More than a neuroanatomical representation in The Creation of Adam by Michelangelo Buonarroti,a representation of the Golden Ratio

Michelangelo Buonarroti (1475–1564) was a master anatomist as well as an artistic genius. He dissected numerous cadavers and developed a profound understanding of human anatomy. Among his best‐known artworks are the frescoes painted on the ceiling of the Sistine Chapel (1508–1512), in Rome. Currently, there is some debate over whether the frescoes merely represent the teachings of the Catholic Church at the time or if there are other meanings hidden in the images. In addition, there is speculation regarding the image of the brain embedded in the fresco known as “The Creation of Adam,” which contains anatomic features of the midsagittal and lateral surfaces of the brain. Within this context, we report our use of Image Pro Plus Software 6.0 to demonstrate mathematical evidence that Michelangelo painted “The Creation of Adam” using the Divine Proportion/Golden Ratio (GR) (1.6). The GR is classically associated with greater structural efficiency and is found in biological structures and works of art by renowned artists. Thus, according to the evidence shown in this article, we can suppose that the beauty and harmony recognized in all Michelangelo's works may not be based solely on his knowledge of human anatomical proportions, but that the artist also probably knew anatomical structures that conform to the GR display greater structural efficiency. It is hoped that this report will at least stimulate further scientific and scholarly contributions to this fascinating topic, as the study of these works of art is essential for the knowledge of the history of Anatomy. Clin. Anat. 28:702–705, 2015. © 2015 Wiley Periodicals, Inc.     

The evolving ethics of anatomy: Dissecting an unethical past in order to prepare for a future of ethical anatomical practice

Anatomical practice has arguably one of the most ethically challenging histories in the medical sciences. Among the oldest scientific disciplines in medicine, dissection of the human body for scientific purposes occurred as early as the third century Before the Common Era. Throughout the history of anatomical practice, human dissection has occurred in ways that cross the line from progressing medical science to violating the sanctity of the human body. The dissection of the human body creates ethical dilemmas which stem from the need for anatomical science to gain medical knowledge in juxtaposition with prevailing religious and moral views surrounding anatomy as a threat to the sanctity of the human body. This article examines the unethical history of human dissection throughout the ages and explores the rationale behind the unethical practices. In addition, this article explores imperative modern day ethical standards in anatomy including, the ethical handling of human bodies, respecting human life, and ensuring informed consent for dissection of bodies that are donated. Finally, this article explores the question of which ethical prism we should use when dealing with anatomy collections or works of the past. Learning both the history of unethical practices in anatomy and the rationale behind them is imperative so that the discipline can prepare for an ethical, diverse, and inclusive future. This article provides a foundation for understanding the evolution of ethics in anatomical practice and is a valuable resource for students and anatomists alike.     

From Ars to Scientia: the revolution of anatomic illustration

Art and anatomy have been closely related since the Renaissance, when artists studied the human body to gain more perfect perspectives, and anatomists began illustrating their texts. As the two fields became increasingly intertwined, the distinctions between artistic drawings and scientific illustrations of the human body's form and function became increasingly blurred. Early Renaissance anatomists were more artistic than scientific with their images, but Hieronymus Fabricius ab Acquapendente (1533-1619) provided a crucial turning point in the evolution of anatomic illustration. His new and strict focus upon scientific illustration developed in the context of previous anatomists' work and theories, but his is a critical and previously untold story in the history of medicine.     

Anatomy and academies of art I: founding academies of art

The structure of the human body and its parts is of obvious relevance in medicine, but it has also played a role in art. Accurate observation of surface or external anatomy is essential in both disciplines, and its understanding has been enhanced by knowledge of what is found beneath the skin, the internal anatomy, usually based on dissection. The role of anatomy in art in general, and in academies of art in particular, is the theme of this paper. The revival of dissection in 14th-century Italy was, if not causative, at least coincidental with the Renaissance. In 1563, Vasari founded the Accademia del Disegno in Florence, with una Anatomia included in its regulations. As a liberal art taught by university graduates, anatomy helped raise the status of painters and sculptors from artisans to artists and from guild to academy. Anatomy teaching was required in subsequent academies in Rome (1593) and Paris (1648), where the pattern of drawing from drawings, from casts, and from life was established and a Professor of Anatomy appointed in 1777. Anatomy was central to two of the Academy’s most important genres, history painting and portraiture. The Academy system, with its emphasis on anatomy, spread to other European cities and to the Caribbean and the Americas from the 17th to the 19th centuries. This paper is concerned with the role of anatomy in the founding of art academies in general, while its companion paper, 'A Tale of Two Cities', considers the cases of the academies in London and Dublin in particular.     

Re-examining our roots: Queer history and anatomy

Since its establishment as one of the major authorities on the human body, Anatomy has played a crucial role in social and political spheres. In this article, I review how the history of Anatomy has intersected with queer history and how the effects of these interactions have affected queer lives today. In these historical cases, I aim to demonstrate how Anatomy has affected the social organization of human culture and society and also how society has affected anatomical knowledge in return. As this reciprocal connection between Anatomy and societal organization is elucidated, I argue that anatomists, clinicians, and educators have an ethical duty to address the connections of this history, both in our research and our classrooms. This historical tour begins in the ancient world, which established a connection between sexuality and physiology and reproduction. This is followed by an exploration of the Renaissance and Enlightenment, which highlight the connections between anatomical knowledge, the law, and social organization. The progressive and modern eras are explored next via modern research into the anatomical and biological origins of same-sex attraction and the use of modern technology in these investigations. Finally, the article ends with a call for reform along with suggestions for future steps.     

The evolution of the study of anatomy in Japan

The following review focuses on how the study of anatomy in Japan has evolved throughout the centuries; specifically, we investigate anatomical knowledge during the primitive, ancient, feudal, and early modern periods of Japanese history. Early vague and mythical anatomical concepts derived from China prevailed for many centuries in Japan. Kajiwara wrote one of the earliest anatomical works in 1302. As a science, anatomy was the first basic science to be established in Japan, beginning simplistically during the 1600s and flourishing more recently with the onset of Meiji Restoration. As a result, Japan has produced several of the most influential anatomists of the 20th century, including Buntaro Adachi, who added detail to our knowledge of the vascular system and its variations; and Sunao Tawara, who discovered the atrioventricular node. Herein, we discuss the ways in which Japan has added to and promoted the anatomical sciences. Clin. Anat. 22:425–435, 2009. © 2009 Wiley‐Liss, Inc.     

The evolution of epistemological methodologies in anatomy: From antiquity to modern times

Present day scenario regarding epistemological methods in anatomy is in sharp contrast to the situation during ancient period. This study aimed to explore the evolution of epistemological methodologies in anatomy across centuries. In ancient times Egyptian embalmers acquired anatomical knowledge from handling human bodies and likewise anatomical studies in India involved human dissection. Ancient Greeks used theological principles-based methods, animal dissection and human dissection in practice of anatomy. Human dissection was also practiced in ancient China for gaining anatomical knowledge. Prohibition of human dissection led to use of animal dissection in ancient Rome and the trend continued in Europe through Middle Ages. Epistemological methods used by Muslim scholars during Middle Ages are not clearly chronicled. Human dissection returned as primary epistemological method in Renaissance Europe and empirical methods were reinstated after ancient period in human dissection during 16th century. The situation further improved with introduction of pragmatic experiment based approach during 17th century and autopsy-based methods during 18th century. Advances in anatomical knowledge continued with advent of microscope-based methods and emergence of anatomical sections in practice of human dissection in 19th century. Introduction of human observational studies, medical imaging, and molecular methods presented more options in terms of epistemological methods for investigating the human body during 20th century. Onset of 21st century has witnessed dominance of technology-based methods in anatomy. Limited emphasis on ethics in epistemological methodologies since antiquity is a dark aspect of otherwise an eventful evolutionary journey but recent developments are in positive direction.     

Michelangelo,the Last Judgment fresco,Saint Bartholomew and the Golden Ratio

Art and anatomy were particularly closely intertwined during the Renaissance period and numerous painters and sculptors expressed themselves in both fields. Among them was Michelangelo Buonarroti (1475–1564), who is renowned for having produced some of the most famous of all works of art, the frescoes on the ceiling and on the wall behind the altar of the Sistine Chapel in Rome. Recently, a unique association was discovered between one of Michelangelo's most celebrated works (The Creation of Adam fresco) and the Divine Proportion/Golden Ratio (GR) (1.6). The GR can be found not only in natural phenomena but also in a variety of human‐made objects and works of art. Here, using Image‐Pro Plus 6.0 software, we present mathematical evidence that Michelangelo also used the GR when he painted Saint Bartholomew in the fresco of The Last Judgment, which is on the wall behind the altar. This discovery will add a new dimension to understanding the great works of Michelangelo Buonarroti. Clin. Anat. 28:967–971, 2015. © 2015 Wiley Periodicals, Inc.     

Ultrastructural and developmental features of the tessellated endoskeleton of elasmobranchs (sharks and rays)

The endoskeleton of elasmobranchs (sharks and rays) is comprised largely of unmineralized cartilage, differing fundamentally from the bony skeletons of other vertebrates. Elasmobranch skeletons are further distinguished by a tessellated surface mineralization, a layer of minute, polygonal, mineralized tiles called tesserae. This ‘tessellation’ has defined the elasmobranch group for more than 400 million years, yet the limited data on development and ultrastructure of elasmobranch skeletons (e.g. how tesserae change in shape and mineral density with age) have restricted our abilities to develop hypotheses for tessellated cartilage growth. Using high‐resolution, two‐dimensional and three‐dimensional materials and structural characterization techniques, we investigate an ontogenetic series of tessellated cartilage from round stingray Urobatis halleri, allowing us to define a series of distinct phases for skeletal mineralization and previously unrecognized features of tesseral anatomy. We show that the distinct tiled morphology of elasmobranch calcified cartilage is established early in U. halleri development, with tesserae forming first in histotroph embryos as isolated, globular islets of mineralized tissue. By the sub‐adult stage, tesserae have increased in size and grown into contact with one another. The intertesseral contact results in the formation of more geometric (straight‐edged) tesseral shapes and the development of two important features of tesseral anatomy, which we describe here for the first time. The first, the intertesseral joint, where neighboring tesserae abut without appreciable overlapping or interlocking, is far more complex than previously realized, comprised of a convoluted bearing surface surrounded by areas of fibrous attachment. The second, tesseral spokes, are lamellated, high‐mineral density features radiating outward, like spokes on a wheel, from the center of each tessera to its joints with its neighbors, likely acting as structural reinforcements of the articulations between tesserae. As tesserae increase in size during ontogeny, spokes are lengthened via the addition of new lamellae, resulting in a visually striking mineralization pattern in the larger tesserae of older adult skeletons when viewed with scanning electron microscopy (SEM) in backscatter mode. Backscatter SEM also revealed that the cell lacunae in the center of larger tesserae are often filled with high mineral density material, suggesting that when intratesseral cells die, cell‐regulated inhibition of mineralization is interrupted. Many of the defining ultrastructural details we describe relate to local variation in tissue mineral density and support previously proposed accretive growth mechanisms for tesserae. High‐resolution micro‐computed tomography data indicate that some tesseral anatomical features we describe for U. halleri are common among species of all major elasmobranch groups despite large variation in tesseral shape and size. We discuss hypotheses about how these features develop, and compare them with other vertebrate skeletal tissue types and their growth mechanisms.     

Anatomy atlases

Anatomy atlases are unlike other knowledge sources in the health sciences in that they communicate knowledge through annotated images without the support of narrative text. An analysis of the knowledge component represented by images and the history of anatomy atlases suggest some distinctions that should be made between atlas and textbook illustrations. Textbook and atlas should synergistically promote the generation of a mental model of anatomy. The objective of such a model is to support anatomical reasoning and thereby replace memorization of anatomical facts. Criteria are suggested for selecting anatomy texts and atlases that complement one another, and the advantages and disadvantages of hard copy and computer‐based anatomy atlases are considered. Clin. Anat 12:293–299, 1999. © 1999 Wiley‐Liss, Inc.     

The impact of body worlds on adult visitors’ knowledge on human anatomy: A preliminary study

Body Worlds is an anatomical exhibition that shows human remains to the public. It has been considered controversial since it raises ethical tensions and issues. However, organizers and supporters of Body Worlds have claimed the exhibition is intended to promote visitors’ understanding over the human body. Despite these claims, no studies were found that support or refute the hypothesis that a visit to Body Worlds increases the public's objective knowledge on human anatomy. Consequently, the objective of this study was to determine the impact of Body Worlds on anatomical knowledge. We constructed and delivered a questionnaire to both a previsit random sample and a postvisit random sample of visitors of Body Worlds’ event Facets of Life, in Berlin. The questionnaire was available in both English and German languages and contained (a) basic sociodemographic questions and (b) a valid and reliable anatomy quiz. The quiz consisted of 16 multiple‐choice questions that assessed the ability to identify the location of major anatomical structures on the human body. Average scores achieved on the quiz by the postvisit sample (X¯= 9.08, s = 2.48, n = 164) were significantly higher (unpaired t = 3.3957, P = 0.0008) than those achieved by the previsit sample (X¯= 8.11, s = 2.69, n = 167). Our results suggest that a visit to Body Worlds’ event Facets of Life may have a beneficial effect in anatomical knowledge. However, further studies with better empirical designs and fewer limitations are needed to confirm our results. Clin. Anat. 29:439–445, 2016. © 2016 Wiley Periodicals, Inc.     

Significance of the role of self‐study and group discussion

The study of anatomy is experiencing a reduction in course duration and content, lecture and dissection hours, and number of lectures and examinations. This necessitates that medical students develop skills for self‐study. Toward that end, a self‐study module in basic anatomy was tested. Fifty‐seven new entrants were given a pretest (Pretest A) containing a questionnaire on basic anatomy. Then, in three groups each of 11 and two groups each of 12, they learned basic anatomy from recommended books in the library by self‐study for 2 hours. They discussed what they had learned among their group members during a practical exercise, followed by a posttest (Posttest A). A control group of 57 new entrants during another year was given the same pretest (Pretest B) and a lecture on basic anatomy. Then, without opportunity for self‐study, they were given a posttest (Posttest B). The answers were scored out of 40. The students' mean mark in Pretest A was poor. All the groups performed well in the practical exercise. In Posttest A, the mean mark increased significantly (P < 0.001), by 9.4. It shows that self‐study and group discussions significantly helped the students in construction of core anatomical knowledge as well as the acquisition, assimilation, and application of anatomical concepts and content. The mean mark in Pretest B was also poor. In Posttest B, the mean mark increased significantly (P < 0.001), by 14.2. This indicates that the traditional teaching session is also useful and serves to advance student knowledge. Thus our innovative study module can create a positive learning environment and can become an alternative to traditional instruction in teaching anatomical terminology and basic anatomy. Clin. Anat. 12:277–280, 1999. © 1999 Wiley‐Liss, Inc.     

Impact of the clinical ultrasound elective course on retention of anatomical knowledge by second‐year medical students in preparation for board exams

Ultrasound has been integrated into a gross anatomy course taught during the first year at an osteopathic medical school. A clinical ultrasound elective course was developed to continue ultrasound training during the second year of medical school. The purpose of this study was to evaluate the impact of this elective course on the understanding of normal anatomy by second‐year students. An anatomy exam was administered to students enrolled in the clinical ultrasound elective course before the start of the course and after its conclusion. Wilcoxon signed ranks tests were used to determine whether exam scores changed from the pre‐test to the post‐test. Scores from two classes of second‐year students were analyzed. Students who took the elective course showed significant improvement in the overall anatomy exam score between the pre‐test and post‐test (P < 0.001). Scores for exam questions pertaining to the heart, abdomen, upper extremity, and lower extremity also significantly improved from the pretest to post‐test (P < 0.001), but scores for the neck and eye showed no significant improvement. The clinical ultrasound elective course offered during the second year of medical school provided students with an important review of key anatomical concepts while preparing them for board exams. Our results suggested that more emphasis should be placed on head and neck ultrasound to improve student performance in those areas. Musculoskeletal, abdominal, and heart ultrasound labs were more successful for retaining relevant anatomical information. Clin. Anat. 28:156–163, 2015. © 2014 Wiley Periodicals, Inc.     

Medical students' approaches to learning anatomy: Students' experiences and relations to the learning environment

To examine students' perceptions and experiences of learning anatomy, an on‐line Likert‐style questionnaire was administered during 2006 to students reading a Bachelor of Medicine 4‐ and 5‐year program (n = 256, 23.8%). Statistical analysis found that students predominantly felt that understanding anatomy and working with human cadaveric material were very important in becoming a doctor. Students reported that working on cadaveric specimens was an effective way of learning anatomy, and also found the amount of anatomy they needed to learn to be daunting. Student responses were correlated with their approaches to learning [Approaches to Studying Inventory for Students (ASSIST)] scores using a Kruskal Wallis test. Significant relationships between the approach to learning anatomy adopted and students' perception and experience of anatomy were found. A deep approach to learning anatomy correlated with students who reported that the most effective way of learning anatomy in the dissecting room was to get their hands in and feel for structures, who used anatomical terms and language at clinical opportunities, and who frequently used their anatomy‐radiology knowledge in clinical situations. A surface approach to learning anatomy was associated with elements, such as students finding anatomy learning daunting and not seeing the point to it. The outcomes provide clear associations between students' perception of the anatomy learning environment, the approach to learning adopted, and the anatomy activities in which students engage. The findings highlight that understanding and applying anatomical knowledge are best accomplished by the adoption of a deep approach to learning. Clin. Anat. 23:101–103, 2010. © 2009 Wiley‐Liss, Inc.     

“Embodying opposites”—A case illustration of Dance Movement Therapy as an additional intervention in the treatment of co-morbid Borderline Personality Disorder and Complex Post Traumatic Stress Disorder

Dance Movement Therapy is gradually becoming recognized as a treatment option in Mental Health Care. However, the working mechanisms can be difficult to comprehend without experiential knowledge of this therapy form. This article aims to offer insight into the clinical application of Dance Movement Therapy for Sanne, a woman with a history of interpersonal relationship difficulties, problems with self-regulation, low self-efficacy and diagnosed with Borderline Personality Disorder and co-morbid Complex Post Traumatic Stress Disorder. This case illustration describes treatment interventions during two months of bi-monthly Dance Movement Therapy as an additional treatment alongside weekly group therapy and bi-monthly individual Psychotherapy. Post treatment, Sanne demonstrates improvements in self-regulatory behavior, interpersonal relationships and self-efficacy as well as an experience she describes as being whole. This article highlights the implications for practitioners of embodied forms of therapy as well as multidisciplinary teams who wish to better understand how the use of opposites within Dance Movement Therapy may be used as an additional intervention for people with Borderline Personality Disorder and co-morbid complex Post Traumatic stress Disorder.