations.

In addition to the fibularis longus and brevis muscles, a number of anomalous muscles or tendons can arise from the lateral compartment of the leg. The authors describe a bilateral and robust fibularis digiti quinti (FDQ) tendon present in the foot of a 99-year-old female cadaver, present the incidence of this tendon in a cohort of 26 cadavers dissected by podiatric-medical students for a lower-extremity anatomy course, and discuss the anthropological and clinical significance of the findings. In these specimen, the FDQ tendon arose from the fibularis brevis tendon proximal to the lateral malleolus, but did not separate completely from the fibularis brevis tendon until passing through the inferior fibular retinaculum. On the lateral dorsum of the foot, the FDQ passed through a third fibular retinaculum formed by the fibularis tertius tendon, and inserted onto the extensor sling of the fifth digit. This case specimen is designated as an example of the fully present category. Of the 52 limbs dissected, 17 limbs (33%) showed a fully present FDQ, while 20 limbs (38%) exhibited an FDQ in a rudimentary form. Thus, 71% of the limbs showed some presence of the FDQ. Because human bipedality requires less dexterity than that of nonhuman primates in the routine use of their hindlimbs, the authors interpret the high variability of the FDQ, including its absence in many feet, as a relaxation of natural selection maintaining this trait since the divergence of humans from African apes.

Positive impact of a master of science in applied anatomy program on USMLE Step 1 performance.

In this retrospective study of medical student data from Case Western Reserve University School of Medicine, we examined the impact of the Master of Science in Applied Anatomy (MS) program on medical student performance on the United States Medical Licensing Examination(®) (USMLE(®)) Step 1 and Step 2. From 2002 to 2010, 1,142 students matriculated as either students in the medical curriculum (MD group; 1,087 students) or MD students who also participated in the MS program (MD/MS group; 55 students). In addition, students were grouped as in either the Western Reserve Curriculum (2002-2005; WR1) or the Western Reserve 2 Curriculum (2006-2010; WR2). Data were analyzed using SPSS statistical package. The mean Medical College Admission Test(®) (MCAT(®)) score of all students increased significantly between the WR1 and WR2 curricula [from 32.48 ± 3.73 to 34.00 ± 2.92 (P < 0.00)], but MD and MD/MS students showed similar mean MCAT scores in each curriculum. In contrast, the mean USMLE Step 1 score for the MD/MS group (241.45 ± 18.90) was significantly higher than that of the MD group (229.93 ± 20.65; P < 0.00). The MD/MS group in the WR2 curriculum showed significantly higher USMLE Step 1 scores than the MD group. No significant difference was observed in the USMLE Step 2 Clinical Knowledge scores between the groups. The results show that MD/MS students performed better on the USMLE Step 1 than MD students in the WR2 curriculum, although MCAT scores were similar between the two groups. Together, these results suggest that medical student participation in the Masters in Applied Anatomy program enhances student performance on the USMLE Step 1.

New insight into the enigmatic white cord in Rembrandt's The Anatomy Lesson of Dr. Nicolaes Tulp (1632).

The anatomic accuracy of Rembrandt's The Anatomy Lesson of Dr. Nicolaes Tulp (1632) has been debated in the literature for many years. The white cord that courses along the ulnar aspect of the carpus and small finger of the cadaver in Dr. Tulp's dissection conforms to no normal anatomic structure and is believed to represent an anomalous branch of the ulnar nerve, an artistic error, or a combination of both. After the discovery of an accessory abductor digiti minimi (AADM) during a routine dissection of a late-middle-aged male cadaver, we noted that the course of its tendon over the hypothenar eminence resembled the white cord in the painting. After conducting a detailed literature search and anatomic interpretation of the painting, we established 4 criteria for identifying the white cord. Using these criteria, we evaluated the plausibility of an AADM being represented in the painting. We conclude that an AADM should be considered as a possible explanation for the white cord.