Anatomy

Relevance of Anatomy to Medicine
Dr.S. M. Bhatnagar

Anatomy is, and shall always remain the foundation on which the towering edifice of clinical medicine, in all its myriad forms, is built. What has changed, for the better, is its teaching methodology. Today, the study of Anatomy is better integrated, both horizontally and vertically, not only with other basic sciences, but with clinical sciences as well.

Further advances in aids to teaching Anatomy include incorporation of three dimensional models and imaging techniques, plastination, virtual dissection, simulated surgery and multi-media classroom teaching. All this serves only to highlight the perennial relevance of Anatomy, to medicine. Ironically, the 'educationists' out there, continue to cut at the very roots of clinical medicine, by reducing the duration of the basic science course. Perceived by some as an intellectual bully, Anatomy however, continues to extend its sway over every conceivable sub?speciality of Medicine. Why, medicine, is it not Anatomy that the cosmetologist or the obesity clinic specialist seeks to improve and judges of beauty pageants seek to pass judgement over ? The scope of Anatomy is unending and all?embracing.

The term Anatomy brings to mind one of several concepts or things:

1. The branch of morphology dealing with structure of an organism
2. Dissection
3. Analysis
4. A Skeleton

5. A desiccated or mummified body

Human anatomy, as the study of the art and science of structural organization of the body encompasses an entire range, from the molecular level to the collective human population.

Thirty odd terms preceding Anatomy, many of them synonymous, highlight its scope, methodology and relevance to the field of Medicine.

Terms 1,2,3 :-
Applied, Medical and Surgical
Discuss the practical application of anatomic knowledge to the diagnosis and treatment (including surgical techniques), of clinical conditions.

Terms 4,5,6,7,8,9,10 :-
General, Descriptive, Gross, Macroscopic, Systematic, Systemic and Physiological
These include either isolated or correlated reference to tissues, organs and fluids of the body, with or without statement on function and microscopic appearance. They serve to establish in the student's mind the 'identity' of a tissue or organ, greatly facilitating a study of the other aspects.

Terms 11,12,13,14,15,16,17,18,19,20 :-
Practical, Dissectional, Regional, Surface, Topographic, Cross-sectional, Radiological, Artificial, Classic and 'Corrosion'
These constitute the sine qua non of anatomical study for the medical student. Collectively, they give a three-dimensional orientation about the spatial organization of various body parts, and it is the visual images acquired during a study of these, that are crucial in the further understanding of diagnosis and treatment. They are the traditional methods of study by prosections, aided by models, charts, corrosion casts and the various body imaging techniques.

Terms 21,22,23 :-
Minute, Histological, Microscopic including Scanning and Electron Microscopy
As one gains greater insight into the functioning of the body at the cellular and sub-cellular levels, these aspects of Anatomy become more pertinent. A sound basis in microanatomy is essential for a clear understanding of the Pathology of disease.

Terms 24,25,26,27,28,29,30 :-
Morphological, Comparative, Ontogenic, Developmental, Embryological, Temporal (Tempus = Time) and Phylogenetic These include the time dimension, with reference to human evolution, life span of an individual and intrauterine growth and development.

Term 31: Morbid Anatomy, now called Pathology or Pathological Anatomy, refers to 'abnormal' structure and function.
As examples of relevance of Anatomy, reference is invited to all -graphies, -scopies, -centeses, -otomies, -ostomies, -ectomies, radical resections, Endoscopic Surgeries, Biopsies, FNABs, FNACs, Plastic and Reconstructive Surgery. Also, at another level, is exfoliative cytology (Pap. Smears), tissue culture and the entire Genetic Engineering Technology, PCRs, 'Blots' and Immunoflorescence techniques. The scope of Anatomy is unending and all-embracing.

Two living eighteen month old miracles stand testimony to the relevance of thorough knowledge of Anatomy in medicine. As reported in the Reader's digest, April 2003 issue, Dr. Keith Goh and Dr. Chumpon Chan with their teams, in Singapore, performed a ninety-nine hour operation, the longest surgery in history, on Ganga and Jamuna, Nepali twins, who were born with craniopagus or conjoined skulls, with entwinning brains, and successfully separated them. This involved months of studying three?dimensional images of the bewildering anatomy of their brains. Would this have been possible without arming themselves with a thorough knowledge of Anatomy, first the normal, then recognizing the abnormal, and finally performing the miracle of restoring the normal?