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Adult Cadavers (adult + cadaver)
Selected AbstractsFacial Soft Tissue Thicknesses in Australian Adult Cadavers,JOURNAL OF FORENSIC SCIENCES, Issue 1 2006Monica Domaracki B.Sc. ABSTRACT: Craniofacial identification methods heavily rely on the knowledge of average soft tissue depths. This study measured soft tissue thicknesses of an Australian cadaver sample (N=33) using published needle puncture techniques at 13 anatomical locations. Data were compared and contrasted with other studies that used essentially identical samples and methods. Full descriptive statistics were calculated for measurements made in this study and means, medians, and modes were reported. Differences between mean values for males and females were found to be minimal (2.2 mm or less) and considerable overlap was found between the groups. There were no statistically significant differences between the soft tissue depths of the sexes (P>0.05). These findings indicate that differences between male and female soft tissue depths are of little practical significance for craniofacial identification and, therefore, data (means, standard deviations, and sample sizes) reported for Australians were pooled across the sexes and the studies. Although these new pooled means have increased statistical power, data distributions at some landmarks were skewed and thus emphasis is placed on median and modes reported for this study rather than upon the collapsed data means. [source] Vertebral artery atherosclerosis: a risk factor in the use of manipulative therapy?PHYSIOTHERAPY RESEARCH INTERNATIONAL, Issue 3 2002Jeanette Mitchell BSc (Physiotherapy), MSc Senior Lecturer Abstract Background and Purpose Vertebrobasilar insufficiency, a direct result of compromised blood flow in the vertebrobasilar circulation, may be caused by stretching and/or compression of the vertebral arteries, particularly if superimposed on underlying atherosclerosis of the vessels. This is an important consideration when using manipulative therapy techniques. The aim of the present study was to investigate the incidence of atherosclerosis and to calculate the relative associated decrease in blood flow in the third and fourth parts of the vertebral artery, in a sample of the adult population. Method A laboratory-based experimental investigation was used to study 362 vertebral arteries from embalmed adult cadavers that were routinely processed for light microscopic study. The incidence of each grade of atherosclerosis in the vessels was recorded. Atherosclerosis was classified as grades 0,5, where Grade 0 represented no atherosclerosis and Grade 5 a fully developed plaque occluding more than 75% of the vessel lumen. From mean measurements of 188 of these arteries, the estimated decrease in luminal cross-sectional area and the relative decrease in blood flow in the atherosclerotic vessels were calculated. Results The highest incidence of atherosclerosis found was Grade 3 (third part of the vertebral artery (VA3): 42.0%; fourth part of the vertebral artery (VA4): 35.2%). An estimated decrease in artery luminal cross-sectional area to 6.2% of normal in Grade 5 atherosclerosis was found. Because blood flow is proportional to the fourth power of the vessel radius, relative decreases in blood flow in grades 1,5 atherosclerosis from 100% to 0% (with critical closing pressure in vessels), respectively, are likely to occur. Conclusions These data suggest that, as significant numbers of the sample showed marked (Grade 3+) atherosclerosis, concomitant with decreased blood flow in the vertebral arteries, this population is at risk for developing vertebrobasilar insufficiency. Because other Western populations may be similarly at risk, particular care should be taken when considering the use of rotational manipulative therapy techniques in treatments of the cervical spine. Copyright © 2002 Whurr Publishers Ltd. [source] Microsurgical Anatomy of the Laryngeal Nerves as Related to Thyroid SurgeryTHE LARYNGOSCOPE, Issue 2 2002Ashkan Monfared BS Abstract Objectives The objectives were to explore microsurgical anatomy of the superior and recurrent laryngeal nerves and their importance in thyroid surgery, and to examine areas of potential morbidity, means of identification, and arterial supply of the laryngeal nerves. Study Design Descriptive analysis of anatomical features. Methods Twenty-one adult cadavers, some perfused with colored silicon, were dissected for the study project. Results The right recurrent laryngeal nerve (RLN) branches off the vagus at the level of the subclavian artery and the left one at the level of the aorta. Both ascend parallel to the tracheoesophageal groove and innervate trachea, esophagus, and the inferior pharyngeal constrictors en route. The RLN has the highest probability to pass between the branches of the inferior thyroid artery on the right side and posterior to them on the left side. The RLN always passes posterior to the cricothyroid joint. The RLN is supplied by the branches of the inferior thyroid artery. The superior laryngeal nerve (SLN) branches into internal and external branches deep to the carotid bifurcation. The internal branch passes deep to the superior thyroid artery and descends toward thyrohyoid membrane. The external branch travels deep and parallel to the superior thyroid artery to innervate cricothyroid muscle. The internal branch is supplied by the superior laryngeal artery, and the external branch by the cricothyroid artery. Conclusions The only consistent location of the RLN is when it passes posterior to the cricothyroid joint. Because of extreme variability of the inferior thyroid artery and the RLN, it is suggested that the artery be ligated either proximally or at its tertiary branches on thyroid capsule. The internal branch of the SLN is not potentially at risk during thyroidectomy unless the superior thyroid artery is ligated proximally. The external branch of the SLN accompanies the superior thyroid artery for most of its course and is at potential risk if the trunk of the superior thyroid artery is ligated outside the pretracheal fascia. [source] Protective mechanisms of the common fibular nerve in and around the fibular tunnel: A new conceptCLINICAL ANATOMY, Issue 6 2009Ramadan M. El Gharbawy Abstract The most frequent site at which the common fibular nerve is affected by compression, trauma, traction, masses, and surgery is within and around the fibular tunnel. The aim of this study was to determine whether there were protective mechanisms at this site that guard against compression of the nerve. Twenty-six lower limbs of 13 preserved adult cadavers (11 males and two females) were used. Proximal to the entrance of the tunnel, three anatomical configurations seemed to afford the required protection for the nerve: reinforcement of the deep fascia; tethering of the common fibular nerve to both the tendon of the biceps femoris and the reinforced fascia; and the particular arrangement of the deep fascia, fibular head, and soleus and gastrocnemius muscles. At the entrance of the tunnel, contraction of the first segment of fibularis longus muscle could afford the required protection. In the tunnel, contraction of the second and third segments of fibularis longus muscle could guard against compression of the nerve. The tough fascia on the surface of fibularis longus muscle and the fascial band within it, which have long been accused of compression of the nerve, may actually be elements of the protective mechanisms. We conclude that there are innate, anatomical protective mechanisms which should be taken into consideration when decompressing the common fibular nerve. To preserve these mechanisms whenever possible, the technique should be planned and varied according to the underlying etiology. Clin. Anat. 22:738,746, 2009. © 2009 Wiley-Liss, Inc. [source] Arterial anatomy of the hallucal sesamoidsCLINICAL ANATOMY, Issue 6 2009Bjoern Rath Abstract The aim of this study was to analyze the arterial supply of the sesamoid bones of the hallux. Twenty-two feet from adult cadavers were injected with epoxide resin or an acrylic polymer in methyl methacrylate (Acrifix®) and subsequently processed by two slice plastination methods and the enzyme maceration technique. Afterwards, the arterial supply of the sesamoid bones was studied. The first plantar metatarsal artery provided a medial branch to the medial sesamoid bone. The main branch of the first plantar metatarsal artery continued its course distally along the lateral side of the lateral sesamoid and supplied it. The supplying arteries penetrated the sesamoid bones on the proximal, plantar, and distal sides. The analysis and cataloging of the microvascular anatomy of the sesamoids revealed the first plantar metatarsal artery as the main arterial source to the medial and lateral sesamoid bones. In addition, the first plantar metatarsal artery ran along the lateral plantar side of the lateral sesamoid bone, suggesting that this artery is at increased risk during soft-tissue procedures such as hallux valgus surgery. Clin. Anat. 22:755,760, 2009. © 2009 Wiley-Liss, Inc. [source] The applied anatomy of anterior approach for minimally invasive hip joint surgeryCLINICAL ANATOMY, Issue 2 2009Li Hua Chen Abstract The anterior approach for minimally invasive hip joint surgery is one of the common approaches utilized in hip joint surgery. Here, we report the results of dissections in 60 sides of human adult cadavers. We observed and measured the branches of the superficial circumflex iliac artery, the lateral femoral cutaneous nerves, the lateral circumflex femoral artery, and the superior gluteal nerves in the experiment via the anterior approach for minimally invasive hip joint surgery. The relationship between these structures and the anterior approach was studied. The present study provides important data demonstrating the location, path of dominant structures that might be encountered during the surgery and their relationships with the surgical incision. These data may allow surgeons performing the anterior approach for hip joint surgery to minimize the risk of neurovascular injury. Clin. Anat. 22:250,255, 2009. © 2008 Wiley-Liss, Inc. [source] Anatomical considerations of the deep peroneal nerve for biopsy of the proximal fibula in ThaisCLINICAL ANATOMY, Issue 2 2009S. Chompoopong Abstract The present research aims to study the anatomical relationship between the deep peroneal nerve and the neighboring structures in the proximal fibula of Thais, with special regard to define the boundaries of a "safe" area when performing a biopsy of the proximal fibula. The proximal parts of 118 legs of 59 formalin-embalmed adult cadavers (31 males, 28 females) were investigated. The distance from the apex of the fibular head to the point of origin of the deep peroneal nerve, the distance from the most lateral prominence of the fibular head to the anterior intermuscular septum, and the angle between the deep peroneal nerve and the fibula axis were measured. The results showed that the mean distances from the apex of the fibular head to the point of origin of the deep peroneal nerve was 28.4 ± 4.8 mm and from the most lateral prominence of the fibular head to the anterior intermuscular septum was 14.9 ± 2.0 mm. The mean angle between the deep peroneal nerve and the fibular axis was 28.1° ± 7.2°. In conclusion, these findings suggest that a "safe" area for bone biopsy in the proximal fibula of Thais is palpable anterior to the fibular head and downward laterally, not lower than 28 mm or 8% of the fibular length and from the most lateral prominence transverse medially not further than 14 mm. The inferior boundary of this area is an oblique line of the deep peroneal nerve about 28° from the fibular axis. Clin. Anat. 22:256,260, 2009. © 2008 Wiley-Liss, Inc. [source] A portrait of Aristotle as an anatomist: Historical articleCLINICAL ANATOMY, Issue 5 2007Enrico Crivellato Abstract Aristotle is principally known as a theoretical philosopher and logician but he was also an eminent natural scientist. In particular, he should be considered probably the first anatomist in the modern sense of this term and the originator of anatomy as a special branch of knowledge. Although it seems certain that he did not perform dissections of human adult cadavers, he examined human fetal material and, above all, made systematic analysis of animal bodies. His contribution to comparative anatomy, as well as to human anatomy, was enormous. He founded the anatomical discipline on precise descriptive and scientific ground. He also coined a series of technical terms, which are still in use in the modern nomenclature. His observational skill was astounding. Although many of his physiological concepts turned out to be wrong, still his structural description of organs and body parts was often first-rank. The present study will chiefly focus on Aristotle's anatomical work and will provide only essential mention of his complex physiological and philosophical doctrine. The main purpose of this article is indeed to offer to today's anatomists a systematic account of the extraordinary achievements of this great pioneer of our discipline. Clin. Anat. 20:477,485, 2007. © 2006 Wiley-Liss, Inc. [source] The oblique cord of the forearm in manCLINICAL ANATOMY, Issue 4 2007R. Shane Tubbs Abstract There is minimal and often conflicting data in the literature regarding the oblique cord of the forearm. The current study seeks to elucidate further the anatomy of this structure of the upper extremity. In adult cadavers, the oblique cord was observed for and, when found, measurements were made of it. Ranges of motion were carried out while observation of the oblique cord was made. An oblique cord was found on 52.6% of sides. Gantzer's muscle was found on 55% of sides and, when present, had attachment into the oblique cord on five sides. The oblique cord was present on 13 sides with a Gantzer's muscle. Of the 20 sides with an oblique cord, no Gantzer's muscle was found on 10. The mean length of the oblique cord was 3.4 cm. In the majority of specimens, this cord tapered from proximal to distal. The proximal, middle, and distal widths of this structure had means 9, 7, and 4 mm, respectively. The oblique cord was found to travel ,45 degrees from a line drawn through the ulna and more or less traveled perpendicular to the insertion site of the bicipital tendon. This ligament was lax in the neutral position and with pronation became lax in all specimens. The oblique cord progressively became taut with increased supination from the neutral position and was maximally taut with the forearm fully supinated. Tautness of this cord was also found with distal distraction of the radius. Following the transection of the oblique cord, no discernable difference was observed in regard to maximal supination of the forearm or distal distraction of the radius. No obvious instability of the proximal forearm was found following transection of the oblique cord. Functionally, although the oblique cord may resist supination, it is unlikely that this structure affords significant stability to the proximal forearm, as it was often absent, of a very small caliber, and based on our observations, following its transection, the amount of supination of the forearm did not increase. Moreover, one would expect that this structure would never resist supination alone, as the larger overlying muscles would become taut prior to calling upon the action of this cord. Based on our findings, the function of the oblique cord appears insignificant in providing significant stability to the proximal forearm; however, further investigative studies are now necessary to confirm these data. Clin. Anat. 20:411,415, 2007. © 2006 Wiley-Liss, Inc. [source] Deep fascia on the dorsum of the ankle and foot: Extensor retinacula revisitedCLINICAL ANATOMY, Issue 2 2007Marwan F. Abu-Hijleh Abstract This study revisits the anatomy of the deep fascia over the distal leg, ankle, and dorsum of the foot. The arrangement of the deep fascia in these regions was recorded in 14 lower limbs of adult cadavers using photographs and drawings. The fascial layer from all three sites was subsequently removed in toto, and serial thickness measurements were made along its entire length. In addition, fiber disposition was studied under polarized light, and sections were stained to demonstrate collagen. The arrangement of deep fascia is complex. A common and novel finding at all levels is a crisscross, lattice-like arrangement of fibers. There was little evidence of the clearly defined sturdy band of the superior extensor retinaculum (SER) or of the Y-shaped inferior retinaculum (IER) commonly illustrated in topographical anatomy texts. The SER is a complex area with several thickenings commencing about 3 cm proximal to the tip of the lateral malleolus and gradually increasing to reach a maximum of 270 ,m about 5 cm above the malleolus, then gradually returning to original thickness, about 9 cm above the malleolus. Fibers crossing diagonally to each other are a feature of the region. The IER characteristically has two forms: either a cross-shaped band (9 specimens) or a thickened "node" with small extensions radiating toward the malleoli (5 specimens), located about 1,2 cm distal to the lateral malleolus and centred over the common tendon of extensor digitorum where it has maximum thickness (430 ,m). The deep fascia is thickened and firmly attached over both malleoli and to the tarsals and metatarsals along both borders of the foot. In general, the deep fascial structures were thicker in males than those in females. Clin. Anat. 20:186,195, 2007. © 2006 Wiley-Liss, Inc. [source] Anatomical basis for a successful upper limb sympathectomy in the thoracoscopic eraCLINICAL ANATOMY, Issue 4 2004L. Ramsaroop Abstract In this clinico-anatomical study, factors potentially responsible for unsuccessful upper limb sympathectomy (ULS) by the thoracoscopic route were evaluated. This study comprised two subsets: 1) in the clinical subset, 25 patients (n = 50 sides) underwent bilateral second thoracic ganglionectomy for palmar hyperhidrosis, and factors predisposing to unsuccessful ULS were identified; and 2) in the anatomical subset, the neural connections of the first and second intercostal spaces were bilaterally dissected in 22 adult cadavers (22 right, 21 left; n = 43 sides). Alternate neural pathways (ANP) were noted in 9 of 50 sides in the 25 clinical cases (18%). In three asthenic patients (5 sides), fascia overlying the longus colli muscle mimicked the sympathetic chain. The right superior intercostal vein (SIV) was located anterior to the second thoracic ganglion in 6 of 50 sides (12%) and predisposed to troublesome bleeding in 2 of 50 cases; the SIV was posterior to the ganglion in 19 of 50 sides (38%), posing no technical problem. On the left, the SIV was noted outside the field of dissection in all but one case. A successful outcome to sympathectomy was noted in all 25 patients. A spectrum of sympathetic contributions to the first thoracic ventral ramus for the first intercostal space was noted in 37 of 43 anatomical cases (86%). These were categorized according to the arrangements of the intrathoracic ramus between the second intercostal nerve and the first thoracic ventral ramus. The cervicothoracic ganglion (37/43 cases; 86%) and an independent inferior cervical ganglion (6/43 cases; 14%) were always located above the second rib. The second thoracic ganglion was consistently located in the second intercostal space. This study demonstrates that ANPs have little clinical significance when a second thoracic ganglionectomy is undertaken. Technical failures may be avoided if the surgeon is mindful of anatomical variations at surgery. Clin. Anat. 17:294,299, 2004. © 2004 Wiley-Liss, Inc. [source] Fenestration of the superior medullary velum as treatment for a trapped fourth ventricle: A feasibility studyCLINICAL ANATOMY, Issue 2 2004R. Shane Tubbs Abstract We developed a novel approach for fenestration of the trapped fourth ventricle utilizing the superior medullary velum (valve of Vieussens). Trapped fourth ventricles, which are seen often in the pediatric hydrocephalic population, are troublesome entities surgically. A right burr hole was carried out in 10 adult cadavers with no gross intracranial pathology and the superior medullary velum was fenestrated to the quadrigeminal cistern with the aid of an endoscope. This technique was carried out easily in all cadaveric specimens. With endoscopy, no vascular insult was appreciated either before or after fenestration of the superior medullary velum. These preliminary findings demonstrate that fenestration of the superior medullary velum may provide a good alternative to the present therapy of shunting trapped fourth ventricles, a therapy wrought with complications. Clin. Anat. 17:82,87, 2004. © 2004 Wiley-Liss, Inc. [source] | ||||||||||