Transitional Nerve: A New and Original Classification of a Peripheral Nerve Supported by the Nature of the Accessory Nerve (CN XI)

Classically, the accessory nerve is described as having a cranial and a spinal root. Textbooks are inconsistent with regard to the modality of the spinal root of the accessory nerve. Some authors report the spinal root as general somatic efferent (GSE), while others list a special visceral efferent (SVE) modality. We investigated the comparative, anatomical, embryological, and molecular literature to determine which modality of the accessory nerve was accurate and why a discrepancy exists. We traced the origin of the incongruity to the writings of early comparative anatomists who believed the accessory nerve was either branchial or somatic depending on the origin of its target musculature. Both theories were supported entirely by empirical observations of anatomical and embryological dissections. We find ample evidence including very recent molecular experiments to show the cranial and spinal root are separate entities. Furthermore, we determined the modality of the spinal root is neither GSE or SVE, but a unique peripheral nerve with a distinct modality. We propose a new classification of the accessory nerve as a transitional nerve, which demonstrates characteristics of both spinal and cranial nerves

The development of a core syllabus for the teaching of head and neck anatomy to medical students

The study of human anatomy has traditionally served as a fundamental component in the basic science education of medical students, yet there exists a remarkable lack of firm guidance on essential features that must be included in a gross anatomy course, which would constitute a “Core Syllabus” of absolutely mandatory structures and related clinical pathologies. While universal agreement on the details of a core syllabus is elusive, there is a general consensus that a core syllabus aims to identify the minimum level of knowledge expected of recently qualified medical graduates in order to carry out clinical procedures safely and effectively, while avoiding overloading students with unnecessary facts that have less immediate application to their future careers as clinicians. This paper aims to identify consensus standards of essential features of Head and Neck anatomy via a Delphi Panel consisting of anatomists and clinicians who evaluated syllabus content structures (greater than 1,000) as “essential”, “important”, “acceptable”, or “not required.” The goal is to provide guidance for program/course directors who intend to provide the optimal balance between establishing a comprehensive list of clinically relevant essential structures and an overwhelming litany, which would otherwise overburden trainees in their initial years of medical school with superficial rote learning, which potentially dilutes the key and enduring fundamental lessons that prepare students for training in any medical field

Lessons from hands-free data entry in flexible cystoscopy with Glass for future smart assistance

We explore how Google Glass can be used to annotate cystoscopy findings in a hands-free and reproducible manner by surgeons during operations in the sterile environment inspired by the current practice of hand-drawn sketches. We present three data entry variants involving head movements and speech input. In an experiment with 8 surgeons and Foundation Doctors having up to 30 years’ cystoscopy experience at a UK hospital we assessed the feasibility, benefits and draw-backs of the system. We report data entry speed and error rate of input modalities and contrast it with the participants’ feedback on their perception of usability, acceptance, and suitability for deployment. These results offer an expanded analysis of the participants’ feedback compared to a previous analysis. The results highlight the potential of new data entry technologies and point out directions for future improvement of eyewear computers. The findings can be generalised to other endoscopic procedures (e.g. OGD/laryngoscopy) and could be included with-in hospital IT in the future. The source code of the Glass application is available at https://github.com/sussexwearlab/GlassMedicalDataEntry