A hypermedia tutorial for cross-sectional anatomy: HyperMed.

Modern imaging techniques like computer tomography (CT) and nuclear magnetic resonance (MR) imaging have become essential in clinical diagnostics and also in teaching gross anatomy to medical students. As a consequence, special classes in (cross)-sectional anatomy are being added to the curriculum in many anatomical institutions. Since institutional budgets often do not allow extensive supervision beyond the very limited time frame of traditional courses in gross anatomy, a computer-based hypermedia tutorial (HyperMed) was created and integrated into the teaching program of the Institute of Anatomy at Essen University. HyperMed offers two components, one for authors (e.g. teachers who can customize the contents of the program) and a second for users (e.g. students). In the present version, digital cross-sectional human images have been edited. The relevant anatomical structures in these images have been marked, named, and linked to additional information and figures (in particular schematic figures and CT images). Users can obtain information at different levels: (1) index-based retrieval, (2) navigational retrieval (on inspecting cross-sectional images the user is asked to identify structures) and (3) a history list enabling users to go back to any previous point of navigation. HyperMed was first tested in the winter terms 1995/1996 and 1996/1997 during classes on cross-sectional anatomy which are a supplement to the traditional dissection course of the Institute of Anatomy, University Essen. It was well received by the students who found it a helpful adjunct to learning cross-sectional anatomy.

CT of carpal tunnel syndrome.

The carpal tunnel was investigated by high-resolution computed tomographic (CT) scanning of two cadavers, two healthy persons, and 20 patients with carpal tunnel syndrome to outline normal and pathologic anatomy. The following changes leading to median nerve compression in the carpal canal were demonstrated by CT: (1) thickening of the transverse carpal ligament with resultant decrease in the volume of the carpal tunnel, thus leading to compression of its contents; (2) synovial sheath "hypertrophy" of the flexor tendons, in which compression of the nerve seems to be caused by an increase in volume of the tissues within the carpal canal due to the thickened synovium around the flexor tendon; and (3) recurrent fibrosis after surgery.