Prosection

A prosection is the dissection of a cadaver (human or animal) or part of a cadaver by an experienced anatomist in order to demonstrate for students anatomic structure.[1] In a dissection, students learn by doing; in a prosection, students learn by either observing a dissection being performed by an experienced anatomist or examining a specimen that has already been dissected by an experienced anatomist (etymology: Latin pro- "before" + sectio "a cutting")[2]

A prosection may also refer to the dissected cadaver or cadaver part which is then reassembled and provided to students for review.[3]

Use of prosections in medicine

Prosections are used primarily in the teaching of anatomy in disciplines as varied as human medicine, chiropractic, veterinary medicine, and physical therapy.[4] Prosections may also be used to teach surgical techniques (such as the suturing of skin), pathology, physiology, reproduction medicine and theriogenology, and other topics.

The use of the prosection teaching technique is somewhat controversial in medicine. In the teaching of veterinary medicine, the goal is to "create the best quality education ... while ensuring that animals are not used harmfully and that respect for animal life is engendered within the student."[5] Others have concluded that dissections and prosections have a negative impact on students' respect for patients and human life.[6] Some scholars argue that while actual hands-on experience is essential, alternatives such as plastinated or freeze-dried cadavers are just as effective in the teaching of anatomy while dramatically reducing the number of cadavers or cadaver parts needed.[7] Other alternatives such as instructional videos, plastic models, and printed materials also exist. Some studies find them equally effective as dissection or prosections,[8] and some schools of human medicine in the United States have abandoned the use of cadavers entirely.[9] But others question the usefulness of these alternatives, arguing dissection or prosection of cadavers are required for in-depth learning and teach skills alternatives cannot.[10] Some scholars and teachers go so far as to argue that cadavers and prosections are irreplaceable in the teaching of medicine.[11]

Whether prosections are as effective as dissections in the teaching of medicine is also an unsettled aspect of medical education. Some have concluded that prosections are equally effective.[12] However, others argue that the use of prosections is not as effective,[4] and that dissections help students learn about "detached concern," better understand medical uncertainty, and allow teachers to raise moral issues about death and dying.[13]

But some academics conclude that the effectiveness of prosections versus dissection or other alternatives depends on the type of anatomy or the discipline being taught (e.g., anatomy versus pathology), that the teaching of anatomy is not yet well-enough understood, and that existing studies are too narrow or limited to draw conclusions.[14]

References

  1. ^ "Prosection." In Dorland's Illustrated Medical Dictionary. 30th ed. Douglas Anderson, ed. Philadelphia, Pa.: Saunders, 2007. ISBN 0-7216-0146-4
  2. ^ "Prosector." In Stedman's Medical Dictionary. 25th ed. William R. Hensyl, ed. Baltimore, MD.:Williams & Wilkins, 1990. ISBN 0-683-07916-6
  3. ^ Keith L. Moore, Arthur F. Dalley, and A.M.R. Agur. Clinically Oriented Anatomy. Philadelphia, Pa.: Lippincott Williams & Wilkins, 2006. ISBN 0-7817-3639-0
  4. ^ a b Debra Berube, Christine Murray, and Kathleen Schultze. "Cadaver and Computer Use in the Teaching of Gross Anatomy in Physical Therapy Education." Journal of Physical Therapy Education. Fall 1999.
  5. ^ Siri Martinsen and Nick Jukes. "Towards a Humane Veterinary Education." Journal of Veterinary Medical Education. 32:4 (Winter 2005).
  6. ^ Norman Gustavson. "The Effect of Human Dissection on First-Year Students and Implications for the Doctor-Patient Relationship." Journal of Medical Education. 63:1 (January 1988); J.A. Provo and C.H. Lamar. "Prosection as an Approach to Student-centered Learning in Veterinary Gross Anatomy." Journal of the American Veterinary Medical Association. 206:2 (January 15, 1995).
  7. ^ Othman Mansor. "Use of Plastinated Specimen in a Medical School With a Fully Integrated Curriculum." Journal of the International Society for Plastination. 11:1 (1996); Rafael M. Latorre, Mari P. García-Sanz, Matilde Moreno, Fuensanta Hernández, Francisco Gil, Octavio López, Maria D. Ayala, Gregorio Ramírez, Jose M. Vázquez, Alberto Arencibia, and Robert W. Henry. "How Useful Is Plastination in Learning Anatomy?" Journal of Veterinary Medical Education. 34:2 (Spring 2007); Ann T. Stotter, A.J. Becket, J.P.R. Hansen, I. Capperauld, H.A.F. Dudley. "Simulation in Surgical Training Using Freeze Dried Material." British Journal of Surgery. 73:1 (January 1986); C.L. Greenfield, A.L. Johnson, C.W. Smith, S.M. Marretta, J.A. Farmer, and L. Klippert. "Integrating Alternative Models into the Existing Surgical Curriculum." Journal of Veterinary Medical Education. 21:1 (Spring 1994).
  8. ^ J.F. Guy and A.J. Frisby. "Using Interactive Videodiscs to Teach Gross Anatomy to Undergraduates at the Ohio State University." Academic Medicine. 67:2 (February 1992); D.J. Griffon, P. Cronin, B. Kirby, and D.F. Cottrell. "Evaluation of a Hemostasis Model for Teaching Ovariohysterectomy in Veterinary Surgery." Veterinary Surgery. 29:4 (2000).
  9. ^ J. McLachlan, J. Bligh, P. Bradley, and J. Searle "Teaching Anatomy Without Cadavers." Medical Education. 38 (2004).
  10. ^ Christine Laura Theoret, Éric-Norman Carmel, and Sonia Bernier. "Why Dissection Videos Should Not Replace Cadaver Prosections in the Gross Veterinary Anatomy Curriculum: Results from a Comparative Study." Journal of Veterinary Medical Education. 34:2 (Spring 2007); S.A. Azer and N. Eizenberg. "Do We Need Dissection in an Integrated Problem-Based Learning Medical Course? Perceptions of First- and Second-Year Students." Surgical Radiologic Anatomy. 29:2 (March 2007); J.L. Perry, and D.P. Kuehn. "Using Cadavers for Teaching Anatomy of the Speech and Hearing Mechanisms." The ASHA Leader. 11:10 (September 5, 2006).
  11. ^ M.E. Gordinier, C.C. Granai, N.D. Jackson, et al. "The Effects of a Course in Cadaver Dissection on Resident Knowledge of Pelvic Anatomy: An Experimental Study." Obstetrics and Gynecology. 86:1 (1995).
  12. ^ G.R. Bernard. "Prosection Demonstrations as Substitutes for the Conventional Human Gross Anatomy Laboratory." Journal of Medical Education. 47:9 (September 1972); Karl K. White, Lynn G. Wheaton, and Stephen A. Greene. "Curriculum Change Related to Live Animal Use: A Four-Year Surgical Curriculum." Journal of Veterinary Medical Education. 19:1 (Winter 1992); N.A. Jones, R.P. Olafson, and J. Sutin. "Evaluation of a Gross Anatomy Program Without Dissection." Journal of Medical Education. 53:3 (March 1978); Justin Alexander. "Dissection Versus Prosection in the Teaching of Anatomy." Journal of Medical Education. 45:8 (August 1970).
  13. ^ Lisa M. Parker. "What's Wrong With the Dead Body? Use of the Human Cadaver in Medical Education." Medical Journal of Australia. 176:2 (2002).
  14. ^ J.T. Soley and B. Kramer. "Student Perceptions of Problem Topics/Concepts in a Traditional Veterinary Anatomy Course." Journal of the South African Veterinary Association. 72:3 (September 2001); Martin A. Cake. "Deep Dissection: Motivating Students beyond Rote Learning in Veterinary Anatomy." Journal of Veterinary Medical Education. 33:2 (Summer 2006); Jon Rosenson, Jeffrey A. Tabas, and Pat Patterson. "Teaching Invasive Procedures to Medical Students." Journal of the American Medical Association. 291:1 (January 7, 2004); Gary J. Patronek and Annette Rauch. "Systematic Review of Comparative Studies Examining Alternatives to the Harmful Use of Animals in Biomedical Education." Journal of the American Veterinary Medical Association. 230:1 (January 1, 2007).
Algor mortis

Algor mortis (Latin: algor—coldness; mortis—of death), the second stage of death, is the change in body temperature post mortem, until the ambient temperature is matched. This is generally a steady decline, although if the ambient temperature is above the body temperature (such as in a hot desert), the change in temperature will be positive, as the (relatively) cooler body acclimates to the warmer environment. External factors can have a significant influence.

The term was first used by Dowler in 1849. The first published measurements of the intervals of temperature after death were done by Dr John Davey in 1839.

Dead on arrival

Dead on arrival (DOA), also dead in the field and brought in dead (BID), indicates that a patient was found to be already clinically dead upon the arrival of professional medical assistance, often in the form of first responders such as emergency medical technicians, paramedics, or police.

In some jurisdictions, first responders must consult verbally with a physician before officially pronouncing a patient deceased, but once cardiopulmonary resuscitation is initiated, it must be continued until a physician can pronounce the patient dead.

Death messenger

Death messengers, in former times, were those who were dispatched to spread the news that an inhabitant of their city or village had died. They were to wear unadorned black and go door to door with the message, "You are asked to attend the funeral of the departed __________ at (time, date, and place)." This was all they were allowed to say, and were to move on to the next house immediately after uttering the announcement. This tradition persisted in some areas to as late as the mid-19th century.

Death pose

Dinosaur and bird fossils are frequently found in a characteristic posture consisting of head thrown back, tail extended, and mouth wide open. The cause of this posture—sometimes called a "death pose"—has been a matter of scientific debate. Traditional explanations ranged from strong ligaments in the animal's neck desiccating and contracting to draw the body into the pose, to water currents randomly arranging the remains in the position.Faux and Padian suggested in 2007 that the live animal was suffering opisthotonus during its death throes, and that the pose is not the result of any post-mortem process at all. They also reject the idea of water as responsible for randomly arranging the bodies in a "death pose", as different parts of the body and the limbs can be in different directions, which they found unlikely to be the result of moving water. They also found that the claim that drying out of ligaments would make the position does not seem believable either.

Alicia Cutler and colleagues from Brigham Young University in Provo, Utah, think it is related to water. In 2012, paleontologists Achim G. Reisdorf and Michael Wuttke published a study regarding death poses. According to the conclusions of this study, the so-called "opisthotonic posture" is not the result of a cerebral illness creating muscle spasms, and also not of a rapid burial. Rather, peri-mortem submersion resulted in buoyancy that enabled the Ligamentum elasticum to pull the head and tail back.

Death rattle

Terminal respiratory secretions (or simply terminal secretions), known colloquially as a death rattle, are sounds often produced by someone who is near death as a result of fluids such as saliva and bronchial secretions accumulating in the throat and upper chest. Those who are dying may lose their ability to swallow and may have increased production of bronchial secretions, resulting in such an accumulation. Usually, two or three days earlier, the symptoms of approaching death can be observed as saliva accumulates in the throat, making it very difficult to take even a spoonful of water. Related symptoms can include shortness of breath and rapid chest movement. While death rattle is a strong indication that someone is near death, it can also be produced by other problems that cause interference with the swallowing reflex, such as brain injuries.It is sometimes misinterpreted as the sound of the person choking to death, or alternatively, that they are gargling.

Dignified death

Dignified death is a somewhat elusive concept often related to suicide. One factor that has been cited as a core component of dignified death is maintaining a sense of control. Another view is that a truly dignified death is an extension of a dignified life. There is some concern that assisted suicide does not guarantee a dignified death, since some patients may experience complications such as nausea and vomiting. There is some concern that age discrimination denies the elderly a dignified death.

Fan death

Fan death is a well-known superstition in Korean culture, where it is thought that running an electric fan in a closed room with unopened or no windows will prove fatal. Despite no concrete evidence to support the concept, belief in fan death persists to this day in Korea, and also to a lesser extent in Japan.

First cabinet of Louis Mathieu Molé

The First cabinet of Louis Mathieu Molé was announced on 6 September 1836 by King Louis Philippe I.

It replaced the First cabinet of Adolphe Thiers.

On 19 September 1836 the Ministry of Commerce was replaced by the Ministry of Public Works, Agriculture and Commerce.

Following an insurrection on 30 October 1836 in Strasbourg, on 24 January 1837 the Minister of War, Bernard, introduced a draft law that would stop prosection of crimes committed by the military and the civil authorities during the riots.

Discussion began in the Chamber of Deputies on 28 February and continued until 7 March, when it was rejected by the deputies.

This caused a ministerial crisis.

The cabinet was dissolved on 15 April 1837, replaced by the Second cabinet of Louis Mathieu Molé.

Gross anatomy

Gross anatomy is the study of anatomy at the visible or (macroscopic) level. The counterpart to gross anatomy is the field of histology, which studies microscopic anatomy.

Lazarus sign

The Lazarus sign or Lazarus reflex is a reflex movement in brain-dead or brainstem failure patients, which causes them to briefly raise their arms and drop them crossed on their chests (in a position similar to some Egyptian mummies). The phenomenon is named after the Biblical figure Lazarus of Bethany, whom Jesus Christ raised from the dead in the Gospel of John.

Megadeath

Megadeath (or megacorpse) is one million human deaths, usually caused by a nuclear explosion. The term was used by scientists and thinkers who strategized likely outcomes of all-out nuclear warfare.

Necronym

A necronym (from the Greek words νεκρός, nekros, "dead" and ὄνομα ónoma, "name") is a reference to, or name of, a person who has died. Many cultures have taboos and traditions associated with referring to such a person. These vary from the extreme of never again speaking the person's real name, often using some circumlocution instead, to the opposite extreme of commemorating it incessantly by naming other things or people after the deceased.

For instance, in some cultures it is common for a newborn child to receive the name (a necronym) of a relative who has recently died, while in others to reuse such a name would be considered extremely inappropriate or even forbidden. While this varies from culture to culture, the use of necronyms is quite common.

Necrophobia

Necrophobia is a specific phobia which is the irrational fear of dead things (e.g., corpses) as well as things associated with death (e.g., coffins, tombstones, funerals, cemeteries). With all types of emotions, obsession with death becomes evident in both fascination and objectification. In a cultural sense, necrophobia may also be used to mean a fear of the dead by a cultural group, e.g., a belief that the spirits of the dead will return to haunt the living.Symptoms include: shortness of breath, rapid breathing, irregular heartbeat, sweating, dry mouth and shaking, feeling sick and uneasy, psychological instability, and an altogether feeling of dread and trepidation. The sufferer may feel this phobia all the time. The sufferer may also experience this sensation when something triggers the fear, like a close encounter with a dead animal or the funeral of a loved one or friend. The fear may have developed when a person witnessed a death, or was forced to attend a funeral as a child. Some people experience this after viewing frightening media.The fear can manifest itself as a serious condition. Treatment options include medication and therapy.The word necrophobia is derived from the Greek nekros (νεκρός) for "corpse" and the Greek phobos (φόβος) for "fear".

Obituary

An obituary (obit for short) is a news article that reports the recent death of a person, typically along with an account of the person's life and information about the upcoming funeral. In large cities and larger newspapers, obituaries are written only for people considered significant. In local newspapers, an obituary may be published for any local resident upon death. A necrology is a register or list of records of the deaths of people related to a particular organization, group or field, which may only contain the sparsest details, or small obituaries. Historical necrologies can be important sources of information.

Two types of paid advertisements are related to obituaries. One, known as a death notice, omits most biographical details and may be a legally required public notice under some circumstances. The other type, a paid memorial advertisement, is usually written by family members or friends, perhaps with assistance from a funeral home. Both types of paid advertisements are usually run as classified advertisements.

Pallor mortis

Pallor mortis (Latin: pallor "paleness", mortis "of death"), the first stage of death, is an after-death paleness that occurs in those with light/white skin.

Post-mortem interval

Post-mortem interval (PMI) is the time that has elapsed since a person has died. If the time in question is not known, a number of medical/scientific techniques are used to determine it. This also can refer to the stage of decomposition of the body.

Prosector

A prosector is a person with the special task of preparing a dissection for demonstration, usually in medical schools or hospitals. Many important anatomists began their careers as prosectors working for lecturers and demonstrators in anatomy and pathology.

The act of prosecting differs from that of dissecting. A prosection is a professionally prepared dissection prepared by a prosector – a person who is well versed in anatomy and who therefore prepares a specimen so that others may study and learn anatomy from it. A dissection is prepared by a student who is dissecting the specimen for the purpose of learning more about the anatomical structures pertaining to that specimen. The term dissection may also be used to describe the act of cutting. Therefore, a prosector dissects to prepare a prosection.

Prosecting is intricate work where numerous tools are used to produce a desired specimen. Scalpels and scissors allow for sharp dissection where tissue is cut, e.g. the biceps brachii muscle can be removed from the specimen by cutting the origin and insertion with a scalpel. Probes and the prosector's own fingers are examples of tools used for blunt dissection where tissue may be separated from surrounding structures without cutting, i.e. the bellies of biceps brachii and coracobrachialis muscle were made clearer by loosening the fascia between the two muscles with a blunt probe.

Rigor mortis

Rigor mortis (Latin: rigor "stiffness", mortis "of death"), or postmortem rigidity, is the third stage of death. It is one of the recognizable signs of death, characterized by stiffening of the limbs of the corpse caused by chemical changes in the muscles postmortem. In humans, rigor mortis can occur as soon as four hours after death.

Skeletonization

Skeletonization refers to the final stage of decomposition, during which the last vestiges of the soft tissues of a corpse or carcass have decayed or dried to the point that the skeleton is exposed. By the end of the skeletonization process, all soft tissue will have been eliminated, leaving only disarticulated bones. In a temperate climate, it usually requires three weeks to several years for a body to completely decompose into a skeleton, depending on factors such as temperature, humidity, presence of insects, and submergence in a substrate such as water. In tropical climates, skeletonization can occur in weeks, while in tundra areas, skeletonization may take years or may never occur, if subzero temperatures persist. Natural embalming processes in peat bogs or salt deserts can delay the process indefinitely, sometimes resulting in natural mummification.The rate of skeletonization and the present condition of a corpse or carcass can be used to determine the time of death.After skeletonization, if scavenging animals do not destroy or remove the bones, acids in many fertile soils take about 20 years to completely dissolve the skeleton of mid- to large-size mammals, such as humans, leaving no trace of the organism. In neutral-pH soil or sand, the skeleton can persist for hundreds of years before it finally disintegrates. Alternately, especially in very fine, dry, salty, anoxic, or mildly alkaline soils, bones may undergo fossilization, converting into minerals that may persist indefinitely.

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