Understanding Clinical Sectional Anatomy

Introduction

This paper discuses ten individual case studies of different anatomical regions of the human body. Each individual case study has been briefly justified by providing the reasons why the case were chosen for the study and also provide a clinical context for the case. In addition, each case study has provided an overview and review of the imaging protocol that were performed in each image to demonstrate why the imaging protocol was performed and also to answer some of the relevant clinical questions poised for each case study. This included elaboration on the anatomical planes, structure and whether contrast media has been used or is needed to clearly show anatomical structures of each anatomical image. All the images used in this paper are anonymised to avoid breaching patient confidentiality. Finally, each case study has been provided with detailed annotation for each images. The case studies used included three for skeletal parts, four for human body organs, and three for muscular skeletal muscles anatomical regions

1.0 Case study 1: Skull

1.1 A brief justification

The bones found on the head play a critical role protecting the brain, nerves, sensory organs and the blood vessels of the head from mechanical damage. These bone’s movements by the muscles attached to the head provide for speech, eating, facial expressions and movement of the head (Larsen, 1997). According to Mays (1999), the skull is made up of 22 facial and cranial bones tightly fused together except the mandibles. The case was chosen because the skull is very vital to humans since it encases and protects the human brain and other special sensory organs of hearing, vision, taste, balance and smell

The skull also has muscle attachment points of the neck and the head located on the skull’s exterior surfaces and allow for movements such as facial expression, speech and chewing. Teeth are also deeply rooted in the sockets of the maxillary and mandible bones. Moreover, the upper sections of the respiratory and digestive tracts are also housed within the hollow nasal and oral skull cavities.

1.2 Overview & review of the imaging protocol performed

The skull images of this case studies has been presented in different anatomical planes, that is transverse, sagittal and frontal planes. Moreover, different anatomical directions has been applied in the imaging of the case study skull such as the frontal, lateral, posterior and superior anatomical directions. The anatomical structures of the skull has been labelled in the diagram for easier comprehension. A contrast media particularly a colored imaging is also helpful especially in the superior view of the cranium to differentiate the lobes, fissures, canals, openings and the sutures

1.3 Detailed annotation of all normal anatomy demonstrated on each image

1.3.1 Anterior view of the skull

The skull’s anterior view consisted of the facial bones in addition to supporting the structures and eyes of the face. The anterior view of the skull is majorly dominated by the orbits openings and nasal cavity. Also present are the lower and upper jaws and their respective teeth as shown in Figure 1. The orbit in the anterior part of the skull is the socket housing the eyeball and the neighbouring muscles that assist in the movement of the eyeball or opening the upper eyelid. Supraorbital margin is the anterior orbit’s upper margin. Supraorbital foramen is a small opening located near the supraorbital margin mid-point. Supraorbital foramen provides a passage for the skulls sensory nerve to the forehead skin. Infraorbital foramen is located below the orbit and is the emergence point for the sensory nerve supplying the anterior face just below the orbit (OpenStax, n.d).

Figure 1: Frontal view of the skull

Inside the skull’s nasal area, the nasal septum divides the nasal cavity into halves. The perpendicular plate of the ethmoid bone forms the nasal septum’s upper portion and Vomer bone forms the lower portion. Every side of the nasal cavity has shape of a triangle, with a broad inferior space narrowing superiorly. Closely looking into the nasal cavity from the skull’s front, there are two projecting bones from each lateral wall. Inferior nasal concha is the larger among these projecting bones and it is an independent skull bone (Roberts & Manchester, 2010). Middle nasal concha is located above the inferior nasal concha, and it forms part of the ethmoid bone. Lastly, superior nasal concha which is the third bony plate and also part of the ethmoid bone is out of sight and smaller and is located above the middle concha. The location of the superior nasal concha is in the upper nasal cavity and lateral to the perpendicular plate as shown in Figure 1 (OpenStax, n.d).

1.3.2 Lateral view of the skull

The lateral view of the skull is dominated by the rounded, large brain case above and the lower and upper jaws with their teeth as shown in Figure 2 and 3. Zygomatic arch is a bridge of bone that separates these areas. OpenStax (n.d) defined zygomatic arch as the bony arch located on the side of the skull spanning from the areas just above the cheek to the area above the ear canal. Zygomatic arch is formed by two bony processes junction: zygomatic bone temporal processes (cheek bone) which is a short anterior component and the zygomatic process of the temporal bone which is longer posterior portion that extends from the temporal bone forward (OpenStax, n.d). Therefore, the zygomatic process (posteriorly) and the temporal process (anteriorly) join together to form the zygomatic arch. OpenStax (n.d) pointed out that one of the major muscles pulling the mandible during chewing and biting upwards originates from the zygomatic arch.

Figure 2: Lateral view of the skull.

According to White & Folkens (2005), on the brain case ‘lateral side, there is a shallow space above the zygomatic arch level called the temporal fossa. Additionally, deep to the mandibles deep portion and belwo the zygomatic arch level is another space referred to as the infratemporal fossa. Larsen (1997) stated that both infratemporal fossa and temporal fossa contain muscles acting on the mandible during the process of chewing.

Figure 3

1.3.3 Internal and external views of the skull base

Part (a) of Figure 4 shows the hard plate that is anteriorly formed by the maxilla bones ‘palatine processes and posteriorly by the palatine bones ‘horizontal plate. Part (b) of Figure 4 shows the complex cranial cavity floor that is formed by ethmoid, frontal, temporal, sphenoid and occipital bones. The sphenoid bones’ lesser wings separates the middle and anterior cranial fossae. In addition, the petrous ridge (temporal bones petrous portion) separates the posterior n and middle cranial fossae.

Figure 4: Internal and external parts of the skull

1.3.4 Sutures of the skull

According to Mays (1999), suture is a joint between skull adjacent bones that are immobile. The narrow gap that exists between the bones is filled with fibrous connective dense tissue that unites the bones. Roberts & Manchester (2010) pointed out that the long sutures found on the brain case bones are not straight rather follow tightly twisting irregular paths. The twisting lines serve the purpose of tightly interlocking the adjacent bones hence providing additional strength to the skull for protection of the brain

Sagittal and coronal sutures are found on top of the skull. The coronal suture runs across the skull side to side, within the coronal plane as shown in Figure 3. Moreover, it joins the left and right parental bones to the frontal ones. The sagittal suture, on the other hand, posteriorly extends from the coronal suture and runs along the midline at the skull’s top in the sagittal plane as shown in Figure 3, 6 and 7. Sagittal sutures unites the lefts and the right parietal bones (White & Folkens, 2005).

Figure 5

Figure 6

On the skull’s, the sagittal suture ends by joining the lambdoid suture which extends laterally and downwards to either sideway from where it meets with the sagittal suture. The lambdoid suture runs and joins the occipital bone to the left and right and temporal bones as shown in Figure 3 and 5.

The squamous suture is found on the lateral skull and it unites the parietal bone with the temporal bone’s squamous portion as shown in Figure 3.pterion is located at the four bones intersection and is a small suture line region that is capital H shaped uniting the parietal, frontal, temporal bone’s squamous portion, and sphenoid bone’s greater wing. Pterion is the skull’s weakest part (Larsen, 1997).

Figure 7

Sagittal section of the skull

2.0 Case study 2: Thoracic cage

2.1 A brief justification

The thoracic cage consist of ribs paired in 12 sets or curved bones surrounding the chest region. The thoracic cage helps in protecting the blood vessels and the vital organs in addition to expanding and contracting alongside the lungs for efficient breathing. Thoracic cage was chosen as case study in this paper because of its significant role in protecting the vital body organs such as the heart and lungs. The rib cage also helps assists during breathing using the intercostal muscles which lifts and lower the rib cage. The first seven ribs in the thoracic cage are referred to as the true ribs (Flynn, 1996).the ribs are directly connected to the sternum via costal cartilage which adds elasticity to the whole thoracic cage allows the ribs to move. The other five remaining ribs are referred to as the false ribs (Hale et al, 1983). Three ribs out of the false ribs are connected to the sternum via cartilage while the remaining two are not connected to the sternum but only the vertebrae hence referred to as the floating ribs as shown in Figure 8 (Kenyon, 1989).

Figure 8

Generally, ribs of the human being beings increase in length from rib one to rib seven and start decreasing n length again up to rib 12. Because of the change in size, the human ribs progressively become slanted (oblique) from rib one to rib nine, then again less slanted to rib 12.

2.2 Overview & review of the imaging protocol performed

The imaging protocol used in this study varied to give a clear view of different anatomical labels and directions of the thoracic cage. First, some x-ray was used as an imaging protocol to show the rib cage bones and the upper part of the spinal cord. Additionally, the images has been taken from different views which included rib projection on expiration, on inspiration and during fast and slow breathing. The views of the images in this case study were also taken at 30⁰ and 45⁰ angles sequentially in anterior oblique positions. The images of this case study also indicate that the subjects were standing in erect positions. Other imaging techniques used include line sketch images, CT scan, Ultra sound and bone scan.

The images are presented in different anatomical planes such as sagittal, frontal and transverse planes. The anatomical regions of the images are labelled clearly in each image for distinction. Contrast media were also used in some images to help in distinguishing key anatomical structures pertinent to each individual anatomical region of the thoracic age

2.3 Detailed annotation of all normal anatomy demonstrated on each image

2.3.1 Anterior view of the thoracic cage

On the anterior view of the thoracic cage is the sternum which is made up of the Xiphoid process, corpus Sterni and the Manubrium and the ribs forming the thoracic cage. From rib one to rib seven, the ribs normally increase in size and then decreases from rib seven to rib twelve (White & Folkens, 2005). The upper seven ribs on each side of the thoracic cage distally directly connect to the sternum. Additionally, the last two ribs referred to as the floating ribs have short cartilage at their ends freely lying on the body wall sides. According to White & Folkens (2005), the basic anatomy landmark of the rib include the long shaft, neck, head and the tubercle articulating with the thoracic vertebrae as shown in Figure 9. In Figure 9 below, the ribs head are medial while the sternal ends of the ribs are lateral. The cranial edge is the side that is superior while the caudal edge is the inferior part. Each pair of the ribs in the thoracic cage posteriorly articulates with the thoracic vertebrae. Costovertebral joints are the joints where the ribs articulates with the vertebrae. Flynn (1996) pointed out that on the anterior side of the thoracic cage, only the first seven ribs directly articulates with the sternum at the costosternal joints and they are referred to as the true ribs, while the rest are referred to as the floating ribs

Figure 9

Some of the distinctive elements of the thoracic cage include the following

• The first rib is the most unusual and can be easily be identified. Is normally thick, broad and blunt and that ribs has no caudal groove as observed by Roberts & Manchester (2010).
• The second rib serves as an intermediary to the first and the third rib up to the ninth ribs that are more regular. This rib also has a tuberosity that is large for the anterior serrator muscles half way long its length
• The eleventh rib has a sternal end that is often pointed and lacks the tubercle
• The twelfth rib is shorter compared to the eleventh rib and sometimes can be even be shorter that the first rib. Moreover, it lacks the costal and the angle groove and is identifiable easily (Mary, 1999).

Sternum

The sternum is made up of the three bones; the Xiphoid process, corpus Sterni and the Manubrium. As shown in Figure 10 and 11, there are seven facets laterally locates for the anterior of thoracic cage’s true ribs alongside manubrium and sterni. The manubrium is the squarest and thickest section of the sternum bones and is easily identifiable. At the superior corners of the manubrium are the clavicular notches which articulates with the lefst and right clavicles. The scapula and the clavicles helps in forming the shoulder girdle (Hale et al, 1983).

Figure 10

Compared to the manubrium. Corpus sterni is thin and is bladelike. Moreover, there is presence of costal notches and they cover for the second to seventh rib as shown in Figure 11. Lastly, the xiphoid process is inferiorly located to the corpus sterni. Xiphoid process in the sternum shares the seventh costal north and highly variable in shape (Kenyon, 1989).

Figure 11

Costal cartilage

They make up the ribs medial portion on the anterior side to be more flexible as shown in Figure 12. The thoracic arch, which is a landmark on the surface is entirely made up of the costal cartilage.

Figure 12

Thoracic vertebrae

It runs down the posterior thoracic cage midline. Flynn (1996) indicated that the twelve thoracic vertebrae found on the posterior of the thoracic cage are regarded as part of the thoracic cage and the spinal column. Additionally, thoracic vertebrae are the only vertebrae in the spinal column with costal facets which makes sense because there is no any other kind of vertebrae which articulate with the ribs as shown in Figure 12 (Hale et al, 1983).

Case study 3: Arm skeleton

A brief justification

The bones of the hand and the arm have the critical job of providing the muscles attachment points moving the upper limb and also supporting the upper limbs. The arm skeleton was selected for this case study because these bones of the arms form joints which offer flexibility and wide range of motion that is needed to manipulate objects with the hand and arm deftly. The bones of the arms also provide strength to resist stresses and forces that are extreme and at upon the hands and arms during exercises, sports and heavy labour (Parker & Dowell, 1988).

Overview & review of the imaging protocol performed

The imaging protocol performed on the arm skeleton anatomy to best demonstrate the relevant anatomy to enable answering of the clinical question poised for the case study three. The images included different anatomical regions of the arm skeleton such as the clavicle, scapula, humerus, ulna, radius, phalanges, carpals, metacarpals and the joints. The images presented in the case study has been presented in different anatomical planes and direction. First, coronal and transverse planes are evident in the images in this case study three. Contrast media has not be used in these case study images like the way earlier case studies used the contrast media. However, some of the images in this case study used colored background to bring out the aesthetic beauty of the images. Moreover, the images has also used the line drawings to best illustrate the anatomical regions and easier understanding of the labels of the images.

Detailed annotation of all normal anatomy demonstrated on each image

The pectoral girdle which consist of the clavicles and the scapula forms the point of attachment between the arm and the chest. The clavicle is a long bone connecting the scapula to the sternum if the thoracic cage. According to Green (2006), clavicle forms two joints, that is the sternoclavicle joint formed with the sternum and the joint formed with the scapula’s acromion called acromioclavicular. The clavicle bone allows the shoulder joint to remain attached to the chest bones while moving in circles as shown in Figure 13

Figure 13

Scapula lies posteriorly to the clavicle and is a triangular flat bone that is located laterally to the thoracic spine in the body’s dorsal region. Parker (1989) indicated that the scapula forms two joints, that is the humeroscapular or shoulder joint with the humerus and the acromioclavicular joint with the clavicle. The glenoid cavity is situated on scapula’s lateral end and forms the socket for the shoulder joint that is ball and socket. Several muscles attach the scapula and assist in moving the shoulder as shown in Figure 13 and 14

Figure 14

Parker & Dowell (1988) stated that the humerus is the only bone found in the upper arm. It is a large long bone extending from the scapula of the shoulder to the radius and ulna of the lower arm. The humerus proximal end also referred to as the head is a round structure forming the shoulder joint’s ball and socket. On the distal end of the humerus, it forms a cylindrical wide process that meets the radius and ulna to form the elbow joint’s inner hinge as shown in Figure 13, 14 and 15. The deltoid, pectoral, rotator cuff and latissimus dorsi attach to the humerus to raise, rotate and lower the shoulder joint’s lower arm.

Figure 15

The forearm contains two parallel, long bones: the radius and the ulna. Between the two bones, ulna is the larger and longer residing in the medial side of the forearm. Green (2006) asserted that at the proximal of the ulna, it is widest and considerably narrows to the distal end. Furthermore, at the proximal end of ulna, it forms the elbow joint hinge with the humerus. Olecranon is the ulna’s end and it extends past the humerus forming the elbow’s bony tip. Ulna bone also forms a wrist joint at its distal end with the carpals and the radius as shown in Figure 15 and 16

Figure 16

When comparison is made to the ulna, the radius is slightly thinner, shorter and located at the forearms medial side. The radius bone at the elbow is narrowest and widens as it is extending towards the wrist. The radius rounded head at its proximal end forms the pivoting pint at the joint of the elbow that allows lower arm and hand rotation. Additionally, the radius at its distal end is much wider compared to the ulna and forms the wrist joint bulk with the carpals and the ulna (Parker, 1989). The radius distal end also rates around the ulna wen the forearm and hand rotate as shown in Figure 17

Figure 17

Parker & Dowell (1988) pointed out that despite the hand being such a small body region, it contains 27 tiny bones and many joints that are flexible.

• The carpals are collection of eight bones that are cube shaped roughly in the hand’s proximal end. Together with radius and ulna, they form the wrist joint and also forms joints with the palms metacarpals. Green (2006) asserted that carpals forms many small joints that are gliding with each other to provide extra flexibility to the hand and wrist as shown in Figure 17 and 18
• The five cylindrical, long metacarpals forms the palms supporting bones of the hand. Every metacarpal forms a joint with proximal phalanx of a finger and another joint with the carpals. Parker (1989) indicated that metacarpals have the ability of abducting to spread the palm and fingers apart and can also adduct to bring the palm and the fingers together. Additionally, metacarpals provide flexibility to the hand when touching the thumb, gripping an object and when pinkly fingers together as shown in Figure 16 and 18.
• The phalanges according to Parker & Dowell (1988), are a collection of 14 bones that move and supports the digits. Every digit has three phalanges that is the distal, middle and the proximal, except the thumb which only has the distal phalanx and the proximal phalanx. Green (2006) defined phalanges as long bones forming hinge joints between themselves and also the oval (condyloid) joints with the metacarpals. These joints allows the extension, flexion, abduction and adduction of the digits as shown in Figure 16, 17 and 18

Figure 18

Case study 4: The human Heart anatomy

A brief justification

The heart is a muscular body organ that operates as the circulatory pump of the body. The heart is located posterior to the sternum and medial to the lungs in the thoracic cavity (Boyd, 2003). The heart was chosen for this case study for its significance to the human body’s circulatory system. According to Lapatza et al (1994), the heart takes the deoxygenated blood in through the veins and then deliver it to the lungs where it is oxygenated before pumping it back into different arteries. These arteries provide nutrients and oxygen to the tissues of the body by transporting the oxygenated blood throughout the body.

Perin (1983) indicated that at the superior end of the heart is attached to the pulmonary vein, aorta and vena cava. On the other hand, the apex or the heart’s inferior tip just rests to the superior of the diaphragm. The heart’s base is situated along the midline of the body with its apex pointing to the left side. Therefore, given that the heart points towards the left side, about two-thirds of the mass of the heart is found on the body’s left side and the other one-third is found to the right.

Overview & review of the imaging protocol performed

The heart organ discussed in this case is entirely made of cardiac muscles. Therefore, to different anatomical parts, the images presented in this case study used contrast media where the images were presented in different colours. In all the images of the heart in this case study, the part of the heart that transports the deoxygenated blood are painted in blue colour whereas the sections of the heart that transports the oxygenated blood has been indicated by the red colour. These contrasting colours used in the imaging protocol has been performed to best demonstrate the relevant anatomy to enable answering of the clinical question poised for the case. The images have been presented in coronal plane where anterior and posterior view of the heart has been presented. The major anatomical regions covered on the coronal plane include the major blood vessels of the heart, the chambers and surface features. On the images that shows the internal parts of the heart, anatomical structures include the internal muscles, valves and the vessels

Detailed annotation of all normal anatomy demonstrated on each image

Anterior and posterior view

The anterior and posterior view of the heart shows the organ lying in the coronal plane. The anatomical structures found on the anterior side of the heart are many. This section will annotate some of these anatomical structures of the heart (Boyd, 2003).

The pericardium which is a double walled sac encases the heart and it functions to protect the heart in addition to anchoring it within the chest region. The outer wall of the heart comprises of three layers: pericardium or the outermost wall layer, myocardium or the middle layer which contains the contracting muscles, and the endocardium or the inner layer which is the lining in contact with the blood (Boyd, 2003).

Figure 19

Coronary arteries- These are network of blood vessels that carry nutrient and oxygen rich blood to the cardiac muscle tissue. The heart muscles according to Lapatza et al (1994) is primarily composed of cardiac muscle tissue that contract and relax continuously and therefore must have supply of nutrients and oxygen constantly. The blood that leaves the left ventricle of the heart exits through the aorta, the main artery of the body. The two major coronary arteries known as the right and left coronary arteries emerge near the top of the heart from the beginning of the aorta the left main coronary which is the initial left coronary artery segment branches into two smaller arteries: the left circumflex coronary artery and the left anterior descending coronary artery which is embedded on the hearts front side on the surface. On the other hand, the left circumflex coronary artery is embedded on the hearts surface at the posterior side of the heart and circulates on the hearts left side

Perin (1983) pointed out that the coronary arteries progressively branch into smaller vessels which penetrate the heart muscles. The capillaries, which are the smallest branches are so narrow that only allows the red blood cells to travel only in single file

Superior vena cava- Is one of the major veins that brings de-oxygenated blood to the heart from the body. The veins from the upper body parts and the head feeds into the superior vena cava and then are emptied into the hearts right atrium.

Inferior vena cava- It is one of the major veins that brings de-oxygenated blood to the heart from the body. The veins from the lower torso and the legs feed into the inferior vena cava and then are emptied into the hearts right atrium.

Coronary sinuses– they collect the draining blood from the myocardium.

Aorta- It is the single largest blood vessel in the human body. The vessel carries blood that is rich in oxygen from the left ventricle to different body parts (Boyd, 2003).

Pulmonary artery-It is the vessel that transports de-oxygenated blood to the lungs from the right ventricle

Pulmonary vein– it is the vessel that transport blood that is rich in oxygen from the lungs to the left atrium

Right Atrium– it receives blood that is de-oxygenated from the body from both superior and inferior vena cava. It also allows the collected deoxygenated blood to flow into the right ventricle

Right Ventricle– it receives blood that is deoxygenated from the right atrium as it contracts. Moreover, it pumps the blood towards the lungs through the pulmonary vein

Left atrium– it receives blood that is oxygenated from the lungs through the pulmonary vein. It also passes the oxygenated blood to the left ventricle (Lapatza et al, 1994).

Left ventricle- it receives blood that is oxygenated as the left atrium contracts. The left ventricles contract when it is full with blood allowing the blood to flow throughout the body through aorta. The ventricles (right and left) of the heart are the discharging chambers or the hearts actual pumps. Compare to the atria, the ventricles’ walls are larger and upon contraction, they propel blood into circulation out of the heart. The right ventricle of the heart pumps blood into the pulmonary human trunk, which directs the blood to the lungs for gaseous exchange (Lapatza et al, 1994).

Figure 20

The human heart has four cambers, which is the two inferior ventricles and the two superior atria. The inter-atrial septum is an internal partition dividing the heart longitudinally and the inter-ventricular septum separates the ventricles. Perin (1983) stated that the right ventricle of the heart forms the most of hearts anterior surface whereas the heart apex is formed by the left ventricle.

On the surfaces of the heart, two grooves indicates the heart’s four chambers. The atrioventricular groove also referred to as the coronary sulcus encircles the atria and ventricles junction like the crown. Similarly, the anterior interventriculae sulcus marks the septum anterior position and cradles the anterior interventriculae artery where the left and right ventricles separate. This continues as the posterior interventriculae sulcus, that marks a similar position on the surface of the poseroinferior. Auricles are the only surface feature found on every atrium and it is wrinkled, small appendage (Boyd, 2003).

Internal view of the heart

Internally in the heart, the right atrium of the heart has two basic parts: that is a smooth anterior and posterior portion in which muscle tissue bundles form ridges on the wall. These bundles of muscles are referred to as the pectinate muscles. The anterior and posterior region of the right atrium are separated by crista terminalis, which is a C-shaped ridge. Contrastingly, the left atrium is almost wholly smooth and the auricle is the only region with pectinate muscles additionally, the interatrial septum has a shallow depression referred to as the fossa ovalis, which marks the spot where foramen ovale, an opening, existed in heart of a foetus. This opening closes after birth (Lapatza et al, 1994).

The irregular muscle ridges referred to as the trabeculae carneae mark the ventricular chambers inner walls. Moreover, the papillary muscles which is another bundles of muscles project into the cavity of the ventricles and play a role in function of the valve

Figure 21

Heart valves

The heart has four valves which enforce one way traffic of blood flow. The atrioventricular (AV) valves are two and prevent backflow of blood into the atria chamber when the ventricles pump or contracts. The tricuspid valve or the right AV valve has three cusps which are flexible whereas the mitral valve or the left AV valve or the bicuspid valve has two cusps. Chordae tedineae are collagen chords that are attached to each flap of AV valve, and they help in anchoring the cusps to the papillary muscles. Perin (1983) indicated that the papillary muscles and the chordae tendineae serve anchorage wires to the valve flaps during their closed positions as shown in Figure 22

Figure 22

Semilunar (SL) valves– the pulmonary and aortic semilunar valves guard largest arteries bases that stem from the ventricles and prevent backflow into the respective ventricles. Each valve has crescent moon shaped three cusps. The SL valves open and close due to pressure differences as shown in Figure 23

Figure 23

Case study 5: kidney anatomy

A brief justification

Kidneys are body organs that filters and dispose wastes from the body system. The kidney organ was selected for this case study because about a third of the blood that leaves the blood passes through it for filtration before flowing to the entire tissues of the body. Kidney organs are very vital to the human body to the point that any of them could result to rapid waste accumulation and even death. Kidney are found in pairs and located along the abdominal cavity’s posterior muscular wall. Brenner & Rector (1991) pointed out that the left kidney is slightly located superiorly than the right kidney because of the liver’s larger size on the right hand side of the body. Additionally, it lies behind the peritoneum lining the abdominal cavity. The perirenal fat, an adipose tissue surrounds the kidney organs and act as a padding for protection. Other reasons why kidney was chosen for the case study because of its further significant functions of electrolytes regulation, fluid regulation, acid-base balance and stimulation of production of the red blood cells. Moreover, kidneys serve in regulation of blood pressure through the renin-angiotensin-aldosterone system where it controls water reabsorption and intravascular volume maintenance. Lastly, kidney are very important as an anatomical organ since it reabsorbs amino acids and glucose in addition to having hormonal functions via vitamin D, calcitriol and erythropoietin activation (Resnick & Parker, 1982).

Overview & review of the imaging protocol performed

The selected images used in this case study has been presented in unique imaging protocol so as to bring out the relevant and distinctive anatomical parts of the kidney to enable answering the poised clinical questions presented in the case study. Majorly the images in this case study focused on the internal part of the kidney in sagittal plain and also slightly on the external features of the veins and arteries that connect with the kidneys. The key anatomical regions of the kidney presented in the images include the internal parts such as the kidney pelvis, cortex, blood vessels and tubules. Additionally, the nephron of the kidney and its anatomical structures have been shown. The most notable imaging protocol in the images is the contrasting colours used in the images to indicate different structures of the kidney.

Detailed annotation of all normal anatomy demonstrated on each image

The kidney organs are bean shaped with the concave side located medially and the convex side laterally located. The renal hilus, or the indented concave side of the kidney provides space for the ureter, renal vein and renal artery to enter the kidney as shown in Figure 24

Figure 24

Sagittal plane

The thin fibrous connective tissue layer forms the surrounding renal capsule for every kidney. Graves (1971) stated that the renal capsule of the kidney provides the outer shell that is stiff to maintain the shape of the inner tissues that are soft as shown in Figure 25

Dense, soft vascular renal cortex are found deep in the renal capsule. The renal medulla is formed by seven cone shaped pyramids deep to the renal cortex. These renal pyramids are aligned with their apexes pointing inwardly toward the kidney’s centre, and their bases outwardly facing toward the renal cortex.

Each apex is connected to the minor carylx, which is a small hollow tube collecting urine. Kinne (1989) stated that the minor calyces then merge forming three larger and major calyces that also further merge forming the hollow renal pelvis and the kidney’s centre. The renal hilus, is the section which the renal pelvis exits, where the urine flows into the ureter.

Figure 25

The anatomy for the kidney’s blood supply is a network of both veins and arteries within the kidney organ. The renal arteries directly branching from the abdominal aorta enters into the kidneys via the renal hilus. The renal arteries inside the kidneys then diverge into afferent smaller arterioles of the kidneys. The afferent arterioles are connected to the renal cortex where they carry blood and separates into capillaries bundle referred to as the glomerulus. The blood recollects from the glomerulus into smaller efferent arterioles descending into the renal medulla. The renal tubules are surrounded by the peritubular capillaries which separated from the efferent arterioles. The peritubular capillaries merges to form veins which also further merge forming the larger renal vein, which exist the kidney and joining the inferior vena cava (Brenner & Rector, 1991).

The nephron

These are microscopic functional units of the kidney that filters blood to produce urine as waste. There are two main parts of the nephron: renal tubule and the renal corpuscle. The renal corpuscle is responsible for blood filtration and is formed by the glomerulus capillaries and the glomerular capsule or the Bowman’s capsule. Resnick & Parker (1982) indicated that the glomerulus is a bundled capillaries network that increases the blood surface area that is in contact with the walls of blood vessels. Glomerular capsule, which is a cup-shaped simple squamous epithelium which is double layered with a hollow space in between the layers, surrounds glomerulus. Podocytes which are special epithelial cells form glomerular capsule layer surrounding glomerulus capillaries. Podocytes work in conjunction with the capillaries’ endothelium to form a thin filter that separates urine from the blood that passes through the glomerulus. The glomerular capsule’s outer layer holds the separated urine from the blood within the capsule. Graves (1971) pointed out that at the glomerular capsule’s far end, opposite the glomerulus, is the renal tubule mouth

Series of tubes known as the renal tubule recover solutes that are non-waste from urine by concentrating urine. The renal tubule of the nephron carries urine to the renal pelvis from the glomerular capsule as shown in Figure 26

Figure 26

Case study 6: Liver anatomy

A brief justification

Liver organ is the second largest body organ and weighs about three pounds after the skin. The liver was selected for the case study because it performs several essential functions that are related to metabolism, digestion, storage of nutrients and immunity within the body hence making it a vital organ. These functions of the liver make it important without which the human body will die because of lack of nutrients and energy (Ryū, & Cho, 2009).

Overview & review of the imaging protocol performed

The three images used in this case study of the liver has applied contrast media to clearly show both external and internal anatomical structure of the liver. Clear presentation of the images has been done best demonstrate the relevant anatomy to enable answering of the clinical question poised for the case. The images presented the liver in the frontal plane which showed the anterior and posterior parts. Moreover, internal anatomical structure have also been shown. Some of the anatomical regions shown include the blood vessels, the four lobes, and the bile ducts among other minor anatomical regions

Detailed annotation of all normal anatomy demonstrated on each image

Frontal plane

The liver organ is grossly triangular extending across the whole abdominal cavity below the diaphragm. The liver is made of pinkish-brown very soft tissues that are encapsulated by a capsule of the connective tissue. The capsule is further reinforced and covered by the abdominal cavity’s peritoneum, which hold it in place and protects it within the abdomen (Gadžijev & Ravnik, 1996).

The peritoneum of the abdominal cavity connects the liver organ into four locations: the right and left triangular ligaments, coronary ligament and the falciform ligament. Self (2009) stated that the connections are not true or normal ligaments anatomically but are just peritoneal membrane regions that are condensed that supports the liver.

The liver is made up of four different and distinct lobes: quadrate, caudate, right and left lobes. The right and the left lobes are the largest and are separated by the falciform ligament. The caudate lobe that is small extends posteriorly of the right lobe wrapping around the inferior vena cava. Moreover, the quadrate lobe which is also small is inferior to the caudate lobe, extending posteriorly to the right lobe and wrapping around the gall bladder as shown in Figure 27

Figure 27

The bile ducts

These are tubes which carry bile through the gallbladder and liver and they form a biliary tree, which is a branched structure. Bile canaliculi are microscopic canals that join together to form many bile ducts, which also join together to form larger right and left hepatic ducts. These two hepatic ducts also join and form common hepatic duct which drains all the bile from the liver. Glisson et al (1994) pointed out that the common hepatic duct eventually joins the cystic duct which is from the gall bladder forming the common bile duct as shown in Figure 28.

Blood vessels

Because of the hepatic portal system, blood collected in the hepatic portal vein from the capillaries of the pancreas, stomach and spleen is delivered to the liver tissues where its contents are subdivided into smaller vessels and then processed before passing to the entire body. The blood that leaves the liver tissues collects in the hepatic veins leading to the vena cava and then heart. Additionally, the liver organ has its own arteries and arterioles system which provide its tissues with the oxygenated blood (Ryū & Cho, 2009).

Figure 28

Lobules

These are small hexagonal functional units found in the livers internal structure. Each lobule comprises of the central vein that is surrounded by six hepatic arteries and six hepatic portal veins. Sinusoids are capillary like tubes that connect these blood vessels, and extends from the arteries and portal veins to meet the central vein (Gadžijev & Ravnik, 1996).

Figure 29

Case study 7: stomach anatomy

A brief justification

In the human body, stomach is the main storage tank of food. The stomach organ was chosen as a case study because of its significance to the body and the digestion system. Were it not for the storage capacity of the tank, then human beings would have to constantly eat. The stomach is also important in that it secretes digestive enzymes, mucus and mixture of acid that helps in the sanitization and digestion of the food while still in the stomach (Templeton, 1964)

Overview & review of the imaging protocol performed

Different images has been presented for this case study to better illustrate the anatomy of the stomach. First, contrast media has been applied to better bring out the frontal plane of the stomach’s different regions. Moreover, other images have used colours in the 3-D images to better elaborate on the layers of the stomach organ. Different anatomical regions has been shown in the diagrams and labelled in the images that are in the frontal plane. Some of the major anatomical regions presented include the fundus, cardia, body, and pylorus. Internally, the major anatomical regions include the rugae of mucosa, the pyloric canal, serosa and muscularis.

Detailed annotation of all normal anatomy demonstrated on each image

Anterior view

Stomach organ is rounded and hollow and is located inferior to the diaphragm to the abdominal cavity’s left part. The stomach is located between the duodenum and oesophagus and is roughly crescent shaped gastrointestinal tract enlargement as shown in Figure 30.

Figure 30

The stomach’s inner layer has many wrinkles known as gastric folds or rugae which allows the stomach the stomach to expand and stretch so as to accommodate large meals in addition to helping in gripping and moving food during the process of digestion (Agur et al, 1999).

Based on function and shape, the stomach organ can be classified into four regions according to Wolf-Heidegger & Köpf-Maier (2006) as shown in Figure 30 above:

1. The oesophagus that connects to the stomach at cardia, which is tube-like narrow region opening up into wider regions of the stomach. Lower Oesophageal sphincter located within the cardia, is a bundle of muscle tissue contracting to hold acid and food inside of the stomach.
2. The body of the stomach connects with the cardia and it forms the largest and central region of the stomach
3. Fundus is superior to the body and has a shape of dome
4. Pylorus is a funnel shaped region and is inferior to the body. The pylorus connects duodenum to the stomach and also contains the pyloric sphincter which controls the flow of chime or partially digested food out of the stomach to the duodenum.

Microscopic view of the stomach

Microscopic imaging of the stomach organ structures shows that it is made of multiple, distinct tissue layers: serosa, muscularis, sub-mucosa and mucosa layers as shown in Figure 31

Figure 31

The mucosa is the stomach’s innermost layer made up of the mucous membrane. The stomach’s mucous membrane has simple columnar epithelium tissue with several exocrine cells. Muscularis mucosae is a thin layer of smooth muscle found deep inside the mucosa. The muscularis mucosae layer permits mucosa to form folds and also to increase its contact with the contents of the stomach (Templeton, 1964).

Sub-mucosa layer of the stomach surrounds the mucosa and is made up of different blood vessels, connective tissues, and nerves. The connective tissues of the submucosa supports the mucosa tissues and also connects it to the muscularis layer. Additionally, the supply of blood of the submucosa provides the stomach wall some nutrients (Agur et al, 1999).

The stomach’s muscularis layer surrounds the submucosa and forms the large amount of the mass of the stomach. Wolf-Heidegger & Köpf-Maier (2006) pointed out that the muscularis is made up of three smooth muscle tissue layers arranged with its fibres running in three different directions. These smooth muscle layers allow the stomach to contract, mix and move the food through the digestive tract.

Serosa is the stomach’s outermost layer surrounding the muscularis layer. Templeton (1964) defined serosa as a thin serous membrane that is made up of areolar connective tissue and the simple squamous epithelial tissue. Serosa has a slippery, smooth surface and secrets the serous fluid. The wet, smooth surface of serosa helps in protecting the stomach from friction wen the stomach is expanding with the food and also moves to churn and mix and propel the chime

Figure 32

Case study 8: Muscles of the arm and the Hand

A brief justification

The muscles found on the hand and the arm is designed specifically to meet the diverse needs of the body speed, strength and precision while completing several complex daily duties. This case study choose muscles of the arms and the hand because daily activities such as lifting heavy load such as the boxes and other weights requires arm muscles brute strength. Similarly, typing, paining and writing all require precision and speed from the same arm and hand muscles (Liberace, Lubkin, & Liberace Studio (Firm), 2013).

Overview & review of the imaging protocol performed

The imaging protocol performed in case study six varies depending on the image. Some of the imaging techniques applied in the images of this case study include use of the contrast colour images, line diagrams and CT scans that provided computerised images. all these techniques used in the imaging protocol has been applied to bring out the relevant anatomical regions in the arm and the hand body parts to enable answering of the clinical questions for the case study six. The images provided clear and distinct anatomical regions of the arm and the hand such as the upper arm muscles, shoulder muscles, forearm muscles and hand muscles that are relevant for the case. Moreover, the images are presented in different anatomical planes such as the frontal, and sagittal planes. Similarly, the images of the forearm have been presented in both posterior and anterior views to get better view of the inner muscles located in the arm and the forearm. However, these images as much as some of them were coloured, they lacked contrast colours to better distinguish specific muscles in a muscle group. For instance, in the triceps branchii, the image needs contrast media to distinguish individual muscles that comprise triceps branchi for clearer view.

Detailed annotation of all normal anatomy demonstrated on each image

The arm in human anatomy is the upper limb comprising of the body regions between the elbow joint and the glunohumeral joint (Chung & Steinbach, 2010). However, the arm is commonly used to refer to the arm and also the hand. The arm and the hand comprises of the upper arm, the forearm and the hand. Doyle & Botte (2003) indicated that anatomically, shoulder girdle is considered part of the arm. The muscles of the arm and hand are divided into anterior and posterior components. Moreover, other muscles also considered to be part of the arm include the deltoid muscle which has part of itself in the anterior compartment if the arm. The deltoid muscles extends over the shoulder is the major abductor muscle found in the upper limb. Another muscle is the branchioradialits muscle which originates from the arm and insert into the forearm. This muscle is responsible for supination or the rotation of the hand so that the palm can face forward as shown in Figure 33

Figure 33

The upper arm muscles are responsible for the extension and flexion of the forearm at the elbow joint. Liberace, Lubkin & Liberace Studio, (2013) indicated that forearm flexion is achieved by a three muscle group: the branchioradialis, biceps branchii and the branchialis. These flexor muscles are found on the upper arm anterior side and extend from the scapula and humerus to the radius and ulna of the forearm. In addition, the biceps branchii functions as forearm supinator by moving the palm of the hand and rotating the radius anteriorly as shown in Figure 34. The triceps branchi are located on the posterior side of the upper arm and it acts as the forearm extensor at the shoulder humerus and the elbow. As the name indicates, biceps branchii has three heads which originates from the scapula and the humerus. The three heads then merge and insert on the ulna’s olecranon as shown in Figure 34.

Figure 34

Chung & Steinbach (2010) pointed out that most of the muscles moving the fingers, hand and wrist are located on the forearm. These strap-like, thin muscles extend from the radius, ulna and humerus and insert into the carpals, phalanges and the metacarpals via long tendons as sown in Figure 35. The muscles located on forearm anterior side such as the flexor digitorum superficialis and the flexor carp radialis, forms the groups of flexor that flexes the hand as the wrists joints and each and every phalanges. Doyle & Botte (2003) indicated that the tendons of these muscles goes through a small corridor found in the wrist referred to as the carpal tunnels as shown in Figure 35

Figure 35

The extensor muscles on the posterior side of the arm such as the extensor digitorum, extensor carpi act as the antagonists to the flexor muscles found on the anterior side of the arm by extending the fingers and the hand. The extensor muscles run as thin, long straps from the humerus to the metacarpals and the phalanges as shown in Figure 36. Generally, extensors are somewhat weaker compared to the flexor muscles that they antagonize, because of the ease in opening a hand than gripping something firmly (Liberace, Lubkin & Liberace Studio, 2013).

Figure 36

Case study 9: Muscles of the leg and the Foot

A brief justification

Propelling, balancing and supporting of the human body is the work of the leg and foot’s muscular system. From the string and large muscles of the legs and buttocks to the fine, tiny muscles of the toes and feet, these muscles has the ability of exerting tremendous power while making small adjustments constantly for balance. This anatomical region of the human body was chosen for the case study because of the leg and foot muscles’ importance for the human movement and daily functions. It is the presence of the legs that human beings are able to be mobile and explore the environment for its own survival (Behnke & Donnelly, 2001).

Overview & review of the imaging protocol performed

The images of muscles of the leg and the foot of this case study has been presented in frontal anatomical plane. Moreover, different anatomical directions has been applied in the imaging of the case study leg muscles such as the frontal, lateral, posterior and superior anatomical directions. The anatomical structures of the muscles of the leg has been labelled in the diagrams for easier comprehension. Major anatomical structures identified include the quadriceps, hamstrings, soleus, gluteus muscle, Achilles tendon and the gastrocnemius. A contrast media particularly of colored imaging was also helpful especially in bringing out different anatomical parts in the muscles of the leg.

Detailed annotation of all normal anatomy demonstrated on each image

Anterior view and Posterior view

The anterior muscles of the leg such as the iliopsoas, quadriceps femoris and Sartorius function as a group to flex the hip thigh and also extend the knee as the knee joint. The posterior muscles such as the gluteus Maximus and hamstrings produce the opposite motion to the anterior muscles. That is thigh extension at the hip joint and leg flexion at the knee joint. The lateral muscles like the gluteus medius abduct the thigh region at the hip joint while the muscles of the medial groin adduct the thigh. These leg muscles elaborated provide powerful contractions to make the body move and also make fine adjustments for maintenance of the body posture and balance (Draves & Zelichowski, 1986).

Figure 37

On the lower part of the leg and the foot, there are a number of muscles that are located inferiorly to the leg and move the toes, foot and ankle. The muscles of the calf including soleus and gastrocnemius join and form the Achilles (calcaneal) tendon to the heel and also attach to the heel’s calcaneus bone. Shin muscles such as the extensor digitorium longus and tibialis anterior extends the toes and dorsiflex the foot. Additionally, the calf muscles subtly work to stabilize the foot and ankle joint so as to maintain the body balance (Gresczyk, 1967).

Figure 38

The largest leg muscles are present in the calf and thigh.

Quadriceps

Are the leanest and the strongest muscles in the body (MacConaill & Basmajian, 1969).quadriceps which is located on the front of the thigh is made up of four muscles and are the major knee extensors. They include:

• Vastus lateralis: it is the largest among the quadriceps and is located outside the thigh. In addition, it extends to the kneecap from the top of the femur.
• Vastus medialis-it is a muscle of the inner thigh that is tear dropped shaped and it attaches along the femur bone to the kneecap’s inner border
• Vastus intermedius– it is the deepest among the quadriceps and it lies between vastus lateralis and vastus medailis
• Rectus femoris– this muscle amongst the quadriceps it has the least effect on knee flexing and it attaches to the kneecap (Parker, 2004).

Figure 39

Hamstrings

These are the three muscles located at the back of the thigh and affect the movement of the knee and hip. They originate under the gluteus Maximus and attach to the knee to the tibia. They include:

• Biceps femoris– it is a long muscle that flexes the knee. It starts in the thigh area extending to the fibula head near the knee. It originates from ischium and back of femur. These fibres from two origins then joins and get attached to the head of tibia and fibula.
• Semitendinosus- it flexes the knee and extends the thigh
• Semimembranosus– this is a long muscle extending to the tibia from the pelvis. It flexes the knee, extends the thigh and helps in the rotation of the tibia (Behnke & Donnelly, 2001).

The muscles of the calf are significant to the toes, foot and ankle movement. Some of the major calf muscles include:

• Gastrocnemius (calf muscle) – it is one of the leg’s largest muscles connecting to the heel. It extends and flexes the foot, knee and ankle. This muscle originates from the back of femur and patella and join soleus and then get attached to the Achilles tendon at the heel
• Soleus– this muscle extends to the heel from the back of the knee. It is important in standing and walking
• Plantaris– the function of this thin, small muscle is superseded by the gastrocnemius muscles (Draves & Zelichowski, 1986).

Achilles tendon is the most important tendon found in the leg in terms of mobility. This tendon is located at the back of ankle and calf and connects the soleus, gastrocnemius and plantaris muscles to the heel bone (Gresczyk, 1967).

Figure 40

Adductor– are also referred to as the inner thigh muscles and they draw the body towards the median line. In the human thighs, there are three adductor muscles that are powerful and they include adductor longus, adductor Magnus and adductor brevis. These ribbon like muscles originate from the ischium and pubis which the pelvis lower portions and attach to the femur. Adductors muscles squeeze the thigh together and aid in flexion and rotation of the thigh (MacConaill & Basmajian, 1969).

Tibialis anterior– is a muscle strip that makes up the shin and assist in flexing the ankle to move the foot towards the knee.

Sartorius muscle-is ribbon like, narrow and long thigh muscle that begins at the pelvic girdle’s crest and obliquely extend down the front side and insert to the upper and inner portion of the tibia. It flexes the leg and thigh at the knee and outward femur rotation (Parker, 2004).

Figure 41

Gluteus muscle– it is the fleshy, large buttocks muscles that stretch from the pelvic girdle back portion down to the greater trochanter, which is the bony protuberance on femurs top. The gluteus muscle consists of three muscles which include:

• Gluteus maximus –is the thick, wide and large muscle at the buttocks surface originating at the ilium and the positions of the coccyx and sacrum. Its major functions is thigh extension such as climbing, running and arising from the sitting position. Moreover, it rotates the thigh outward (Behnke & Donnelly, 2001).
• Gluteus medius-is directly located under the gluteus Maximus and originates at the back of the ilium and stretches downward to the femur’s greater trochanter.
• Glueteus minimus– is located under the gluteus medius and also begin at the ilium and get attached to the femur. Gluteus minimus and gluteus medius abduct the thigh that is laterally pull away from the body’s midline. Additionally, they help in rotating inward the thigh (Draves & Zelichowski, 1986).

Case study 10: muscles of the hip

A brief justification

The human hip joint is one of the joints that is most flexible n the whole human body. The many hip muscles provide stability, strength and movement to the bones of the thigh and hip and the joint itself. These hip muscles can be categorised based upon their function and location. The hip muscles were chosen for this case study because the hip is the major joint that bears weight. Bearing of the body weight stress the hip when walking, running or jumping or even at rest. These large and strong hip muscles which move and support the hip is the major focus for this case study (Brungardt et al, 2006).

Overview & review of the imaging protocol performed

The imaging protocol used in this study varied to give a clear view of different anatomical planes, labels and directions of the hip muscles. First, the images has been taken from different views which included anterior and posterior view of the hip muscles at the thigh region. The views of the images in this case study were also taken at different angles sequentially in anterior oblique positions. The images of this case study also indicate that the subjects were standing in erect positions. The images are presented in different anatomical planes such as sagittal and frontal planes. The anatomical regions of the images are labelled clearly in each image for distinction. Contrast media were also used in the images to help in distinguishing key anatomical structures pertinent to each individual anatomical region of the hip muscles. Some of the anatomical regions identified has been grouped into four major muscles groups which include: the posterior group, anterior group, abductor group and adductor group

Detailed annotation of all normal anatomy demonstrated on each image

The muscles of the lower back and thigh work together in keeping the hip joint stable, moving and aligned. The muscles of the hip are divided into four distinct groups based on their location. The four categories include the posterior group, anterior group, abductor group and adductor group.

Frontal plane

The anterior group of muscles features the muscles which flex the thigh at the hip joint.these anterior group of muscles include:

• The quadriceps femoris group consisting of the vastus intermedius, rectus femoris, vastus medialis, vastus lateralis
• The iliopsoas group consisting of the iliacus muscles and psoas major (Dimon & Qualter, 2008).

The posterior muscle group comprises of the muscles which extend the thigh at the hip joint. The posterior muscles groups include gluteus maximus and the hamstring group which comprises of semimimebranosus, biceps femoris and the semitendinosus muscle (Muscolino, 2010) as shown in Figure 42.

Figure 42

Sagittal plane

The groin muscles of the adductor muscle group is located at the thigh’s medial side. The adductor muscles move the thigh towards the midline of the body. The adductor group of muscles consists of the adductor longus, adductor magnus, addutctor brevis, gracilis muscles and pectineus (Wilson, 1992) as shown in Figure 43

Figure 43

The abductor muscle group of the hip is located on the thigh’s lateral side and moves the thigh away from the midline of the body. These muscles include the superior gemellus, piriformis, tensor fasciae latae, inferior gemellus, gluteus medius, Sartorius and gluteus minimus muscle Brungardt et al (2006) as shown in Figure 44

Figure 44

Conclusion

In conclusion, the paper discussed ten case studies about normal anatomy of different body regions. Each case study was discussed individually where the major focus for each case study being brief justification, review and overview of the imaging protocol and image annotations. The case studies used in the paper include the skull, thoracic cage, arm skeleton, human heart, kidney anatomy, liver anatomy, stomach, muscles of the arm and hand, muscles of the leg and foot, and finally muscles of the hip

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Herman Bailey

With a student-centered approach, I create engaging and informative blog posts that tackle relevant topics for students. My content aims to equip students with the knowledge and tools they need to succeed academically and beyond.