Int. J. Morphol.

,
24(3):377-382, 2006.

An Interactive Tool for the Human Anatomy Laboratory

Una Herramienta Interactiva para el Laboratorio de Anatoma Humana
Victor E. Maldonado-Zimbrn; Rodrigo E. Elizondo-Omaa; Beatriz A. De la Garza Cepeda;
Flix Vilchez-Cavazoz; Oscar de la Garza Castro & Santos Guzmn-Lpez
MALDONADO-ZIMBRN, V. E.; ELIZONDO-OMAA, R. E.; CEPEDA, G. B. A., VILCHEZ-CAVAZOZ, F.; CASTRO, G. O.
GUZMN-LPEZ, S. An interactive tool for the human anatomy laboratory. Int. J. Morphol., 24(3):377-382, 2006.
SUMMARY: A multimedia program has been developed at the Departament of Human Anatomy, Medicine School of Universidad Autnoma de Nuevo Len. It offers an alternative to support the traditional laboratory practice and resolve, during the dissection, the
most common problems that we have already identify in our students. Some features of this program are: photographys, diagrams,
information about the structures, clinical correlation and tests. All this tools were integrated in a software using Macromedia Flash. The
final result is a multimedia program that will be used by students during their laboratory practice. At present, we are making a study to
determine the effect that is produced in the development of the students in the anatomy lab.
KEY WORDS: Laboratory practice; Multimedia program, Dissection; Teaching anatomy.

INTRODUCTION

We live in a era when computers have become an

essential part of our lives. Day by day, we use these tools to
communicate in real time with distant places; we trust them
to control the information of the financial market and even
to control the multiple variables that occur during landings
and takeoffs. Generally, they allow us to do in hours the
tasks that otherwise would take days.
Sciences are not beyond this revolution. Almost all
of the discoveries of the last times have been, to a certain
extent, because of the computers. Some examples are the
sequence of the human genome, the description of the
electrons behavior, and the advances of quantum physics.
Researchers in every field have taken advantage of the power
of these tools. Scientists in different continents can work in
the same project; they can share and analyze results without
traveling. They can even control experiments or make
distance simulations. Their impact is noticeable in the
frequency with which we discover new concepts or explain
the already existing.
The medical sciences have characterized for being at
the forefront of the innovation in the use and application of
the techniques of computer science in investigation and

teaching. (Rojas et al., 1999; Jastrow & Hollinderbraumer,

2004). Molecular biology, genetics, the images of diagnosis, and the handling of clinical histories are clear examples
of the use that can be given to these tools (McLane, 2005).
The simulation of clinical cases and even whole cells has
allowed us to access a vast array of new knowledge, useful
in diagnosing and treating patients; they have also allowed
us to achieve a higher knowledge of the physiological
processes of our organisms (Jacobs et al., 2003a; Caudell et
al., 2003). The processing and obtaining of sharper images
have also provided diagnostic tools which precision was
unimaginable half a century ago (Jacobs et al., 2003b;
Shaffer, 2004).
Anatomy, a basic science of medicine, has taken
advantage of these inventions and has applied them in
teaching and visualization of the disposition of complex
structures (Trelease, 2002; Silva-Lopes & Monteiro-Leal,
2003; Inzunza & Bravo, 2002). Despite the advantages of
the use of these tools, the traditional anatomic teaching is
based on the dissection of cadavers (Jones, 1997; Mc Garvey
et al., 2001; Ellis, 2001; Aziz et al,. 2002) and in the use of
static images in atlas (Rosse, 1999). Nowadays, different
studies have tried to prove which the most effective method

Department of Human Anatomy. Medicine School. Universidad Autnoma de Nuevo Len, Monterrey, NL, Mxico.

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MALDONADO-ZIMBRN, V. E.; ELIZONDO-OMAA, R. E.; CEPEDA, G. B. A., VILCHEZ-CAVAZOZ, F.; CASTRO, G. O. GUZMN-LPEZ, S

is, some authors are in favor of the traditional method (Ellis;

Babinski et al., 2003; Granger, 2004; Pawlina, 2004), some
others are in favor of the use of computers (McLachlan et
al., 2004), and some others believe in the integration of
both methods (Inzunza et al., 2003; Sinav & Ambron, 2004;
Elizondo-Omaa et al., 2005). The projects like the visible
human body (Jastrow & Vollrath, 2003) and the interactive
anatomic atlas with clinical images are some examples of
the utility of these new techniques (Guiraldes et al., 2001).
These applications allow the students to appreciate in more
detail and in a realistic way the structures and the study
areas (Paalman, 2000; Inzunza & Bravo; Sinav & Ambron).
The dynamism and interactivity of these programs are
characteristics that allow the user to determine his own
study pace (Drake, 1998).
In our particular experience from the Human
Anatomy Department of the Medicine School of the
UANL, we have identified some problems that arise in the
lab practice and that can be solved with the use of the
computer. The current lab program for medicine students
implies them to realize at least 12 dissections trough the
semester with a instructors help, these dissections are
presented to the teacher in a weekly session. Before the
dissection practice, the instructor must make sure that the
students have enough anatomic knowledge to make the
dissection. Despite this, in practice we have realized that
there are factors that prevent the students from making the
most of the dissection, some of these factors are: the
anatomic variations, the lack of experience in the tools
handling, and above all, the confusion that results from
the lack of supporting didactic material in the lab.
Because of these issues, we decided it was necessary
to develop a tool to override these common problems
students have during dissections. The chosen alternative
was the creation of a supporting multimedia program that
optimizes the use of corpse dissection. This alternative
offers the advantage of integrating a great variety of
resources in one program. Nowadays, there are tools
created for this purpose (Inzunza & Bravo; Inzunza et al.;
Todd, 2005) although with a different approach. Our
objective was to create a multimedia program,
complementary to the dissection course, that solved the
doubts that are frequently presented during the lab practice.
The characteristics that are needed to solve this
problem are: easy handling, high resolution photographs
with complementary diagrams that identify the structures,
relevant information of every structure, useful clinical
information, and feedback for the student through
identification theoretical and about images exams. Then it
was necessary to develop such software, starting from

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scratch without having any sort of reference we could base

our project upon. The software employed to make the
program was Flash MX 2004 of Macromedia, due to the
facility of the integration of images with information and
the high interactivity degree that can be achieved with an
intuitive interphase.
The supporting multimedia program was adapted
to the dissection manual that is used during the course
(Hernndez Ramrez et al., 1990). Six modules with 5
stuffing regions each were included, except for the first
introductory block, which only includes general
information about tools and suture techniques (Fig. 1).
Every module has common characteristics such as:
photographic images and diagrams of the study regions,
information about the structures that must be identified,
radiographic images, clinical correlations, and a selfevaluation.
Photographic images. The photographic images employed
for the development of the program were created ex
professo for this purpose. The dissections were made by
instructors and professors of the department, and for the
photographic documentation, a Nikon reflex camera (model
AF F-401s) was used. Later, the photographs negatives
were digitalized by an hp scanjet 8200 series scanner
(Hewlett-Packard) with a 300 dpi resolution. The printed
photographs were used to create a collection that can be
used later. In total, we selected 30 dissections that show
the main structures that should be identified by the students.
Images diagrams. After the digitalization of the images,
they were processed in Adobe Photoshop CS to create on
the image a diagram that corresponds exactly to the original photograph. This diagrams are black and white
renderings of the original pictures with the structures
painted with different colors. Both the photographs and
the diagrams are shown at the same time, this way the
student has a clear guide to understand the un-edited
photograph. We think that this is one of the most important
characteristics because it makes possible the identification
of the structures on the corpse and not only in a drawing.
Furthermore, we included drawings to clarify in cases where the diagrams themselves were not clear enough.
The drawings were kindly done by Miss Beatriz Alejandra
de la Garza Cepeda, a scholarship recipient of the
Departament.
Information of the identified structures. Every one of
the structures that must be identified by the students are
pointed in the diagrams and there is also a description of
the typical anatomy that allows the student to remember

An interactive tool for the human anatomy laboratory. Int. J. Morphol., 24(3):377-382, 2006.

Fig. 1. Show the map with the contents of the developed program.

the most important anatomic relations and the

characteristics for their recognition during the lab
dissection. The descriptions were made by the members
of a teamwork using different anatomy books as reference
(Lockhart, 1965; Van de Graaff, 2000; Moore, 2003).
Clinical correlations. Radiographies of every one of the
modules were included to show the bone structures and
some of their radiographic characteristics. The material is
shown, just like the dissection photographs, in two screens:
one shows the digitalized photograph in high resolution
and the other one emphasizes the most important structures
that must be recognized. In the same way, information about
the structures appears once the pointer is on them.

Evaluations. In order to provide a way of feedback to the

student, two modalities of self-evaluation were included
in the program. One of them consists of random questions
on the topic with multiple-choice answers; by answering
the question, a text chart that indicates whether the answer
is correct or incorrect is displayed; if it is incorrect, there
is an explanation of the correct answer. The other modality
consists of the visual identification of different structures
on the photographic images. The program then proceeds
to ask the student to identify certain structure; the student
then must click on the right structure. Just like in the
multiple choice questions, the correct answer and an
explanation are shown. At the end of the test provide the
student with a mark.

We also included some basic clinical notes with the

intention the student realizes the importance of the
structures being studied. In every module, two clinical
comments are included; one is related tothe internal medicine and the other one to surgery, emphasizing the
importance of anatomical knowledge to understand the
presentation of the case.

Integration. In order to integrate these tools, an intuitive,

easy handling interphase was designed in the program Flash
of Macromedia. At the beginning of the program, a screen
with the main menu is shown, in which it is possible to
choose a dissection area that contains different regions
(secondary menu). By selecting a region, a study screen
that shows the contents of the region is displayed.

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MALDONADO-ZIMBRN, V. E.; ELIZONDO-OMAA, R. E.; CEPEDA, G. B. A., VILCHEZ-CAVAZOZ, F.; CASTRO, G. O. GUZMN-LPEZ, S

The main menu screen (Fig. 2) shows a drawing of

the human body in anatomical position, where it is possible
to choose a dissection area or general information of the
CD and the introductory block.
The secondary menu screen (Fig. 3) presents a list
of the regions that can be studied in the chosen area. By
passing the cursor on the name of the region, a
representative image is displayed. This list also shows the
options for clinical correlations and self-evaluations.
The study screen (Fig. 4) is divided into three parts
that show the photographic image, the corresponding
diagram, and the description that depends on the pointed
structure. The photographic image and the diagram can be
displaced in a synchronic way, so there can always be seen
the same portion of the images. It is also possible to increase
or decrease their size in order to observe the structures in
more detail. By passing the mouse for every structure on
the photograph, a color change (red: arteries, blue: veins,
yellow: nerves, etc.) is produced in the diagram and the
description appears. It is important to point that the
photograph and the diagram will remain synchronized no
matter if they are dragged or zoomed; therefore the diagram
always corresponds with the photograph and vice versa
From any screen, it is always possible to go back to
the main menu and also to exit the program.

Module of introduction. The introductory block differs

from the others because it does not present images of
dissections. On the other hand, this one presents
information about the lab material and the adequate suture
techniques. This block includes images that allow the
student the visual identification of the material and a video in which the technique of the manual knot is taught
step by step.
Conclusion. On the one hand, this supporting multimedia
program for the lab accomplishes all of the objectives that
were suggested at the beginning of the project. On the other
hand, we know that there are tools that were not used in
this program: 3D images, MRI, TAC, which could be useful
for the students and we consider their absence as a limit.
We believe we have achieved an important first step
in the integration of the computer and the traditional
dissection. We trust in the advantages offered by the
computer tools, such as the access to a huge variety of
images and information in a simple way, to benefit our
students; and also, we believe in the traditional laboratory
practice as a way to learn anatomy. The most important:
we think the integration of both resources could improve
the achievement of students.
At present, we are making a study to determine the
effect that is produced in the development of the students
in the anatomy lab. We hope that our project placates the
development of a higher
quantity of applications that
integrate the use of the
computer to the lab practice
as a tool that solves problems
and not as a substitute of the
traditional techniques.

Fig. 2. Show the main menu

screen of the program. You
can choose an area to study.

380

An interactive tool for the human anatomy laboratory. Int. J. Morphol., 24(3):377-382, 2006.

Fig. 3. Show the secondary menu screen. It is possible to select a specific region.

Fig. 4. Show the study screen. By passing the mouse on each structure on the photograph
a short description related will appear just under the images.
MALDONADO-ZIMBRN, V. E.; ELIZONDO-OMAA, R. E.; CEPEDA, G. B. A., VILCHEZ-CAVAZOZ, F.; CASTRO, G. O.
GUZMN-LPEZ, S. Una herramienta interactiva para el laboratorio de Anatoma. Int. J. Morphol., 24(3):377-382, 2006.
RESUMEN: Hasta hoy, diferentes estudios han tratado de determinar la manera ms efectiva de aprender Anatoma: algunos autores
apoyan el mtodo tradicional, otros prefieren el uso de computadores y algunos creen en la integracin de ambos. En nuestra Escuela de
Medicina utilizamos el mtodo tradicional y el uso de computadores, as hemos desarrollado un programa multimedia que tiene por objetivo
optimizar la diseccin como herramienta de aprendizaje. Este programa multimedia de apoyo est adaptado al manual de disecciones que es
utilizado durante el curso. El programa cuenta con 6 mdulos, de 5 regiones cada uno, en los que se incluyen: imgenes fotogrficas y diagramas
de las regiones, informacin acerca de las estructuras que deben ser identificadas, radiografas, correlaciones clnicas y autoevaluaciones.
PALABRAS CLAVE: Prctica de Laboratorio; Programa de multimedia; Diseccin, Enseanza de la Anatoma.

381

MALDONADO-ZIMBRN, V. E.; ELIZONDO-OMAA, R. E.; CEPEDA, G. B. A., VILCHEZ-CAVAZOZ, F.; CASTRO, G. O. GUZMN-LPEZ, S

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Correspondence to:
Dr. Rodrigo E. Elizondo-Omaa
Departament of Human Anatomy,
Medicine School, Universidad Autnoma de Nuevo Len.
Ave. Madero y Dr. Aguirre Pequeo s/n. Col.
Mitras centro, Monterrey, N.L.
C.P.64460
MXICO
Received : 23-03-2006
Email: [email protected]
Accepted: 25 -06-2006