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Anatomical planes: are we teaching accurate surface anatomy?
S Ali Mirjalili1, Sarah L McFadden, Tim Buckenham
1Department of Anatomy, Otago School of Medical Sciences, University of Otago, Dunedin, New Zealand.
Clinical Anatomy (New York, N.Y.)
|June 8, 2012
Summary
Anatomical planes derived from cadavers are inaccurate in living patients. Computed tomographic (CT) imaging reveals discrepancies, necessitating revisions to clinical surface markings for better anatomical accuracy.
Area of Science:
- Anatomy
- Radiology
- Medical Education
Background:
- Clinical anatomical planes are traditionally based on cadaveric studies.
- Existing anatomical reference texts show inconsistencies in surface markings.
- This variability impacts clinical practice and anatomical teaching.
Purpose of the Study:
- To evaluate the in vivo accuracy of commonly used anatomical planes.
- To compare cadaver-derived planes with computed tomographic (CT) imaging findings.
- To identify discrepancies in surface anatomy for clinical application.
Main Methods:
- Analysis of trunk CT scans from 313 adult patients.
- Exclusion of patients with spinal deformities or organomegaly.
- Dual consensus reporting to define five key anatomical planes: sternal angle, transpyloric, subcostal, supracristal, and pubic crest.
Main Results:
- Sternal angle plane located at T4 (females) or T4/5 (males); major thoracic structures often inferior.
- Subcostal plane at L2 (58%) and supracristal plane at L4 (69%) in abdominal scans.
- Transpyloric plane between L1/L2, containing superior mesenteric artery and portal vein formation, but not consistently the gallbladder or right renal hilum.
Conclusions:
- Current anatomical planes require revision based on in vivo CT data.
- Modern imaging techniques highlight inaccuracies in traditional surface markings.
- Revised anatomical planes will improve clinical practice and anatomical education.
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