Anatomy Theory Notes, Lecture notes of Anatomy

Download Anatomy Theory Notes and more Lecture notes Anatomy in PDF only on Docsity! AETCOM MODULE 1.5 CADAVER AS A TEACHER The cadaveric dissection is an integral part of anatomy curriculum in MBBS 1 st prof. The cadavers are the first exposure as human body to a medical student. Dissection of cadavers lays down a strong foundation for sound medical knowledge and good clinical practice later on. Dissection hall in anatomy department is the only place where “the dead teach the living”. Therefore, the idea of cadavers as a teacher is very apt and conveys the utility of human dissection. In addition, dissection also helps to instill a spirit of team work, patience, technical skills and the art to visualize structures correctly. No other method of anatomy teaching like dissection videos, didactic lectures or demonstration of specimens can take the place of exploring the human body yourself. Now a days, even clinicians have recognized its immense importance and there is an increasing trend in conducting ‘cadaveric workshops’ to demonstrate/practice important clinical skills. From where do the bodies are procured? (i) The ‘Anatomy Act’ implemented way back in 1959 is applicable to many states in India. This act provides for the supply of unclaimed bodies to hospitals and medical teaching institutions for the purpose of anatomical dissection and other similar purposes. (ii) The Second most common source is voluntary body donation by individuals or their families. Many departments run a body donation program. Citizens from Chandigarh and adjoining areas fill a form to pledge their bodies after death. The department issues them a donor card so that relatives are aware of the deceased’s wish. After death (if it is not a medicolegal case or the person was not suffering from communicable disease); the body is handed over to the anatomy department after completing some formalities. The department issues a certificate of honour to pay gratitude towards the donor. The GMCH website displays all the requisite information for voluntary body donation. (iii) In case of scarcity, the cadavers can be provided by the neighbouring medical institutes after due permission from the authorities. Dissection hall mannerisms  Most of the cadavers are obtained through body donation program. Persons pledging their body receive no financial compensation. Therefore, this is truly an ultimate gift. Hence it is essential that proper respect should be given to cadavers.  The students should take cadaveric oath, a pledge that emphases proper handling of the cadaver and respect towards the soul.  Teachers and students should observe professional conduct while in the dissection hall.  Only students, teachers and technical staff for handling the cadavers should be allowed access to the dissection hall. It should not be open for anyone else.  The cadaver should be kept covered and moist at all times with wet cotton gauze. Only the area under dissection should be uncovered.  Students are required to protect themselves to come in direct contact with cadavers. For that they should always wear ‘apron’ (white coat) and disposable gloves.  The students should follow general hygienic rules in dissection hall: Nails should be properly trimmed and no nail paint should be worn. Hair should be properly cut or tied in a bun high enough so that these do not fall on cadaver while dissecting.  Only dissection manuals and instruments are allowed in dissection hall. All backpacks and other personal items should be kept away from dissection tables. Foods and drinks are strictly forbidden in the dissection hall.  Proper handling and washing of dissection instruments should be done by students and attendants.  The ventilation system should be switched on at all times.  All tissues removed from the cadavers must be collected and placed in the designated tray.  Remember, any disrespect for the cadaver will be a disgraceful act as a human being. Students remember their dissection hall experiences, fears, memories throughout their clinical career. Their attitude and approach will help them to imbibe humanistic values for their clinical training. iv. Surface embalming: It supplements the other methods especially for visible and injured body parts. Embalming Chemicals: Components of embalming fluid are :- a. Preservatives - It arrests decomposition. These are mixture of formaldehyde, glutaraldehyde and phenol. This solution causes coagulation of tissue proteins that get fixed and hardened. b. Germicides – Chemicals used to kill microorganisms e.g. quaternary ammonium compounds and glutaraldehyde. c. Modifying agents – These include buffers, humectants and inorganic salts. These agents influence the action of preservative agents. d. Anticoagulants – They retard the natural tendency of blood to become viscous after death e.g. sodium citrate. e. Surfactants – These agents reduce the molecular cohesion of a liquid so that it may flow through smaller apertures. e.g. Sulfonates. f. Dyes (coloring agents) – They impart a definite color to embalming solution e.g. Eosin, erythrosine etc. g. Perfuming agents /masking agents /Deodarants – These agents reduce the raw odour of the solution e.g. oil of cloves, Benzaldehyde h. Vehicles (Diluents) – This serves as a solvent for the numerous ingredients e.g. water, alcohol. Purpose of Embalming: 1. For display purposes (Social embalming): To preserve human remains temporarily to forestall decomposition and make it suitable for display at funeral. 2. For teaching and research purposes: Cadavers are usually well fixed by this method and can be used for anatomical dissection as well as research purposes. 6. Other methods : It includes other modern techniques used for various purposes as follows: i. Soft embalming method – This method is introduced to make the bodies more ‘life like’ and better suited for training purposes. Traditional methods of anatomical embalming depended on the use of formalin which often led to over hardening, making it difficult for precise anatomical and surgical training. A major change was brought in by the introduction of the technique of ‘soft embalming.’ Where the tissue retained its soft consistency after embalming. ii. Saturated salt solution (SSS) method – This method is also introduced for surgical skill training purposes. iii. Cryopreservation – It is the process where cells or whole tissues are preserved by cooling to low sub-zero temperatures such as -196ºC (boiling point of liquid nitrogen). At these low temperatures, any biological activity is effectively stopped. Importance of body preservation: - 1. In medical colleges, to preserve the dead bodies for the purpose of dissection. 2. To prevent decomposition during transportation of dead body from one country to another for burial or cremation. 3. Necessity to preserve the dead body of some important personality for public view. 4. To make the dead body suitable for training and research purpose. Health hazards of Embalming: - The diseases and organisms which may pose particular risks in embalmed body may include tuberculosis, viral hepatitis, HIV infection, Viral hemorrhagic fevers such as Ebola and other viral infections, fungi (candida albicans) protozoa (Giardia Lamblia), worms and prions. Prevention: - Whether dealing with recently dead or old burials and regardless of which infections agents may be present, the risk of health hazards can be greatly reduced by – i. Covering cuts or lesions with waterproof dressings ii. Careful cleansing of any injuries sustained during procedures. iii. Good personal hygiene iv. Use of appropriate gloves and protective clothing Dr. Kanchan Kapoor Department of Anatomy GMCH-32, Chandigarh