Khanday, Shifan (2019) Anatomical variations in the human body : exploring the boundaries of normality. (PhD thesis), Kingston University, .
Abstract
Aim: The aim of this thesis is to collate and reflect on my published studies exploring the variations within the anatomic, clinical, anthropometric and other aspects of different structures of the human body. Background: The anatomy of living organisms is diverse within each species, including the humans. The scope of anatomical variations cannot be just limited to variants or anomalies; it encompasses the interesting field of “normal variations” among individuals. Anatomical variations need to be considered as an integral component of anatomy teaching because the knowledge of common variants reflects the ability to recognise the diverse clinical reality of anatomy with important surgical and other medical implications. A series of scientific papers published by myself and my colleagues addresses different variations in the human body morphology and function. Therefore, the proposed work scrutinises and critically appraises the published work in the abovementioned area of interest. The objective (or main theme) in this thesis is to understand and address the implications that the identified variations in structure and function might have in health and clinical management. Methods: A common introduction to the published work which focuses on the anatomical and functional morphology and the related variations is presented using selected published articles and case reports. The material and methods section of all the selected papers are reviewed and the salient findings highlighted. Four key themes have been identified in my published work. These are: Theme 1: variations in the foramina of human skull and case reports related to the head and neck region. Theme 2: variations in muscles, knee menisci and height prediction in musculoskeletal system. Theme 3: variations and case reports related to organs. Theme 4: variations and case reports related to blood vessels of circulatory system. Discussion: One question that is often asked today is whether publications and studies of anatomical variations have relevance and clinical significance for medicine and biology of the 21st century, or do they rather represent an exhausted topic with little insignificant implications. The main themes in this thesis discuss the objective response to this valid question and highlight the fact that medical progress needs more accurate knowledge of the variability of the human morphology to improve diagnosis and therapeutic management. Moreover, the advances in the new imaging and surgical techniques (Echography, MRI, CT, Endoscopy, and reconstructive, minimal invasive surgery) have opened new fields of research for the descriptive anatomy that is considered promising. Anatomical variations will always have relevance and applications in the medical and biological fields and developments. As variant anatomy, at least in part contributes to a significant number of malpractice claims, there is a need to improve the basis of anatomical knowledge among practicing physicians and surgeons. This thesis highlights the importance of carefully assessing the quality and reviewing and scrutinising the designs, interpretation and conclusions made, in the light of the clinical interest and clinical implications.
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