Three dimensional reconstruction of anatomical structures from the Visible Human dataset will be used in conjunction with other media to illustrate complex areas and relationships not easily realized by  conventional anatomical approaches. We  are developing tutorials that illustrate anatomical concepts that benefit  from the three-dimensional views provided by reconstruction of the Visible Human data. For example,  segmentation of the pelvic viscera from the Visible Human data is relatively straightforward; images can be acquired without serious anatomical expertise. On the other hand, segmentation of the pelvic muscles is more complex and requires considerable experience with the anatomy of this region.  Similarly, anatomy students can easily dissect and view the pelvic viscera but the pelvic muscles are difficult to dissect and their three dimensional relationships to other anatomical structures are difficult to visualize. In an effort to develop application driven segmentation and reconstruction of the Visual Human rather than random visualizations, we have focused initially on the Pelvis and Perineal regions.  These anatomical regions prove to be extremely difficult for first year medical students to understand and currently available anatomical models do not provide sufficient detail, nor are they designed for interactive approaches. Medical students thus find this portion of human anatomy particularly frustrating and often come away with only a minimal understanding of the urogenital structures and their three dimensional relationships.  Since reproductive health, obstetrics and health problems of associated pelvic structures constitute a high proportion of visits to the physician each year, development of learning tools that will provide a clearer three dimensional view of these anatomical regions is essential.

        Relationships between pelvic structures are most clearly viewed by using three-dimensional models in conjunction with dissection, textbook illustrations and skeletal models. However, conventional anatomical dissection by necessity destroys or removes clinically relevant structures. In addition, because of the compact nature of the perineal/urogenital region, anatomical features are difficult to find in cadavers.  This difficulty is compounded by anatomical atlas illustrations that are misleading because they portray structures to be far more robust than they are in reality. We are developing a Pelvic Anatomy Lesson that focuses on the use of an interactive format allowing the student to view and build the pelvic anatomy from the "Inside-Out".  This will complement standard gross anatomical laboratory dissections that generally approach this region from the "Outside-In" and provide a view of the pelvic anatomy from different perspectives and support different learning-styles.   These interactive tutorials will allow the student to add components of pelvic region to the bony skeleton.  We have begun by illustrating the muscles of the pelvic walls and pelvic diaphragm.  Next, the individual layers of the superficial and deep perineal pouches will be added.  Ultimately, the pelvic viscera will be combined with the other structures to generate a complete three dimensional pelvis. In this way students can add components one at a time and examine their relationships.   Alternatively, the student can begin with all structures in place and remove them as in conventional dissection and view them from the "outside-in".   By using 3D images generated from the Visible Human data for these tutorials, the student will be better able to relate the structures to those observed in cadaveric specimens in the anatomy laboratory.